Association of lifestyle behaviours with self-esteem through health-related quality of life in Spanish adolescents

Emily Knox,Jose Joaquin Muros

doi:10.1007/s00431-017-2886-z

Abstract

The present research examined the association of Mediterranean diet adherence and physical activity with self-esteem through five components of health-related quality of life. Data were collected from 456 adolescents attending one of five schools in Granada, Spain using a cluster-randomised design. Participants completed questionnaires on Mediterranean diet adherence, physical activity, self-esteem and health-related quality of life (HRQoL). Models were constructed to identify associations between Mediterranean diet adherence and physical activity on self-esteem. Mediational analysis using bootstrapped confidence intervals examined possible mediation by five components of HRQoL. Mediterranean diet adherence and physical activity engagement were associated with four components of HRQoL: more positive physical wellbeing, psychological wellbeing, family relationships and autonomy support and perceptions of the school environment. Both lifestyle behaviours were positively associated with self-esteem. Both relationships were mediated through positive psychological wellbeing and perceptions of the school environment. Physical wellbeing was also a mediator of the relationship between physical activity and self-esteem.Conclusion: Interventions promoting Mediterranean diets or physical activity to adolescents may facilitate improvements in self-esteem in addition to wider health benefits previously identified. Approaches within such interventions targeting improvements in physical wellbeing, psychological wellbeing and positive perceptions of the school environment may improve their efficacy.What is Known:• It is known that engagement in lifestyle behaviours such as physical activity is positively linked with psychological health.• Whilst its consumption is declining, the Mediterranean diet is nutritionally recommended and remains popular in parts of Greece, Southern Italy and Spain. Research into Mediterranean diet adherence and psychological health is lacking.What is New:• The present research furthers this knowledge by examining potential mechanisms through which two lifestyle behaviours (physical activity and following a Mediterranean diet) may be associated with self-esteem.• Implications for the promotion of positive mental health in young people. Mediterranean diet and physical activity were positively associated with self-efficacy via positive psychological self-concept and perceptions of the school environment. These novel findings can contribute to the development of more efficacious interventions targeting positive self-esteem in young people.

Highlights

Adolescence is the period in human growth and development that occurs after childhood and before adulthood, between the ages of 10 and 19 years [21, 22]
Path c′, which examined the relationship of Mediterranean diet through the mediating variables, was non-significant (β = 0.12, SE = 0.13, p = 0.35), suggesting that the influence of following a Mediterranean diet on self-esteem was not mediated by all five components of subjective wellbeing
Results from the present study suggest that adolescents who follow a Mediterranean diet tend to hold more positive perceptions of their physical wellbeing, psychological wellbeing, autonomy support and family relationships and of their school environment, regardless of their body mass index (BMI) or gender

Summary

Introduction

Adolescence is the period in human growth and development that occurs after childhood and before adulthood, between the ages of 10 and 19 years [21, 22] It can be an especially challenging period of the life course as rapid cognitive, physical, psychological and emotional changes take place which impinge on health and wellbeing [3]. It is estimated that around 20% of Spanish individuals will encounter some form of mental health disorder at some point during their adolescence [17]. For these reasons the mental health of young people is a national priority in Spain [17] and across Europe [38]. The school offers a potential setting for intervention as aspects such as school peers have been found to have a strong impact on self-esteem during adolescence [32]

Results

Discussion

Conclusion