Healthy lifestyle and eating perceptions: correlations with weight and low-fat and low-sugar food consumption in adolescence

Figures & data

Figure 1. Research framework.

Table 1. Main indicators in Spain.

Total population	46,755,000
Gross national income per capita	31,670
Life expectancy at birth m/y	79/85
Probability if dying between 15 and 60 years m/y (per 1000 population)	86/40
Total expenditure on health per capita	3145
Total expenditure on health as % of GDP	9.6

Source: World Health Organization (2014).

Table 2. Spain health profile 2013.

		Country	Regional average	Global average
Total population (thousands)		46,755	…	…
Population living in urban areas (%)		78	71	53
GNI per capita		31,670	26,352	12,018
Total fertility rate (per women)		1.5	1.7	2.5
Life expectancy at birth (years)	Both sexes	82	76	70
Life expectancy at age 60 (years)	Both sexes	25	22	20
Healthy expectancy at birth (years)	Both sexes	73	67	62
Under-five mortality rate (per 1000 live births)	Both sexes	5	12	48
Adult mortality rate (probability of dying between 15 and 60 years per 1000 population)	Male	86	179	187
	Female	40	80	124
Maternal mortality ratio (per 100,000 live births)		4	17	210
Prevalence of tuberculosis (per 100,000 population)		17	56	169

Source: World Health Organization (2014).

Table 3. Measurement scales.

Variable	Items	Authors
Low-sugar and low-fat food consumption
Low- sugar food consumption Frequency scale (1 = never, 5 = every day)	Sugar-free breakfast cereals	Grimaldo (2010)
	Low-sugar cookies
	Sugar-free yogurt
	Juice with no added sugar
Low-fat food consumption Frequency scale (1 = never, 5 = every day)	Ham or turkey	Grimaldo (2010)
	Skimmed milk (or semi)
	Wholemeal bread
	Low-fat cheese
	Non-fat yogurt
Healthy/unhealthy lifestyle
Sports activities Frequency scale (1 = never, 5 = everyday)	Individual sports	Grimaldo (2010)
	Team sports
	Combat sports
	Outdoor and adventure sports
Repose and sleep habits Frequency scale (1 = never, 5 = everyday)	My nap is about 30 minutes	Grimaldo (2010)
	I have a set time for bed
	I have a set schedule to get up
	I take some time to relax before going to bed or go to sleep
	My bedroom is maintained at a suitable temperature
	When I wake up I feel I’ve slept enough
	Having rested, I feel I’ve recharged the batteries
Unhealthy habits Frequency scale (1 = never, 5 = everyday)	Tobacco consumption	He et al. (2004)
	Drugs consumption
	Alcoholic beverages consumption
Perceptions of healthy/unhealthy eating
Perceptions of healthy eating 5-point Likert scale (1 = nothing important; 5 = very important)	Have a balanced diet	Chan et al. (2011)
	Eat at regular time intervals
	Have three meals a day (5 in Spain)
	Eat natural food
	Eat almost the same amount each meal
Perceptions of unhealthy eating 5-point Likert scale (1 = nothing important; 5 = very important)	Eat fast foods	Chan et al. (2011)
	Eat too fast
	Eat food with preservatives or additive
	Eat a narrow range of food

Table 4. The international classification of adult underweight, overweight and obesity according to BMI.

	BMI(kg/m^2)
Classification	Principal cut-off points	Additional cut-off points
Underweight	<18.50	<18.50
Severe thinness	<16.00	<16.00
Moderate thinness	16.00–16.99	16.00–16.99
Mild thinness	17.00–18.49	17.00–18.49
Normal range	18.50–24.99	18.50–22.99
	23.00–24.99
Overweight	≥25.00	≥25.00
Pre-obese	25.00–29.99	25.00–27.49
	27.50–29.99
Obese	≥30.00	≥30.00
Obese class I	30.00–34.99	30.00–32.49
	32.50–34.99
Obese class II	35.00–39.99	35.00–37.49
	37.50–39.99
Obese class III	≥40.00	≥40.00

Source: Adapted from WHO (1995, 2000).

Table 5. Descriptive analysis.

	Sample (100%)	Public (57.7%)	Private (43.3%)	Women (53.6%)	Men (46.4%)
Age	15.04	15.04	15.05	15.03	15.05
Weight (Kg.)	58.76	58.92	58.51	55.65*	62.34*
Height (cm.)	166.28	167.71*	164.17*	162.55*	170.54*

*Significant differences, p < 0.05.

Table 6. Overall BMI.

			Frequency	%	Cumulative percentage
BMI	Group 1: Underweight N = 70	Severe thinness	13	2.2	2.2
		Moderate thinness	15	2.5	4.7
		Mild thinness	42	7.1	11.9
	Group 2: Normal	Normal range	475	80.5	92.4
	Group 3: Overweight N = 45	Overweight	40	6.8	99.2
		Obese_Class I	2	0.3	99.5
		Obese_Class II	3	0.5	100.0
		Total	590	100.0

Table 7. Psychometric properties of the measurement instrument: reliability and convergent validity.

Variable	Items	Lij (Stand Charge)	T robust	R^2	Cronbach Alpha	CR	AVE
BMI	BMI	1.00		1.00	1.00
Low-sugar and low-fat food consumption
Low- sugar food consumption		–	–	–	0.6	0.6	0.5
	Low-sugar cookies	0.50	10.49	0.26
	Sugar-free yogurt	0.80	19.09	0.64
		–	–	–
Low-fat food consumption		–	–	–	0.7**	0.7	0.5
		–	–	–
	Wholemeal bread	0.57	14.54	0.33
	Low-fat cheese	0.65	16.86	0.42
	Non-fat yogurt	0.84	26.69	0.70
Healthy/unhealthy lifestyle
Sports activities		–	–	–	0.5***	0.5	0.3
		–	–	–
	Combat sports	0.60	7.022	0.36
	Outdoor and adventure sports	0.53	8.539	0.28
Repose and sleep habits		–	–	–	0.8***	0.8	0.7
		–	–	–
		–	–	–
		–	–	–
		–	–	–
	When I wake up I feel I’ve slept enough	0.60	7.848	0.36
	Having rested, I feel I've recharged the batteries	0.99	9.128	0.99
Unhealthy habits	Tobacco consumption	0.73	12.61	0.53	0.8***	0.8	0.5
	Drugs consumption	0.76	9.17	0.57
	Alcoholic beverages consumption	0.69	9.45	0.47
Perceptions of healthy/unhealthy eating
Perceptions of healthy eating	Have a balanced diet	0.77	9.62	0.60	0.6***	0.6	0.4
		–	–	–
		–	–	–
	Eat natural food	0.52	8.56	0.28
		–	–	–
Perceptions of unhealthy eating	Eat fast foods	0.71	9.77	0.50	0.6**	0.6	0.4
	Eat too fast	0.59	9.27	0.35
		–	–	–
		–	–	–

Note: Chi-square = 320.48 (fd = 92); p = 0.000; chi-square/fd = 3.48; NFI = 0.85; NNFI = 0.82; CFI = 0.88; IFI = 0.88; RMSEA = 0.064.

*p < .1.

**p < .05.

***p < .01 (Hotelling, Tukey’s test).

Table 8. Psychometric properties of the measurement instrument: discriminant validity.

Table 9. Hypotheses testing.

		BMI
		Underweight Group 1 (N = 70)	Normal Group 2 (N = 475)	Overweight Group 3 (N = 45)	Total (N = 590) Mean	Total (N = 590) Correlat.	Test
H1a	Low-fat food intake →BMI	2.78	2.86	2.62	2.83ns	−0.024ns	Not accepted
H1b	Low-sugar food intake →BMI	2.58	2.58	2.72	2.59ns	0.024ns	Not accepted
H2a	Unhealthier life style →BMI	1.64	1.39	1.46	1.43**	−0.065ns	Accepted
H2b	Healthier life style: SPORT →BMI	2.36	2.11	2.28	2.15**	−0.048ns	Accepted
H2b	Healthier life style: SLEEP →BMI	3.19	3.23	3.10	3.22ns	−0.018ns	Not accepted
H3a1	Unhealthier life style→Low-fat food intake				1.43***	−0.016ns	Accepted
H3a2	Unhealthier life style→Low sugar food intake				1.43*	−0.041ns	Accepted
H3b1	Healthier life style: SPORT →Low-fat food intake				2.15***	0.054ns	Accepted
H3b1	Healthier life style: SLEEP →Low-fat food intake				3.22***	0.083*	Accepted
H3b2	Healthier life style: SPORT→Low sugar food intake				2.15***	0.114**	Accepted
H3b2	Healthier life style: SLEEP→Low sugar food intake				3.22*	0.094*	Accepted
H4a	Unhealthier eating perceptions →BMI	2.47	2.31	2.4159	2.34*	−0.033ns	Accepted
H4b	Healthier eating perceptions →BMI	3.48	3.63	3.5378	3.61ns	0.031ns	Not accepted
H5a1	Unhealthier eating perceptions → Low-fat food intake				2.34ns	−0.074ns	Not accepted
H5a2	Unhealthier eating perceptions → Low sugar food intake				2.34ns	−0.098*	Not accepted
H5b1	Healthier eating perceptions → Low-fat food intake				3.60***	0.260**	Accepted
H5b2	Healthier eating perceptions → Low sugar food intake				3.61***	0.230**	Accepted

Ns, not significant.

*p < 0.1.

p < 0.05.

***p < 0.001.

Table 10. Low-sugar food intake and BMI groups.

	Cereals	Cookies	Yogurt	Juice	Mean low sugar
UnderweightGroup 1 (N = 70)	2.62	2.42	2.38	2.92	2.58
NormalGroup 2 (N = 475)	2.56	2.40	2.47	2.87	2.58
OverweightGroup 3 (N = 45)	2.73	2.39	2.23	3.52	2.72
Total (N = 590)	2.58	2.40	2.44	2.92***	2.59

*p < 0.1.

p < 0.05.

***p < 0.001.

Table 11. Low-fat food intake and BMI groups.

	HAM	Milk	Bread	Cheese	Yogurt	Mean low fat
UnderweightGroup 1 (N = 70)	3.24	3.17	2.51	2.45	2.53	2.78
NormalGroup 2 (N = 475)	3.43	3.19	2.68	2.53	2.48	2.86
OverweightGroup 3 (N = 45)	3.09	3.02	2.07	2.64	2.30	2.62
Total (N = 590)	3.38*	3.17	2.62**	2.53	2.48	2.83

*p < 0.1.

p < 0.05.

***p < 0.001.

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