Diet quality among adolescents in the public education system in a municipality in Southern Brazil: a cross-sectional study, 2019

Etiene Dias Alves

Universidade Federal de Pelotas, Programa de Pós-Graduação em Nutrição e Alimentos, Pelotas, RS, Brazil

Caroline Cardozo Bortolotto

Universidade Federal de Pelotas, Programa de Pós-Graduação em Epidemiologia, Pelotas, RS, Brazil

Nathalia Brandão Peter

Faculdade Anhanguera de Pelotas, Departamento de Nutrição, Pelotas, RS, Brazil

Cristina Corrêa Kaufmann

Universidade Federal de Pelotas, Faculdade de Nutrição, Pelotas, RS, Brazil

Gicele Costa Mintem

Universidade Federal de Pelotas, Programa de Pós-Graduação em Nutrição e Alimentos, Pelotas, RS, Brazil

Renata Moraes Bielemann

Universidade Federal de Pelotas, Programa de Pós-Graduação em Nutrição e Alimentos, Pelotas, RS, Brazil

Ludmila Correa Muniz

Universidade Federal de Pelotas, Programa de Pós-Graduação em Nutrição e Alimentos, Pelotas, RS, Brazil

Authors’ Contribution

Muniz LC, Kaufmann CC, Bielemann RM and Mintem GC collaborated with the study conception and design. Alves ED collaborated with data collection, drafting and interpretation of the results. Bortolotto CB performed the statistical analysis. Bortolotto CB and Peter NB collaborated with the interpretation of the results and critical reviewing of the manuscript content. All authors have approved the final version of the manuscript and declared themselves to be responsible for all aspects of the work, including ensuring its accuracy and integrity.

Conflicts of Interest

The authors declared that there is no conflict of interest.

Index components	Score by consumotion category
Healthy^a	0 = did not eat in the last week
Fresh fruit or fruit salad (fruit); cooked greens and vegetables; raw salad (raw vegetables); beans; milk/ yogurt.	1 = ate 1-3 days/week
	2 = ate 4-6 days/week
	3 = ate every day
Unhealthy^b	0 = ate every day
French fries, potato packets and fried snacks (fried snacks), filled or sweet crackers/biscuits, candies and chocolates (processed sweets), savory crackers/biscuits or salted packet snacks (processed snacks), hamburger and charcuteries; soft drink.	2 = ate 1-3 days/week
	1 = ate 4-6 days/week
	3 = did not eat in the last week

Characteristics	N^a	%
Sex
Male	391	48.4
Female	417	51.6
Age group (in full years)
13-14	314	38.9
15	336	41.6
16-19	158	19.5
Race/skin color
White	488	61.3
Black/Asian/Brown/Indigenous	308	38.7
Maternal schooling (in complete years)
<8	153	24.4
8-11	106	16.9
≥12	368	58.7
Eat family meal
No	117	14.6
Yes	684	85.4
Tobacco experimentation
No	637	81.8
Yes	142	18.2
Alcohol experimentation
No	208	26.4
Yes	581	73.6
Leisure-time physical activity
Inactive	436	54.2
Active^b	369	45.8

Index components	Score range	Diet quality scores			p-value^b
		Low	Intermediate	High
		Mean (SD^a)	Mean (SD^a)	Mean (SD^a)
Healthy^c
Fruit	0 - 3	0.89 (0.84)	1.30 (0.86)	1.99 (0.90)	<0.001
Cooked greens or vegetables	0 - 3	0.75 (0.73)	1.31 (0.86)	2.10 (0.89)	<0.001
Raw vegetables	0 - 3	0.76 (0.81)	1.14 (0.93)	1.91 (0.99)	<0.001
Beans	0 - 3	1.36 (0.97)	1.81 (0.93)	2.20 (0.88)	<0.001
Milk/yogurt	0 - 3	1.21 (1.10)	1.52 (1.12)	1.95 (1.09)	<0.001
Unhealthy^d
Fried snacks	0 - 3	1.62 (0.79)	2.09 (0.58)	2.31 (0.61)	<0.001
Processed sweets	0 - 3	1.05 (0.81)	1.67 (0.79)	1.92 (0.72)	<0.001
Processed snacks	0 - 3	1.49 (0.88)	2.03 (0.73)	2.15 (0.71)	<0.001
Hamburger and charcuteries	0 - 3	1.46 (0.86)	1.78 (0.87)	2.18 (0.82)	<0.001
Soft drink	0 - 3	1.28 (0.89)	1.78 (0.80)	2.20 (0.71)	<0.001
Total	0 - 30	11.8 (2.14)	16.4 (1.13)	20.9 (2.06)

Characteristics	Intermediate diet quality^a
Characteristics	Crude OR^b (95%CI^c)	p-value^d	Adjusted OR^b (95%CI^c)	p-value^d
Level 1
Sex		0.450		0.450
Male	1.00		1.00
Female	0.88 (0.64;1.22)		0.88 (0.64;1.22)
Age group (in full years)		0.399		0.352
13-14	1.00		1.00
15	0.83 (0.57;1.19)		0.82 (0.57;1.18)
16-19	0.93 (0.60;1.44)		0.92 (0.59;1.42)
Race/skin color		0.624		0.549
White	1.00		1.00
Black/Asian/Brown/Indigenous	1.09 (0.78;1.52)		1.11 (0.79;1.56)
Maternal schooling (in complete years)		0.401^d		0.362^e
<8	1.00		1.00
8-11	0.92 (0.51;1.66)		0.89 (0.49;1.60)
≥12	0.83 (0.53;1.30)		0.81 (0.51;1.28)
Level 2
Eat family meal		0.652		0.902
No	1.00		1.00
Yes	1.11 (0.71;1.74)		1.03 (0.64;1.66)
Tobacco experimentation		0.008		0.009
No	1.00		1.00
Yes	1.74 (1.15;2.63)		1.73 (1.15;2.62)
Alcohol experimentation		0.200		0.552
No	1.00		1.00
Yes	0.78 (0.53;1.14)		0.89 (0.59;1.32)
Leisure-time physica activity^f		0.204		0.189
No	1.00		1.00
Yes	1.24 (0.89;1.71)		1.25 (0.90;1.75)

Characteristics	High diet quality^a
Characteristics	Crude OR^b (95%CI^c)	p-value^d	Adjusted OR^b (95%CI^c)	p-value^d
Level 1
Sex		0.092		0.577
Male	1.00		1.00
Female	0.74 (0.68;1.13)		0.90 (0.61;1.31)
Age group (in full years)		0.254		0.427
13-14	1.00		1.00
15	1.02 (0.69;1.50)		1.00 (0.68;1.48)
16-19	0.70 (0.42;1.16)		0.69 (0.41;1.13)
Race/skin color		0.385		0.549
White	1.00		1.00
Black/Asian/Brown/Indigenous	1.17 (0.82;1.69)		1.24 (0.86;1.79)
Maternal schooling (in complete years)		0.643^d		0.445^e
<8	1.00		1.00
8-11	1.05 (0.56;1.96)		0.98 (0.52;1.86)
≥12	0.91 (0.56;1.47)		0.84 (0.51;1.38)
Level 2
Eat family meal		0.315		0.979
No	1.00		1.00
Yes	1.30 (0.78;2.15)		0.99 (0.58;1.69)
Tobacco experimentation		<0.001		<0.001
No	1.00		1.00
Yes	2.76 (1.66;4.59)		2.92 (1.74;4.92)
Alcohol experimentation		0.027		0.138
No	1.00		1.00
Yes	0.63 (0.42;0.95)		0.73 (0.47;1.11)
Leisure-time physica activity^f		0.012		0.007
No	1.00		1.00
Yes	1.57 (1.10;2.23)		1.65 (1.15;2.38)

Brasil