Exploring the links between unhealthy eating behaviour and heavy alcohol use in the social, emotional and cultural lives of young adults (aged 18-25): A qualitative research study.

Alcohol use peaks in early adulthood and can contribute both directly and indirectly to unhealthy weight gain. This is the first qualitative study to explore the links between unhealthy eating behaviour and heavy alcohol use in the social, emotional and cultural lives of young adults. We conducted 45 in-depth interviews with 18-25-year-olds in North-East England to inform development of a dual-focused intervention to reduce health risk due to excess weight gain and alcohol use. Data were analysed thematically, following the principles of constant comparison, resulting in three intersecting themes: (1) how food and alcohol consumption currently link together for this population group; (2) influences upon linked eating and drinking behaviours and (3) young adults' feelings and concerns about linked eating and drinking behaviours. Socio-cultural, physical and emotional links between food and alcohol consumption were an unquestioned norm among young adults. Eating patterns linked to alcohol use were not tied only to hunger, but also to sociability, traditions and identity. Young adults conceptualised and calculated risks to weight, appearance and social status, rather than to long-term health. This study is the first to evidence the deeply interconnected nature of food and alcohol consumption for many young adults. Findings have important implications for intervention development, UK public health policy and practice, and point to a need for similar research in other countries.

The 'Voice' of Key Stakeholders in a School Food and Drink Intervention in Two Secondary Schools in NE England: Findings from a Feasibility Study.

Background: Overweight/obesity affects one-third of UK 11-15-year olds. Individually focussed interventions alone have limited effectiveness. Food choice architecture approaches increase the visibility and convenience of foods to facilitate the choice of 'healthier' foods and reduce 'unhealthy' foods. This qualitative component of a School Food Architecture (SFA) study aimed to determine the perceptions of pupils and staff in relation to school food provision and their perceptions of the intervention. Methods: Pupil focus groups and staff one-to-one interviews. Topic guides were developed from literature and in consultation with a Young Person's Advisory Group. Thematic analysis was applied. Results: Focus group (n = 4) themes included: dining hall practices, determinants of choice, and aspects of health. Interview themes (n = 8) included: catering practices, health awareness, education, and knowledge of intervention. Pupils liked to purchase hand-held, quick to purchase foods potentially limiting the access to fruits and vegetables. Pupils were aware of 'healthier' food choices but would choose other options if available. Conclusions: Schools provide a daily school meal for large numbers of pupils, with time and dining environment constraints. Pupils consume 35-40% of their daily energy intake at school, therefore interventions enabling healthier eating in school are essential, including making healthier choices readily available and accessible.

Non-Pharmacological Interventions to Reduce Unhealthy Eating and Risky Drinking in Young Adults Aged 18⁻25 Years: A Systematic Review and Meta-Analysis.

Alcohol use peaks in early adulthood and can contribute both directly and indirectly to unhealthy weight gain. This review aimed to systematically evaluate the effectiveness of preventative targeted interventions focused on reducing unhealthy eating behavior and linked alcohol use in 18⁻25-year-olds. Twelve electronic databases were searched from inception to June 2018 for trials or experimental studies, of any duration or follow-up. Eight studies (seven with student populations) met the inclusion criteria. Pooled estimates demonstrated inconclusive evidence that receiving an intervention resulted in changes to self-reported fruit and vegetable consumption (mean change/daily servings: 0.33; 95% CI -0.22 to 0.87) and alcohol consumption (mean reduction of 0.6 units/week; CI -1.35 to 0.19). There was also little difference in the number of binge drinking episodes per week between intervention and control groups (-0.01 sessions; CI -0.07 to 0.04). This review identified only a small number of relevant studies. Importantly, included studies did not assess whether (and how) unhealthy eating behaviors and alcohol use link together. Further exploratory work is needed to inform the development of appropriate interventions, with outcome measures that have the capacity to link food and alcohol consumption, in order to establish behavior change in this population group.