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BMC Public Health. 2017 Dec 14;17(1):926. doi: 10.1186/s12889-017-4920-5.

Bidirectional associations between psychosocial well-being and adherence to healthy dietary guidelines in European children: prospective findings from the IDEFICS study.

Author information

1
Section for Epidemiology and Social Medicine (EPSO), The Sahlgrenska Academy, University of Gothenburg, Box 453, 405 30, Gothenburg, Sweden. louise.arvidsson@gu.se.
2
Section for Epidemiology and Social Medicine (EPSO), The Sahlgrenska Academy, University of Gothenburg, Box 453, 405 30, Gothenburg, Sweden.
3
Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
4
Department of Paediatrics, Clinical Center, University of Pécs, Pecs, Hungary.
5
Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstrasse 30, 283 59, Bremen, Germany.
6
National Institute for Health Development, Tallinn, Estonia.
7
Institute of Food Sciences, CNR Via Roma, 64-83100, Avellino, Italy.
8
Research and Education Institute of Child Health REF, Strovolos, Cyprus.
9
GENUD (Growth, Exercise, Nutrition, and Development) Research group, University of Zaragoza; Instituto Agroalimentario de Aragón (IA2); Instituto de Investigación Sanitaria Aragón (IIS Aragón); Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Zaragoza, Spain.
10
Nutritional Epidemiology Unit, Department of Preventive Medicine, Fondazione IRCSS Istituto Nazionale dei Tumori, Milan, Italy.

Abstract

BACKGROUND:

In children the relationship between a healthy diet and psychosocial well-being has not been fully explored and the existing evidence is inconsistent. This study investigates the chronology of the association between children's adherence to healthy dietary guidelines and their well-being, with special attention to the influence of weight status on the association.

METHODS:

Seven thousand six hundred seventy five children 2 to 9 years old from the eight-country cohort study IDEFICS were investigated. They were first examined between September 2007 and June 2008 and re-examined again 2 years later. Psychosocial well-being was measured using self-esteem and parent relations questions from the KINDL® and emotional and peer problems from the Strengths and Difficulties Questionnaire. A Healthy Dietary Adherence Score (HDAS) was calculated from a 43-item food frequency questionnaire as a measure of the degree to which children's dietary intake follows nutrition guidelines. The analysis employed multilevel logistic regression (country as random effect) with bidirectional modeling of dichotomous dietary and well-being variables as both exposures and outcomes while controlling for respective baseline values.

RESULTS:

A higher HDAS at baseline was associated with better self-esteem (OR 1.2, 95% CI 1.0;1.4) and fewer emotional and peer problems (OR 1.2, 95% CI 1.1;1.3 and OR 1.3, 95% CI 1.2;1.4) 2 years later. For the reversed direction, better self-esteem was associated with higher HDAS 2 years later (OR 1.1 95% CI 1.0;1.29). The analysis stratified by weight status revealed that the associations between higher HDAS at baseline and better well-being at follow-up were similar in both normal weight and overweight children.

CONCLUSION:

Present findings suggest a bidirectional relation between diet quality and self-esteem. Additionally, higher adherence to healthy dietary guidelines at baseline was associated with fewer emotional and peer problems at follow-up, independent of children's weight status.

KEYWORDS:

Childhood overweight; Dietary guidelines; Healthy diet score; IDEFICS; Psychosocial well-being

PMID:
29237434
PMCID:
PMC5729410
DOI:
10.1186/s12889-017-4920-5
[Indexed for MEDLINE]
Free PMC Article

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