Nathalie Michels1, Lisa Vynckier2, Luis A Moreno3, Laurent Beghin4, Alex de la O5, Maria Forsner6, Marcela Gonzalez-Gross7, Inge Huybrechts2,8, Isabel Iguacel2, Antonio Kafatos9, Mathilde Kersting10, Catherine Leclercq11, Yannis Manios12, Ascension Marcos13, Denes Molnar14, Michael Sjöström15, Kurt Widhalm16, Stefaan De Henauw2. 1. Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185-4K3, 9000, Ghent, Belgium. Nathalie.michels@ugent.be. 2. Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185-4K3, 9000, Ghent, Belgium. 3. GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, , Edificio del SAI, C/Pedro Cerbuna s/n, 50009, Zaragoza, Spain. 4. Centre d'Investigation Clinique CH&U Inserm, Bd Pr Leclercq, Hôpital Cardiologique, Lille Cedex, France. 5. Department of Physiology, Faculty of Medicine, Granada University, Granada, Spain. 6. School of Education, Health and Social Sciences, Dalarna University, Falun, Sweden. 7. Department of Health and Human Performance, Facultad de Ciencias de la Actividad Física y del Deporte, Universidad Politécnica de Madrid, Madrid, Spain. 8. Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France. 9. School of Medicine, University of Crete, Crete, Greece. 10. Research Institute of Child Nutrition, Rheinische Friedrich-Wilhelms-Universität Bonn, Dortmund, Germany. 11. INRAN (National Research Institute on Food and Nutrition), Via Ardeatina, 546I00176, Roma, Italy. 12. Department of Nutrition and Dietetics, Harokopio University, Athens, Greece. 13. Department of Metabolism and Nutrition, ICTAN Institute Frı´o Spanish National Research Council C/ Jose´ Antonio Novais, Madrid, 28000, Spain. 14. Department of Pediatrics, University of Pécs, Pécs, Hungary. 15. Department of BioScience and Nutrition, Karolinska institutet, Stockholm, Sweden. 16. Department of Pediatrics, Division of Clinical Nutrition, Medical University of Vienna, Vienna, Austria.
Abstract
PURPOSE: To examine the underlying reasons for the positive relation between socio-economic status (SES) and the diet quality of adolescents. METHODS: In 2081 adolescents (12.5-17.5 years) of the European HELENA study, a continuous variable on diet quality via 2-day 24-h recalls was available. SES was reflected by parental education, parental occupation and family affluence. Mediation by several psychosocial determinants was tested: self-efficacy, availability at school and home, social support, barriers, benefits, awareness and some self-reported influencers (parents, school, taste, health, friends, food readily available, easy preparation, hunger, price and habits). Multiple mediation analyses were adjusted for age, sex and country. RESULTS: The availability of soft drinks and fruit at home, social support, parental influence, barriers, price influence, taste influence, health influence and food being readily available were significant mediators. The multiple mediation indirect effect accounted for 23-64% of the total effect. Both occupation and education and both maternal and paternal factors could be explained by the mediation. The unavailability of soft drinks was the strongest mediator (17-44% of the total effect). CONCLUSION: Up to 64% of the positive relation between SES and the diet quality in adolescence could be explained by several healthy eating determinants. Focusing on these factors in low-SES populations can minimize social inequalities in diet and health by improving the diet of these specific adolescents.
PURPOSE: To examine the underlying reasons for the positive relation between socio-economic status (SES) and the diet quality of adolescents. METHODS: In 2081 adolescents (12.5-17.5 years) of the European HELENA study, a continuous variable on diet quality via 2-day 24-h recalls was available. SES was reflected by parental education, parental occupation and family affluence. Mediation by several psychosocial determinants was tested: self-efficacy, availability at school and home, social support, barriers, benefits, awareness and some self-reported influencers (parents, school, taste, health, friends, food readily available, easy preparation, hunger, price and habits). Multiple mediation analyses were adjusted for age, sex and country. RESULTS: The availability of soft drinks and fruit at home, social support, parental influence, barriers, price influence, taste influence, health influence and food being readily available were significant mediators. The multiple mediation indirect effect accounted for 23-64% of the total effect. Both occupation and education and both maternal and paternal factors could be explained by the mediation. The unavailability of soft drinks was the strongest mediator (17-44% of the total effect). CONCLUSION: Up to 64% of the positive relation between SES and the diet quality in adolescence could be explained by several healthy eating determinants. Focusing on these factors in low-SES populations can minimize social inequalities in diet and health by improving the diet of these specific adolescents.
Authors: Tatiana Sadalla Collese; Augusto César Ferreira De Moraes; Juan Miguel Fernández-Alvira; Nathalie Michels; Stefaan De Henauw; Yannis Manios; Odysseas Androutsos; Anthony Kafatos; Kurt Widhalm; Myriam Galfo; Laurent Beghin; Michael Sjöström; Raquel Pedrero-Chamizo; Heráclito Barbosa Carvalho; Luis A Moreno Journal: Int J Public Health Date: 2018-12-04 Impact factor: 3.380
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