Alimentación y dieta
A continuación se recogen los artículos de investigación publicados por el equipo HBSC. Para hacer más sencilla la búsqueda, los artículos se dividen por áreas temáticas. Pulse aquella que le interese y será redirigido a las publicaciones científicas publicadas en esta temática.
Alimentación y dieta
En el periodo de la adolescencia aumenta la necesidad fisiológica de los nutrientes esenciales (hidratos de carbono, proteínas, vitaminas y minerales) y se hace especialmente importante tener una dieta de alta calidad nutricional. Un buen modelo de alimentación en la infancia y la adolescencia promueve un óptimo crecimiento y desarrollo, teniendo además un gran impacto en el futuro estado de salud adulto. A pesar de que un hábito nutricional importante para la salud es la regularidad en la alimentación, la omisión del desayuno o su realización de forma inadecuada o insuficiente son prácticas de alimentación relativamente frecuentes entre los adolescentes. Los expertos demuestran que los cambios metabólicos causados por el ayuno prolongado llevan consigo una respuesta de fatiga que no solo interfiere en el rendimiento físico y muscular, sino también en diferentes aspectos cognitivos: falta de concentración, disminución de la capacidad de locución o expresión, memoria, creatividad y resolución de problemas, además del consiguiente decaimiento y mal humor. Así mismo, el tipo de alimentos que consumen los chicos y chicas en la adolescencia es muy importante para su desarrollo. Los resultados acuerdan en mostrar que la tendencia general desde la infancia hasta la adolescencia es consumir cada vez menos fruta y verdura, mientras que el consumo de dulces y refrescos crece de forma significativa. Sin embargo, las recomendaciones nutricionales especifican que el patrón de consumo de estos alimentos debería ser justo el contrario. Actualmente existe una dicotomía en la preocupación hacia la alimentación, la imagen corporal y el control del peso en la población juvenil. Por un lado, la prevalencia del sobrepeso y la obesidad se ha convertido en una de las cuestiones principales que han despertado la preocupación de los profesionales y responsables de la salud pública. De hecho, la Organización Mundial de la Salud insta a la promoción de estilos de vida saludables en la infancia y adolescencia como una clave crucial para detener la que califican como rápida y progresiva epidemia de la obesidad. Por otro lado, en el otro extremo, un sector cada vez más numeroso de jóvenes se siente insatisfecho con su imagen corporal y aspira a estar cada vez más delgado, practicando a menudo métodos poco saludables para controlar el peso. Para analizar estas últimas cuestiones, en este bloque también se presenta información relacionada con el Índice de Masa Corporal y la frecuencia con la que los escolares dicen seguir alguna dieta u otro método para perder peso. El Índice de Masa Corporal (IMC) es una medida antropométrica que se calcula a partir de la masa en kilogramos dividida por el cuadrado de la estatura en metros (Kg/m2). En general, cuando el cociente oscila entre 18 y 25, se considera que el adolescente se encuentra en un peso normal.
A continuación se recogen los artículos de investigación publicados por el equipo HBSC en esta temática.
The Role of Body Image in Internalizing Mental Health Problems in Spanish Adolescents: An Analysis According to Sex, Age, and Socioeconomic Status.
    Ramos, P., Moreno-Maldonado, C., Moreno, C., & Rivera, F. (2019).
Frontiers in Psychology, 10:1952.
JCR (2018): PSYCHOLOGY, MULTIDISCIPLINARY (40 OF 137): Q2
FI: 2,129
Enlace
Abstract: During adolescence there is a relatively high prevalence of weight problems and eating disorders. Furthermore, body image plays an important role in weight control and eating behaviors as well as in mental health. This study analyses the influence of body mass index, perception of being overweight, and body image satisfaction (BIS) on internalizing symptoms related to mental health in adolescents. In addition, sex, age, socioeconomic status (SES), dieting, and physical activity are taken into consideration. This research is based on the international study Health Behaviour in School-aged Children (HBSC). The sample consists of 4531 Spanish adolescents from 13 to 18 years old. Participants were selected through random multi-stage sampling stratified by conglomerates. Two instruments were employed: the HBSC questionnaire and the Youth Self-Report (Achenbach System of Empirically Based Assessment, ASEBA). Results demonstrated that BIS –the emotional component related to body image– was the main predictor of adolescent internalizing symptoms. In addition, results show double-inequalities according to the interaction effects of sex, age, and SES. Likewise, interesting results are shown regarding how dieting behaviors to lose or gain weight/volume and physical activity relate to body image perception and satisfaction, as well as with internalizing symptoms. This study highlights important body image aspects relevant to intervention and prevention of internalized mental health problems in adolescence.
Direct and Indirect Influences of Objective Socioeconomic Position on Adolescent Health: The Mediating Roles of Subjective Socioeconomic Status and Lifestyles.
    Moreno-Maldonado, C., Ramos, P., Moreno, C., & Rivera, F. (2019).
International Journal of Environmental Research and Public Health, 16(9), 1637.
JCR (2018): ENVIRONMENTAL SCIENCES (112 OF 250): Q2, PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH (67 OF 185): Q2
FI: 2,468
Enlace
Abstract: The use of composite indices and subjective measures to evaluate socioeconomic position, taking into account the effect of inequalities on adolescent health-related behaviors, can contribute to understanding the effect of inequalities on health during adolescence. The aim of this study was to examine the direct and indirect contribution of objective and subjective socioeconomic factors in a broad range of health and lifestyles outcomes. The data come from a representative sample of adolescents (N = 15,340; M age = 13.69) of the Health Behavior in School-aged Children study in Spain. Structural equation modeling was used for data analysis. A global index for evaluating objective socioeconomic position predicted both health and healthy lifestyles. Subjective socioeconomic status mediated the relationship between objective socioeconomic position and health but did not have a significant effect on healthy lifestyles when objective indicators were considered. Lastly, fit indices of the multiple-mediator model—including the direct effect of objective socioeconomic position on health and its indirect effects through the subjective perception of wealth and lifestyles—explained 28.7% of global health variance. Interventions aimed at reducing the impact of health inequalities should address, in addition to material deprivation, the psychological and behavioral consequences of feeling poor.
Multidimensional poverty among adolescents in 38 countries: Evidence from the Health Behaviour in School-aged Children (HBSC) 2013/14 Study. 
Chzhen, Y., Bruckauf, Z., Toczydlowska, E., Elgar, F. J., Moreno-Maldonado, C., Stevens, G. W., ... & Gariépy, G. (2018).
Child Indicators Research, 11(3), 729–753.
JCR (2017) SOCIAL SCIENCES, INTERDISCIPLINARY (21 OF 98). Q1
FI: 1,858
Enlace
Abstract: This study applied UNICEF’s Multiple Overlapping Deprivation Analysis (MODA) framework to adolescents (aged 11, 13 and 15) in 37 European countries and Canada using data from the 2013/14 Health Behaviour in School-aged Children survey. It is one of the first applications of MODA based entirely on data collected from adolescents themselves rather than from household reference persons on their behalf. Unlike most other multidimensional child poverty studies, the present analysis focuses on non-material, relational aspects of child poverty. Substantial cross-country variation was found in the prevalence of adolescent deprivations in nutrition, perceived health, school environment, protection from peer violence, family environment and information access. These single dimensions of poverty did not closely relate to national wealth and income inequality. However, when we looked at deprivation in three or more dimensions (i.e., multidimensional poverty), we found association with income inequality. In most countries, girls were at a higher risk of multidimensional poverty than boys. In addition, adolescents who lived with both parents in the household or reported higher family wealth were consistently less poor than other adolescents, in both single and multiple dimensions. The results of this study show the interconnectedness of social (family, school support) and psychological (health and violence) dimensions of poverty for adolescents in higher income countries. Children poor in the domains of family and school environment are also likely to be poor in terms of perceived health and protection from peer violence. 
How family socioeconomic status, peer behaviors, and school-based intervention on healthy habits influence adolescent eating behaviors.
Moreno-Maldonado, C., Ramos, P., Rivera, F., & Moreno, C. (2018).
School Psychology International, 39(1), 92-118.
JCR (2017) PSYCHOLOGY, EDUCATIONAL (44 OF 59). Q3
FI: 1,103
Enlace
Abstract: Psychologists in schools can play an important role in developing policies and programs to promote healthy eating habits. This study analyses the contributions of family socioeconomic status, peer influence (schoolmates’ food consumption), and school-based nutrition interventions to explain adolescent eating behaviors. Data were obtained from the 2014 Health behaviour in school-aged children survey in Spain, with a sample of 6,851 adolescents (11- to 16-years-old). The results suggest that school-based healthy-eating programs could improve by considering parental education level and by implementing interventions focused on the peer social network. Policies that limit access to unhealthy products in schools – rather than simply offering healthy foods alongside unhealthy products – could be more effective.
Characterization of vulnerable and resilient Spanish adolescents in their developmental contexts. 
Moreno, C., García-Moya, I., Rivera, F., & Ramos, P. (2016).
Frontiers in Psychology, 7: 983.
JCR (2015): PSYCHOLOGY, MULTIDISCIPLINARY (29 OF 129). Q1
FI: 2,463
Enlace
Abstract: Research on resilience and vulnerability can offer very valuable information for optimizing design and assessment of interventions and policies aimed at fostering adolescent health. This paper used the adversity level associated with family functioning and the positive adaptation level, as measured by means of a global health score, to distinguish four groups within a representative sample of Spanish adolescents aged 13–16 years: maladaptive, resilient, competent and vulnerable. The aforementioned groups were compared in a number of demographic, school context, peer context, lifestyles, psychological and socioeconomic variables, which can facilitate or inhibit positive adaptation in each context. In addition, the degree to which each factor tended to associate with resilience and vulnerability was examined. The majority of the factors operated by increasing the likelihood of good adaptation in resilient adolescents and diminishing it in vulnerable ones. Overall, more similarities than differences were found in the factors contributing to explaining resilience or vulnerability. However, results also revealed some differential aspects: psychological variables showed a larger explicative capacity in vulnerable adolescents, whereas factors related to school and peer contexts, especially the second, showed a stronger association with resilience. In addition, perceived family wealth, satisfaction with friendships and breakfast frequency only made a significant contribution to the explanation of resilience. The current study provides a highly useful characterization of resilience and vulnerability phenomena in adolescence.
Indicadores para detectar y evaluar el impacto de las desigualdades socioeconómicas en los estilos de vida y la salud de los adolescentes españoles. 
Moreno-Maldonado, C., Moreno, C. y Rivera, F. (2016).
Apuntes de Psicología, 34(2-3), 177-188.
JSM (2015) PSYCOLOGY (923 OF 1027), Q4
Enlace
Abstract: En este estudio se comparan distintos indicadores socioeconómicos en cuanto a su capacidad para predecir desigualdades en la salud y los estilos de vida de la población adolescente. Los resultados muestran que la relación entre los diferentes indicadores socioeconómicos, a pesar de ser significativa, es débil, sugiriendo que cada uno evalúa en cierto grado aspectos distintos del constructo socioeconómico. Además, mientras que el nivel educativo de los progenitores, y especialmente el nivel educativo de las madres, es la variable que muestra mayor capacidad para detectar desigualdades en los estilos de vida adolescentes, la percepción subjetiva de riqueza se revela como el predictor más importante de las desigualdades en salud. Adicionalmente, los resultados de este estudio muestran que no todas las conductas relacionadas con los estilos de vida adolescente y su bienestar están igualmente influenciadas por determinantes socioeconómicos. De esta forma, mientras que las conductas relacionadas con los hábitos de alimentación o la salud adolescente se ven fuertemente influidas por factores socioeconómicos, el efecto de las desigualdades es menos claro en conductas tales como el consumo de tabaco y alcohol. Esta investigación subraya la importancia de la elección de un determinado indicador en estudios que evalúan los efectos de las desigualdades socioeconómicas en los estilos de vida y la salud adolescente. 
Diferencias de género en la imagen corporal y su importancia en el control de peso.
Ramos, P., Rivera, F., Pérez, R.S., Lara, L., & Moreno, C. (2016).
Escritos de Psicología, 9, 42-50. 
Indexada en bases de datos como Latindex, INRECS, DOAJ, DICE, REDALYC, Scielo, etc.
Enlace
Abstract: Adolescence is the most vulnerable stage for the emergence of body image issues. This study examined the differences between boys and girls (ranging from 13 to 18 years old) in Body Mass Index (BMI), perception of and satisfaction with their body image, and dieting to lose weight. The results show that girls, although being less overweight and obese than boys, were more dissatisfied with their body image, had a greater perception of obesity, and tended to diet to control their weight with greater frequency. In both groups, body image perception was more relevant than the adjusted bodyweight calculated by BMI in predicting behaviour regarding dieting to lose weight. Furthermore, body image satisfaction was also more relevant than BMI in predicting dieting in girls. The results highlight the importance of taking into account adolescents' perceptions of their body image when designing, developing, and implementing intervention programs aimed at the prevention and treatment of eating disorders. Moreover, the gender differences found imply the need to take into account the differing perceptions of boys and girls to improve the likelihood of success of interventions.
Recent changes in school-based policies on physical activity and nutrition in Spain.
Gallego, P., Galán, I., Medrano, M.J., Ramos, P., Rivera, F & Moreno, C.  (2014).
European Journal of Public Health, 24(6), 899-904. 
JCR: PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH (44 OF 165). Q2 
FI: 2,591 
Enlace
Background: This study evaluates the changes in Spain between 2006 and 2012, of school-based policies encouraging healthy eating and the undertaking of physical activity (PA). Methods: A longitudinal study was undertaken comprising 277 representative schools from all the regions of Spain. The questionnaires were completed by the school management board. An indicator for school policies on PA was constructed (score 0-4) from the following indicators: (i) participation in PA programmes, (ii) existence of written PA guidelines, (iii) training of teachers about PA and (iv) organization of extracurricular PA activities. For nutrition, indicators similar to the first three for PA were evaluated, together with access to healthy foods (score 0-4). In addition to comparing the scores for 2006 and 2012, multivariate linear regression was used to study the association between the characteristics of the schools and the changes in the scores. Results: The indicators for school-based policies on nutrition and PA improved between 2006 and 2012: the average score for PA increased from 1.33 to 1.79 (P < 0.001) and that for nutrition from 1.28 to 1.92 (P < 0.001). The greatest changes were seen regarding the written guidelines for action and participation in PA and nutrition programmes as well as the training of teachers about nutrition. The schools with the least number of students had the highest changes in scores for policies on nutrition (P < 0.05).
Eating habits and physical activity in dieter and non-dieter youth: A gender analysis of English and Spanish adolescents.
Ramos, P., Brooks, F., García-Moya, I., Rivera, F., & Moreno, C. (2013).
Social Science Journal, 50(4), 575–582. 
JCR: SOCIAL SCIENCE, INTERDISCIPLINARY (61 OF 92). Q3 
FI: 0,483 
Enlace
Abstract: A high prevalence of youth is overweight or obese, and a frequent lack of monitoring of their weight control strategies is observed. Consequently, this paper compares the eating habits and physical activities of male and female dieters and non-dieters. Data are obtained from the large cross-national WHO collaborative study Health Behavior in School-aged Children 2010. The current sample consists of 9,444 students aged 11, 13 and 15 years from England and Spain. Participants are asked about dieting, vigorous and moderate to vigorous physical activity, breakfast frequency and fruit, vegetable, sweet and soft drink consumption. A logistic regression is used to examine the differences between dieters and non-dieters with regard to the aforementioned eating and physical activity habits. Differences between genders, countries, and those associated with BMI (body mass index) are also considered. The results suggest that the reality of weight control differs from the major health promotion recommendations during adolescence.
Diferencias de sexo en imagen corporal, control de peso e Índice de Masa Corporal de los adolescentes españoles.
Ramos, P., Rivera, F., & Moreno, C. (2010).
Psicothema, 22 (1), 77-83. 
JCR: MULTIDISCIPLINARY PSYCHOLOGY (70 of 120). Q3
FI: 0,939
Enlace
Abstract: Sex differences in body image, weight control and Body Mass Index of Spanish adolescents. This research paper studied the differences among 21,811 adolescents (between the ages of 11 and 18) in key variables in the development of eating disorders, including the Body Mass Index, the perception of and satisfaction with their body image, and the behaviours used to control weight. In spite of the fact that the girls had a better adjusted BMI and a lesser degree of overweight and obesity, we found that they perceived themselves as being fatter, were less satisfied with body image, and the ones who dieted the most to lose weight. On the other hand, we found that the main reason for boys and girls to diet in an effort to lose weight was not their real body weight, but rather their perception of their own bodies, followed by just how satisfied they were with their bodies. Therefore, important differences are revealed between boys and girls in this article, which must be taken into consideration in the design and development of the various programs that are aimed at the prevention of problems with body image and diet behaviour.
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