Magendiran Mugambikai, Appannah Geeta, Emi Nor Aishah, Chin Yit Siew, Shariff Zalilah Mohd, Anuar Zaini Azriyanti, Shamsuddin Nurainul Hana, Suppiah Subapriya, Saini Suraini Mohamad, Thambiah Subashini C, Ching Siew Mooi
Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), 43400, Selangor, Malaysia.
Department of Paediatrics, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
Nutr Metab (Lond). 2024 Sep 4;21(1):71. doi: 10.1186/s12986-024-00832-w.
Little is known on the prospective associations between an empirically derived dietary pattern (DP) and life satisfaction among adolescents. This PUTRA-Adol follow-up study aimed to assess the prospective associations between the empirically derived DP and life satisfaction during adolescence.
A total of 585 and 262 adolescents participated in the baseline PUTRA-Adol study in 2016 and PUTRA-Adol follow-up study in 2019-2020, respectively. These adolescents were recruited from three southern states in peninsular Malaysia, namely Negeri Sembilan, Melaka and Johor. Dietary assessments were estimated using a validated food frequency questionnaire (FFQ) while a Multidimensional Students' Life Satisfaction Scale (MSLSS) was used to measure life satisfaction at baseline in 2016 as well as at follow-up in 2019-2020. A DP characterised by foods high in free sugar and energy dense was identified using reduced rank regression (RRR), cross-sectionally at baseline and was reported elsewhere. Similar RRR analysis was used to find a DP that best explained the variation in response variables linked to poorer life satisfaction, including dietary energy density (DED), fiber density, and percentage of energy from total fat and sugar at the PUTRA-Adol follow-up study. Prospective relationship between adherence to the identified DPs and overall life satisfaction scores as well as its domains between 2016 and 2019-2020 were evaluated using generalized estimating equation models (GEE).
A DP characterized by high intakes of percentage energy from sugar, fibre and low in DED and percentage energy from total fat was identified at the 2019-2020 follow-up. The identified DP explained 11% of total variations in the response variables and was characterized by high intakes of sweets, sugar sweetened beverages (SSB) and fruits. Female adolescents [67.6(8.9)] had a mean (SD) of life satisfaction that was higher than male adolescents [67.5(10.8)] p < 0.05 in 2019-2020. Prospective analysis found a significant positive association between the identified DP and school domain, in male adolescents (β = 0.117; 95% CI 0.001, 0.234) and an inverse relationship between the DP z-score and self-domain in all adolescents (β = - 0.060; 95% CI - 0.115, - 0.005) from 2016 to 2019-2020.
An increasing score for the predominant 'High sugar and High fibre' DP was prospectively associated with increasing life satisfaction score for the school domain in male adolescents and decreasing score for self-domain in both male and females during adolescence. A lifestyle intervention targeting reduced dietary intakes, particularly sugar, may improve life satisfaction in adolescents and promote healthier future without compromising dietary intakes for chronic disease prevention later in life.
关于根据经验得出的饮食模式（DP）与青少年生活满意度之间的前瞻性关联，人们了解甚少。这项PUTRA - Adol随访研究旨在评估根据经验得出的DP与青少年时期生活满意度之间的前瞻性关联。
分别有585名和262名青少年参加了2016年的PUTRA - Adol基线研究和2019 - 2020年的PUTRA - Adol随访研究。这些青少年是从马来西亚半岛的三个南部州招募的，即森美兰州、马六甲州和柔佛州。使用经过验证的食物频率问卷（FFQ）进行饮食评估，同时使用多维学生生活满意度量表（MSLSS）来测量2016年基线以及2019 - 2020年随访时的生活满意度。在基线时通过降秩回归（RRR）横断面确定了一种以游离糖含量高和能量密集的食物为特征的DP，并已在其他地方报道。在PUTRA - Adol随访研究中，使用类似的RRR分析来找出最能解释与较差生活满意度相关的响应变量变化的DP，包括饮食能量密度（DED）、纤维密度以及来自总脂肪和糖的能量百分比。使用广义估计方程模型（GEE）评估2016年至2019 - 2020年期间对所确定的DP的依从性与总体生活满意度得分及其各个领域之间的前瞻性关系。
在2019 - 2020年随访中确定了一种以糖的能量百分比摄入量高、纤维含量高、DED低以及总脂肪的能量百分比低为特征的DP。所确定的DP解释了响应变量总变异的11%，其特征是甜食、含糖饮料（SSB）和水果的摄入量高。2019 - 2020年，女性青少年的生活满意度平均（标准差）为[67.6(8.9)]，高于男性青少年[67.5(10.8)]，p < 0.05。前瞻性分析发现，在男性青少年中，所确定的DP与学校领域之间存在显著正相关（β = 0.117；95%置信区间0.001，0.234），并且在2016年至2019 - 2020年期间，DP z评分与所有青少年的自我领域之间存在负相关（β = - 0.060；95%置信区间 - 0.115， - 0.005）。
在青少年时期，占主导地位的“高糖和高纤维”DP得分增加与男性青少年学校领域的生活满意度得分增加以及男性和女性自我领域得分降低存在前瞻性关联。针对减少饮食摄入量，特别是糖摄入量的生活方式干预，可能会提高青少年的生活满意度，并在不影响日后预防慢性病饮食摄入量的情况下促进更健康的未来。
