Do adolescents accurately evaluate their diet quality? The HELENA study.
BACKGROUND & AIMS
The aim of this study was to assess the diet quality awareness and associated factors in a large sample of European adolescents.


METHODS
The study included 3389 healthy adolescents, aged 12.5-17.5 years, who participated in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) Study. The adolescents' diet quality was based on repeated 24 h recalls and scored into a Diet Quality Index for Adolescents (DQI-A) considering four components: meal, equilibrium, diversity and quality. A self-rated diet quality questionnaire was administered to adolescents to assess their dietary awareness. The association of DQI-A with dietary awareness was studied using a linear mixed model including the center as the random effect and dietary awareness as the fixed effect.


RESULTS
There was a positive association between DQI-A scores and diet quality perception levels (p < 0.0001). The mean DQI-A was 59.0 (SD = 14.8) in adolescents with a low dietary awareness compared with 65.4 (SD = 12.6) in adolescents with high dietary awareness (p < 0.0001). Similar results were found for all the DQI components. When analyses were stratified, we found a significant heterogeneity across the nutritional status, with no significant association between DQI-A and dietary awareness level in obese adolescents, but a positive association in overweight, normal and undernourished groups. We found also a significant heterogeneity associated with the lunch location (school or home). No other factor affected dietary awareness (gender, pubertal status and maternal educational level).


CONCLUSION
European adolescents evaluate well their food quality whatever their pubertal status, gender and parental educational level, except for the obese who are not able to assess their diet quality. Improving the dietary awareness in obese adolescents might help to induce behavioral changes.
['Vanhelst|Jérémy|J|', 'Béghin|Laurent|L|', 'Duhamel|Alain|A|', 'De Henauw|Stefaan|S|', 'Ruiz|Jonatan R|JR|', 'Kafatos|Anthony|A|', 'Androutsos|Odysseas|O|', 'Widhalm|Kurt|K|', 'Mauro|Beatrice|B|', 'Sjöström|Michael|M|', 'Kersting|Mathilde|M|', 'Gottrand|Frédéric|F|']
D000293:Adolescent D000294:Adolescent Behavior D002648:Child D003430:Cross-Sectional Studies D059026:Diagnostic Self Evaluation D004032:Diet D005060:Europe D005260:Female D015438:Health Behavior D006801:Humans D008019:Life Style D008297:Male D015596:Nutrition Assessment D009752:Nutritional Status D050177:Overweight D063766:Pediatric Obesity D015995:Prevalence D011795:Surveys and Questionnaires
Assessment Awareness Nutrition Epidemiology study Youth