A latent class analysis of Mediterranean diet adherence and positive and negative affect in adolescents

Adherence to the Mediterranean diet (MedDiet) is associated with physical and mental health benefits. However, little is known about how specific dietary patterns within the MedDiet influence emotional well-being in adolescents. This study examined the association between MedDiet adherence and positive and negative affect (PA and NA) among Spanish adolescents using a latent class approach.

Cross-sectional analysis of 643 adolescents (12-17 years) from the Eating Healthy and Daily Life Activities (EHDLA) study. MedDiet adherence measured with Mediterranean Diet Quality Index for children and adolescents (KIDMED). Latent class analysis identified three profiles: "balanced eaters", "breakfast skippers", and "optimal dieters". PA and NA assessed with Positive and Negative Affect Schedule - 10-Item for Children (PANAS-C10). Associations analyzed with generalized linear models adjusted for sociodemographic, lifestyle, and anthropometric variables.

Adjusted mean PA scores were 18.1 (95% confidence interval [CI]: 17.4-18.9) for balanced eaters, 16.8 (95% CI: 15.7-17.9) for breakfast skippers, and 18.3 (95% CI: 17.7-18.8) for optimal dieters. Optimal dieters had significantly higher PA than breakfast skippers (p = 0.021); balanced eaters showed a near-significant trend (p = 0.051). NA means show no significant differences.

Greater MedDiet adherence, particularly regular breakfast consumption, is associated with higher PA in adolescents, supporting promotion of healthy eating to enhance youth emotional well-being and inform public health strategies in Spain.

Greater adherence to the MedDiet, particularly consistent breakfast consumption, is associated with emotional well-being in adolescents. Using latent class analysis, the research identified three dietary profiles and breakfast skippers had the lowest positive affect and the highest negative affect. This novel approach offers a more granular understanding than previous studies that used only general adherence scores; these findings provide evidence for public health strategies to promote healthy dietary patterns, especially breakfast, to enhance youth mental health.