| Youth in rural Appalachia are at a disproportionately greater risk for obesity and related health complications than the general population. Inadequate physical activity and poor dietary habits are two primary causes of obesity in West Virginia adolescents. To design and implement regional nutrition interventions combating overweight, adolescent perceptions of a healthy diet and healthy weight needed to be identified in rural Appalachia. Adolescents were recruited in four West Virginia schools from ninth grade health and physical education classes. Sixteen rural Appalachian adolescents, ranging in age from 14-18 years participated in the study. Focus group interviews were conducted with West Virginia adolescents and their caregivers. Grounded theory was used to develop questions addressing specific domains of interest. Verbatim transcripts were analyzed to assess cultural perceptions of a healthy diet and healthy weight.; Participants defined healthy diets through statements relating to federal and professional dietary recommendations, including an increased intake of vegetables and fruits while consuming diets low in fat. Specific foods were commonly described to be either healthy or unhealthy. Vegetables and fruits were cited most often as healthy foods, while snack foods, soda, chips, and pizza were not considered to be part of a healthy diet. Portion control and eating three meals daily were also discussed as healthy diet components. Knowledge was often attributed to teachings in health classes, through the media, and from family members with chronic diseases. However, knowledge of and adherence to popular fad diets contradicted some of these perceptions, and a number of students reported never considering whether or not foods were healthy prior to consumption.; Additionally, many teens had unrealistic and unhealthy perceptions of weight. Female participants were more concerned with weight than males, but both expressed a social stigma associated with overweight. Many perceptions of healthy weight and appropriate body size were shaped by the media and entertainment industry. Additionally, some participants admitted to performing unsafe practices to reduce body mass, such as very low calorie diets or fasting. Identifying perceptions will provide valuable formative data to develop targeted nutrition education and health promotion programming. |
