The bidirectional associations between self-esteem and problematic eating behaviors in adolescents.

OBJECTIVE: Theories propose that low self-esteem and problematic eating behaviors (PEBs) negatively impact each other. While previous studies suggested bidirectional associations between self-esteem and PEBs, they did not separate within-person from between-person associations. Therefore, this prospective study investigated the within-person bidirectional associations between self-esteem and four PEBs in adolescence, while accounting for between-person differences. METHOD: We used two independent longitudinal samples of Dutch adolescents, each including three annually collected waves of data. Sample 1 consisted of 1856 adolescents (Baseline: 50.4% males; Mage = 13.79 years, SDage = 0.72), with measures of self-esteem, emotional eating, restrained eating, and loss of control (LOC) while overeating. Sample 2 consisted of 555 adolescents (Baseline: 49.7% males; Mage = 13.13 years, SDage = 0.68), with measures of self-esteem and LOC eating. The data were analyzed using random intercept cross-lagged panel models (CLPMs). RESULTS: Within persons, lower self-esteem was associated with higher emotional and restrained eating (both Sample 1) one year later, and vice versa. Self-esteem did not predict, nor was predicted by, LOC while overeating (Sample 1) or LOC eating (Sample 2). Between persons, self-esteem was negatively correlated with all PEBs (Samples 1 and 2). DISCUSSION: We found within-person bidirectional associations between low self-esteem and emotional and restrained eating (but not LOC while overeating/LOC eating), and between-person correlations between low self-esteem and all PEBs. These results have theoretical and practical implications. Within-person processes clarify underlying mechanisms that explain the occurrence of PEBs; between-person associations are important to identify adolescents at risk of PEBs. PUBLIC SIGNIFICANCE: While theories indicate that low self-esteem and PEBs are inversely associated within individuals, empirical studies have not disentangled within-person processes from between-person differences. This study addressed this disparity, finding that lower self-esteem was bidirectionally associated with higher emotional and restrained eating (but not LOC eating) within persons. These findings suggest that enhancing self-esteem is a viable option for prevention and intervention.

Adolescents' food intake changes during the COVID-19 pandemic: The moderating role of pre-pandemic susceptibility, COVID-19 related stressors, and the social food context.

Although insight in how adolescents' food intake is affected by the COVID-19 pandemic is critical, knowledge is limited. Hence, this longitudinal study (N = 691, Mage = 14.30, SDage = 0.62; 52.5% female) investigated changes in adolescents' unhealthy (sugar-sweetened beverages, sweet snacks, savoury snacks) and healthy (fruit and vegetables) food intake (in total, obtained from home, and from outside the home) from pre-pandemic (Spring 2019) to the first lockdown (Spring 2020) and to six months later (Fall 2020). Moreover, several moderating factors were assessed. Results showed that the intake of unhealthy and healthy food in total and obtained from outside the home decreased during the lockdown. Six months later, unhealthy food intake returned to pre-pandemic levels, while healthy food intake remained lower. COVID-19 stressful life events and maternal food intake further qualified these longer-term changes in intake of sugar-sweetened beverages and fruit and vegetables, respectively. Future work is warranted to elucidate longer-term COVID-19 effects on adolescents' food intake.

Self-esteem and negative affectivity as mediators of the prospective links between adolescent interpersonal peer problems and disordered eating behaviors.

The current prospective study examined whether both self-esteem and negative affectivity mediate subsequent associations between interpersonal peer problems (i.e., peer victimization, peer rejection, lack of friendships) and disordered eating behaviors (i.e., loss of control while overeating, emotional eating, restrained eating) in adolescents using secondary data. The sample included 2051 adolescents (Mage baseline = 13.81, SDage baseline = 0.72; 48.5% female) who participated in a longitudinal project, which includes three annually collected waves of data. Participants completed self-report and peer-report measures describing interpersonal problems with peers, and self-report measures describing negative affectivity, self-esteem, and disordered eating behaviors. The results provided no support for either self-esteem or negative affectivity as mediators of the associations between interpersonal peer problems and disordered eating behaviors two years later. However, self-esteem was more robustly linked to all three types of subsequent disordered eating behaviors than negative affectivity. This highlights the importance of adolescent's self-evaluations in the development of disordered eating behaviors.

Efficacy and moderators of short-term psychodynamic psychotherapy for depression: A systematic review and meta-analysis of individual participant data.

BACKGROUND: Short-term psychodynamic psychotherapy (STPP) is frequently used to treat depression, but it is unclear which patients might benefit specifically. Individual participant data (IPD) meta-analyses can provide more precise effect estimates than conventional meta-analyses and identify patient-level moderators. This IPD meta-analysis examined the efficacy and moderators of STPP for depression compared to control conditions. METHODS: PubMed, PsycInfo, Embase, and Cochrane Library were searched September 1st, 2022, to identify randomized trials comparing STPP to control conditions for adults with depression. IPD were requested and analyzed using mixed-effects models. RESULTS: IPD were obtained from 11 of the 13 (84.6%) studies identified (n = 771/837, 92.1%; mean age = 40.8, SD = 13.3; 79.3% female). STPP resulted in significantly lower depressive symptom levels than control conditions at post-treatment (d = -0.62, 95%CI [-0.76, -0.47], p < .001). At post-treatment, STPP was more efficacious for participants with longer rather than shorter current depressive episode durations. CONCLUSIONS: These results support the evidence base of STPP for depression and indicate episode duration as an effect modifier. This moderator finding, however, is observational and requires prospective validation in future large-scale trials.

The effect of a multi-component school-based social network intervention on children's body mass index: a four-arm intervention study.

Objective: Schools are considered an important setting for stimulating healthy weight. The current study is unique in examining effects of a multi-component school-based social network intervention on children's body mass index z-scores (zBMI).Methods: Four schools were randomly allocated to one of four conditions: a social network intervention using influence agents focusing on water consumption, physical activity, a combination of the two, or a passive control condition. Participants included a total of 201 6- to-11-year-old children (53.7% girls; Mage = 8.51, SDage = 0.93). At baseline, 149 (76.0%) participants had a healthy weight, 29 (14.8%) had overweight and 18 (9.2%) had obesity.Results: Linear mixed effect models indicated that a multi-component school-based social network intervention targeting both water consumption and physical activity was most effective in decreasing children's zBMI.Conclusion: This study suggests that schools can contribute to the intervention of childhood obesity-even without involving the parents-by targeting both children's water consumption and physical activity through influential peers, but more research is needed to identify mechanisms of change.

A longitudinal study on changes in food parenting practices during COVID-19 and the role of parental well-being.

The COVID-19 pandemic may negatively influence food parenting practices, also among parents of adolescents. Parental well-being (stress and depressive symptoms) may explain these COVID-19 related changes in food parenting practices (snack structure, healthy structure, modeling, autonomy support, and coercive control). However, most previous studies performed before or during the COVID-19 pandemic have been limited by cross-sectional designs. The aim of the current study among parents of adolescent children was twofold. First, we aimed to examine prospective differences in food parenting practices comparing the situation before and during COVID-19. Second, we aimed to examine both cross-sectional and longitudinal associations between parental well-being and the dimensions of food parenting, while additionally examining whether these prospective associations were more pronounced in parents who had experienced more COVID-19 stressful life events. Parents (N = 290; 74.9% female; at baseline: Mage = 46.9; SDage = 4.3) of adolescent children (at baseline: Mage = 14.3; SDage = 0.6) completed online surveys about parental well-being and food parenting twice: One year before the COVID-19 pandemic (spring 2019) and during the COVID-19 pandemic, 1.5 years after the first measurement (autumn 2020). In general, we found consistent evidence for an average decrease in food autonomy support and an increase in coercive control during COVID-19. However, parental well-being did not seem to explain (changes in) food parenting practices during COVID-19, also not in combination with stressful life events. Our findings suggest that, regardless of parental well-being, the general COVID-19 situation had some small negative influences on autonomy support and coercive control among parents of adolescents. These findings might be explained by parents being more often confronted with unhealthy eating occasions in the COVID-19 home context, triggering these negative parental responses.

Understanding the behavioral determinants of adolescents' water consumption: A cross-country comparative study.

Substituting the consumption of sugar-sweetened beverages (SSB) with that of water can have a positive effect on adolescents' health. However, despite the attention on this topic in the Global North, it is relatively understudied in other regions of the world, such as the Caribbean. To guide the development of future interventions, understanding the factors determining water consumption among Caribbean adolescents is important. This study examined the behavioral determinants of water consumption among adolescents in Aruba (the Caribbean) and compared them to those in the Netherlands (Western Europe). We used a theoretical model that integrates the dominant theoretical perspectives in the field of public health, including theories of planned behavior, social norms, and intrinsic motivation. This cross-country study included 1,584 adolescents from Aruba and the Netherlands (52% girls; M = 12.34 years; SD = 2.14). The data were analyzed using regression analyses. This study found that in Aruba, adolescents with higher scores of intrinsic motivation, friends' descriptive norms, attitudes, and behavioral control regarding water consumption drank more water. Moreover, the associations between water consumption and both intrinsic motivation as well as friends' descriptive norms for adolescents in Aruba were stronger than those found in the Netherlands. These associations imply that it is even more important for Aruban adolescents than Dutch adolescents to be intrinsically motivated or to perceive their friends often consuming water to drink more water. The cross-country comparison implies that future interventions in Aruba aimed at increasing adolescents' water consumption as an alternative to SSB should focus on enhancing their intrinsic motivation while considering their friends' social norms.

Assessing Peer Influence and Susceptibility to Peer Influence Using Individual and Dyadic Moderators in a Social Network Context: The Case of Adolescent Alcohol Misuse.

Higher accepted friends are known to influence the alcohol misuse of lower accepted friends, but not the reverse. The present study was designed to address the origins of this influence: Are higher accepted friends particularly influential or are lower accepted friends particularly susceptible to influence? To address this question, we introduce an innovative application of longitudinal social network techniques (RSIENA) designed to distinguish being influential from being susceptible to influence. The results revealed that influence was a product of heightened susceptibility among low accepted adolescents, rather than heightened influence among high accepted adolescents. The findings are consistent with claims that low accepted youth fear the consequences of nonconformity and adjust their behavior to more closely resemble their affiliates.

Examining food intake similarities in adolescent best friend dyads using longitudinal Actor-Partner Interdependence Models.

Little is known about how adolescent best friends may affect each other's food intake. This study explored whether friendship selection and socialization mechanisms explained potential food intake similarities in adolescent reciprocated best friend dyads. We also tested whether socialization processes were moderated by dyad member's relative zBMI. Members of 145 same-gender best friendship dyads (56% female; Mage = 12.79; SDage = 0.61) reported on their intake of food obtained from home and from outside the home at the beginning and the end of the school year through food frequency questionnaires. Longitudinal Actor-Partner Interdependence Models results showed no indication of selection or socialization, and very limited evidence for the moderation of socialization processes by relative zBMI. These findings indicate that focusing on adolescent reciprocated best friends in dietary interventions may not be valuable.

The Prevalence of Overweight Status among Early Adolescents from Private Schools in Indonesia: Sex-Specific Patterns Determined by School Urbanization Level.

(1) Background: Few studies have investigated (demographic) correlates of (prevalent) overweight rates among early adolescents, especially from higher socioeconomic positions (SEP) in developing countries, such as Indonesia. The current study aims to fill this gap. (2) Methods: Participants included 411 adolescents from five private schools in Indonesia. Adolescents' weight and height were measured, and adolescents completed questionnaires on demographic factors (i.e., sex, school area, ethnicity, pocket money) and previous year dieting. (3) Results: Results showed that more than one-third of the sample was overweight, with higher rates among adolescent males (47%) than females (24%). Moreover, adolescents attending schools in urban areas (compared with suburban areas), and those reporting past dieting (compared with those reporting no dieting) had higher overweight rates. Ethnicity and the amount of pocket money were not related to overweight status. Finally, a clear sex-specific interaction was found involving school area, showing that males in urban areas had a significantly higher risk to be overweight, whereas this did not apply to females. (4) Conclusions: males from urban area private schools in Indonesia may be an important target group for future preventive overweight interventions.

With a little help from my empathic friends: The role of peers in the development of empathy in adolescence.

Despite ample research on empathy development, its social origins have been understudied, particularly in the context of peer relations. This two-wave study of Swedish adolescents (N = 318; MageT1 = 16.28, SD = .49; 55% females) examined longitudinal associations between youth friendships and empathy. The results showed that adolescents befriended peers with similar levels of empathy and that, controlling for the initial similarity in empathy, youth who had more empathic friends increased in empathy over time compared with youth with less empathic friends. These selection and influence effects were comparable for the affective and cognitive empathy components (i.e., empathic concern and perspective taking). These results provide strong evidence for the role of friendships in the development of empathy. They underscore the importance of peer-based, social-emotional programs to foster adolescent empathy. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Process and effect evaluation of the app-based parenting program Samen Happie! on infant zBMI: A randomized controlled trial.

Background: Although energy balance-related parenting practices are regarded critical components in the prevention of childhood obesity, most programs targeting parenting practices with respect to a wide range of energy balance-related behaviors were not aimed at high-risk families with a lower socioeconomic position (SEP). Objective: The Samen Happie! app-based program aimed to stimulate healthy child weight development especially among families with a lower SEP, by encouraging healthy energy balance-related parenting practices. Methods: A two-armed randomized controlled trial examined the process and effectiveness of the Samen Happie! program on child zBMI outcomes at 6- and 12-months follow-up. In total, 357 Dutch parents with infants aged 5-15 months old at baseline participated. Parents in the app condition (n = 179) received access to the Samen Happie! app and were compared to a waitlist-control condition (n = 178). Changes in zBMI were examined through linear mixed-effects models based on intention-to-treat and exploratory per-protocol principles. Results: Process data showed low levels of sustained app use and moderate app acceptability. A general increase in child zBMI was observed in both conditions after 6 and 12 months. Intention-to-treat analyses using multiple imputations showed several statistically significant differences between conditions and high-risk subgroups. Specifically, at 6-months follow-up, zBMI increase was least pronounced in the app condition among children of parents with lower educational level. These findings were supported by exploratory per-protocol analyses including only frequent app users. In addition, per-protocol analyses showed benefits of app use at 6-months follow-up for children of parents with higher BMI. However, these effects were reversed at 12-months follow-up in both intention-to-treat and per-protocol analyses, where children of parents in the app condition in general increased the most in zBMI. Conclusions: This study suggests that the Samen Happie! program might prevent zBMI increases after 6 months among children of parents with lower educational level, and children of parents with higher BMI who more frequently use the app. However, the app did not prevent increases in zBMI after 12 months. Future research should investigate strategies to increase sustained app use and engagement in mHealth parenting programs for childhood obesity as well as options to combine app-based programs with additional support strategies aimed at high-risk families. Trial registration: Netherlands trial register (ID: NTR6938), https://trialsearch.who.int/Trial2.aspx?TrialID=NTR6938.

Emerging Adults' Mental Health During the COVID-19 Pandemic: A Prospective Longitudinal Study on the Importance of Social Support.

The aim of this longitudinal study was to investigate emerging adults' mental health before and during the COVID-19 pandemic, and whether social support from mothers, fathers, and best friends moderated the change in mental health. Participants were 98 emerging adults (46% men) who were assessed prior to COVID-19 (M age = 20.60 years) and during the first lockdown (M age = 22.67 years). Results indicated that the pandemic did not uniformly lead to elevated levels of mental health problems, but instead depended on level of mental health problems prior to COVID-19 and the source of support. For emerging adults who already experienced more problems prior to COVID-19, more maternal support was related to decreases in general psychological distress and depressive symptoms, whereas more paternal support was related to increases in general psychological distress and depressive symptoms. Support from best friends were not associated with (changes in) mental health.

A Longitudinal Social Network Perspective on Adolescents' Exposure to Violent Video Games and Aggression.

Adolescents play video games as a social leisure activity, yet it is unclear whether peer influences play a role in spreading violent video game exposure (VVE) and aggression. It has been suggested that adolescents' aggression increases because of their friend's exposure to violent video games. This study tests this suggestion by using longitudinal social network analyses to investigate selection and socialization of aggression owing to VVE. A total of 796 adolescents from 34 different classrooms were followed from grade 7 to grade 8 (Mage = 12.60 years, 51 percent male adolescents). Exposure to violent video games, physical aggression, and within-classroom friendships were assessed at both time points. Data were analyzed by means of stochastic actor-based modeling in RSiena to estimate the effects of VVE and aggressive behavior on changes in friendships (selection), and the effects of friendships on changes in participants' VVE and aggressive behavior (socialization). Results showed homotypic selection effects, that is, adolescents became friends with peers who were similar in aggression and similar in violent video game exposure. Furthermore, there was a homotypic socialization effect, as friends became more similar in aggression over time. Friends did not become more similar in VVE over time. Violent games played by friends did not increase adolescents' own aggressive behavior. This suggests that concerns about peer influences on violent video games are unwarranted. Future studies on socialization processes of VVE should focus on influences from closest friends and investigate behavior during actual play.

Promoting water consumption among Dutch children: an evaluation of the social network intervention Share H2O.

BACKGROUND: There is a need to develop and improve interventions promoting healthy drinking behaviors among children. A promising method could be to stimulate peer influence within children's social networks. In the Share H2O social network intervention (SNI), peer influence was utilized by selecting a subset of influential children and training them as 'influence agents' to promote water consumption-as an alternative to SSBs. Previous research has mainly focused on the process of selecting influence agents. However, the process of motivating influence agents to promote the behavior has hardly received any research attention. Therefore, in the SNI Share H2O SNI, this motivation process was emphasized and grounded in the self-determination theory (SDT). This study evaluated the implementation of the Share H2O SNI, focusing on whether and how applying SDT-based techniques can motivate the influence agents and, indirectly, their peers. METHODS: This study included data collected in the Netherlands from both the influence agents (n = 37) and the peers (n = 112) in the classroom networks of the influence agents. Self-reported measurements assessed the influence agents' enjoyment of the training, duration and perceived autonomy support during the training, and changes in their intrinsic motivation and water consumption before and after the start of the intervention. Changes in the peers' intrinsic motivation, perceived social support, and social norms were measured before and after the start of the intervention. RESULTS: The influence agents enjoyed the training, the duration was adequate, and perceived it as autonomy supportive. There was an increase in the influence agents' intrinsic motivation to drink water and their actual water consumption. Providing personal meaningful rationales seemed to have motivated the influence agents. The intrinsic motivation and perceived descriptive norm of the peers remained stable. The peers reported an increase in their perceived social support and injunctive norm concerning water drinking after the intervention. Influence agents appeared to mainly use face-to-face strategies, such as modeling, talking to peers, and providing social support to promote the behavior. CONCLUSIONS: The current findings provided preliminary evidence of the promising effects of using SDT-based techniques in an SNI to motivate the influence agents and, indirectly, their peers. TRIAL REGISTRATION: NTR, NL6905, Registered 9 January 2018, https://www.trialregister.nl/trial/6905.

Schema therapy with exposure and response prevention for the treatment of chronic anxiety with comorbid personality disorder.

BACKGROUND AND OBJECTIVES: A considerable group of patients with anxiety disorders do not respond to guideline CBT treatment, possibly due to comorbid personality disorder (PD) traits. Schema therapy (ST) is an integrative treatment for personality disorders, and preliminary evidence suggests that it also affects anxiety. The present study examined the effects of a combination treatment ('SCHerp': ST + exposure and response prevention) in a non-responsive outpatient group suffering from chronic anxiety and comorbid cluster C personality disorder. METHODS: Psychological malfunction (n = 42), and adaptive and maladaptive schema modes (n = 49) were assessed pre- and post-treatment. RESULTS: Patients showed statistically significant decreases in psychological malfunction and maladaptive modes, and significant increases in adaptive modes from pre- to post-treatment. Changes in modes were correlated with changes in psychological malfunction. LIMITATIONS: No control group or follow-up measurements were included. CONCLUSIONS: The combination of ST and exposure with response prevention may be a viable avenue for research and treatment for this subpopulation. However, further research is needed to confirm and enhance effectiveness and identify working mechanisms of SCHerp. PRACTITIONER POINTS: The SCHerp programme combines schema therapy with exposure and response prevention to tackle chronic anxiety in patients with comorbid personality disorder SCHerp significantly reduced psychological malfunction and maladaptive modes, and increased adaptive modes Changes in schema modes correlated with changes in psychological malfunction, suggesting that schema modes are an appropriate treatment target in this population No active control group was included so no therapy-specific factors can be determined at this stage.

Promoting water consumption among children: a three-arm cluster randomised controlled trial testing a social network intervention.

OBJECTIVE: To test the effectiveness of a social network intervention (SNI) to improve children's healthy drinking behaviours. DESIGN: A three-arm cluster randomised control trial design was used. In the SNI, a subset of children were selected and trained as 'influence agents' to promote water consumption-as an alternative to sugar-sweetened beverages (SSB)-among their peers. In the active control condition, all children were simultaneously exposed to the benefits of water consumption. The control condition received no intervention. SETTING: Eleven schools in the Netherlands. PARTICIPANTS: Four hundred and fifty-one children (Mage = 10·74, SDage = 0·97; 50·8 % girls). RESULTS: Structural path models showed that children exposed to the SNI consumed 0·20 less SSB per day compared to those in the control condition (ß = 0·25, P = 0·035). There was a trend showing that children exposed to the SNI consumed 0·17 less SSB per day than those in the active control condition (ß = 0·20, P = 0·061). No differences were found between conditions for water consumption. However, the moderation effects of descriptive norms (ß = -0·12, P = 0·028) and injunctive norms (ß = 0·11-0·14, both P = 0·050) indicated that norms are more strongly linked to water consumption in the SNI condition compared to the active control and control conditions. CONCLUSIONS: These findings suggest that a SNI promoting healthy drinking behaviours may prevent children from consuming more SSB. Moreover, for water consumption, the prevailing social norms in the context play an important role in mitigating the effectiveness of the SNI.

Food parenting practices and children's weight outcomes: A systematic review of prospective studies.

This systematic review is the first to provide an overview of the prospective links between food parenting practices and children's weight outcomes. Three databases were searched. All titles, abstracts and full-texts were double screened by two independent reviewers. Peer-reviewed journal articles published after 1990 assessing the prospective association between food parenting practices and weight outcomes of children aged 2-18 years were eligible. A total of 38 eligible studies were identified, focusing on 12 separate food parenting practices. Restriction, pressure to eat, and monitoring were generally not associated with children's weight over time, but higher quality studies suggest that pressure to eat was associated with lower weight outcomes over time. Most studies on food availability and accessibility found null-findings as well. Instrumental-but not emotional-feeding was associated with higher weight over time, but higher quality studies are needed to confirm this link. Results involving the link between frequency of mealtime and child weight were mixed. Autonomy supporting and other structure-related food parenting practices were understudied. In conclusion, food parenting practices receiving the most attention within prospective studies (i.e., restriction, pressure to eat, monitoring) were generally not associated with children's weight outcomes over time. Future high quality studies should focus more on other food parenting practices, further unravel bidirectional links between food parenting and children's eating behaviors and weight outcomes, and examine the mediating role of dietary intake.

The reciprocal effects of physical activity and happiness in adolescents.

BACKGROUND: Positive associations exist between physical activity and happiness in adolescents. However, previous studies have mostly used self-reported measures and cross-sectional designs. There is a need for more insight into the directionality and duration of this association. The current study was the first to investigate whether an increase in physical activity leads to happiness and whether adolescents become more physically active when they are happier. These two effects were studied between (on a day-to-day basis) and within days (on an hour-to-hour basis). METHODS: The study used data from the MyMovez project in which 1484 adolescents between the ages of 8 and 17 years wore an accelerometer on their wrist and answered experience sampling questions on happiness at random moments during the day for several weeks in 2016-2018. RESULTS: The preregistered analyses demonstrated an association between physical activity and happiness. More specifically, the number of steps per day predicted the experienced happiness on that day. In addition, a short-term reciprocal effect of physical activity and happiness was observed. Happiness was predicted by the number of steps accumulated in the previous hour and it also predicted the number of steps accumulated in the subsequent hour. However, convincing evidence was found that these effects did not occur in the long-term between days. The number of steps on the previous day did not predict happiness, nor did happiness predict the number of steps of the subsequent day. CONCLUSIONS: This study confirms an association between physical activity and happiness in adolescents and shows that in the short-term, physical activity promotes happiness and vice versa. Therefore, we conclude that physical activity is not only important for the physical health of youth, but also plays an important role in their mental well-being. In addition, this knowledge can be used to further understand the importance of physical activity in adolescents' health and help in promoting a healthy lifestyle among youth. TRIAL REGISTRATION: The data used are stored at the Data Archiving and Networked Services ( https://doi.org/10.17026/dans-zz9-gn44 ). Hypotheses, study design, sample, data collection procedure, measured variables, and plan of analysis were preregistered on the Open Science Framework (OSF, https://osf.io/5yk7r/ ).

Is Adolescents' Food Intake Associated with Exposure to the Food Intake of Their Mothers and Best Friends?

Both mothers' and best friends' food intake are associated with adolescents' food intake, but they are rarely investigated simultaneously. In this study, we tested the associations of mothers' and best friends' food intake with adolescents' intake of unhealthy and healthy food, obtained from home and from outside the home, and the moderating role of adolescents' exposure to their food intake. Participants included 667 adolescents (53% female, Mage = 12.9) and 396 of their mothers. Within this adolescent sample, 378 best friend dyads were identified. All participants completed food frequency questionnaires. Mothers separately reported on their food intake in the presence and absence of their child, and adolescents indicated how often they ate and drank together with their best friend during school breaks. Mothers', but not best friends', food intake was positively related to adolescents' intake of unhealthy and healthy food obtained from home and healthy food obtained from outside the home. Exposure to mothers' healthy food intake magnified mother-child similarities in healthy food intake. Exposure to best friends' intake of unhealthy food moderated adolescent-friend similarities in unhealthy food intake. Future work should assess the mechanisms that underlie these similarities, and should investigate these associations over time and in later developmental periods.