Association of lifestyle behaviours with self-esteem through health-related quality of life in Spanish adolescents Knox, Emily Muros Molina, José Joaquín Mediterranean diet Physical activity Self-esteem The present research examined the association of Mediterranean diet adherence and physical activity with self-esteem through five components of health-related quality of life. Data were collected from 456 adolescents attending one of five schools in Granada, Spain using a cluster-randomised design. Participants completed questionnaires on Mediterranean diet adherence, physical activity, self-esteem and health-related quality of life (HRQoL). Models were constructed to identify associations between Mediterranean diet adherence and physical activity on self-esteem. Mediational analysis using bootstrapped confidence intervals examined possible mediation by five components of HRQoL. Mediterranean diet adherence and physical activity engagement were associated with four components of HRQoL: more positive physical wellbeing, psychological wellbeing, family relationships and autonomy support and perceptions of the school environment. Both lifestyle behaviours were positively associated with self-esteem. Both relationships were mediated through positive psychological wellbeing and perceptions of the school environment. Physical wellbeing was also a mediator of the relationship between physical activity and self-esteem. 2024-10-15T08:00:45Z 2024-10-15T08:00:45Z 2017-03-06 journal article Knox, E., Muros, J.J. Association of lifestyle behaviours with self-esteem through health-related quality of life in Spanish adolescents. Eur J Pediatr 176, 621–628 (2017). https://doi.org/10.1007/s00431-017-2886-z https://hdl.handle.net/10481/95943 10.1007/s00431-017-2886-z eng http://creativecommons.org/licenses/by/4.0/ open access Atribución 4.0 Internacional Springer Nature