Prevalence and associated factors of unhealthy diet among adolescents: cross-sectional study among Tunisian high school students.

Objectives: According to World Health Organization (WHO),Unhealthy Diet (UD)is a major risk factor for chronic diseases. That's why it is important to study the UD and its associated factors. Our study aimed to describe the dietary behavior of young high school students and determine associated factors of UD.

Methods: A cross-sectional study was carried out among students of seven high schools in center-eastern Tunisia during the academic year 2021/2022. Data collection was carried out in April2022 by questionnaires. The questions concerned the socio-demographic characteristics, food habits and physical activity. WHO defined UD as the consumption of less than five fruits and vegetables per day. Data analysis was done using SPSS software.

Results: A total of 740 adolescents were included. The mean age was17±1.16 years with extremes ranging from 14to19 years. Sex-ratio was 0.66. UD was found among 91.6 % of the study population. At multivariate analysis, eating cake (aOR=4.062; CI [1.685-9.795]; p=0.002),eating fried-food (aOR=3.239; CI [1.118-9.385]; p=0.03)and consuming sweets (aOR=3.263; CI [1.666-6.394]; p=0.001)were independent risk factors of UD. In the other hand, regular physical activity (aOR=0.524; CI [0.294-0.936]; p=0.029)and having breakfast regularly (aOR=0.523; CI [0.297-0.923]; p=0.025)were independent protective factors of UD.

Conclusions: The findings of this study showed an alarming prevalence of UD. Therefore, it is mandatory to establish effective strategies to support healthy diets and physical activity among adolescents in order to reduce non-communicable diseases related to UD.