Association of Self-esteem with Dietary and Lifestyle Habit Self-efficacy, Stage of Eating Behavior Change, and Dietary Intake in High School Students

Abstract

Objective: To identify the causal structure of the association of self-esteem with dietary and lifestyle habit self-efficacy, stage of eating behavior change, and dietary intake in high school students.

Methods: Of 357 second-year students enrolled in 2015 in a public high school in City A, Hyogo Prefecture, 301 from whom responses were obtained were included in the analysis. Self-esteem was evaluated by the Rosenberg Scale. As observed variables with potential associations, dietary and lifestyle habit self-efficacy (12-item scale with confirmed reliability and validity), stage of eating behavior change (5-point scale based on the Transtheoretical Model), and dietary intake (based on a Food Frequency Questionnaire and Dietary Reference Intakes for Japanese) were used to develop a hypothetical model and perform a covariance structure analysis.

Results: Configural invariance evaluation revealed that the hypothetical model had acceptable goodness of fit (χ² = 226.458, df = 176, GFI = 0.919, AGFI = 0.874, CFI = 0.948, RMSEA = 0.031). In boys, no significant positive path was observed from self-esteem to the variables, including the 12-item dietary and lifestyle habit self-efficacy scale. In girls there was a significant positive path from self-esteem to self-efficacy (0.16, p = 0.041) and from self-efficacy to dietary intake (0.19, p = 0.013) via stage of eating behavior change (0.29, p = 0.002), indicating indirect effects.

Conclusion: The results suggest that, in second-year female high school students, higher self-esteem leads to greater dietary and lifestyle habit self-efficacy and, through improved stage of eating behavior change, influences diet.