Screen Time Use and Ultra-Processed Food Consumption in Adolescents: A Focus Group Qualitative Study.

Background: Sedentary lifestyles and ultra-processed food (UPF) consumption contribute to a high prevalence of overweight and obesity among adolescents. Screen time may be associated with higher UPF consumption and affect eating behaviors substantially.

Objective: The aim of this study was to explore adolescents' perceptions, attitudes, and motivations concerning the consumption of UPF when using screens; investigate their perceived educational needs regarding nutrition; and explore their knowledge about UPF.

Design: This was a qualitative study using focus groups.

Participants/setting: Four focus groups with 30 adolescents aged 12 to 16 years at a Spanish high school were recruited in May 2022. Participants were chosen using purposive sampling based on a theoretical saturation criterion.

Analyses: Focus group discussions were audio-recorded, transcribed verbatim, and analyzed using inductive thematic analysis.

Results: Three themes emerged from the thematic analysis. Participants explained that most of their meals were eaten in front of screens. They confirmed more consumption of UPF at breakfast, as mid-afternoon snacks, on weekends, and during their main meals when alone. Participants reported that the high consumption of UPF during social gatherings was related to its easy availability, convenience, and palatability. Adolescents expressed that eating in front of screens and exposure to UPF advertising led to compulsive and impulsive consumption of these products. They described UPF as addictive and unhealthy. Although participants had little awareness of UPF health effects, they expressed interest in learning about healthy eating habits. Parental attitudes toward food were considered by the participants as relevant in establishing their eating behaviors.

Conclusions: Loneliness, social gatherings, and parental attitudes toward UPF consumption emerged as important influences on adolescents' dietary behaviors in front of screens. In addition, availability, palatability, and exposure to advertising were key factors reported to influence adolescents' UPF consumption in front of screens. Addressing these influences through nutritional and educational interventions, as well as regulating the adolescent obesogenic environment and managing screen time could help modulate these effects.