Mediation of psychosocial determinants in the relation between socio-economic status and adolescents’ diet quality

• Published in: European journal of nutrition 2018-04, Vol.57 (3), p.951-963
• Main Authors: Michels, Nathalie, Vynckier, Lisa, Moreno, Luis A., Beghin, Laurent, de la O, Alex, Forsner, Maria, Gonzalez-Gross, Marcela, Huybrechts, Inge, Iguacel, Isabel, Kafatos, Antonio, Kersting, Mathilde, Leclercq, Catherine, Manios, Yannis, Marcos, Ascension, Molnar, Denes, Sjöström, Michael, Widhalm, Kurt, De Henauw, Stefaan
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescent Behavior - ethnology; Adolescent Nutritional Physiological Phenomena - ethnology; Adolescents; Beverages; Chemistry; Chemistry and Materials Science; Cross-Sectional Studies; Diet; Diet quality; Diet, Healthy - economics; Diet, Healthy - ethnology; Diet, Healthy - psychology; Educational Status; Europe; Female; Food availability; Food Preferences - ethnology; Health and Welfare; Health Knowledge, Attitudes, Practice - ethnology; Humans; Hunger; Hälsa och välfärd; Male; Medicin och hälsovetenskap; Models, Psychological; Nutrition; Original Contribution; Parenting - ethnology; Parents - education; Patient Compliance - ethnology; Patient Compliance - psychology; Peer Influence; Psychosocial Support Systems; Self Report; Social interactions; Socio-economic class; Socioeconomic Factors; Soft drink availability; Taste; Teenagers
• ISSN: 1436-6207; 1436-6215; 1436-6215
• DOI: 10.1007/s00394-017-1380-8

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.