Nutritional Behaviors, Health Literacy, and Health Locus of Control of Secondary Schoolers in Southern Poland: A Cross-Sectional Study.

Mariusz Duplaga,Marcin Grysztar

doi:10.3390/nu13124323

Abstract

Nutritional behaviors remain an essential part of a healthy lifestyle. It seems obvious that unfavorable health behaviors adopted in adolescence are maintained late in adulthood and may have a profound effect on health status. The main aim of this study was to assess the association between nutritional behaviors and health literacy (HL), health locus of control (HLC), and socioeconomic variables in secondary school pupils from a voivodship (the main unit of territorial division) in southern Poland. The analysis was based on dataTable from a paper-and-pencil survey taken by 2223 pupils from schools selected as the result of cluster sampling. The survey questionnaire encompassed a set of five items asking about dietary patterns and the consumption of fruit and vegetables as well as fast food, a European Health Literacy Project Questionnaire consisting of 47 items, the Multidimensional Health Locus of Control (MHLC) scale, and items asking about sociodemographic and economic variables. Uni- and multivariate logistic regression models have been developed to assess the predictors of indicator nutrition behaviors. The adjusted models revealed that internal HLC was not significantly associated with any of analyzed nutritional behaviors. “Powerful other HLC” and “Chance HLC” (dimension of external HLC) were significant predictors of the selected dietary patterns. Furthermore, higher HL was associated with higher consumption of fruit and vegetables [odds ratio, 95% confidence interval (OR, 95% CI)]: 1.02 (1.01–1.04) and with lower consumption of fast food (OR, 95% CI, 0.98, 0.95–0.999). There was a significant relationship between gender, the size of the household, self-assessed economic situation, expenditures on mobile phones, and weekly duration of Internet use and selected nutrition behaviors. In conclusion, developed regression models confirmed a significant relationship between HL and the types of consumed food, but not with dieting patterns. Contrary to earlier studies, internal HLC was not associated with nutrition behaviors. In our study, boys showed more favorable nutritional behaviors than girls. More intense use of the Internet was associated with less beneficial nutritional behaviors. This study brings important results that should have an impact on health promotion interventions addressed to adolescents in southern Poland.

Highlights

A higher internal health locus of control (IHLC) was associated with higher odds (OR, 95% confidence interval (95% CI): 1.17, 1.04–1.33) and higher subscores reflecting the influence of other people (PHLC) and chance (CHLC) with lower odds of having regular meals (OR, 95% CI: 0.89, 0.81–0.99, and 0.75, 0.67–0.83, respectively)
This study performed among secondary school students from a voivodship in southern Poland revealed rather complex patterns of relationships between predictor variables and the behaviors selected as indicators of nutrition patterns
There was no significant association between IHLC and nutrition behaviors in the study group

Summary

Introduction

As stated by the Lancet Commission on Adolescent Health and Wellbeing, this period is recognized as the healthiest time of life [1]. It is clear that unfavorable health behaviors initiated during adolescence persist in adulthood. Health behaviors may be influenced by many factors. Among factors with a considerable impact on the nutritional behaviors of adolescents, Das et al list peers’ opinions, parental example, food availability, food preferences, cost, convenience, personal and cultural beliefs, mass media, and the perception of body image [2]. Moreno et al underline the importance of dietary factors in the development of obesity, including meal frequency and distribution, snacking, skipping meals, sweetened beverage consumption, size of the food portions, eating away from home, and the consumption of fast food [3]

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