INTRODUCTION

Overweight and obesity (SP/OB after the names in Spanish) are considered health problems worldwide. In 2017, 3.4 million deaths related to this condition ¹were recorded; one of the most vulnerable groups is that of adolescents, since this population is predisposed to develop this condition ^{2 3}. This may be due to food desire, access to fast food, and the negative impact caused by alimentary abstinence ^{4 5}; additionally, SP/OB are risk factors to develop comorbidities such as diabetes mellitus type 2, cardiovascular disease, and some types of cancer ¹.

SP/OB occurs in more than 18% of adolescents at world level; in Mexico, this amount duplicates since there is a prevalence of 39.2% in women and 33.5% in men, from 12 to 19 years of age; the states located in the northern part of Mexico are the most affected ^{6 7}. The increase in prevalence of SP/OB is a risk factor that contributes to reduce the quality of life of the people. In the last years, studies have been carried out in order to understand the factors that influence the development of this condition, such as the access to food with high caloric content, the reading of the nutritional content in the labels, the consumption of large amounts of food, and physical inactivity. However, few studies have addressed food addiction (AC in Spanish) in adolescents^{8 9 10}.

Approximately 38% of adolescents with SP/OB show AC; this variable is defined as a chronic problem that is characterized by the addiction to and excessive consumption of highly caloric food, with great amounts of salt, sugar, and grease. Moreover, this condition may take the form of binge eating disorder; AC is related to the increase in the body mass index (BMI) in adolescents ^{10 11 12}.

Various mental health disorders are related to AC in adolescents, such as low self-esteem, depression, and feeling of loneliness. Additionally, is important to mention that depression and AC are associated to obesity problems in this age group ^{13 14}. Therefore, it is necessary to carry out studies that address this situation and thus develop interventions to promote health and to help reduce prevalence of obesity in adolescents, taking into consideration behavioral variables. The nutritional status in adolescents from 10 to 19 years of age is obtained from the BMI, which is the most used indicator based on sex ¹⁵.

The objectives of this study were: be aware of AC prevalence according to age, sex, and BMI, and to determine the association between AC and nutritional status in a sample of adolescents of the northern part of Mexico.

MATERIAL AND METHOD

RESULTS

The total sample correspond to 245 adolescents, where women predominate with 53,1%, and an average age of 15,83 years (S= 0,69); BMI was higher in women (Table 1).

Table 1: Age and Anthropometric Measurements per Sex in a Sample of Adolescents from a Public High School in Mexico, 2018. 

Source: Sociodemographic and clinical data card

^an = 245

Regarding AC, most of the participants showed 3 positive criteria, which show: a) Frustrated desire to stop consumption (87,8%); b) Tolerance (36,3%); and c) Consumption despite consequences (34,3%) (Table 2).

Table 2: Diagnostic Criteria for Food Addiction in a Sample of Adolescents from a Public High School in Mexico, 2018. 

With regards to sex, women showed a greater AC prevalence (20%). According to the nutritional status, greater AC prevalence in overweight adolescents was noted (20,7%). Regarding the nutritional status and sex, greater AC prevalence is noted in overweight men (33,3%) and in normal-weight women (22,3%) (Table 3).

Table 3: Food Addiction per Sex and Nutritional Status in a Sample of Adolescents from a High School in Mexico, 2018. 

According to age, the 17 years old participants showed greater AC prevalence AC (25%), predominating in obese adolescents (33,3%) (Table 4).

Table 4: Percentage of Addiction to Food per Nutritional Status and Age in a Sample of Adolescents from the Northern Part of Mexico, 2018. 

One of the objectives of the study was to determine the association between AC and the nutritional status in adolescents of the northern part of Mexico; however, no relationship was found between the variables of interest (p> 0,05).

DISCUSSION

The purpose of this study was to find out the AC prevalence, according to age, sex, and BMI, and to determine the association between AC and the nutritional status in adolescents of the Northern part of Mexico. A study carried out in Chile in order to determine the association of AC and the nutritional status in a sample of 292 university students with an average age of 21,4 years (S = 2,4), the results showed that most part of the adolescents met the 4 criteria for AC; greater AC prevalence was present in women (14,4% vs. 4,7%) ¹⁹. Similar results to those obtained in this study.

In food addiction differences regarding sex are shown, and multiple biological and behavioral variables may be associated to these results. A study shows that neuronal activity related to anxiety for food is lower in men when some distraction is provided, while in women it is less probable to reduce the anxiety signal to eat despite any distraction. Likewise, hormones and menstrual cycle can have an effect on the anxiety for food, interfering with eating control and weight reduction ^20,21; however, a study carried out in India shows there is no significant differences in food addiction with respect to sex ²².

Regarding age, most part of adolescents that met the AC criteria correspond to the 17 year-old participants (25%); likewise, within this age group, adolescents with obesity and AC predominated (33,3%). In a study carried out with a population ranging from 18 to 65 years of age, the results show a negative correlation between AC and age, where prevalence is greater in the age group that ranges from 18 to 29 years ²⁴.

Currently, adolescents have an easy access to social networks and to the publicity shown in them, such as recipes with low nutritional value and fast food restaurants; moreover, they represent a distractor for selection of healthy food ²⁴. A study shows that 85% of adolescents who use Instagram share photos of food in their profile, of which most of them (67,7%) refers to highly caloric food ²⁵.

In this study, the group of overweight adolescents who got positive criteria for (20,7%) predominated. A research carried out with university students (= 20,19 years) showed a positive association between BMI and AC²⁶. It is important to note that overweight or obese adolescents obtained higher score for AC and addictive food that stands out in consumption prevalence in this group are chocolate, french fries, ice cream, flour and pasta; thus, since childhood AC could have direct influence on obesity during adult age ²⁷.

Significant correlation was not found between AC and the nutritional status in the sample studied (p > .05); findings differ of those reported in another similar research¹⁹. The latter could be explained due to the characteristics of the sample of this study, since for the most part the sample was comprised by adolescents within the parameters of normal weight according to BMI, considering that one of the main characteristics in AC is the risk to present SP/OB ²⁸.

Family and school environment exercise an important influence in the adoption of healthy food habits in adolescents; however, the perception of parents and children regarding what is a balanced diet is mainly related to prepare food at home, and the minimum use of artificial colorants and other chemicals, forgetting the actual nutritional make-up of the food, while teachers think that the commitment of education regarding a balanced diet is actually up to the parents, more than to them ²⁹.

It is necessary to carry out studies that take into account the influence of the context in the AC; the sample corresponds to adolescent of Nuevo León (Northern part of Mexico), where SP/OB prevalence in this group was 37% in 2012³⁰, while that in the states of the Southern part of Mexico, such as Oaxaca (26,7%) and Chiapas (28,9%) is lower ^{1 2}. It should be mentioned the economic and health inequality between the North and South parts of Mexico, since 20,4% of the population in Nuevo León lives in poverty, while in Chiapas this amount increases to 76,2%⁷.

One of the limitations that was encountered in this study was the context, since only one sample of adolescents from Nuevo León, Mexico, was studied. Therefore, it is recommended to carry out future studies including other states in the North and South parts of Mexico to compare the results. Another limitation was that the BMI of the adolescents was that most of them showed a normal weight, thus, a sample of students with SP/OB could give different results.

CONCLUSIONS

According to international recommendations, most of adolescents of both sexes have normal weight; women presented a higher body mass index than men. Most of the adolescents showed more than three positive criteria for food addiction; and lower positive percentage for significant clinical alteration.

Women showed greater addiction to food than men; 17 year-old adolescents presented greater levels of food addiction than younger ones. This condition increases in overweight and obese adolescents. There was no statistically significant association among food addiction and the nutritional status in adolescents.