The influence of diet quality and dietary behavior on health-related quality of life in the general population of children and adolescents: a systematic review and meta-analysis

  • Xiu Yun WuEmail author
  • Li Hui ZhuangEmail author
  • Wei Li
  • Hong Wei Guo
  • Jian Hua Zhang
  • Yan Kui Zhao
  • Jin Wei Hu
  • Qian Qian Gao
  • Sheng Luo
  • Arto Ohinmaa
  • Paul J. Veugelers



The association between diet quality, dietary behavior and health-related quality of life has been mostly examined in children and adolescents with specific chronic diseases. No systematic review has synthesized the influence of diet quality and dietary behavior on health-related quality of life in the general population of children and adolescents. The purpose of this study was to systematically review the primary studies that evaluated the association between diet quality, dietary behavior and health-related quality of life in the general population of children and adolescents and to synthesize the findings for the association.


A computer search in the databases of MEDLINE, EMBASE and PSYCINFO was performed to retrieve English language studies that were published from 1946 up to April 8, 2018. We also screened the PubMed-related articles and the reference lists of the existing relevant literature to identify other eligible studies. We synthesized the association between diet quality, dietary behavior and health-related quality of life using both a qualitative method and meta-analysis. We reported the review following up the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guideline.


Seventeen studies were included in the synthesis including twelve cross-sectional studies and five longitudinal studies. We found that diet quality and dietary behavior were associated with health-related quality of life in children and adolescents. The positive effect of healthy diets on health-related quality of life was observed for multiple domains of health-related quality of life, including physical, school and emotional functioning, and psychosocial quality of life. We observed a dose–response relationship between the diet exposure and health-related quality of life, where an unhealthy dietary behavior or lower diet quality was associated with decreased health-related quality of life among children and adolescents.


The findings of the systematic review suggest the importance of promoting healthy diets and nutrition for good health-related quality of life among children and adolescents. Future research is needed to strengthen the evidence for prospective relationships and for the dose–response effect between diet quality, dietary behavior and health-related quality of life among children and adolescents.


Children Adolescents Diet quality Dietary behavior Health-related quality of life Systematic review Meta-analysis 



The authors thank the staffs of the Department of Scientific Research Management, Weifang Medical University, for their work related to the program management.

Author contributions

Conceptualization: XYW; Literature searching: XYW; Study selection, data extraction and quality assessment: XYW and LHZH; Data analysis: XYW; Draft of the manuscript writing: XYW; Manuscript writing—Review and editing: All authors. All authors have reviewed and approved the manuscript.


The present study was funded by Natural Science Foundation of Shandong Province, China (Grant number: ZR2017LH060).

Compliance with ethical standards

Conflict of interest

The authors declared that they have no conflict of interests.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Supplementary material

11136_2019_2162_MOESM1_ESM.doc (96 kb)
Supplementary material 1: Table S1. Literature search strategies for the databases of EMBASE, MEDLINE and PSYCINFO (DOC 96 KB)
11136_2019_2162_MOESM2_ESM.doc (64 kb)
Supplementary material 2: Table S2. PRISMA checklist (DOC 63 KB)


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.School of Public Health and ManagementWeifang Medical UniversityWeifangChina
  2. 2.School of Public HealthUniversity of AlbertaEdmontonCanada

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