The mediating effect of food choice upon associations between adolescent health-related quality of life and physical activity, social media use and abstinence from alcohol

Abstract

Background Understanding how health-related quality of life (HRQoL) is related to lifestyle factors during adolescence is crucial to effective health promotion. The aim of this analysis was to identify associations between HRQoL and lifestyle and to determine the degree to which they are mediated by food choices in adolescents. Methods The Wellbeing in Schools (NI) survey (N = 1609; 13–14 years) assessed HRQoL using the Kidscreen52. Food choice was assessed by Food Frequency Questionnaire (FFQ) and physical activity was assessed using the Physical Activity Questionnaire for Adolescents (PAQ-A). Social media and alcohol abstinence were self-reported. Results Path analysis indicated that fruit and vegetable intake was associated with higher HRQoL on dimensions of moods and emotions, parent relations and home life, financial resources, and social support and peers. Bread and diary intake was related to higher physical wellbeing. Protein was associated with higher psychological wellbeing, moods and emotions, self-perception, parent relations and home life, financial resources, and lower social support and peers. Junk food was related to lower moods and emotions. Males had higher psychological wellbeing, moods and emotions, parental relations and home life. Females had higher self-perception, autonomy, and social support and peers. Greater physical activity explained higher HRQoL on all dimensions. Less social media was associated with higher psychological wellbeing, moods and emotions, self-perception, parent relations and home life, and school environment. Alcohol abstinence was associated with higher physical wellbeing, psychological wellbeing, moods and emotions, self-perception, parent relations and home life, and school environment dimensions. Conclusion Intervention to promote HRQoL in adolescents should consider food choices whilst encouraging physical activity, discouraging social media and deterring alcohol, and targeting boys and girls separately.

Association between dietary factors and health-related quality of life in adolescents longitudinally over three years from age 11-16 years

“…Lower HRQoL on the other hand has been linked to more frequent intake of processed food [14], fast food and sugar-sweetened drinks [15]. There is also evidence that diet mediates the relationships between HRQoL, social media use and physical activity [51]. Given the importance of dietary patterns to HRQoL and health behaviour, this research considers whether dietary patterns at an earlier age are associated with HRQoL later in adolescence.…”

“…A longitudinal study conducted in Norway observed a decrease in HRQoL (Kidscreen10) in both boys and girls aged 11-14 years over three years [19]. Compared to females, adolescent males make less healthy food choices [1,3,16,[20][21][22]51] and consume meat more frequently [20,[23][24].. Given some evidence for gender differences in HRQoL along with consistent evidence for gender differences in dietary practices, boys and girls have been considered separately for the purpose of this analysis.…”

Health Misinformation on Social Media and Adolescent Health

“…Misleading claims, poorly labeled advertisements, heavily filtered or edited images, and health advice that has not been fact-checked often dominate social media, leading to distorted perceptions of body image and healthy behaviors. 4,5 An estimated 13% of young adults experience an eating disorder and 15% to 47% participate in disordered eating behaviors by age 20, reporting social media as a source driving these behaviors. 4 The constant comparison to unattainable body standards on social media also contributes to body dissatisfaction, low self-esteem, and increased anxiety and depression levels.…”

“…Health misinformation exacerbates the adoption of harmful behaviors, including disordered eating (irregular eating behaviors that may or may not be diagnosable as an eating disorder, such as restrictive dieting; rigid eating routines; or use of exercise, food restriction, or purging to compensate for food consumed) among youth. Misleading claims, poorly labeled advertisements, heavily filtered or edited images, and health advice that has not been fact-checked often dominate social media, leading to distorted perceptions of body image and healthy behaviors . An estimated 13% of young adults experience an eating disorder and 15% to 47% participate in disordered eating behaviors by age 20, reporting social media as a source driving these behaviors .…”

“…Under the proper guardrails and with informed support, social media has enormous potential to facilitate positive connections and enhance rather than undermine mental well-being. Social media use among adolescents is associated with increased perceived social support, peer connectedness, and flourishing, a well-being construct that encompasses 6 subdomains (happiness, meaning and purpose, physical and mental health, character, close social relationships, and financial stability) . For example, having several people to talk to online when feeling lonely was significantly associated with flourishing among adolescents .…”