Soft drink consumption in adolescence:Associations with food-related lifestyles and family rules in Belgium Flanders andthe Veneto Region of Italy

Background: The number of studies among adolescents that focus on several lifestyle behaviours and family rules as determinant of soft drink consumption are limited. The aim of this study is to investigate the associations between daily soft drink consumption, food-related lifestyles and family rules in adolescence. Methods: The data are part of the Health Behavior in School-aged Children (HBSC) crosssectional survey. Adolescents between 11 and 16 years of age were included, resulting in a final sample of 14 407 adolescents representative of Belgium Flanders (N= 7904) and the Veneto Region of Italy (N= 6503). Binary logistic regression was used to test the association between soft drink consumption and food-related lifestyle (breakfast habits, family meals, snacking, meals in fast food restaurants and television viewing) and family rules (restriction and obligation rules) by region and gender. Results: Each independent variable is significantly associated with daily soft drink consumption, despite some sub-groups exceptions. When we entered all the variables into the same statistical model, the positive association with daily soft drink consumption remained significant for frequent meals in fast food restaurants, television variables and low restriction rules. Breakfast during weekdays, evening meal with parents and obligation rules remained significant only in specific sub-groups and not the entire sample. Finally, the association with breakfast with parents and during the weekend disappeared. Conclusion: These findings suggest that considering gender and cultural differences, involving parents and limiting adolescents’ exposure to television would increase the effectiveness of interventions aimed to reduce soft drink consumption in adolescence.