Adolescent obesity is a global public health crisis with increasing prevalence in low-income and middle-income economies like India (1, 2). During the last decade, India has witnessed a substantial rise in adolescent obesity (3, 4) particularly in urban settings (5), with a varying prevalence ranging from 19.6 to 26.6% (3, 6). Likewise, 22.9% males and 24% females (age: 15–49 years) were diagnosed either as overweight or obese in a recent nationwide survey (7). This mounting prevalence of adolescent obesity is likely to impose an increased disease burden in adulthood as it is associated with psychosocial and cardiovascular morbidity as well as premature mortality (2, 8–10), thus placing a great load on India’s healthcare system and economy (1). Therefore, behavior change interventions aimed at reducing adolescent obesity through improved eating behaviors and its associated comorbidities are of national importance (1, 2).

One of the possible behavior change strategies to tackle this emerging health crisis could be the development and maintenance of healthy dietary behaviors. However, both local and international evidence reveals that adolescents practice unhealthy dietary behaviors such as meal skipping and snacking on high energy foods with low nutrient value (11–15). Overconsumption of energy-dense, nutrient-poor (ENDP) snacks is widely cited as one of the potential drivers of the obesity epidemic (11, 16–18). Yet, little research has been conducted to understand snacking behaviors among Indian adolescents.

In contrast, snacking on healthy foods and drinks like legume-based snacks, fruits, and low-fat dairy is known to promote appetite control, thereby reducing the risk of adiposity (19, 20). In addition, Leidy and colleagues noted that consumption of nutrient dense snacks in the afternoon was associated with appetite control, improved satiety, and overall diet quality in adolescent boys (21). In the same vein, mid-morning and mid-afternoon snacking on healthy foods is known to alleviate the potential digestive and metabolic overload caused by three large meals (i.e., breakfast, lunch, and dinner) (22) as well as assist consumers to meet their daily recommendations for food groups (i.e., fruits, dairy) which are sparingly consumed on a daily basis (23). This healthy snacking is further reflected in the Scientific Statement released by the American Heart Association which recommends consumption of smaller portions of food spread across four to six eating occasions every 2–3 h over three main daily meals (24). Considering these benefits associated with healthy snacking, public health specialists strongly endorse the development and implementation of snacking interventions to encourage adolescents to consume healthy snacks and drinks between meals (23, 25, 26).

As part of the development of interventions to encourage healthy snacking in adolescents, it is important to understand the contextual factors that influence adolescents’ snacking behaviors. Nutrition researchers have identified a range of factors including individual (intrapersonal), social environmental (interpersonal), physical environmental (community settings), and societal (macrosystem) factors influencing adolescents’ snacking behaviors (25, 27–34). Some common intrapersonal predictors of snacking include taste preferences, gender, socio-economic status, body image, health attitude and behavioral factors like self-efficacy and autonomy (25, 27, 28, 35, 36).

At the interpersonal level, both family and peer groups play a significant role in determining snacking behavior of adolescents through family food rules and implicit peer pressure, respectively (28–31, 37, 38). Community settings also play a crucial role in influencing snacking, with the school food environment being of prime importance because of the provision of snacks in school canteens (39–42). At the macrosystem level, mass media and associated food marketing are recognized as the most prominent determinants of adolescent snacking behavior (36, 43–45).

Unfortunately, many of these emerging findings about the influences over snacking behaviors in adolescence are predominantly limited to developed economies like the United States (28), the United Kingdom (46), Ireland (25), and Australia (44). As such, they may or may not be applicable to developing economies like India which have different socio-cultural structures and dietary landscapes. For example, the consumption of meat and meat products is more popular in the Western world (e.g., USA, Germany) when compared to India because of the dominance of religion triggered vegetarianism in the Indian dietary landscape (47–49). Moreover, in addressing the emerging obesity burden in India, there is a need for nutrition interventions that account for unique Indian socio-cultural influences on snacking behaviors. Therefore, the present study was designed to gain novel insights into factors that may impact snacking behaviors of Indian adolescents through in-depth interviews. The use of in-depth qualitative research methods was warranted in the present context as they allow for the elucidation of diverse factors including culture-specific influences that impact adolescent snacking behavior which may not be adequately captured through quantitative research techniques. The emerging findings will guide the development of effective and sustainable nutrition interventions specially harnessing the facilitators and overcoming the barriers to healthy snacking and thereby potentially reducing overweight and obesity in Indian adolescents.

This qualitative inquiry contributes to the limited evidence on snacking behaviors in Indian adolescents. Key findings were that adolescents primarily perceived snacks as non-nutritious, ready-to-eat food items consumed between meals. The snacking rules set by parents emerged as a facilitator of healthy snacking. The perceived barriers to healthy snacking included peers, school food services, neighborhood food environment and food and beverage marketing. These findings can be applied to inform effective and sustainable nutrition interventions specially harnessing the facilitators and overcoming identified barriers to healthy snacking and thereby potentially reducing overweight and obesity in Indian adolescents.

Overall, the respondents viewed snacks as mostly unhealthy food items which were consumed between meals, a perspective widely published in the literature (25, 61, 62). They further mentioned that unhealthy snacks were cheap, and their frequent consumption can result in various health complications. Again, similar views have been observed in previous qualitative research investigations (25, 61, 63). For example, adolescents from the neighboring country Bangladesh reiterated that less nutritious snacks were affordable, palatable and filling when compared to healthy snacks (38). However, unlike Indian counterparts, Bangladeshi adolescents expressed concerns over foodborne illnesses arising from lack of food safety and hygiene protocol followed during snack preparation, emphasizing probable cultural nuances. The socio-cultural differences in the study populations could have resulted in this disparity as the Bangladeshi evidence was primarily restricted to high school pupils attending public schools whereas the present study captured the insights of both middle and high school students from private as well as public schools. Future interventions aimed at promoting healthy snacking should make culturally relevant nutritious snacks more available, tasty, and affordable (38, 64).

Despite being aware of the health complications associated with unhealthy snacking, the study participants showed preference for unhealthy snacking as they relished the taste of unhealthy snacks over healthy snacks. They found unhealthy snacks highly palatable whereas labeled healthy snacks as boring and bland. Parallel views about the taste of unhealthy and healthy snacks were shared by American (28, 64), Irish, (25), Chinese (63) and Welsh adolescents (65). Furthermore, empirical evidence suggests that adolescents are less concerned about their long-term health and rather give more priority to instant gratification which they usually derive from consuming unhealthy snacks (38, 66). Taking this into account, government bodies might subsidize healthy snacks as well as tax unhealthy snacks. In addition, parents and school Home Economics teachers should engage adolescents in preparing tasty and healthy snacks.

Snacking rules set by parents prompted adolescents to consume healthy snacks. This facilitator of healthy snacking was also found in a US-based study in which health-oriented food rules at home were associated with healthy snacking among adolescents (67). The adolescents in our study also noted that their parents would be upset if they consumed non-nutritious snacks, again this is consistent with international findings (67). For example, a Dutch study showed that the use of restrictive snacking rules by both mothers and fathers was significantly and negatively related to adolescents’ snack intake (68). On the other hand, lack of parental food rules has been associated with unhealthy snacking among adolescents as observed in a Slovakian study (69). Some of our participants also mentioned that they often defied household snacking rules, especially in the absence of their parents, a perspective also echoed by Ecuadorian adolescents (70). To cultivate healthy snacking habits in adolescents, a systematic review recommends that parents should consistently follow the same food rules they set for their adolescents as it would help to strengthen and reinforce the family’s eating norms and values (71). Also, there is a need for parental education programs for enhancing the nutrition knowledge as well as food parenting practices of Indian parents which can positively influence adolescents’ snacking habits (72–74).

In contrast to home food rules, peers were typically viewed as significant barriers to healthy snacking. Peers mostly indulged in unhealthy snacking, and this stimulated our study participants to consume greater amounts of non-nutritious snacks when in the company of their peers, a finding observed among Danish (30), Lithuanian (75) and Iranian (41) adolescents. Interestingly, Bruening and colleagues highlighted that friendship networks are both catalysts for healthy and unhealthy eating behaviors among adolescents (76). They found significant positive associations for cereal and dairy food consumption as well as breakfast intake between adolescents and their peer groups and best friends (76). Significant positive associations were also reported between adolescents’ and their best friends’ vegetable intake, but no associations were observed among peers for fruit consumption (76).

Our interviewees also mentioned a few instances when their friends motivated them to consume healthy snacks. This suggests an important intervention opportunity. This positive peer influence could be leveraged by marketing nutritious snacks in the milieu of interaction with friends, accentuating shared experience, communication and positive emotions while snacking together (75). Another viable alternative could be the implementation of school-based Social Norms Approach (SNA) interventions (77). The SN approach rectifies misconceptions about others’ (e.g., peers) behaviors by highlighting the gap between perceived and actual norms, thereby minimizing peer pressure to conform to unhealthy behaviors such as drinking alcohol heavily (78). Adolescents from the secondary schools in the North and Midlands of England who participated in a SNA intervention were less likely to overrate their peers’ unhealthy snacking attitudes and consumed fewer EDNP snacks post-intervention and had less positive attitudes toward unhealthy snacking compared to the control group (77).

Another potential barrier to healthy snacking reported by our participants was the school food environment. They noted that there was a limited supply of healthy foods as well as widespread availability of non-nutritious snacks in their schools. This barrier has been reported widely in the literature (42, 79–83). Our finding reflects a lack of healthy canteen policies in Indian schools (84–86). Although, the Food Safety and Standards Authority of India (FSSAI) recently published regulations (Safe Food and Balanced Diets for Children in School) for Indian school canteens to provide safe and balanced diets for pupils (79, 86). Paradoxically, the present findings indicate that these FSSAI 2020 Regulations may not have been implemented in all Indian schools. Plausible reasons behind the lack of implementation of the FSSAI regulations could include lack of comprehensive and the plurality of directives (e.g., lack of heuristic coding of foods to green, yellow, red; absence of operational definition of “right portion size” with regards to all available food and beverage items) (79). Thus, more work is needed to examine the evolution of the policy in adolescent snacking behaviors. This underscores the need for rigorous implementation, regular monitoring and surveillance of these guidelines in all schools to facilitate healthy snacking among Indian school children (79).

Alternatively, healthy snacking habits could be inculcated in Indian pupils through implementation of school-based, culturally sensitive, behaviorally focused nutrition education interventions (72, 73). For yielding successful behavioral outcomes (e.g., healthy eating), nutrition education programs should be underpinned by theoretical models and culturally tailored (i.e., use of culturally appropriate behavior change initiatives) (72, 87). One such initiative is the HEAPS (Healthy Eating and Activity Program for Schoolchildren) intervention, a behaviorally focused nutrition education program underpinned by the Health Belief Model (HBM) was developed to enhance knowledge, attitudes, and practices associated with food habits and physical activity levels in adolescents aged 10–12 years from Mumbai, India (72). HEAPS was effective in reducing the daily intake of locally available deep fried Indian snacks in the participants (72). Other positive outcomes of the HEAPS intervention included increased frequency of breakfast and vegetable consumption as well as improvement in mean scores of family dietary habits (72).

Our participants often reported the easy availability and accessibility of EDNP snacks and carbonated drinks in their residential and school neighborhoods. Comparable views were highlighted in a local study conducted in New Delhi where high school and college students mentioned that ultra-processed food and sugar sweetened beverages were easily available within educational institutes as well as in their surroundings (79). Moreover, findings from a recent systematic review suggest that adolescents’ exposure to unhealthy local retail food environments was positively associated with non-nutritious food purchases including EDNP snacks and sugary drinks and subsequently unhealthy food intakes (88). In this light, food laws and regulations that limit the availability of EDNP snacks and carbonated drinks and increase the availability of healthy foods like fruits and vegetables are necessary to improve retail food environments in India and other developing countries (89). For instance, the Indian Government could launch mobile produce markets or portable fruit and vegetable markets in urban neighborhoods to increase access to fruits and vegetables in the obesogenic local food environment (90, 91).

Besides the obesogenic local food environment, digital food and beverage marketing through social media and online food delivery applications seem to have a detrimental impact on Indian adolescents’ snacking behaviors. The study participants often mentioned that they regularly receive notifications on their mobile phones from fast food restaurants regarding discounts which often tempted them to order unhealthy snacks through food delivery applications, a view also echoed by Uruguayan adolescents (92). In line with Mexican (93) and Canadian (94) research, our study also highlighted that most frequently marketed foods on social media were ready-to-eat ultra-processed snacks. According to a systematic review (95), the proliferation of digital food and beverage marketing has a consistent negative effect on adolescent eating outcomes including increased purchasing and consumption of non-core food items. This calls for implementation of digital marketing regulations to reduce adolescents’ exposure to ultra-processed food on various digital media platforms. This is most likely to involve bans on the marketing of these products, a strategy recommended by Uruguayan adolescents (92) as well as public health experts (96–98). Indian policymakers could adopt similar digital marketing regulations to those implemented in Chile, which ban the marketing of non-nutritious food and beverages to children and adolescents across different media including the internet (99). A similar regulatory policy that might be adopted is found in the Quebec province of Canada. Under its Consumer Protection Act, food advertising to individuals under 13 years of age has been prohibited (100). Recently, the Central Consumer Protection Authority of India introduced mandatory Guidelines for Prevention of Misleading Advertisements and Endorsements for Misleading Advertisements 2022 to safeguard children from marketing of unhealthy foods and drinks across all media (101). However, this policy and other existing policies have invited lot of criticism including the narrow scope of “child-directed” advertisements and absence of food classification systems for defining EDNP foods (101). Hence, robust regulations are required to protect Indian children from the harmful impacts of EDNP food marketing with clear evidence-based food classification criteria (101). Alternatively, less draconian measures involving collaborations between public health organizations and social media influencers could be promising initiatives in promoting healthy eating among adolescents (102–104).

This qualitative research inquiry contributes to the snacking literature exploring the perceptions of a sample of Indian adolescents about their snacking behaviors and its associated factors. Snacks were commonly perceived as unhealthy ready-to-eat food items consumed between meals. This research shows that multiple determinants such as parental snacking rules, peer group influences, provision of food in schools, price of snacks, local food environment, and food and beverage marketing are likely to affect Indian adolescents’ snack consumption. These determinants could potentially inform the development and implementation of effective school food policies and culturally tailored behavioral interventions to inculcate healthy snacking behaviors among nutritionally vulnerable Indian adolescents. School food environments could be improved by subsidizing healthy snacks, provision of culturally acceptable and affordable healthy snack options in school canteens and restrictions on the sale and marketing of EDNP foods both in school and across all media. Parental education could also serve as a fruitful measure in cultivating healthy snacking habits in adolescents.