Background: Dietary behaviours and physical activity are modifiable risk factors to address increasing levels of\nobesity among children and adolescents, and consequently to reduce later cardiovascular and metabolic disease.\nThis paper explores perceptions, attitudes, barriers, and facilitators related to healthy eating and physical activity\namong adolescent girls in rural South Africa.\nMethods: A qualitative study was conducted in the rural Agincourt subdistrict, covered by a health and\nsociodemographic surveillance system, in Mpumalanga province, South Africa. Semistructured ââ?¬Å?duo-interviewsââ?¬Â were\ncarried out with 11 pairs of adolescent female friends aged 16 to 19 years. Thematic content analysis was used.\nResults: The majority of participants considered locally grown and traditional foods, especially fruits and vegetables, to\nbe healthy. Their consumption was limited by availability, and these foods were often sourced from family or\nneighbourhood gardens. Female caregivers and school meal programmes facilitated healthy eating practices. Most\nparticipants believed in the importance of breakfast, even though for the majority, limited food within the household\nwas a barrier to eating breakfast before going to school. The majority cited limited accessibility as a major barrier to\nhealthy eating, and noted the increasing intake of ââ?¬Å?convenient and less healthy foodsââ?¬Â. Girls were aware of the benefits\nof physical activity and engaged in various physical activities within the home, community, and schools, including\nhousehold chores, walking long distances to school, traditional dancing, and extramural activities such as netball and\nsoccer.\nConclusions: The findings show widespread knowledge about healthy eating and the benefits of consuming locally\ngrown and traditional food items in a population that is undergoing nutrition transition. Limited access and food\navailability are strong barriers to healthy eating practices. School meal programmes are an important facilitator of\nhealthy eating, and breakfast provision should be considered as an extension of the meal programme. Walking to\nschool, cultural dance, and extramural activities can be encouraged and thus are useful facilitators for increasing\nphysical activity among rural adolescent girls, where the prevalence of overweight and obesity is increasing.
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