Predictors of discretionary energy intake in Indigenous Australian adolescents

Background: European colonisation has disrupted Australian Indigenous traditional dietary patterns and hunter-gatherer traditions. Consequently, Indigenous diets are typically characterised by energy-dense, processed foods. Aims: To investigate the predictors of discretionary energy intake (DEI) among Indigenous Australian adolescents. Methods: Data from the 2012 to 13 National Aboriginal and Torres Strait Islander Nutrition and Physical Activity Survey (n = 264, 15-17 years) were analysed. Dietary data were collected using an Automated Multiple-Pass Method. Demographic, anthropometric, and body image characteristics were considered as potential predictors of DEI. Results: In generalised linear models, males from remote locations reported a higher DEI compared to females from remote locations (5.1 vs 3.0 MJ; P = .007) and males from non-remote locations (5.1 vs 3.6 MJ, P = .007). Adolescents who perceived themselves as overweight had a higher DEI compared to those who perceived themselves as underweight (5.0 vs 3.0 MJ, P = .022), or an acceptable weight (5.0 vs 3.6 MJ, P = .022). Weight dissatisfaction influenced higher DEIs in males (5.0 vs 3.2 MJ, P < .001) and lower DEIs in females (2.0 vs 4.6 MJ, P < .001), compared to those that were satisfied. For each increase in self-assessed health category (from poor to excellent), DEI in males was lower by 1 MJ compared to females (P = .005). There were no differences in DEI by dieting status or risk of metabolic complications. Conclusion: In Indigenous adolescents, there was a relationship between DEI and self-assessed health, body weight satisfaction and geographical remoteness, moderated by sex. There is a need for well-designed intervention studies to test the effect of community-based nutrition and lifestyle interventions on Indigenous adolescent health and wellbeing.