High nutritional knowledge during adolescence is associated with healthier dietary habits in adulthood: a longitudinal cohort study.

purposeCardiovascular disease is the leading cause of mortality worldwide and is driven by atherosclerosis, which develops from a young age. Several lifestyle factors, including diet, physical activity, physical fitness, and sleep quality, influence cardiovascular health. However, limited research has investigated the association of nutritional knowledge with long-term health outcomes. This study assessed the association between adolescents' nutritional knowledge and adulthood dietary habits, physical fitness, and cardiovascular risk factors.

methodsThis longitudinal cohort study included 143 adolescents aged 12.5-17.5 years who were reevaluated as young adults (22-31 years) after a follow-up period of 10-14 years. The study was conducted in four European centers: Ghent (Belgium), Lille (France), Rome (Italy), and Zaragoza (Spain). Nutritional knowledge was assessed during adolescence and adulthood using the Nutritional Knowledge Test. Cardiovascular health was evaluated based on HDL and non-HDL cholesterol levels, blood pressure, body mass index, glycemia, and calculation of modified Pathobiological Determinants for Atherosclerosis in Youth (mPDAY) cardiovascular risk scores. Diet Quality Index (DQI), Planetary Health Diet Index (PHDI), ultra-processed food consumption, cardiorespiratory fitness (CRF) and upper-body muscular strength were also assessed. Spearman correlational analysis was used to identify associations between adolescents' nutritional knowledge and cardiovascular, dietary, and physical fitness parameters in adulthood.

resultsCorrelation analysis showed that greater nutritional knowledge during adolescence was associated with a better dietary quality in adulthood, as reflected by a higher DQI (p = 0.004; r = 0.25; 95% CI [0.08-0.40]). Nutritional knowledge during adolescence correlated inversely with the mPDAY cardiovascular risk score in adulthood. Cross-sectional analysis in adolescence and adulthood showed that nutritional knowledge in adolescence was not associated with cardiovascular parameters, physical fitness, or dietary quality indices during adolescence. Nutritional knowledge in adulthood was associated only with a better CRF (p = 0.003; r = 0.37 [0.13-0.58]) in adulthood.

conclusionNutritional knowledge during adolescence is associated with a dietary quality in adulthood, as measured by the DQI. These findings suggest that assessment of nutritional knowledge during adolescence might serve as a simple and effective tool for early identification of individuals at risk of poor dietary habits and increased cardiovascular risk. These findings also highlight the potential value of school-based interventions involving nutritional knowledge in promoting long-term cardiovascular health. NCT number: NCT02899416.