Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Quality of Life Research
Published in: Quality of Life Research 3/2022

01-03-2022

Dietary patterns and health-related quality of life among Iranian adolescents

Authors: Seyedeh-Elaheh Shariati-Bafghi, Bahram Rashidkhani, Javad Salehi Fadardi, Mohammad Safarian, Javad Edalatian, Golnaz Ranjbar, Mohsen Nematy

Published in: Quality of Life Research | Issue 3/2022

Login to get access

Abstract

Purpose

Examining the associations of a-posteriori-defined dietary patterns and health-related quality of life (HRQOL) among Iranian adolescents.

Methods

This cross-sectional study was conducted among 900 apparently healthy students (mean age 15.33 years; 53.0% female) during 2020–21. The validated Persian version of self-report Pediatric Quality of Life Inventory™ Version 4.0 Generic Core Scales (PedsQL) for healthy adolescents was used in an online survey to assess HRQOL. Total, physical health, psychosocial health, emotional functioning, social functioning, and school functioning PedsQL scores were calculated, and impaired HRQOL was defined as > 1 standard deviation below the total population sample mean PedsQL scores. A validated food frequency questionnaire was used to assess dietary intakes during telephone interviews. Daily intakes of 20 predefined food groups were calculated and submitted to the principal component factor analysis to identify a-posteriori-defined dietary patterns.

Results

Three major dietary patterns labeled as Mediterranean, mixed, and unhealthy were identified, of which only the Mediterranean pattern characterized by high intakes of vegetables, fruits, olives, potatoes, eggs, nuts and legumes, pickles, low-fat dairy, fish, poultry, and vegetable oils was consistently associated with HRQOL. Controlling for covariates in the multivariable-adjusted binary logistic regression analysis, participants in the top tertile of Mediterranean pattern score were less likely to have impaired HRQOL than those in the bottom tertile (total: OR 0.25; physical health: OR 0.35; psychosocial health: OR 0.15; emotional functioning: OR 0.17; social functioning: OR 0.15; and school functioning: OR 0.18; all P < 0.010).

Conclusion

Current findings indicate that an a-posteriori-defined Mediterranean-style dietary pattern is associated with better HRQOL among healthy Iranian adolescents.

Literature
  1. U.S. Departement of Health and Human Services, Office of Disease Prevention and Health Promotion. (2010). Healthy People 2020 Foundation Health Measure Report on Health-related Quality of Life and Well-being. Retrieved March 7, 2021, from https://​www.​healthypeople.​gov/​2020/​about/​foundation-health-measures/​Health-Related-Quality-of-Life-and-Well-Being
  2. Centers for Disease Control and Prevention. (2018). Health-related Quality of Life (HRQOL). Retrieved March 7, 2021, from https://​www.​cdc.​gov/​hrqol/​concept.​htm
  3. Testa, M. A., & Simonson, D. C. (1996). Assessment of quality-of-life outcomes. New England Journal of Medicine, 334(13), 835–840.
  4. Meade, T., & Dowswell, E. (2016). Adolescents’ health-related quality of life (HRQoL) changes over time: A three year longitudinal study. Health and Quality of Life Outcomes. https://​doi.​org/​10.​1186/​s12955-016-0415-9View ArticlePubMedPubMed Central
  5. Wu, X. Y., Zhuang, L. H., Li, W., Guo, H. W., Zhang, J. H., Zhao, Y. K., Hu, J. W., Gao, Q. Q., Luo, S., Ohinmaa, A., & Veugelers, P. J. (2019). The influence of diet quality and dietary behavior on health-related quality of life in the general population of children and adolescents: A systematic review and meta-analysis. Quality of Life Research, 28(8), 1989–2015.PubMed
  6. Vajdi, M., & Farhangi, M. A. (2020). A systematic review of the association between dietary patterns and health-related quality of life. Health and Quality of Life Outcomes, 18(1), 337. https://​doi.​org/​10.​1186/​s12955-020-01581-zView ArticlePubMedPubMed Central
  7. Hu, F. B. (2002). Dietary pattern analysis: A new direction in nutritional epidemiology. Current Opinion in Lipidology, 13(1), 3–9.PubMed
  8. Tucker, K. L. (2010). Dietary patterns, approaches, and multicultural perspective. Applied Physiology, Nutrition and Metabolism, 35(2), 211–218.
  9. Ocké, M. C. (2013). Evaluation of methodologies for assessing the overall diet: Dietary quality scores and dietary pattern analysis. The Proceedings of the Nutrition Society, 72(2), 191–199.PubMed
  10. Davison, J., Stewart-Knox, B., Connolly, P., Lloyd, K., Dunne, L., & Bunting, B. (2021). Exploring the association between mental wellbeing, health-related quality of life, family affluence and food choice in adolescents. Appetite, 158, 105020. https://​doi.​org/​10.​1016/​j.​appet.​2020.​105020View ArticlePubMed
  11. Movassagh, E. Z., Baxter-Jones, A. D. G., Kontulainen, S., Whiting, S. J., & Vatanparast, H. (2017). Tracking dietary patterns over 20 years from childhood through adolescence into young adulthood: The Saskatchewan pediatric bone mineral accrual study. Nutrients. https://​doi.​org/​10.​3390/​nu9090990View ArticlePubMedPubMed Central
  12. Lake, A. A., Mathers, J. C., Rugg-Gunn, A. J., & Adamson, A. J. (2006). Longitudinal change in food habits between adolescence (11–12 years) and adulthood (32–33 years): The ASH30 study. Journal of Public Health, 28(1), 10–16.PubMed
  13. Danaei, G., Farzadfar, F., Kelishadi, R., Rashidian, A., Rouhani, O. M., Ahmadnia, S., Ahmadvand, A., Arabi, M., Ardalan, A., Arhami, M., Azizi, M. H., Bahadori, M., Baumgartner, J., Beheshtian, A., Djalalinia, S., Doshmangir, L., Haghdoost, A. A., Haghshenas, R., Hosseinpoor, A. R., … Malekzadeh, R. (2019). Iran in transition. Lancet, 393(10184), 1984–2005.PubMed
  14. Zarei, N., & Ahmadi, A. (2015). Nutrition transition: An intergenerational comparison of dietary habits among women of Shiraz. Iranian Journal of Public Health, 44(2), 269–275.PubMedPubMed Central
  15. Amiri, P., Ardekani, E. M., Jalali-Farahani, S., Hosseinpanah, F., Varni, J. W., Ghofranipour, F., Montazeri, A., & Azizi, F. (2010). Reliability and validity of the Iranian version of the Pediatric Quality of Life InventoryTM 4.0 Generic Core Scales in adolescents. Qual Life Res, 19(10), 1501–1508.PubMed
  16. Varni, J. W., Seid, M., & Kurtin, P. S. (2001). PedsQLTM 4.0: Reliability and validity of the Pediatric Quality of Life InventoryTM Version 4.0 Generic Core Scales in healthy and patient populations. Med Care, 39(8), 800–812.PubMed
  17. Varni, J. W. (1998–2021). The PedsQLTM Measurement Model for the Pediatric Quality of Life Inventory TM. Retrieved March 7, 2021, from https://​www.​pedsql.​org/​about_​pedsql.​html
  18. Varni, J. W., Burwinkle, T. M., Seid, M., & Skarr, D. (2003). The PedsQL 4.0 as a pediatric population health measure: feasibility, reliability, and validity. Ambul Pediatr, 3(6), 329–341.PubMed
  19. Esfahani, F. H., Asghari, G., Mirmiran, P., & Azizi, F. (2010). Reproducibility and relative validity of food group intake in a food frequency questionnaire developed for the Tehran Lipid and Glucose Study. Journal of Epidemiology, 20(2), 150–158.PubMed
  20. Mirmiran, P., Esfahani, F. H., Mehrabi, Y., Hedayati, M., & Azizi, F. (2010). Reliability and relative validity of an FFQ for nutrients in the Tehran lipid and glucose study. Public Health Nutrition, 13(5), 654–662.PubMed
  21. Asghari, G., Rezazadeh, A., Hosseini-Esfahani, F., Mehrabi, Y., Mirmiran, P., & Azizi, F. (2012). Reliability, comparative validity and stability of dietary patterns derived from an FFQ in the Tehran lipid and glucose study. British Journal of Nutrition, 108(6), 1109–1117.
  22. Ghaffarpour, M., Houshiar-Rad, A., & Kianfar, H. (1999). The manual for household measures, cooking yields factors, and edible portion of foods. Agriculture Sciences Press.
  23. Azar, M., & Sarkisian, E. (1980). Food composition table of Iran. Shaheed Beheshti University Press.
  24. Boyce, W., Torsheim, T., Currie, C., & Zambon, A. (2006). The family affluence scale as a measure of national wealth: Validation of an adolescent self-report measure. Social Indicators Research, 78(3), 473–487.
  25. de Onis, M., Onyango, A. W., Borghi, E., Siyam, A., Nishida, C., & Siekmann, J. (2007). Development of a WHO growth reference for school-aged children and adolescents. Bulletin of the World Health Organization, 85(9), 660–667.PubMedPubMed Central
  26. Kelishadi, R., Rabiee, K., Khosravi, A., Famouri, F., Sadeghi, M., Roohafza, H., & Shirani, S. (2001). Assessment of physical activity in adolescents of Isfahan. J Shahrekord Univ Med Sci, 3(2), 55–66.
  27. Aadahl, M., & Jorgensen, T. (2003). Validation of a new self-report instrument for measuring physical activity. Medicine and Science in Sports and Exercise, 35(7), 1196–1202.PubMed
  28. Jalilpiran, Y., Dianatinasab, M., Zeighami, S., Bahmanpour, S., Ghiasvand, R., Mohajeri, S. A. R., & Faghih, S. (2018). Western dietary pattern, but not Mediterranean dietary pattern, increases the risk of prostate cancer. Nutrition and Cancer, 70(6), 851–859.PubMed
  29. Karamati, M., Jessri, M., Shariati-Bafghi, S. E., & Rashidkhani, B. (2012). Dietary patterns in relation to bone mineral density among menopausal Iranian women. Calcified Tissue International, 91(1), 40–49.PubMed
  30. Kim, J. O., & Mueller, C. W. (1978). Factor analysis: Statistical methods and practical issues. SAGE Publications, Inc.
  31. MacCallum, R. C., Widaman, K. F., Zhang, S., & Hong, S. (1999). Sample size in factor analysis. Psychological Methods, 4, 84–99.
  32. Garson, G. D. (2019). Multilevel modeling: Applications in STATA®, IBM® SPSS®, SAS®, R, & HLMTM. SAGE Publications.
  33. Costarelli, V., Koretsi, E., & Georgitsogianni, E. (2013). Health-related quality of life of Greek adolescents: The role of the Mediterranean diet. Quality of Life Research, 22(5), 951–956.PubMed
  34. Knox, E., & Muros, J. J. (2017). Association of lifestyle behaviours with self-esteem through health-related quality of life in Spanish adolescents. European Journal of Pediatrics, 176(5), 621–628.PubMedPubMed Central
  35. Muros, J. J., Salvador Perez, F., Zurita Ortega, F., Gamez Sanchez, V. M., & Knox, E. (2017). The association between healthy lifestyle behaviors and health-related quality of life among adolescents. Journal de Pediatria, 93(4), 406–412.
  36. Zervaki, K., Yiannakouris, N., Sdrali, D., & Costarelli, V. (2017). Diet quality, disordered eating and health-related quality of life in Greek adolescents. Nutr Food Sci, 47(4), 511–521.
  37. Evaristo, O. S., Moreira, C., Lopes, L., Abreu, S., Agostinis-Sobrinho, C., Oliveira-Santos, J., Povoas, S., Oliveira, A., Santos, R., & Mota, J. (2018). Associations between physical fitness and adherence to the Mediterranean diet with health-related quality of life in adolescents: Results from the LabMed physical activity study. European Journal of Public Health, 28(4), 631–635.PubMed
  38. Zurita Ortega, F., Salvador Pérez, F., Knox, E., Gámiz Sánchez, V. M., Chacón-Cuberos, R., Rodríguez Fernández, S., & Muros, J. J. (2018). Physical activity and health-related quality of life in schoolchildren: Structural equations analysis. An de Psicol, 34(2), 385–390.
  39. Esteban-Gonzalo, L., Turner, A. I., Torres, S. J., Esteban-Cornejo, I., Castro-Pinero, J., Delgado-Alfonso, A., Marcos, A., Gomez-Martinez, S., & Veiga, O. L. (2019). Diet quality and well-being in children and adolescents: The UP&DOWN longitudinal study. British Journal of Nutrition, 121(2), 221–231.
  40. Ferrer-Cascales, R., Albaladejo-Blazquez, N., Ruiz-Robledillo, N., Clement-Carbonell, V., Sanchez-SanSegundo, M., & Zaragoza-Marti, A. (2019). Higher adherence to the Mediterranean diet is related to more subjective happiness in adolescents: The role of health-related quality of life. Nutrients. https://​doi.​org/​10.​3390/​nu11030698View ArticlePubMedPubMed Central
  41. Boraita, R. J., Ibort, E. G., Torres, J. M. D., & Alsina, D. A. (2020). Gender differences relating to lifestyle habits and health-related quality of life of adolescents. Child Indicators Research. https://​doi.​org/​10.​1007/​s12187-020-09728-6View Article
  42. Jimenez Boraita, R., Arriscado Alsina, D., Gargallo Ibort, E., & Dalmau Torres, J. M. (2020). Factors associated with adherence to a Mediterranean diet in adolescents from La Rioja (Spain). British Journal of Nutrition. https://​doi.​org/​10.​1017/​S000711452000380​3View Article
  43. Solera-Sanchez, A., Adelantado-Renau, M., Moliner-Urdiales, D., & Beltran-Valls, M. R. (2020). Health-related quality of life in adolescents: Individual and combined impact of health-related behaviors (DADOS study). Quality of Life Research. https://​doi.​org/​10.​1007/​s11136-020-02699-9View ArticlePubMed
  44. Mayo Clinic Staff. (2017). Mediterranean diet: A heart-healthy eating plan. Retrieved March 7, 2021, from https://​www.​mayoclinic.​org/​healthy-lifestyle/​nutrition-and-healthy-eating/​in-depth/​mediterranean-diet/​art-20047801
  45. Davis, C., Bryan, J., Hodgson, J., & Murphy, K. (2015). Definition of the Mediterranean diet; a literature review. Nutrients, 7(11), 9139–9153.PubMedPubMed Central
  46. Bolton, K. A., Jacka, F., Allender, S., Kremer, P., Gibbs, L., Waters, E., & de Silva, A. (2016). The association between self-reported diet quality and health-related quality of life in rural and urban Australian adolescents. Australian Journal of Rural Health, 24(5), 317–325.
  47. Novak, D., Stefan, L., Prosoli, R., Emeljanovas, A., Mieziene, B., Milanovic, I., & Radisavljevic-Janic, S. (2017). Mediterranean diet and its correlates among adolescents in non-mediterranean European countries: A population-based study. Nutrients. https://​doi.​org/​10.​3390/​nu9020177View ArticlePubMedPubMed Central
  48. Munoz, M. A., Fito, M., Marrugat, J., Covas, M. I., Schroder, H., & Regicor & investigators. (2009). Adherence to the Mediterranean diet is associated with better mental and physical health. Br J Nutr, 101(12), 1821–1827.PubMed
  49. Gomez-Pinilla, F. (2008). Brain foods: The effects of nutrients on brain function. Nature Reviews Neuroscience, 9(7), 568–578.PubMedPubMed Central
  50. Casas, R., Sacanella, E., & Estruch, R. (2014). The immune protective effect of the Mediterranean diet against chronic low-grade inflammatory diseases. Endocrine, Metabolic & Immune Disorders: Drug Targets, 14(4), 245–254.
  51. Del Chierico, F., Vernocchi, P., Dallapiccola, B., & Putignani, L. (2014). Mediterranean diet and health: Food effects on gut microbiota and disease control. International Journal of Molecular Sciences, 15(7), 11678–11699.PubMedPubMed Central
  52. Jennings, A., Mulligan, A. A., Khaw, K. T., Luben, R. N., & Welch, A. A. (2020). A Mediterranean diet is positively associated with bone and muscle health in a non-mediterranean region in 25,450 men and women from EPIC-Norfolk. Nutrients. https://​doi.​org/​10.​3390/​nu12041154View ArticlePubMedPubMed Central
  53. Kjelgaard, H. H., Holstein, B. E., Due, P., Brixval, C. S., & Rasmussen, M. (2017). Adolescent weight status: Associations with structural and functional dimensions of social relations. Journal of Adolescent Health, 60(4), 460–468.
  54. Martinez, M. E., Marshall, J. R., & Sechrest, L. (1998). Invited commentary: Factor analysis and the search for objectivity. American Journal of Epidemiology, 148(1), 17–19.PubMed
  55. Ferguson, C. J. (2009). An effect size primer: A guide for clinicians and researchers. Prof Psychol Res Pr, 40(5), 532–538.
  56. Davies, H. T., Crombie, I. K., & Tavakoli, M. (1998). When can odds ratios mislead? BMJ, 316(7136), 989–991.PubMedPubMed Central
  57. Ansari-Moghaddam, A., Rakhshani, F., Shahraki-Sanavi, F., Mohammadi, M., Miri-Bonjar, M., & Bakhshani, N. M. (2016). Prevalence and patterns of tobacco, alcohol, and drug use among Iranian adolescents: A meta-analysis of 58 studies. Children and Youth Services Review, 60, 68–79.
  58. Davis, C. G., Thake, J., & Vilhena, N. (2010). Social desirability biases in self-reported alcohol consumption and harms. Addictive Behaviors, 35(4), 302–311.PubMed
  59. Messeri, P., Cantrell, J., Mowery, P., Bennett, M., Hair, E., & Vallone, D. (2019). Examining differences in cigarette smoking prevalence among young adults across national surveillance surveys. PLoS ONE, 14(12), e0225312. https://​doi.​org/​10.​1371/​journal.​pone.​0225312View ArticlePubMedPubMed Central
  60. Marques, A., Peralta, M., Santos, T., Martins, J., & Gaspar de Matos, M. (2019). Self-rated health and health-related quality of life are related with adolescents’ healthy lifestyle. Public Health, 170, 89–94.PubMed
  61. Dube, S. R., Thompson, W., Homa, D. M., & Zack, M. M. (2013). Smoking and health-related quality of life among US adolescents. Nicotine Tob Res, 15(2), 492–500.PubMed
  62. Coathup, V., Northstone, K., Gray, R., Wheeler, S., & Smith, L. (2017). Dietary patterns and alcohol consumption during pregnancy: Secondary analysis of avon longitudinal study of parents and children. Alcoholism, Clinical and Experimental Research, 41(6), 1120–1128.PubMed
  63. Gutierrez-Pliego, L. E., del Camarillo-Romero, S., Montenegro-Morales, L. P., & de Garduno-Garcia, J. (2016). Dietary patterns associated with body mass index (BMI) and lifestyle in Mexican adolescents. BMC Public Health, 16(1), 850. https://​doi.​org/​10.​1186/​s12889-016-3527-6View ArticlePubMedPubMed Central
  64. Mehio-Sibai, A., Feinleib, M., Sibai, T. A., & Armenian, H. K. (2005). A positive or a negative confounding variable? A simple teaching aid for clinicians and students. Annals of Epidemiology, 15(6), 421–423.PubMed
  65. Khaw, K.-T., Day, N., Bingham, S., & Wareham, N. (2004). Observational versus randomised trial evidence. Lancet, 364(9436), 753–754.PubMed
  66. Morabia, A. (1995). Poppers, Kaposi’s sarcoma, and HIV infection: Empirical example of a strong confounding effect? Preventive Medicine, 24(1), 90–95.PubMed
  67. Allison, C., Colby, S., Opoku-Acheampong, A., Kidd, T., Kattelmann, K., Olfert, M. D., & Zhou, W. (2020). Accuracy of self-reported BMI using objective measurement in high school students. J Nutr Sci. https://​doi.​org/​10.​1017/​jns.​2020.​28View ArticlePubMedPubMed Central
  68. Bonell, C., Jamal, F., Harden, A., Wells, H., Parry, W., Fletcher, A., Petticrew, M., Thomas, J., Whitehead, M., Campbell, R., Murphy, S., & Moore, L. (2013). Systematic review of the effects of schools and school environment interventions on health: Evidence mapping and synthesis. NIHR Journals Library. https://​doi.​org/​10.​3310/​phr01010View Article
Metadata
Title
Dietary patterns and health-related quality of life among Iranian adolescents
Authors
Seyedeh-Elaheh Shariati-Bafghi
Bahram Rashidkhani
Javad Salehi Fadardi
Mohammad Safarian
Javad Edalatian
Golnaz Ranjbar
Mohsen Nematy
Publication date
01-03-2022
Publisher
Springer International Publishing
Published in
Quality of Life Research / Issue 3/2022
Print ISSN: 0962-9343
Electronic ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-021-02942-x

Other articles of this Issue 3/2022

Quality of Life Research 3/2022 Go to the issue

OriginalPaper

Measurement properties of the ICECAP-A capability well-being instrument among dermatological patients

OriginalPaper

Quality of life in urologic cancer patients: importance of and satisfaction with specific quality of life domains

OriginalPaper

Psychometric properties of the spinal cord injury-quality of life (SCI-QOL) Resilience item bank in a sample with spinal cord injury and chronic pain

OriginalPaper

The ICECAP-A instrument for capabilities: assessment of construct validity and test–retest reliability in a general Dutch population

OriginalPaper

Health-related quality of life deviations from population norms in patients with lumbar radiculopathy: associations with pain, pain cognitions, and endogenous nociceptive modulation

OriginalPaper

Quality of life among chronic myeloid leukemia patients in the second-line treatment with nilotinib and influential factors