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Abstract
Purpose:
This study examined the relationship among the use of food-related content (FRC), dietary behaviors, and dietary self-efficacy to demonstrate the need for nutrition education to help adolescents build healthy eating habits and provide evidence for developing nutrition education programs for adolescents.
Methods:
Three hundred and eighty-one high school students in Seoul and Gyeonggi areas participated in the study. The subjects were divided into three groups (low, medium, and high) according to the level of use of the FRC, and their general characteristics, dietary behaviors, and dietary self-efficacy were analyzed. Correlation analysis was performed between FRC usage, dietary behaviors, and dietary self-efficacy, and the mediating effects of dietary self-efficacy on the relationship between the level of the use of FRC and dietary behaviors were estimated.
Results:
A higher level of FRC usage was associated with an increased daily cost of eating out and snacking, but no difference was observed in the BMI range. The subjects in a group with a high level of FRC usage ate convenience store or instant foods instead of homemade meals (p=0.033), had a late-night meal or snack (p=0.024), and turned to emotional eating under stress (p<0.001) more than those in the low level group. In addition, the high level group checked the nutrition facts label more carefully when purchasing processed foods (p=0.016) and exercised at least 30 minutes daily, not considering physical education classes (p=0.057). The higher level of FRC use, the lower the dietary self-efficacy, whereby the subscales ‘environmental stimulus control efficacy’ and ‘affective factor control efficacy’ showed complete mediating effects.
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Fig. 1
The mediating effect models for dietary self-efficacy on the path from the level of food-related content usage (predictor) to dietary behaviors (outcome): (A) Environmental stimulus control efficacy subscale; (B) Affective factor control efficacy subscale. # () indicates the path coefficient when controlled by dietary self-efficacy (mediator).
Table 1.
General characteristics of the subjects and the use of food-related content
| Variable | Number (Total: 381) | Level of food-related content usage | (p-value) χ2 | |||
|---|---|---|---|---|---|---|
| Low (n = 126) | Medium (n = 144) | High (n = 111) | ||||
| Sex | Male | 188 (49.3) | 81 (64.3) | 71 (49.3) | 36 (32.4) | 23.955 |
| Female | 193 (50.7) | 45 (35.7) | 73 (50.7) | 75 (67.6) | (< 0.001∗∗∗) | |
| Grade | 1st | 171 (44.9) | 69 (54.8) | 64 (44.4) | 38 (34.2) | 10.07 |
| 2nd | 210 (55.1) | 57 (45.2) | 80 (55.6) | 73 (65.8) | (0.007∗∗) | |
| BMI1) | Underweight | 45 (11.8) | 15 (11.9) | 20 (13.9) | 10 (9.0) | 6.876 |
| Normal weight | 227 (59.6) | 69 (54.8) | 87 (60.4) | 71 (64.0) | (0.332) | |
| Overweight | 45 (11.8) | 13 (10.3) | 18 (12.5) | 14 (12.6) | ||
| Obese | 64 (16.8) | 29 (23.0) | 19 (13.2) | 16 (14.4) | ||
| Spending on eating out and | < 4,000 | 186 (48.8) | 80 (63.5) | 65 (45.1) | 41 (36.9) | 20.083 |
| snacking (won/day) | 4,000 ~ 8,000 | 141 (37.0) | 33 (26.2) | 61 (42.4) | 47 (42.3) | (0.002∗∗) |
| > 8,000 | 54 (14.2) | 13 (10.3) | 18 (12.5) | 23 (20.7) | ||
Table 2.
Dietary behaviors and the level of food-related content usage1)
| Item | Level of food-related content usage | F (p-value) | ||
|---|---|---|---|---|
| Low (n = 126) | Medium (n = 144) | High (n = 111) | ||
| 1. Do you eat three meals a day? | 3.33 ± 1.51b | 2.90 ± 1.41a | 3.07 ± 1.26ab | 3.270 (0.039∗) |
| 2. Do you always have breakfast? | 3.21 ± 1.57 | 2.79 ± 1.54 | 2.86 ± 1.40 | 2.890 (0.057) |
| 3. Do you have a regular meal time? | 3.07 ± 1.38b | 2.70 ± 1.19a | 3.07 ± 1.25b | 3.807 (0.023∗) |
| 4. Do you eat a moderate amount without overeating or binge eating? | 3.57 ± 1.14 | 3.41 ± 0.98 | 3.25 ± 0.91 | 2.915 (0.055) |
| 5. Do you take enough time to eat? (20 minutes or more) | 3.07 ± 1.37 | 3.01 ± 1.16 | 3.12 ± 1.12 | 0.263 (0.769) |
| 6. Do you eat grains in every meal? | 3.83 ± 1.07 | 3.55 ± 1.12 | 3.55 ± 1.17 | 2.561 (0.079) |
| 7. Do you eat protein in every meal? | 3.71 ± 1.04 | 3.46 ± 1.02 | 3.53 ± 0.98 | 2.075 (0.127) |
| 8. Do you eat vegetables in every meal? | 3.06 ± 1.22 | 3.13 ± 1.12 | 3.26 ± 1.06 | 0.915 (0.401) |
| 9. Do you eat fruits every day? | 3.12 ± 1.31 | 3.11 ± 1.14 | 3.23 ± 1.10 | 0.401 (0.670) |
| 10. Do you eat milk and other dairy products? | 3.31 ± 1.34 | 3.21 ± 1.14 | 3.38 ± 1.10 | 0.655 (0.520) |
| 11. Do you ever replace meals with convenience store foods or instant foots?# | 3.10 ± 1.14b | 2.99 ± 1.03ab | 2.75 ± 1.01a | 3.437 (0.033∗) |
| 12. Do you often eat fast food?# | 3.53 ± 0.94 | 3.50 ± 0.90 | 3.27 ± 1.10 | 2.496 (0.084) |
| 13. Do you often eat sweets (cookies, candies, chocolates, doughnuts, cakes, etc.) as snacks?# | 3.15 ± 1.15b | 3.21 ± 1.04b | 2.81 ± 1.00a | 4.861 (0.008∗∗) |
| 14. Do you often eat instant noodles?# | 3.31 ± 1.01 | 3.18 ± 1.04 | 3.08 ± 0.98 | 1.527 (0.219) |
| 15. Do you often drink soda?# | 2.70 ± 1.13 | 2.90 ± 1.10 | 2.69 ± 1.01 | 1.603 (0.203) |
| 16. Do you check the nutrition facts label when buying processed foods? | 1.98 ± 1.19a | 2.11 ± 1.08a | 2.41 ± 1.25b | 4.159 (0.016∗) |
| 17. Do you often have a late-night meal or snack?# | 3.91 ± 1.13b | 3.72 ± 1.03ab | 3.52 ± 1.13a | 3.770 (0.024∗) |
| 18. Do you eat compulsively under stress?# | 4.12 ± 1.18b | 3.87 ± 1.14b | 3.27 ± 1.20a | 16.289 (< 0.001∗∗∗) |
| 19. Do you exercise at least 30 minutes a day, not considering physical education classes? | 2.48 ± 1.33 | 2.76 ± 1.36 | 2.88 ± 1.35 | 2.893 (0.057) |
| 20. Do you wash your hands thoroughly before eating a meal? | 3.35 ± 1.23 | 3.47 ± 1.16 | 3.47 ± 1.11 | 0.452 (0.637) |
| Total score | 64.92 ± 10.78 | 62.96 ± 9.44 | 62.50 ± 8.93 | 2.142 (0.119) |
1) The scores of the items regarding dietary behaviors are assessed on a 5-point Likert scale, whereby the higher the score, the better the dietary behaviors [1 = not at all, 2 = very little (1 ~ 2 times a week), 3 = somewhat (3 ~ 4 times a week), 4 = to a great extent (5 ~ 6 times a week), 5 = always (everyday)].
Table 3.
Taste and cooking method preferences and the level of food-related content usage1)
Table 4.
Dietary self-efficacy and the level of food-related content usage1)
| Variable | Level of food-related content usage | F (p-value) | |||
|---|---|---|---|---|---|
| Low (n = 126) | Medium (n = 144) | High (n = 111) | |||
| Food intake control efficacy | 1. Can you eat three meals a day at scheduled times? | 2.74 ± 1.00 | 2.53 ± 0.84 | 2.69 ± 0.83 | 1.943 (0.145) |
| 2. Can you lower the pace of your eating to match that of the people around? | 3.00 ± 0.82 | 3.11 ± 0.78 | 3.05 ± 0.70 | 0.702 (0.496) | |
| 3. Can you refrain from overeating and always eat a moderate amount of food? | 2.91 ± 0.80a | 3.15 ± 0.76b | 2.80 ± 0.74a | 7.111 (< 0.001∗∗∗) | |
| 4. Can you eat foods without salting them? | 2.56 ± 1.00 | 2.56 ± 0.97 | 2.43 ± 0.97 | 0.659 (0.518) | |
| 5. Can you refrain from eating snacks after supper? | 2.79 ± 0.95 | 2.83 ± 0.93 | 2.65 ± 0.96 | 1.167 (0.312) | |
| Food choice control efficacy | 6. Can you choose baked or steamed foods over fried or roasted foods? | 3.01 ± 0.72b | 3.08 ± 0.72b | 2.77 ± 0.87a | 5.443 (0.005∗∗) |
| 7. Can you eat fresh fruits instead of candies or cookies as snacks? | 3.41 ± 0.67 | 3.44 ± 0.72 | 3.26 ± 0.81 | 2.155 (0.117) | |
| 8. Can you eat milk or yogurt instead of ice cream as snacks? | 3.18 ± 0.84 | 3.25 ± 0.84 | 3.23 ± 0.75 | 0.244 (0.783) | |
| 9. Can you drink water instead of soda when you are thirsty? | 3.17 ± 0.96 | 3.41 ± 0.79 | 3.23 ± 0.87 | 2.723 (0.067) | |
| Environmental stimulus control efficacy | 10. Can you watch TV or read a book without eating something? | 2.94 ± 0.97 | 2.86 ± 0.93 | 2.86 ± 0.89 | 0.265 (0.767) |
| 11. Can you refuse delicious food when offered? | 2.54 ± 0.98 | 2.43 ± 0.93 | 2.48 ± 0.92 | 0.45 (0.638) | |
| 12. Can you resist delicious food placed in front of you? | 2.58 ± 0.99 | 2.58 ± 0.99 | 2.47 ± 0.90 | 0.538 (0.584) | |
| 13. Can you resist your caving for food on coming back home after school? | 2.82 ± 1.02b | 2.62 ± 0.99ab | 2.48 ± 0.95a | 3.553 (0.030∗) | |
| 14. Can you control your appetite at a birthday party or festival banquet? | 2.56 ± 1.07b | 2.47 ± 0.96ab | 2.23 ± 0.91a | 3.306 (0.038∗) | |
| 15. Can you control your craving for food when you are bored? | 2.92 ± 0.92b | 2.97 ± 0.91b | 2.63 ± 0.93a | 4.656 (0.010∗) | |
| Affective factor control efficacy | 16. Can you control your craving for food when you are stressed? | 3.17 ± 0.90c | 2.89 ± 1.00b | 2.51 ± 1.02a | 13.639 (< 0.001∗∗∗) |
| 17. Can you control your craving for food when you are anxious or nervous? | 3.33 ± 0.82b | 3.28 ± 0.79b | 2.91 ± 0.96a | 8.488 (< 0.001∗∗∗) | |
| 18. Can you control your craving for food when you feel sad or moody? | 3.25 ± 0.88b | 3.04 ± 0.90b | 2.55 ± 1.03a | 17.528 (< 0.001∗∗∗) | |
| Overall mean of the items regarding dietary self-efficacy | 52.87 ± 9.35b | 52.51 ± 8.80b | 49.24 ± 7.96a | 6.113 (0.002∗∗) | |
Table 5.
Correlation analysis between the constructs
| Variables | Mean ± SD | 1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|---|---|
| 1. Level of food-related content usage | 2.39 ± 0.91 | 1 | ||||
| 2. Dietary behaviors Dietary self-efficacy subscales | 3.17 ± 0.49 | -0.115∗ | 1 | |||
| 3. Food intake control efficacy | 2.79 ± 0.54 | -0.082 | 0.585∗∗ | 1 | ||
| 4. Food choice control efficacy | 3.21 ± 0.57 | -0.038 | 0.411∗∗ | 0.474∗∗ | 1 | |
| 5. Environmental stimulus control efficacy | 2.64 ± 0.68 | -0.140∗∗ | 0.348∗∗ | 0.503∗∗ | 0.412∗∗ | 1 |
| 6. Affective factor control efficacy | 3.01 ± 0.83 | -0.275∗∗ | 0.324∗∗ | 0.349∗∗ | 0.340∗∗ | 0.510∗∗ |
Table 6.
Regression analysis between the constructs
| Independent variable | Dependent variable | B | SE | R2 | F (p-value) |
|---|---|---|---|---|---|
| Level of food-related content usage Dietary self-efficacy subscales | Dietary behaviors | -0.061 | 0.027 | 0.013 | 5.049 (0.025∗) |
| Food intake control efficacy | Dietary behaviors | 0.531 | 0.038 | 0.340 | 196.875 (< 0.001∗∗∗) |
| Food choice control efficacy | 0.354 | 0.040 | 0.169 | 76.972 (< 0.001∗∗∗) | |
| Environmental stimulus control efficacy | 0.251 | 0.035 | 0.121 | 52.169 (< 0.001∗∗∗) | |
| Affective factor control efficacy | 0.190 | 0.028 | 0.105 | 44.484 (< 0.001∗∗∗) | |
| Level of food-related content usage | Food intake control efficacy | -0.048 | 0.030 | 0.007 | 2.576 (0.109) |
| Food choice control efficacy | -0.024 | 0.032 | -0.001 | 0.552 (0.458) | |
| Environmental stimulus control efficacy | -0.104 | 0.038 | 0.019 | 7.527 (0.006∗∗) | |
| Affective factor control efficacy | -0.251 | 0.045 | 0.076 | 31.009 (< 0.001∗∗∗) |
Table 7.
Mediating effect of the environmental stimulus control efficacy subscale of dietary self-efficacy
| Stage | Independent variable | Dependent variable | B | SE | β | t (p-value) |
|---|---|---|---|---|---|---|
| Stage 1 | Level of food-related content usage → | Environmental stimulus control efficacy | -0.104 | 0.038 | -0.140 | -2.744 (0.006∗∗) |
| F (p-value) = 7.527 (0.006∗∗) | R2 (adj-R2) = 0.019 (0.017) | |||||
| Stage 2 | Environmental stimulus control efficacy → | Dietary behaviors | 0.251 | 0.035 | 0.348 | 7.223 (< 0.001∗∗∗) |
| F (p-value) = 52.169 (< 0.001∗∗∗) | R2 (adj-R2) = 0.121 (0.119) | |||||
| Stage 3 | Level of food-related content usage → | Dietary behaviors | -0.061 | 0.027 | -0.115 | -2.247 (0.025∗) |
| F (p-value) = 5.049 (0.025∗) | R2 (adj-R2) = 0.013 (0.011) | |||||
| Stage 4 | Level of food-related content usage → | Dietary behaviors | -0.036 | 0.026 | -0.067 | -1.388 (0.166) |
| Environmental stimulus control efficacy → | Dietary behaviors | 0.244 | 0.035 | 0.338 | 6.967 (< 0.001∗∗∗) | |
| F (p-value) = 27.112 (< 0.001∗∗∗) | R2 (adj-R2) = 0.125 (0.121) | |||||
Table 8.
Mediating effect of the affective factor control efficacy subscale of dietary self-efficacy
| Stage | Independent variable | Dependent variable | B | SE | β | t (p-value) |
|---|---|---|---|---|---|---|
| Stage 1 | Level of food-related content usage | → Affective factor control efficacy | -0.251 | 0.045 | -0.275 | -5.569 (< 0.001∗∗∗) |
| F (p-value) = 31.009 (< 0.001∗∗∗) | R2 (adj-R2) = 0.076 (0.073) | |||||
| Stage 2 | Affective factor control efficacy | → Dietary behaviors | 0.190 | 0.028 | 0.324 | 6.670 (< 0.001∗∗∗) |
| F (p-value) = 44.484 (< 0.001∗∗∗) | R2 (adj-R2) = 0.105 (0.103) | |||||
| Stage 3 | Level of food-related content usage | → Dietary behaviors | -0.061 | 0.027 | -0.115 | -2.247 (0.025∗) |
| F (p-value) = 5.049 (0.025∗) | R2 (adj-R2) = 0.013 (0.011) | |||||
| Stage 4 | Level of food-related content usage | → Dietary behaviors | -0.015 | 0.027 | -0.028 | -0.546 (0.585) |
| Affective factor control efficacy | → Dietary behaviors | 0.186 | 0.03 | 0.317 | 6.256 (< 0.001∗∗∗) | |
| F (p-value) = 22.350 (< 0.001∗∗∗) | R2 (adj-R2) = 0.106 (0.101) | |||||
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