Socio-ecological influences on adolescent dietary typologies

Background: Dietary behaviours of adolescence are concerning, and this may impact long-term well-being. Aim: This study examined the socio-ecological determinants of dietary behaviours in a national prospective cohort study of English adolescents. Methods: Latent class analysis was used to identify the typologies of eight dietary behaviours: fruit, vegetable, breakfast, sugar-sweetened beverages, artificial-sweetened beverages, fast-food, bread, and milk from 7402 adolescents aged 13-15 years (mean 13.8 ± 0.45 years) (50.3% female and 71.3% white ethnicity) participating in the U.K. Millennium Cohort Study (sixth survey). Multinomial logistic regression and path analysis predicted associations between personal characteristics, individual, influential others, social environment and physical environment determinants and three distinct diet typologies: (1) healthy, (2) less-healthy and (3) mixed, (reference category = mixed). Results: Within Path analysis, the magnitudes of coefficients were small to moderate suggesting a relatively weak relationship between the variables. Model 1 reported adolescents within the less-healthy compared to mixed typology had lower levels of physical activity (β = 0.074, 95% CI = -0.115, -0.033), and have siblings (β = 0.246, 95% CI = 0.105, 0.387). Model 2 reported adolescents within the healthy compared to mixed typology had lower screen time (β = 0.104, 95% CI = 0.067, 0.141), and lower social media usage (β = 0.035, 95% CI = 0.024, 0.046). Conclusion: This study highlights the importance of considering multiple dietary determinants. These findings are likely to be useful in supporting the development of multi-faceted interventions. They emphasise the need to move away from investigating silo behaviours on individual diet components and a step towards more systems thinking to improve adolescent eating behaviours.