Cross-sectional and prospective association between an empirically derived dietary patterns and life satisfaction among adolescence

In Malaysia, little is known about the prospective connections between adolescents' life satisfaction and an empirically derived dietary pattern (DP). PUTRA-Adol study aimed to assess the cross sectional and prospective associations between the empirically derived dietary pattern and life satisfaction among adolescents. A total of 262 with 79 males and 183 females from 585 adolescents from the baseline study agreed to participate and were followed-up at 16 years old from three southern states in peninsular Malaysia, namely Negeri Sembilan, Melaka and Johor. Majority of the adolescents were Malays (84.8%), followed by Chinese (10.1%), Indian (3.8%) and other race (1.3%). Most of the adolescents’ parents reported to have a monthly income of less than the median monthly household income of RM 5, 873 (90.1%). The total prevalence of overweight and obesity among the adolescents were 11.8% and 16.1% respectively. The data collection of the study was conducted from October 2019 to July 2021 in both physical and online mode. The overall response rate was 45%. The followed-up adolescents provided accurate dietary data, which were evaluated utilizing a verified food frequency questionnaire (FFQ). The reduced rank regression (RRR) approach was used to find a DP that best explained the variation in response variables, such as dietary energy density, fiber density, and the percentage of energy from total fat and sugar. The identified ‘High Sugar, High Fibre, Low Energy Density and Low Fat’ DP, were characterized by high intakes of sweets, sugar-sweetened beverages (SSB) and fruits and low intakes of meat and meat-based dishes, cereal and cereal-based dishes, and seafood and shellfish which explained a 11% of the variation in all response variables. A Multidimensional Students' Life Satisfaction Scale (MSLSS) was used to measure life satisfaction and it had five domains: family, school, self, friends, and living. Prospective relationship between the DP and life satisfaction scores were evaluated using generalized estimating equation models (GEE). Regression models were used to investigate the associations between DP and life satisfaction level and were adjusted for race, school location, maternal education, and dietary misreporting. The factor loadings for the identified DP in 2016 and 2019 were comparable in the highest intake of key food group which is sugar sweetened beverages (SSB) in 2016 and sweets in 2019. Moreover, both boys’ and girls' life satisfaction scores decreased when compared to 2016. In 2019, girls had a mean (SD) of life satisfaction that was higher than boys' [67.6(8.9)] [67.5(10.8)], p 0.05. The self-domain score was prospectively lower in both boys and girls when their DP score increased (= -0.060; 95% CI: -0.115, -0.005). Alternatively, the school domain score was prospectively higher in boys when their DP score increased (= 0.117; 95% CI: 0.001, 0.234). The implications of these findings may suggest that, as part of a lifestyle intervention, decreasing the consumption of sugary food and beverages can increase adolescents' levels of life satisfaction, particularly of those self and school domain.

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