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Individual and Environmental Factors Influencing Adolescents’ Dietary Behavior in Low- and Middle-Income Settings

Author

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  • Roosmarijn Verstraeten
  • Jef L Leroy
  • Zuzanna Pieniak
  • Angélica Ochoa-Avilès
  • Michelle Holdsworth
  • Wim Verbeke
  • Lea Maes
  • Patrick Kolsteren

Abstract

Objective: Given the public health importance of improving dietary behavior in chronic disease prevention in low- and middle-income countries it is crucial to understand the factors influencing dietary behavior in these settings. This study tested the validity of a conceptual framework linking individual and environmental factors to dietary behavior among Ecuadorian adolescents aged 10–16 years. Methods: A cross-sectional survey was conducted in 784 school-going Ecuadorian adolescents in urban and rural Southern Ecuador. Participants provided data on socio-economic status, anthropometry, dietary behavior and its determining factors. The relationships between individual (perceived benefits and barriers, self-efficacy, habit strength, and a better understanding of healthy food) and environmental factors (physical environment: accessibility to healthy food; social environment: parental permissiveness and school support), and their association with key components of dietary behavior (fruit and vegetables, sugary drinks, breakfast, and unhealthy snack intake) were assessed using structural equation modeling. Results: The conceptual model performed well for each component of eating behavior, indicating acceptable goodness-of-fit for both the measurement and structural models. Models for vegetable intake and unhealthy snacking showed significant and direct effects of individual factors (perceived benefits). For breakfast and sugary drink consumption, there was a direct and positive association with socio-environmental factors (school support and parental permissiveness). Access to healthy food was associated indirectly with all eating behaviors (except for sugary drink intake) and this effect operated through socio-environmental (parental permissiveness and school support) and individual factors (perceived benefits). Conclusion: Our study demonstrated that key components of adolescents’ dietary behaviors are influenced by a complex interplay of individual and environmental factors. The findings indicate that the influence of these factors varied by type of dietary behavior.

Suggested Citation

  • Roosmarijn Verstraeten & Jef L Leroy & Zuzanna Pieniak & Angélica Ochoa-Avilès & Michelle Holdsworth & Wim Verbeke & Lea Maes & Patrick Kolsteren, 2016. "Individual and Environmental Factors Influencing Adolescents’ Dietary Behavior in Low- and Middle-Income Settings," PLOS ONE, Public Library of Science, vol. 11(7), pages 1-15, July.
    • Handle: RePEc:plo:pone00:0157744
    DOI: 10.1371/journal.pone.0157744
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    1. Stead, Martine & McDermott, Laura & MacKintosh, Anne Marie & Adamson, Ashley, 2011. "Why healthy eating is bad for young people's health: Identity, belonging and food," Social Science & Medicine, Elsevier, vol. 72(7), pages 1131-1139, April.
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    1. Jaroslava Voráčová & Erik Sigmund & Dagmar Sigmundová & Michal Kalman, 2016. "Family Affluence and the Eating Habits of 11- to 15-Year-Old Czech Adolescents: HBSC 2002 and 2014," IJERPH, MDPI, vol. 13(10), pages 1-11, October.

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