Nutrition counseling is a structured educational effort aimed at improving students’ understanding, attitudes, and practices regarding healthy eating. School environments are considered strategic settings for nutrition intervention because adolescents spend most of their daily time in school and are highly influenced by peer interaction and school food environments. Research from 2020–2024 consistently emphasizes that effective nutrition education in schools can significantly improve knowledge and encourage healthier food choices among adolescents. Several studies (e.g., Rahmawati & Yuliana, 2021; Hidayat et al., 2023) showed that nutrition counseling integrated into school programs has a positive effect on students’ dietary behavior, especially regarding snack selection and consumption patterns.

Puzzle media is categorized as a form of interactive and game-based learning that supports cognitive engagement and improves retention. Educational gamification strategies have been increasingly utilized in health education due to their effectiveness in motivating learners and transforming abstract concepts into concrete, visual, and enjoyable experiences (Putri et al., 2020; Sari & Widodo, 2022). Studies in nutrition education indicate that interactive media such as puzzles enhance students’ concentration, stimulate problem-solving abilities, and strengthen memory retention. This method is particularly effective for younger learners (ages 10–15), who respond positively to tactile and visual learning activities.

Adolescent nutrition knowledge plays a critical role in shaping healthier eating habits. However, numerous studies in Indonesia and Southeast Asia report that adolescents have relatively low knowledge regarding balanced nutrition, food labeling, and the health risks of consuming unhealthy snacks (Fitriani, 2021; Mahesa et al., 2024). Common issues include the popularity of cheap, tasty, and widely available processed snacks containing excess sugar, sodium, artificial colorants, and preservatives. Improving knowledge through engaging educational methods such as puzzles has been shown to increase students’ awareness of food quality and nutritional value.

Attitude is a key determinant of food choice behavior. Although knowledge influences attitude, various factors such as peer influence, marketing exposure, taste preference, and family habits also shape adolescents’ attitudes toward snack foods (Nurdin & Harahap, 2022). Recent research (2020–2024) indicates that interventions combining cognitive and affective approaches such as interactive games, group discussion, and counselling are more effective in improving attitudes than lecture-based methods alone. Using puzzle media allows students to reflect on their choices, engage in hands-on learning, and develop positive attitudes toward nutritious snack options.

Empirical studies demonstrate that puzzle-based learning significantly impacts nutrition-related outcomes among school-aged children. For example, a 2021 quasi-experimental study reported that puzzle media increased nutrition knowledge scores by up to 40% post-intervention. Similar findings from 2022 and 2023 show improvements in attitudes toward healthy snacks and reduced interest in consuming high-calorie, low-nutrient foods after exposure to interactive educational tools. These outcomes suggest that puzzle media strengthens both cognitive domains (knowledge acquisition) and affective domains (attitude formation), supporting its use in school nutrition counseling programs.

The majority of respondents in this study were 13 years old (75 students) and 75 students (52%) were female. Adolescents are considered a nutritionally vulnerable group due to rapid physical growth and increased nutrient needs. Knowledge and attitudes toward food are key factors influencing snack choices during adolescence. Individuals aged 12 and above are capable of abstract thinking, logical reasoning, and understanding more complex cause and effect relationships. This aligns with the respondents in this study, who were at an appropriate cognitive developmental stage to receive counseling interventions.

The results of this study are consistent with previous findings by Ton Nu et al. in France, who found that age and gender influence adolescents' eating habits, with girls tending to be more health conscious than boys. Rahmawati et al. in South Kalimantan reported that differences in eating behavior between male and female adolescents were influenced by parenting patterns and increasing age. However, Gonzalez et al. in Jakarta found that environmental factors and visual information on packaging had a stronger influence on snack food selection than demographic characteristics, such as age and gender.

The results of this study indicate an increase in students' knowledge about nutrition and snack foods after the counseling. The Wilcoxon signed rank test showed a P-value of 0.000 (≤ 0.05), indicating that the counseling was effective in improving students' knowledge. These results align with constructivist learning theory, which states that knowledge is more effectively internalized when students actively participate in constructing their own understanding. The puzzle media used in this study provided an interactive and experiential form of learning, where students were directly involved in arranging, identifying, and connecting images related to food groups and nutritional messages. This hands- on activity encouraged cognitive engagement, attention, and memory retention, all of which contributed to improved learning outcomes.

The use of puzzle media also integrates visual, kinesthetic, and cooperative learning styles, which is particularly effective for adolescents. According to Mokhtari et al., interactive instructional media that combines visual and tactile components can improve the understanding and motivation of students aged 12- 15 years. Similarly, Rahman et al. found that students exposed to participatory nutrition learning demonstrated higher retention rates of dietary knowledge compared to those who received lecture-based instruction.

The increase in knowledge in this study is in line with the research of Indriani et al. who reported that puzzle-based nutrition counseling among elementary school students significantly improved their ability to identify food groups and balanced meal portions. This shows that puzzles are not only engaging but can also be adapted to different levels of education, including adolescents. The increased knowledge about snack food in this study suggests that puzzle media can help clarify the characteristics of healthy versus unhealthy snack food, which is crucial for encouraging better food choices among students. Before the intervention, 94 students (65.2%) had good knowledge about snack food. After the intervention, this number increased to 124 students (86%). These results indicate that the counseling was effective in increasing student knowledge.

These results support the view of interactive media as an alternative to traditional teaching, where learning occurs through exploration, rather than passive listening. Incorporating fun and game-like elements can reduce student boredom and create a positive learning environment, ultimately improving their academic and health outcomes.

Attitude change is an important behavioral component that accompanies knowledge acquisition. The results showed an improvement in students' attitudes toward nutrition and snack foods after the intervention, with a P-value of 0.000 (≤ 0.05). The number of students with positive attitudes toward nutrition increased from 77 (53.5%) to 118 (81.9%). Students with positive attitudes toward

snack foods also increased from 69 (47.9%) to 103 (71.5%).

These results indicate that puzzle-based learning not only improves students' knowledge but also influences their affective and behavioral dimensions. When learning is fun and participatory, students are more likely to internalize the message and adopt positive attitudes. According to Ajzen's Theory of Planned Behavior (TPB), attitudes are a strong predictor of behavioral intentions; therefore, improved attitudes may ultimately lead to healthier food choices among adolescents.

Similar results were reported by Prameswari et al. that educational games improved knowledge and attitudes towards balanced nutrition among junior high school students. Sundari et al. noted that interactive learning strategies were effective in shaping adolescents' self-awareness and responsibility for their own dietary behavior.

The increase in positive attitudes toward snack food, in particular, reflects a shift in students' perceptions of what constitutes healthy snack food. Many students initially associated snack food with taste and convenience rather than nutritional value. Through puzzle-based learning experiences, students became more aware of the importance of food safety, hygiene, and nutritional content. Puzzle media serves as an effective behavior change communication tool that can be integrated into school health programs. Compared to traditional lectures, this approach not only encourages knowledge acquisition but also emotional engagement, which is essential for sustainable attitude change. Locally developed, low-cost outreach media can be a tool in improving health literacy among adolescents.