"Life (Without Sweets) Would Be Black and White": Exploring Primary School Children's Views on Eating Practices and Sugar Consumption.

Considering the growing concern over the health consequences of excessive sugar consumption among children, it has become crucial to design effective and age-appropriate interventions. While existing research has provided relevant insights into sugar consumption from the perspective of adults (e.g., parents), the perspectives of children themselves have received relatively little empirical attention. The current study aimed at exploring how children navigate the often-conflicting individual and contextual influences that shape their eating behaviors. Following a qualitative approach, we explored primary school children's views on their motivations for consuming sugar, the situations/contexts in which sugary foods and drinks are more accessible, the perceived roles of family and school, and their attitudes toward dietary change. Six focus groups were conducted across two schools, involving 44 fourth-grade students. The resulting recordings were transcribed verbatim and subject to content analysis. The findings suggest children were able to identify sugar sources and recognize potential health consequences of their intake. However, sugar consumption remains driven by a strong sensory and hedonic attraction to sweets. The insights emerging from this discussion were further synthesized into barriers and facilitators of sugar intake according to the dimensions of capability, opportunity, and motivation of the COM-B framework. These findings indicate that intake can be facilitated (or hindered) by capability (e.g., knowledge of sugar sources), opportunity (e.g., family influences, related learning at school), and motivation (e.g., sensory appeal, affective attachment to sweets). This study informs future research and interventions on sugar consumption among children, adding valuable insights from their own perspectives.