Association Between Dietary Quality, Socioeconomic Level, Body Mass Index, and Age in Adolescents (Eastern Algeria): A Cross-sectional Study

Abstract

Aim: This article aims to evaluate the quality of adolescents’ diet in Constantine (Eastern Algeria) and investigate factors associated with this quality: Socio-economic Level (SEL), nutritional status (BMI), and age.
 Methods: A cross-sectional survey was conducted in Constantine (Eastern Algeria) in 2019 with 1126 adolescents (aged 11–19 years). The dietary data were collected by a 24-hr recall. The diet quality was assessed by a diet diversity score (DDS) calculated for 9 food groups (DDS above the mean reflects a diversified diet) and a mean adequacy ratio (MAR) calculated for 12 nutrients. MAR’s cut-off value was "one." Weight and height were measured, and BMI was interpreted according to the World Health Organization reference values. The SEL was assessed using a socioeconomic classification score (SECS) according to parents' education level, profession, and other household information.
 Results: The mean DDS was 3.97 ± 1.25. It was shifted to the lowest values compared to the theoretical mean value (4.5). Insufficient scores (DDS ≤4.5) were found in 65.0% of subjects. The mean MAR was 0.59 ± 0.20 and values <1 represented 79.1%. A significant negative correlation was recorded between age and MAR (r = −15%; P < 0.0001), and a positive correlation was found between it and SECS (r = 18%; p < 0.0001). BMI is inversely and significantly associated with MAR (r = −9.9%; P = 0.0009).
 Conclusion: In addition to highlighting a low diversity and a poor adequacy with nutritional recommendations among adolescents in Algeria, this study underlines the significant effect of age, BMI, and socioeconomic level on the quality of diet.
 Keywords: dietary diversity score (DDS), mean adequacy ratio (MAR), BMI, socioeconomic level, adolescents