UNHEALTHY EATING HABITS, PSYCHOACTIVE SUBSTANCE USE, AND MENTAL HEALTH IN BRAZILIAN ADOLESCENTS: A PUBLIC HEALTH APPROACH
Name: MARCYELLE PAVESI WERNECK
Publication date: 27/03/2025
Examining board:
Name |
Role |
|---|---|
| BLANCA ELENA GUERRERO DABOIN | Examinador Interno |
| LUIZ CARLOS DE ABREU | Presidente |
| TAMIRES DOS SANTOS VIEIRA | Coorientador |
| TASSIANE CRISTINA MORAIS | Examinador Externo |
Summary: Introduction: adolescence is a transitional period between childhood and adulthood, characterized by
biological, psychological, and social transformations, accompanied by an increase in autonomy. During this
stage, young people adopt new behaviors that may pose health risks, such as smoking, alcohol consumption,
use of psychoactive substances, poor diet, and physical inactivity. The consumption of unhealthy foods, such
as sweets and fast food, is widely recognized for its harmful effects, especially in adolescents. Given the
exposure of these young individuals to various risk factors, it becomes essential to investigate how these
influences impact eating habits, body image, mental health, and the use of psychoactive substances.
Objective: this study aims to examine the associations between the use of psychoactive substances,
unhealthy eating habits, body image dissatisfaction, and mental health in Brazilian adolescents.
Methodology: the study is a cross-sectional and descriptive survey conducted through a structured electronic
questionnaire, called the National School Health Survey (PeNSE), in partnership with IBGE and the
Ministry of Health, with support from the Ministry of Education. The publicly available PeNSE 2019 data
indicates that 159,245 valid questionnaires were collected, involving students from public and private
schools in Brazil. The questionnaire was individually administered on smartphones, under the supervision of
trained researchers. The sample represented an estimated population of 11,851,941 Brazilian students aged
13 to 17, of which 7,665,502 were aged 13 to 15 and 4,186,439 were aged 16 to 17. The study analyzed a
subsample of 124,898 Brazilian students aged 13 to 17, using prevalence ratios (PR) and confidence
intervals (CI) to investigate associations between the use of psychoactive substances, body image, mental
well-being, and food consumption in the past 24 hours, including 13 ultra-processed foods classified by
NOVA. Poisson regression was applied, with food consumption (healthy and unhealthy) as the dependent
variable and psychoactive substance use as the independent variable. The SPSS software (version 26.0) was
used to calculate prevalence ratios (PR) and 95% confidence intervals (CI), adjusting the data for
sociodemographic variables to control for potential confounders. Results: the study revealed that alcohol and
tobacco consumption were significantly associated with higher consumption of sweets, soft drinks, and fast
food. Male adolescents had lower consumption of sweets (PR: 0.947; CI: 0.946–0.949; p<0.001), but higher
consumption of soft drinks (PR: 1.015; CI: 1.013–1.016; p<0.001) and fast food (PR: 1.005; CI: 1.004–
1.006; p<0.001) compared to females. Those aged 13-15 years consumed more unhealthy foods (sweets, soft
drinks, and fast food) than older adolescents. Emotional difficulties, such as sadness and body image
dissatisfaction, were associated with higher consumption of ultra-processed foods, while body satisfaction
and the absence of psychoactive substance use were linked to healthier eating habits. Regional factors and
maternal education level also influenced food choices, with adolescents from families with lower education
levels and from certain regions showing higher consumption of unhealthy foods. Conclusion: the study
highlights the need for public health interventions that integrate support in schools related to mental health,
nutrition education, and substance use prevention. Addressing these multifaceted influences on adolescents'
eating habits is essential for improving public health outcomes and preventing future issues.
