The impact of energy balance-related behaviours on health-related quality of life according to body composition and maturation

• Autor(a) principal: Marcelino, Ana Lúcia Silva
• Data de Publicação: 2020
• Idioma: eng
• Título da fonte: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
• Texto Completo: http://hdl.handle.net/10400.5/23915
• topic: Children and adolescentes; Diet and nutrition; Energy balance; Health-related quality of life; Physical activity; Atividade física; Balanço energético; Crianças e adolescentes; Dieta e nutrição; Qualidade de vida relacionada com a saúde; Domínio/Área Científica::Ciências Médicas::Outras Ciências Médicas

Adolescence is marked by a set of biological, emotional and social changes. As biological maturation progress, a decline in diet quality and physical activity (PA) levels allied with a lower quality of life perception, is observed. The shift in diet quality and nutrition intakes along with physical inactivity, both recognized as the major energy balance-related behaviours, may potentially cause energy imbalances, critical to optimal growth and development of children and adolescents. As a result, if energy intake (EI) persistently exceeds energy expenditure (EE), during maturation, fat will be stored, increase, and quietly give rise to obesity and other health problems. Together, these aspects highlight the need to track these health-related behaviours, during childhood and adolescence, in order to improve overall health and well-being. Recent national surveys reveal that Portuguese adolescents do not meet the recommendations for health concerning diet and PA. Although this information, on diet and PA of Portuguese adolescents, is of great importance and current interest does not address inter-individual differences in terms of maturity and body composition. As far as we know there is still a great lack of knowledge about biological variables, such as maturity and body composition, on energy balance-related variables, that is diet and PA behavious. The meaning of those variables on psychosocial aspects of health still remains underexplored despite the current great interest on adolescent’s perceptions of life. Based on that, we hipothesized that adolescents with higher diet quality or that meet the dietary and nutrition recommendations for health would reveal better outcomes in specific lifestyle variables, such as higher levels of PA, and therefore better perceive its health-related quality of life (HRQoL). The present study aimed to explore the impact of energy balance-related variables on HRQoL, according to body composition and maturity. Four original research were developed considering the timeframe we would have to explain our goals. The lack of a valid food frequency questionnaire for Portuguese adolescents, led us to develop a relative validity of a semi quantitative food frequency questionnaire (SQ-PortFood-FQ) in the first study. The SQ-PortFood FQ was proven to be valid for energy intake and most studied nutrients when compared with the multiple-pass 24-hour recall. The nutritional data contributed to characterize the Portuguese adolescents’ diet quality according to the diet quality index-international (DQI-I) in the second original research. The DQI-I was chosen because it allows the characterization of both recommendations for health and prevention for diseases. Also, it permits comparisons between 6 countries. Our results showed that Portuguese adolescents have poor overall diet quality, as described for Spanish adolescents. As regards to national comparisons, adolescents reported similar results to other national outcomes, being especially relevant the decrease of fruits and vegetables, grains and fibre consumption, and the increase of saturated fat, sodium, and “empty calorie foods”. Particularly relevant were the associations between higher levels of PA and grain and calcium intakes in girls, which may reflect the tendency of diet and PA variables to cluster. Also, our results showed that older boys with lower fat mass (FM) showed better adequacy for grain and fibre intakes, whereas worse compliance for cholesterol. Further analyses explored the implication of diet (as macronutrients) and PA in the ratio of energy intakes and expenditures, when considering biological variables, as body composition and maturity. Our results showed that fat free mass (FFM), and not only FM, accounts largely for the differences in EE, probably due to its impact on rest EE. Also, our results suggest that maturity moderates the relationship between EI/EE and body mass index, FFM and PA, especially evident among late maturers with higher FFM and probably with higher PA. Together, our findings concluded in the fourth original research that maturity and PA are contributors in HRQoL dimensions. More specifically our results showed that adolescents who have a higher level of PA and increased maturity reported higher perceptions of school environment and social acceptance and bullying, respectively. Concerning diet and HRQoL, a relatively unexplored topic, it was possible to ascertain that the intake of unhealthy foods was negatively correlated with some HRQoL dimensions, whilst healthy foods showed positive correlations with some HRQoL dimensions. As a conclusion, fat free mass and PA were two of the major influences in the relationship between EI and EE, and especially influenced by maturity status. Thereafter, PA and maturity, nor diet quality, were positively associated with perceptions of school environment and social acceptance and bullying, respectively. Few healthy foods were positively correlated with HQRoL dimensions, whereas unhealthy foods showed opposite relationships.