Empowering Healthy Adolescents: A Dietary Adherence Tool Incorporating Environmental Factors Based on Korean...

Background: Adolescence is a critical period for adopting lifestyle behaviors that influence long-term health. While dietary habits are well-documented, the broader socio-cultural and environmental factors impacting these behaviors are underexplored. This study aimed to develop a dietary adherence tool for adolescents that aligns with the Dietary Guidelines for Koreans, incorporating individual and environmental factors for a comprehensive understanding of dietary behaviors. Methods: A nationwide survey was conducted with 1010 adolescents in Korea to develop and validate a dietary adherence tool based on the Dietary Guidelines for Koreans. Factor analyses and structural equation modeling confirmed the construct validity of the tool, and a grading system was established to evaluate adherence based on survey responses. Results: The survey included participants from 17 regions across South Korea. The original 22 candidate items were revised through factor analysis, resulting in the deletion of 4 items and the addition of 6 new items, leading to a final 24-item tool encompassing three domains: food intake, dietary and physical activity behaviors, and dietary culture. The validity of the revised tool remained intact. The mean dietary guideline adherence score of the participants was 54.5 (SD = 12.1), with domain scores of 39.1 (SD = 14.4) for food intake, 51.6 (SD = 16.6) for dietary and physical activity behaviors, and 66.8 (SD = 15.4) for dietary culture. Conclusions: The dietary adherence tool offers a comprehensive framework for assessing adolescent dietary behaviors by integrating food intake, dietary and physical activity behaviors, and environmental factors. By considering sustainability and family support, it promotes healthier and more sustainable eating patterns among adolescents.