Dietary behaviors, corresponding correlates and socioeconomic differences among adolescents: A cross-sectional study among 8th graders in Øvre Romerike

Background: Overweight and obesity among children and adolescents are a global health challenge. Prevention in adolescence is of particular concern, since behaviors as young can track into adulthood. Consumption of fruit, vegetables, unhealthy snacks and soft drinks with sugar are important behaviors in preventing overweight, and are all found to be unfavorable among adolescents. Identifying potential correlates is important from a health promotion perspective. Further, children with lower socioeconomic position have more unhealthy diets than their counterparts. Exploring factors responsible for these socioeconomic differences is vital in order to address these differences. Aim: The first aim is to describe dietary behaviors (intake of fruit, vegetables, unhealthy snacks and soft drinks with sugar) and explore their potential correlates (perceived accessibility at home, perceived parental rules, perceived parental modeling and self-efficacy for healthy eating) among 8th graders in Øvre Romerike. The second aim is to explore socioeconomic differences in these behaviors and potential mediating effects of the correlates. Methods: A cross-sectional study among 728 8th graders (participation rate 64%) was conducted in Øvre Romerike, by using an electronic questionnaire. Parental educational level was used as indicator of socioeconomic position. Gender differences in dietary behaviors were explored using independent sample t-test. Multivariate linear regression was used to explore potential correlates of dietary behaviors. One-way ANOVA was used to explore differences in dietary behaviors and in correlates of dietary behaviors among the parental educational groups. Multiple mediation analysis was conducted to explore correlates’ potential mediating effect on socioeconomic differences in soft drink consumption. Results: The 8th graders mean intake of fruit, vegetables and unhealthy snacks was 6.9, 8.7, and 4.5 times per week, respectively. The mean intake of soft drinks was 7.0 dl per week, and was the only dietary behavior which differed significantly between genders and between socioeconomic groups. Boys and the low parental educational group had the highest intake of soft drinks. Accessibility, self-efficacy for healthy eating and parental modeling were associated with all the dietary behaviors. In addition, prohibitive rules were also significantly related to intake of unhealthy snacks and soft drinks. Accessibility, prohibitive rules and parental modeling mediated parental educational differences in soft drink intake. Conclusion: The results highlight the importance of the home environment for all the dietary behaviors included. Adolescents' self-efficacy for healthy eating was also important for V making healthy choices. Parents have an important role to play in the improvement of socioeconomic differences in soft drink consumption by reducing accessibility of soft drinks in the home environment, practice more prohibitive rules and by modeling more healthy behavior