How social and environmental contexts shape adolescent girls’ eating behaviors in Southern Iran: a qualitative directed content analysis based on the social cognitive theory

Abstract

Background

Proper nutrition during adolescence particularly for girls in low and middle-income countries is a key determinant of growth, health maintenance, and disease prevention. The increasing rate of unhealthy eating habits among adolescent girls in southern Iran has raised public-health concerns. Several interrelated social and environmental factors, including the role of school, family, and peers, affect adolescents’ nutritional patterns. Therefore, the present study aimed to explore and explain the environmental determinants of adolescent girls’ eating behaviors.

Methods

The present qualitative study used directed qualitative content analysis based on the Social Cognitive Theory (SCT). Participants included 17 female junior high school students and seven of their parents from Bastak City, southern Iran. Data were collected from April to May 2025 through in-depth, semi-structured individual interviews. Participants were purposively selected to ensure maximum variation in age, educational level, and socioeconomic background. The data collection continued until saturation. Interviews were transcribed verbatim and analyzed through directed content analysis in MAXQDA 20.

Results

Data analysis led to the extraction of four main categories and thirteen subcategories: (1) observational learning, including modeling from significant others and influence from environmental contexts; (2) normative beliefs, consisting of motivational belief, social pressure, and cultural beliefs; (3) social support, encompassing informational, emotional, instrumental, and organizational support; and (4) barriers and opportunities, comprising individual and environmental factors. These categories align with the environmental constructs of (SCT).

Conclusion

The findings show that adolescent girls’ eating behavior in southern Iran is broadly shaped by interconnected social and environmental factors. These include adolescents following the eating behaviors of others in the immediate environment, peer norms and social pressure, availability and accessibility of foods in school and neighborhood, and the influence of social media and food advertising. Perceived barriers, such as the cost and limited availability of healthier alternatives, also play a key role. Designing effective nutrition interventions, therefore, requires a multilevel approach addressing individual, familial, school, peer, and broader community systems.

Trial registration

This study was registered in the Iranian Registry of Clinical Trials (IRCT) on 14th May 2025 (Identifier: IRCT20241123063812N1; available at: https://www.irct.ir/trial/83227).

Supplementary Information

The online version contains supplementary material available at https://doi.org/10.1186/s12889-026-28480-0.

Introduction

Proper nutrition is especially important during adolescence because, at this age, the body requires sufficient energy and nutrients to grow, develop, and maintain health. Proper nutrition also plays an important role in preventing diseases [1]. Adolescence is a sensitive stage in life associated with the growth of nutritional behaviors and rapid physical changes, independence, peer group influence, and identity formation [2]. Adolescents’ eating habits are usually not optimal, and the consumption of unhealthy foods, especially foods high in fat and sugar, is more common at this age [3]. Poor nutritional behaviors, such as irregular meal times, skipping breakfast at home or at school, eating large meals, between-meal snacks, and increasing consumption of sugary drinks, sweets, salty snacks, fast food, and processed foods in general, along with reduced consumption of vegetables and fruits, whole grains, dairy products, and fish, prevail more [4, 5]. Bucksch’s study of German children revealed that only 51% of girls and 59% of boys eat breakfast daily and that fruit and vegetable consumption is below the optimal level [6]. According to a study in Iran (CASPIAN-IV), more than 20% of children and adolescents aged 7–18 were overweight or obese [7]. Nutrition is an essential factor in the academic success and health of students, and malnutrition is associated with decreased attention, concentration and academic failure [8]. Adolescent girls are at greater risk of malnutrition due to the unique physiological demands and rapid growth associated with puberty. Given the critical role of adequate nutrition in supporting this phase of development and ensuring long-term health, addressing their nutritional status is a priority for public health [9]. Given the high prevalence of health problems caused by poor diet, including overweight, obesity, and noncommunicable diseases among children and adults, promoting healthy nutrition remains a key public health priority worldwide [10, 11]. However, owing to their multifaceted nature, eating behaviors are influenced by a combination of individual, social, and environmental factors. Among the most common and practical theories that address these factors is the social cognitive theory (SCT). Developed by Bandura, SCT explains human behavior on the basis of a dynamic, three-dimensional model in which behavioral factors, personal cognitive factors, and environmental factors interact with each other (Fig. 1) [12].

Fig. 1.

Constructs of social cognitive theory

This theoretical framework facilitates a deeper understanding of behaviors such as healthy eating due to its emphasis on the simultaneous role of the individual, the environment, and behavior [13]. To better understand the complexities of adolescent girls’ eating behaviors, this study employed SCT as its primary theoretical framework. The key constructs of this theory are included here in the design of study, observational learning, normative beliefs, social support, and perceived barriers and opportunities. These constructs helped us define the objectives of study more precisely. School, as a major social environment for adolescents, plays a fundamental role in the formation and reinforcement of health-oriented patterns. Schools are not only the center for formal education but also provide extensive opportunities for behavioral modeling, shaping social norms, and expanding support networks. Daily interactions among students, teachers, peers, and even the experience of being in the physical school environment can significantly affect the attitudes and beliefs related to healthy eating in children and adolescents [14]. Since students spend most of their daily time at school, this environment is recognized as a main platform for developing, teaching and establishing desirable nutritional behaviors [15–17]. Parents reinforce positive eating behaviors in children through modeling the type of food they buy and cook [18]. Access to healthy food in school cafeterias, restricting unhealthy items, developing skill-based instruction, and family involvement can improve students’ healthy eating behavior [19–21]. In contrast, advertising abundant unhealthy foods, peer pressure, and sociocultural factors are the main obstacles to the acceptance and continuation of these behaviors [22–26].

Poor eating behaviors and the rate of overweight and obesity are increasing among adolescents. This adds to the importance of environmental factors such as family, school, social networks, and sociocultural context in forming and maintaining healthy eating habits. Although many studies have addressed the role of individual factors in adolescent nutritional behaviors [27, 28], fewer have examined the role of environmental factors and the broader sociocultural context. Moreover, the existing literature has predominantly used quantitative approaches, and has rarely applied theory-based qualitative designs to explore how environmental factors interact with personal and social determinants of eating behavior [27, 29]. In particular, there is limited evidence of qualitative research in light of SCT to explore adolescent girls’ eating behaviors in southern Iran, especially in smaller communities such as Bastak. This gap limits the understanding of how context-specific environmental factors shape nutritional behaviors in this population.

Adolescent girls constitute a critical population in all societies, including Bastak County. During adolescence, girls experience heightened nutritional requirements and are increasingly susceptible to the influence of body image concerns, family expectations, and prevailing sociocultural norms. In addition, Bastak’s southern geographical location, hot climate, smaller-community structure, traditional families, and potentially different food features may distinguish adolescents’ nutritional experiences from those living in larger urban centers or central regions of Iran. This population remains underrepresented in nutrition-related research. Therefore, guided by SCT and using a qualitative approach, this study aimed to explore the environmental factors affecting adolescent girls’ eating behaviors in Bastak, southern Iran. Given the limited theory-based qualitative research in this area, the study aims to provide local evidence that can help design culturally and regionally appropriate nutrition interventions.

Methods

Design of study

This qualitative study used semi structured interviews to explore the environmental factors affecting adolescent girls’ eating behaviors in southern Iran. To this end, a comprehensive interview guide was first developed on the basis of the research objectives, theoretical foundations and related literature. The guide included open-ended questions and topic areas that allowed participants to express their views and experiences. In this study, “healthy eating” was understood based on participants’ perceptions of eating behaviors considered beneficial for health, such as fruits, vegetables, and homemade food, less fast food, sugary drinks, and energy-dense, low-nutrient foods. It is acknowledged that among adolescent girls, perception of healthy eating may sometimes overlap with dieting or weight-control behaviors; therefore, participants’ narratives were interpreted within the broader sociocultural context of adolescent eating.

The reasons for the qualitative approach in this study are multifold. First, the qualitative approach allows for a deep and multifaceted understanding of participants’ perceptions, beliefs, and lived experiences, especially in topics explored less in quantitative research. This approach can reveal unknown or less-known dimensions of the phenomenon under study [30]. Researchers believe that the complexities and semantic subtleties of certain phenomena cannot be expressed solely with quantitative tools and numerical measures. Therefore, the use of in-depth interviews helps uncover these subtleties and better understand the processes and influencing factors [31].

In this study, a qualitative directed content analysis was used to identify and better understand the environmental determinants of female high school students’ nutritional behavior. Directed content analysis is a common qualitative data analysis approach to health research that allows researchers to begin the initial coding of data based on concepts and structures derived from an existing theory or theoretical framework [32]. The theoretical framework of this study is the SCT environmental factors.

Ethics approval and consent to participate

This research was conducted as part of a doctoral thesis and was approved by the Ethics Committee of Hormozgan University of Medical Sciences (ethical code #IR.HUMS.REC.1403.270). To comply with research ethics principles, all participants were fully informed about the objectives of the study. Written informed consent was obtained from all participants and their parents or legal guardians prior to participation. All collected data, including audio files and interview transcripts were kept confidential in a separate encrypted folder. The participants had the right to withdraw at any stage of study.

Participants and sampling

Participants were selected using purposive sampling to obtain information‑rich cases aligned with the objectives of study. Adolescent girls as the primary participants were recruited from all three grades of secondary school to ensure diversity in age, socioeconomic status, and school environment. Students who met the eligibility criteria were found with the help of school authorities and were invited to participate if already enrolled in secondary school, were willing to take part in the study, and were able to adequately share their experiences.

Participants were 17 students and seven parents. The latter were selected upon willingness to participate. Parents’ interview aimed to gain a deeper understanding of the contexts related to adolescents’ eating behaviors, particularly regarding household food purchasing, meal preparation, and family eating habits. The participants had the right to withdraw at any stage without any consequences.

Data collection

Overall, 24 semi-structured interviews were conducted face-to-face, including 17 interviews with female junior high school students and seven with parents. The interviews were conducted in private and comfortable settings, mainly in the school counseling rooms. All interviews were held by the main author, fluent in the local dialect and familiar with the local culture. Each interview lasted approximately 30–40 min Interviews began with general open-ended questions (e.g., “Please describe healthy eating in your opinion.”) and were followed by targeted questions aligned with the SCT constructs to guide the study (e.g., observational learning, normative beliefs, social support). The interview guide developed for this study can be seen in Supplementary Material 1.

If needed, and depending on the participant’s response, exploratory and supplementary questions were also used to get deeper into individuals’ experiences and attitudes. For example, please explain more about that, can you provide an example so that I can better understand what you mean by …? What do you mean by …? How did you feel about this? If possible, please provide more details about this experience, how important it is to you and why? When was the last time you had such an experience?

At the beginning of each interview, the researcher introduced himself, explained the purpose, importance, and procedure of study, and after voluntary consent to participate, the informed consent form was completed and signed, to give permission to audio record the interview.

To increase the richness of data and achieve a more comprehensive understanding of the factors affecting students’ nutritional behavior, besides students, seven in-depth interviews were also held with parents. The main reason for interviewing parents was that the nutritional behavior of the family and parents plays a major role in shaping, strengthening or decreasing students’ eating habits. Parents’ experiences and perspectives on factors related to nutritional behavior can help better identify the influential contexts and challenges in this area.

All interviews were audio-recorded with participants’ permission and subsequently transcribed verbatim for analysis. During the interview process, the researcher maintained a friendly and respectful environment, tried to provide a more trusting and relaxed atmosphere for student/parent participation and by using the local language appropriately and observing cultural sensitivities.

The sampling continued until data saturation. After completing 24 interviews (17 with adolescents and seven with parents), since no new concepts emerged from the interviews, the researcher concluded that data saturation had been achieved; thus, the process of further participant recruitment and interview was stopped.

Rigor

To ensure the trustworthiness of findings, several measures were taken at different stages of study. Credibility was enhanced by holding the interviews in a familiar and quiet environment (the school counseling room) wit help of an interviewer fluent in the local dialect, enabling participants to express their views with greater comfort and confidence. Prolonged engagement with the participants’ data over a five-month period, maximum variation sampling, and member check were used to strengthen the credibility of findings.

Dependability was ensured throughout the data collection and analysis processes by audio-recording the interviews with participants’ consent and verbatim transcription. All stages of study, from data collection to analysis and theme development, were documented in detail. An inquiry audit was also conducted to ensure the accuracy and rigor of the research procedure, and the results were approved.

For confirmability, the codes were documented, and discussions were held over coding and themes to minimize the researcher’s personal bias. Furthermore, transferability was supported through a rich description of setting, participants’ demographic characteristics, and procedures of study, allowing readers to assess the applicability of findings to other contexts.

Data analysis

For data analysis, a directed content analysis approach was used based on the environmental constructs of SCT. The coding and categorization process was managed and organized in MAXQDA, version 2020. In this study, a deductive inductive approach was used; accordingly, the main categories were determined based on the SCT constructs, including observational learning, normative beliefs, social support, and barriers and opportunities. Subsequently, in-depth interviews were held with the participants, including adolescents and parents, in an exploratory manner.

All interviews were audio-recorded with the participants’ consent, played several times, and transcribed verbatim. The coding process was done by the main researcher. During coding, similar codes were grouped into subcategories, and this stage was carried out using an inductive approach.

To ensure the accuracy of findings, regular theme review meetings were held by the research team members to discuss the data coding and categorization, and disagreements were resolved through consensus.

The final themes related to environmental factors influencing the eating behavior of female students and the role of parents including observational learning, normative beliefs, social support, and barriers and opportunities were identified and reported based on the interview data supported by the participants’ direct quotations.

Results

Participants’ demographics

In this study, most participating students aged between 14 and 16, mostly living in families of three or more. The highest frequency of education level was that of the eighth and ninth grades. Most fathers were self-employed or held a university degree. Most mothers were housewives and held a diploma or a university degree. The parents were mainly aged 40–50 years, and were mostly married and female.

The data analysis was organized around four main categories: observational learning, normative beliefs, social support, and barriers and opportunities. These categories show that adolescents’ eating behaviors are shaped by social, cultural, and environmental factors. Family members, peers, and institutions can influence adolescents’ food choices, while certain individual and environmental conditions may facilitate or hinder healthy eating, which constitutes the core analytic findings of study.

The main categories and subcategories are described in Table 1.

Table 1.

Categories and subcategories of students’ and parents’ experiences

Categories	Subcategories
Observational learning	Modeling from significant others
	influence from environmental contexts
Normative beliefs	Motivational belief
	Social pressure
	Cultural belief
Social support	Informational support
	Emotional support
	Instrumental support
	Organizational support
Barriers and opportunities	Individual barriers
	Environmental barriers
	Individual opportunity
	Environmental opportunity

Category 1: observational learning

In observational learning, people learn new information and behaviors by observing the behaviors of others and the consequences of these behaviors [33]. In the present study, this category describes how adolescents’ eating behaviors were influenced by observing the eating practices of important others and cues from their surrounding environments. Within this category, two subcategories emerged, Modeling from significant others and Influence from environmental contexts.

Subcategory 1: modeling from significant others

Participants identified modeling as a key factor in the development of healthy eating habits. As noted, observing positive eating behaviors of parents, mentors, peers, or even individuals within their community and social networks encouraged them to adopt similar eating patterns.

“A friend of mine always checks food labels while shopping. After accompanying her a few times, I got interested and learned to note labels too. Now I attend to the ingredients and nutritional value of products when I shop.” (female student aged 13–15).

Parents are children’s main role model in eating, as a mother described here:

“Children usually follow their parents and older siblings. I tried to get my first child to eat healthy food, and now my youngest child follows immediately when he sees the sibling doing so.” (parent).

Subcategory 2: influence from environmental contexts

Participants reported that educational and media environments that creatively promote healthy eating increase adolescents’ motivation to choose healthier foods and can also influence their families’ eating behaviors.

“The school healthy food festival taught me that healthy food can also be very tasty and varied. From then on, I grew interest for making fruit salads and asked my mother to make more for us.” (female student aged 13–15).

Category 2: normative beliefs

These beliefs include cultural norms and social beliefs about the acceptability of a behavior [13]. In the present study, participants described how these beliefs shaped adolescents’ perception of eating behaviors. Three subcategories emerged: motivational belief, social pressure, and cultural belief.

Subcategory 1: motivational belief

Participants described the desire for fitness and healthy skin as their primary motivation for healthy eating, which is further reinforced and sustained by family and peer support.

“My main motivation for healthy eating is to look good, have a fit body, and have healthy skin, because these things are really important to me. Also, seeing my family eat healthy food encourages me to continue doing so.” (female student aged 14–15).

The fear of contracting diseases caused by poor nutrition or experiencing it in those close to you is an important factor for changing attitudes and behaviors.

“When I see foods of a poor nutritional value can cause a disease, I am encouraged to be more careful about my nutrition, think about my health and try to eat healthy food more.” (female student aged 14–15).

Subcategory 2: social pressure

Participants reported that they adjusted their eating behaviors to fit in with their peers and avoid rejection. This social pressure can have both positive and negative effects.

" Once, I decided to take fruit salad for a desert outing, but when I arrived and saw others eating chips, puffs, and junk food, I couldn’t resist and joined them. I really do try to follow a healthy diet, but in a social setting, it becomes much harder for me to choose healthy food.” (female student aged 14–15).

Subcategory 3: cultural belief

Participants said that their culture and customs (marked by high-calorie foods at parties) make it difficult to go for a healthy eating style. Also, the idea that “teens can eat whatever they want” makes them more likely to eat unhealthy foods.

“It is very difficult to change traditional eating habits in this region. People believe that foods like rice and samosa should be cooked with a lot of oil and do not like healthier alternatives. One traditional food is Mahyawe, a very salty fish sauce served with local bread with a lot of oil for breakfast or dinner, and people say this is their traditional food.” (female student aged 15–16).

Category 3: social support

This concept means receiving all kinds of tangible and intangible support from family, friends, and society, through which people experience love, empathy, trust, and care [34]. In the present study, participants explained that receiving informational, emotional, instrumental, and organizational support influenced their eating behaviors. Four subcategories emerged: informational support, emotional support, instrumental support, and organizational support.

Subcategory 1: informational support

As the participants commented, access to information sources (Internet, social networks, artificial intelligence) and family and school help and guidance, through awareness raising, play an important role in improving the eating habits.

“My friends and I talk a lot about healthy eating, especially proper nutrition for the gym. We also always share information that we get from the internet.” (female student aged 15–16).

Subcategory 2: emotional support

Participants emphasized that emotional support by family members, especially mothers, increased their motivation to eat healthy food and also increased their ability to cope with peer pressure.

“My mother is my constant support. Once, when I was mocked for my diet at a gathering, she defended me: ‘My daughter is doing the right thing by prioritizing her health.’ Her words really encouraged me. " (female student aged 14–15).

Subcategory 3: instrumental support

Participants defined instrumental support as providing raw materials and cooking facilities that make it easier to access healthy foods and facilitate good choices.

" My family provides me with everything I need to have a healthy eating. Even though certain foods, like chia seeds, are expensive, they still buy them for me. There are always fresh fruits and vegetables available at home.” (female student aged 14–15).

Subcategory 4: organizational support

Participants viewed organizational support through as providing healthy, home-made foods in the school cafeteria, holding educational workshops and festivals, and the presence of nutrition counselors to publicize healthy food and raise awareness and motivation.

“If the school cafeteria sells homemade, healthy food like bread and cheese, I can easily make a healthy breakfast from the buffet.” (female student aged 13–14).

“If healthy and hot foods are sold in the school buffet, children will definitely welcome them. Or if parents prepare homemade food for children and give it to the school, it can be very useful. Also, holding healthy food festivals at school can be truly effective.” (parent).

Category 4: barriers and opportunities

Features of the social or physical environment can make it harder or easier to perform the expected behaviors [12]. In the present study, participants described various personal and environmental conditions that either constrained or reinforced their ability to adopt healthy eating practices. Four subcategories were extracted: personal barriers, environmental barriers, Individual opportunities, and environmental opportunities.

Subcategory 1:individual barriers

Participants stated that emotions and conditions, such as stress or fatigue, caused them to crave unhealthy foods, thereby reducing their motivation to follow a healthy eating.

“I think one of the biggest obstacles to healthy eating is the pleasure I get from eating unhealthy foods. When not feeling well, I’m more tempted to reach for foods like chocolate and French fries because they make me feel better.” (female student aged 13–14).

Subcategory 2: environmental barriers

As the participants noted, factors such as excessive advertising and the constant availability of unhealthy foods, along with the high cost of healthy food, are the most important environmental barriers to proper nutrition.

“Easy access to fast food and barbecue restaurants in the city is the biggest obstacle to my choice for healthy food. The delicious smell of unhealthy food always tempts when I walk down the street.” (female student aged 15–16).

Subcategory 3: individual opportunity

Participants stated that opportunities such as gym memberships, internet access, online training, and the ability to prepare healthy food increased their nutritional skills and strengthened their intrinsic motivation to choose healthier habits.

“After going to a gym, I personally decided to eat healthy food. This decision aimed to improve my health.” (female student aged 15–16).

Subcategory 4: environmental opportunity

Participants reckoned that easy access to healthy food at home, as well as the variety of foods in restaurants and cafes, was a key factor encouraging them to choose healthy food over fast food.

“There is a good restaurant near our house that serves healthy, homemade food. They use fresh, organic ingredients and have a variety of foods, salads, natural juices, and delicious sugar-free desserts.” (female student aged 13–14).

Discussion

The present qualitative study, which used a directed content analysis, sought to explain the environmental factors affecting nutritional behavior in a population of female students in Bastak, in the south of Iran. These factors included social support, barriers and opportunities, normative beliefs, and observational learning. The findings led to the identification of four main categories and thirteen subcategories.

Observational learning

Observational learning was found to play an important role in the socialization process and formation of healthy eating habits in children and adolescents. This finding is consistent with Bandura’s SCT and studies by Gao et al. and Wan et al.. These showed that adolescents’ eating behaviors are strongly shaped by observation of parents, peers, and other social role models [13, 35, 36]. In the present study, adolescent girls reported that they often learned eating behaviors through observing parents, friends, teachers, and media celebrities in daily environments. It emphasizes the central role of social modeling in food choices during adolescence. Ivanuk et al. found that most adolescents’ food choices resulted from observing the behavior of those around them, which is in line with the present findings [37]. This type of learning, whether at home or at school, plays an important role in the formation of healthy habits. In this regard, Gato showed that the use of videos and visual educational content can help families change eating habits [38]. Pierre et al. reported that school-based practical programs improve students’ attitudes, self-confidence, and healthy choices, with effects extending beyond the school environment [39]. These findings support our results that observational learning becomes more effective when adolescents are exposed to practical examples of healthy eating rather than only receiving theoretical nutrition information.

Peers can raise adolescents’ awareness and motivation to choose healthy food through social modeling and daily interactions [40]. Influencers also affect adolescents’ lifestyle and food choices, as advertising unhealthy food increases its consumption (Coates et al.,), while promoting healthy food can strengthen attitudes and intentions to buy healthy food (Folkward et al.,) [41, 42]. Media can play both a protective and a risky role, which is consistent with our participants’ experiences. They saw social media as both a source of healthy ideas and an attraction to unhealthy foods. Other evidence also suggests that social media may facilitate healthy behaviors or reinforce poor nutrition behaviors depending on the dominant values and content to which adolescents are exposed [43, 44]. Therefore, the present study confirms previous SCT-based evidence that adolescents’ eating behaviors are strongly shaped by modeled behaviors, but it also extends this evidence by showing how family modeling, peer modeling, school-based activities, and culturally relevant media influences interact in the local context of Bastak.

Normative beliefs

The findings showed that normative beliefs, as a key construct of SCT, have a multilayered effect on the motivation, selection, and consistency of healthy eating behaviors in adolescents. In the present study, these beliefs were reflected in their perceived expectations and norms of family, peer group, and cultural environment regarding food choices. The desire to be fit, look good, and have a healthy skin are among the most important motivators of adolescents’ desire to eat healthily, especially in supportive environments.

In the present findings, this preventive perspective was more prominent among mothers. They often emphasized that observing or experiencing nutrition-related diseases, such as obesity and high blood pressure, serves as a critical warning factor. however, it suggests that adolescents’ perception of healthy eating often overlaps with concerns about body image, weight control, and beauty standards, rather than the mere reliance on health promotion. This finding is consistent with previous studies on the role of appearance concerns in shaping eating behavior during adolescence [45]. According to SCT, adolescents’ food choices are influenced by body image, social comparison, cultural norms, and family expectations, in addition to individual knowledge. This finding is consistent with Ezati Rad et al., who emphasized the role of social and environmental factors in nutritional behaviors [46].

Research suggests that peer pressure and the need for social acceptance influence adolescents’ eating choices more than individual recommendations. To avoid rejection, adolescents often align their eating behavior with their peers. This influence can be both in favor or against healthy nutrition [25, 44]. Moreover, a study by Barberis et al. showed that peer pressure affects adolescents’ eating habits through the internalization of group values [22]. This finding suggests that adolescents coordinate their eating behaviors with peers to maintain social acceptance and avoid rejection. Peers play an important role in shaping adolescents’ eating attitudes and habits and can lead to healthy or poor nutrition behaviors. Since adolescents adjust their behavior to peers to ensure membership and acceptance in the group, guiding them towards healthy patterns can be a more effective and sustainable strategy than individual interventions, which proves the importance of peer-based programs. There is evidence to show that cultural traditions and collective beliefs, especially on ritual occasions, are major challenges to eating reforms. Conflicts between scientific advice and traditional customs (such as consuming high-calorie foods), resistance to change, and the high cost of healthy alternatives make it difficult to align daily nutrition with health guidelines. Evidence suggests that food preferences and consumption patterns are deeply influenced by local culture, food traditions, and family structure (Lindsey et al.,). Despite the impact of urbanization and globalization on the increased consumption of processed foods, many features of traditional diets have been preserved in societies with strong cultural identities [47]. Teenagers follow their environment to be accepted by friends or to come as close as possible to media models. In southern Iran, high-calorie foods in daily life and gatherings have caused families and teenagers to get used to this type of nutrition. Therefore, to correct poor eating habits, families, schools, and the media must work hand in hand.

Social support

Social support in informational, emotional, instrumental, and organizational dimensions plays a fundamental role in the formation and maintenance of healthy eating behaviors in adolescents, especially when access to information through the internet, parent and teacher education, and peer exchange is enhanced. This finding is consistent with an SCT-based study showing that education, awareness of nutrition labels, access to healthy alternatives, and social support can foster healthier choices [48]. Therefore, reliable information is more effective when coupled with supportive social environments. In their study, Weiquan Du et al. revealed that parental support by monitoring the appropriate use of cyberspace leads adolescents to make beneficial use of it [49]. Findings show that informational support by family, peers, and online networks plays a key role in promoting healthy eating behaviors, and active online health information seeking strengthens this effect [50]. This pattern was also observed in the present findings, where adolescents reported using online platforms to learn about healthy foods, recipes, and eating recommendations, particularly when such information was discussed or validated by their family members or peers.

Emotional support by parents, teachers, and friends through encouragement and praise increases motivation, the ability to cope with peer pressure, the sense of worth, and helps establish healthy habits [51, 52]. Such emotional reinforcement can strengthen adolescents’ confidence in their ability to make healthy choices and maintain these behaviors despite social or environmental challenges.

Instrumental support for families by providing healthy nutritional resources and facilities reduces barriers and strengthens adolescents’ practical actions, which is directly related to greater parental self-efficacy [53]. In their study, Edward Orehek et al. showed that parental involvement in preparing healthy food and avoiding the purchase of unhealthy food also improved body mass index and eating patterns [54]. These findings help explain why participants in the present study emphasized the importance of parents’ practical involvement such as preparing healthy meals at home or limiting the availability of unhealthy foods as a key facilitator of healthier eating behaviors.

Institutional support by schools through the provision of healthy food and nutrition education improves the quality of student diets [55]. The present findings revealed that challenges such as a lack of funding, inadequate management, and school resistance can reduce the effectiveness of these policies [56]. This finding is consistent with the participants’ experiences as they said access to healthy food and educational programs at school could improve their food choices, but that inconsistent implementation of these programs limited the impact.

Barriers and opportunities

Healthy eating behavior in adolescents is influenced by the interaction of individual and environmental factors. Barriers such as a preference of fast food, stress, boredom, high costs, family habits, and lack of belief in the benefits of healthy eating can challenge adherence to a proper eating, especially in presence of psychological or financial stress. A qualitative study in eastern Uganda based on SCT showed that eating behaviors are not limited to individual preferences and are influenced by structural and social factors such as poverty and lack of support. This is consistent with the results of the present study in southern Iran [57]. It confirms that despite cultural differences, environmental and structural conditions play a decisive role in shaping eating behaviors. The findings reported by Razaz et al. also confirmed this finding and showed that psychological factors, including stress as well as mental health conditions such as depression and anxiety are associated with poor eating habits in students and increase the likelihood of them consuming more unhealthy foods [58]. Keesler-Coyan-Zumaita et al. showed that emotional overeating in adolescents is associated with high stress, poor mental health, and higher consumption of high-calorie foods, and can be a predictor of BMI and overweight; therefore, psychological factors such as anxiety and low self-esteem play an important role [59]. Maija-Paki et al. reported that the false belief “unhealthy food tastes better” increases adolescents’ tendency to consume unhealthy foods [60]. These findings suggest why some participants turn to fast food and snacks during times of stress, boredom, or emotional distress, highlighting the role of emotion regulation in adolescent eating behavior.

At the environmental level, easy and widespread access to unhealthy food in schools, neighborhoods, and social media, along with the widespread advertising of fast foods, provides the major context for the consumption of these foods. The school food environment in Bastak differs from international models. Students have their main meals at home, and school cafeterias provide snacks throughout the day. These cafeterias are often a convenient source of energy-dense, low-nutrient foods, leading to greater access to unhealthy food in the school environment. The scarcity or high cost of healthy foods, lack of proper infrastructure, peer pressure, and poor nutrition social norms are among the challenges to maintaining a healthy lifestyle. Literature in India show that easy access, online ordering, and attractive advertising increase the consumption of unhealthy foods among adolescents [26]. A European study of adolescents aged 10–17 years showed that easy access to unhealthy foods increases their consumption, but developing self-regulation strategies can partially reduce this negative effects [23]. The healthy eating behavior of adolescents is influenced by individual barriers such as stress, emotional overeating, false beliefs and family habits, and environmental barriers such as easy access to unhealthy food, advertising, peer pressure, and a lack of healthy ingredients. Moreover, these challenges make it difficult to maintain a healthy nutrition and involve multiple interventions at the individual, interpersonal, and environmental levels. However, effective eating change is not possible through individual self-regulation alone and requires a multidimensional approach by improving access to healthy alternatives and strengthening social and environmental supports.

Among these, exercise and nutrition education are effective support opportunities. According to a Finnish study (2023), gym membership and coach support promote healthier eating habits in adolescents [61]. Moreover, a study in Iran showed a relationship between club membership and better body image and self-esteem [62], which can strengthen the motivation to follow healthier eating patterns. This study found that access to healthy food at home and school, nutrition education, and family and peer support predicted adolescents’ healthy behaviors. Alber et al. reported an association between access to fruits and vegetables and healthier eating and lower BMI [19]. A study in India also highlighted the role of home access [63]. Marwa Diab-Al-Haraque et al. also confirmed the effectiveness of school-based interventions [20]. Gisela Nyberg et al. confirmed the effect of parental support on reducing unhealthy food consumption [21]. Research findings show that providing access to healthy food, education interventions, family support, and physical activity are useful in addressing various barriers.

This study provides new qualitative insights into the environmental factors influencing the eating behavior of adolescent girls in southern Iran, highlighting the role of family, peer, school norms, and access to healthy food. The results suggest that multiple interventions at individual, interpersonal, and environmental levels can promote healthier behaviors. The study also emphasizes that adolescent eating behavior does not occur in a rigid “healthy/unhealthy” dichotomy, and that healthy eating is more about balancing a variety of food choices, rather than completely eliminating unhealthy foods.

Limitations

This study has several limitations. Due to its qualitative design, purposive sampling, and focus on adolescent girls in a single city, the findings are not statistically generalizable and are more likely to be transferred to similar sociocultural contexts. Inclusion of parents is justified by their key role in daily family practices, such as shopping for food, preparing food, and allocating foods in adolescent parenting practices. Interestingly, the adolescents’ views strongly went toward and direct affirmation of their parents’, more than ever expected. Finally, data interpretation and analysis depend on the researchers. Although it was attempted to control for bias as far as possible, there are chances that the researchers’ beliefs and assumptions have been affected. To address these limitations, it is suggested that future studies be conducted with the participation of more diverse groups in different geographic areas and that complementary methods, such as direct observation or daily recording of eating behavior, be used.

Conclusion

This study explored the lived experiences of adolescent girls in Bastak, southern Iran, and identified challenges and opportunities influencing their eating behaviors. The extracted categories were consistent with the environmental constructs of SCT, including social support, barriers and opportunities, normative beliefs, and observational learning. The findings showed that adolescent girls’ eating behaviors were shaped by multiple interacting influences, such as parental roles, peer interactions, family and school culture, social beliefs, and the broader food environment. Participants’ narratives further showed that nutrition education, family support, peer and social norms, and supportive environments influenced how adolescents responded to food temptations and made daily food choices.

Based on these findings, future nutrition interventions may benefit from several factors at the individual, interpersonal, and environmental levels, culturally sensitive, and participatory strategies that go beyond individual education. The most immediate intervention targets be able to include strengthening family support, improving the school food environment, addressing peer influence, and increasing environmental access to healthy foods. Focusing on these targets may help support sustainable improvements in adolescent eating behaviors.

Abbreviations

SCT

Social Cognitive Theory

Authors' contributions

FP contributed to the design and interview with participants, analysis, interpretation, and drafting of the research manuscript. ZH contributed to the inception, design, interpretation, and final approval of the manuscript for publication. NSH and TA contributed to the data analysis, interpretation, and editing.AH contributed to the revision of the manuscript.

Funding

This project received a research grant from Hormozgan University of Medical Sciences (grant no: 4030329). The funding body (HUMS) was not involved in the design of study, data collection, analysis, and interpretation and writing the manuscript.

Data availability

The datasets generated and/or analyzed during the present study are not publicly accessible due to ethical considerations concerning participant confidentiality. However, data may be obtained from the corresponding author upon reasonable request.

Declarations

Ethics approval and consent to participate

All methods were performed in accordance with the Declaration of Helsinki. The study was approved by the Ethics Committee of Hormozgan University of Medical Sciences (ethical code: IR.HUMS.REC.1403.270). Written informed consent was obtained from all participants and their parents or legal guardians prior to participation.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.