Patterns of lifestyle behaviors, self-efficacy for nutrition, and dietary diversity among adolescents of the Chamba and Mandi districts of Himachal Pradesh
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20250308Keywords:
Adolescent, Diet, Food quality, Nutrition status, Self-efficacyAbstract
Background: The growing unhealthy lifestyle among adolescents, including decreased vegetable intake, high calorie-rich diet, and inadequate physical activity, are posing challenges. However, there is a lack of data on how dietary diversity and self-efficacy, crucial in determining food intakes, are interlinked and affect body mass index (BMI), an indicator of malnutrition. Hence, we aimed to assess unmarried boys’ and girls’ (10-19 years) lifestyle behaviors, self-efficacy for nutrition, dietary diversity, and their association with BMI in Himachal Pradesh.
Methods: It was a cross-sectional quantitative study conducted in the Mandi and Chamba districts using a structured questionnaire. Self-efficacy was measured using a five-point Likert-scale-based tool, and dietary diversity was calculated from 10 major food groups consumed in the last 24h. Besides socio-demographic details, weight and height measurements were obtained to calculate the BMI. We performed linear regression analysis to assess the associations of self-efficacy, BMI, and dietary diversity with socio-demographic determinants.
Results: Out of 942 adolescents, 473 (50.2%) were girls and 469 (49.8%) were boys. Marginalized populations had lower dietary diversity than the non-marginalized. Girls had a lower dietary diversity than boys. Adolescents possessing below-the-poverty-line cards had a lower self-efficacy than those possessing above-the-poverty-line cards. Adolescents who had higher dietary diversity had a lower BMI compared to their counterparts (beta coefficient (95% confidence interval); p value -0.30 (-0.51, -0.10); 0.004).
Conclusions: Dietary diversity and BMI are affected by socio-demographic characteristics like education, income, religion, and social caste. BMI is inversely associated with dietary diversity and conversely, positively associated with self-efficacy.
Metrics
References
Soliman AT, Alaaraj N, Noor Hamed, Alyafei F, Ahmed S, Shaat M, et al. Review Nutritional interventions during adolescence and their possible effects. Acta Biomed. 2022;93(1):e2022087.
National Institute of Nutrition. Dietary guidelines for Indians. ICMR. 2024.
Ministry of Health and Family Welfare (MoHFW), Government of India, UNICEF and Population Council. Comprehensive National Nutrition Survey (CNNS) National Report. New Delhi. 2019.
Pandurangi R, Mummadi MK, Challa S, Reddy NS, Kaliaperumal V, Khadar Babu C, et al. Burden and predictors of malnutrition among Indian adolescents (10-19 years): insights from Comprehensive National Nutrition Survey Data. Front Publ Heal. 2022;10:877073. DOI: https://doi.org/10.3389/fpubh.2022.877073
Vispute S, Mandlik R, Sanwalka N, Gondhalekar K, Khadilkar A. Dietary diversity and food variety scores and their association with nutrition and health status of Indian children and adolescents: A multicenter study. Nutrition. 2023;111:112039. DOI: https://doi.org/10.1016/j.nut.2023.112039
Green R, Milner J, Joy EJ, Agrawal S, Dangour AD. Dietary patterns in India: a systematic review. Brit J Nutrit. 2016;116(1):142-8. DOI: https://doi.org/10.1017/S0007114516001598
Verger EO, Le Port A, Borderon A, Bourbon G, Moursi M, Savy M, et al. Dietary diversity indicators and their associations with dietary adequacy and health outcomes: a systematic scoping review. Adv Nutrit. 2021;12(5):1659-72. DOI: https://doi.org/10.1093/advances/nmab009
Singh AP, Misra G. Adolescent lifestyle in India: Prevalence of risk and promotive factors of health. Psychol Developing Societies. 2012;24(2):145-60. DOI: https://doi.org/10.1177/097133361202400203
Seema S, Rohilla KK, Kalyani VC, Babbar P. Prevalence and contributing factors for adolescent obesity in present era: Cross-sectional Study. J Family Med Primary Care. 2021;10(5):1890-4. DOI: https://doi.org/10.4103/jfmpc.jfmpc_1524_20
Ramadass, S, Gupta, Sanjeev Kumar, Nongkynrih, Baridalyne. Adolescent health in urban India. J Family Med Prim Care. 2017;6(3):468-76. DOI: https://doi.org/10.4103/2249-4863.222047
Gupta A, Sarker G, Das P, Shahnawaz K, Pal R. Prevalence of lifestyle associated cardiovascular risk factors among adolescent students of rural Bengal. J Integrated Heal Sci. 2013;1(2):69-75. DOI: https://doi.org/10.4103/2347-6486.239497
Efthymiou V, Charmandari E, Vlachakis D, Tsitsika A, Pałasz A, Chrousos G, et al. Adolescent self-efficacy for diet and exercise following a school-based multicomponent lifestyle intervention. Nutrients. 2021;14(1):97. DOI: https://doi.org/10.3390/nu14010097
Park J, Lee H. The relationship between depression, self-efficacy, social support, and health-promoting behaviors in Korean single-household women. Preventive Med Rep. 2023;32:102156. DOI: https://doi.org/10.1016/j.pmedr.2023.102156
Tavakoly Sany SB, Ahangari H, Rasoulifar A, Salimi M, Jamali J, Tehrani H. Nutrition self-efficacy intervention to improve nutritional status of Iranian older adults. J Health Popul Nutr. 2024;43(1):22 DOI: https://doi.org/10.1186/s41043-024-00519-1
Sharma S, Akhtar F, Singh RK, Mehra S. Relationships between nutrition-related knowledge, attitude, and self-efficacy among adolescents: A community-based survey. J Family Med Prim Care 2019;8:2012-6. DOI: https://doi.org/10.4103/jfmpc.jfmpc_217_19
Nithya DJ, Bhavani RV. Dietary diversity and its relationship with nutritional status among adolescents and adults in rural India. J Biosocial Sci. 2018;50(3):397-413. DOI: https://doi.org/10.1017/S0021932017000463
Aurino E. Do boys eat better than girls in India? Longitudinal evidence on dietary diversity and food consumption disparities among children and adolescents. Economics Human Biol. 2017;25:99-111. DOI: https://doi.org/10.1016/j.ehb.2016.10.007
Government of Himachal Pradesh. Economic Survey 2022-23. Available at: https://himachalservices.nic.in/economics/en-IN/eco-survey-2022-23.html. Accessed on 04 November 2024.
Khandelwal R, Gupta A, Singh G, Kapil U, Pandey RM, Upadhyay AD. Nutrient intake of adolescents in rural area of Himachal Pradesh. Indian J Community Heal. 2017;29(2):194-7. DOI: https://doi.org/10.47203/IJCH.2017.v29i02.013
Das G, Pathania R, Das G. Assessment of dietary pattern of adolescents in Himachal Pradesh of India. J Paramed Sci. 2016;7(3):1-7
Biswas S, Pramanik KR, Sonowal CJ. Marginalised social groups differentials in nutritional status (BMI) among reproductive-aged women in West Bengal. BMC Public Health. 2023;23(1):842. DOI: https://doi.org/10.1186/s12889-023-15635-6
Bhati D, Tripathy A, Mishra PS. Contribution of socio-economic and demographic factors to the trend of adequate dietary diversity intake among children (6-23 months): evidence from a cross-sectional survey in India. BMC Nutr. 2022;8(1):153. DOI: https://doi.org/10.1186/s40795-022-00655-z
Shadap AM, Pala VE. Nutritional intake and consumption pattern in the states of Himachal Pradesh and Meghalaya. NEHU J. 2017;15(2):15-28.
Vaidya V. A situation analysis of women and girls in Himachal Pradesh: 2004. Available at: https://ncwapps.nic.in/pdfReports/Gender_Profile_Himachal_Pradesh.pdf. Accessed on November 4, 2024.
Oldewage-Theron WH, Egal AA. A cross-sectional baseline survey investigating the relationship between dietary diversity and cardiovascular risk factors in women from the Vaal Region, South Africa. J Nurs Educ Pract. 2013;4:50. DOI: https://doi.org/10.5430/jnep.v4n1p50
Azadbakht L, Esmaillzadeh A. Dietary diversity score is related to obesity and abdominal adiposity among Iranian female youth. Public Health Nutr. 2011;14:62-9. DOI: https://doi.org/10.1017/S1368980010000522
Sung M, Jain A, Kumar A, Kim R, Kulkarni B, Subramanian SV. Patterns of change in the association between socioeconomic status and body mass index distribution in India, 1999-2021. J Global Health. 2024;14:04171. DOI: https://doi.org/10.7189/jogh.14.04171
Sung M, Kumar A, Mishra R, Kulkarni B, Kim R, Subramanian SV. Temporal change in prevalence of BMI categories in India: patterns across States and Union territories of India, 1999-2021. BMC Public Health. 2024;24(1):1322. DOI: https://doi.org/10.1186/s12889-024-18784-4
Sharma S, Akhtar F, Singh RK, Mehra S. Dietary Intake across Reproductive Life Stages of Women in India: A Cross-Sectional Survey from 4 Districts of India. J Nutr Metab. 2020;2020:9549214. DOI: https://doi.org/10.1155/2020/9549214
Raj BM, Suhasini K, Lavanya T, Reddy DS, Supriya K. Dietary Diversity Score among Beneficiaries and Non-beneficiaries of Public Distribution System in Rural and Urban Telangana. Eur J Nutrit Food Safety. 2024;16(6):18-25. DOI: https://doi.org/10.9734/ejnfs/2024/v16i61436
Pandey K. Socio-Economic Background and Use of Latrine in Rural India: An In-Depth Analysis. J Rural Development. 2016;35(3):421-34.
Prestwich A, Kellar I, Parker R, MacRae S, Learmonth M, Sykes B, et al. How can self-efficacy be increased? Meta-analysis of dietary interventions. Heal Psychol Rev. 2014;8(3):270-85. DOI: https://doi.org/10.1080/17437199.2013.813729
Kasmaei P, Mirzajanzadeh P, Rouhani-Tonekaboni N. Self-efficacy and nutritional behaviors in young adolescents: A Model-guided Study. Medical Sci. 2019;23(98):432-0.
Bhawra J, Khadilkar A, Krishnaveni GV, Kumaran K, Katapally TR. The 2022 India Report Card on physical activity for children and adolescents. J Exerc Sci Fit. 2023;21(1):74-82. DOI: https://doi.org/10.1016/j.jesf.2022.10.013