Canadian Journal of Public Health

, Volume 109, Issue 1, pp 61–69 | Cite as

Dieting predicts engagement in multiple risky behaviours among adolescent Canadian girls: a longitudinal analysis

  • Amanda Raffoul
  • Scott T. Leatherdale
  • Sharon I. KirkpatrickEmail author
Quantitative Research



We investigated associations between dieting and other health-compromising behaviours among adolescent girls, both cross-sectionally and longitudinally. The behaviours considered included smoking, binge drinking, and breakfast-skipping, and clusters of these.


Data for 3386 adolescent Ontario girls were drawn from COMPASS, a school-based study, which collects self-reported measures of weight, dieting, and other health-related factors. Multilevel logistic regression models were used to investigate relationships between dieting at baseline and smoking, binge drinking, and breakfast-skipping, as well as clusters of these behaviours at baseline and 2 years later.


Baseline dieters were at an elevated risk of smoking and binge drinking (RR = 1.8 and 1.5, respectively) by follow-up compared to non-dieters. Further, dieting was associated with combinations of these behaviours, with the highest risks for smoking/breakfast-skipping (RR = 1.64) and smoking/binge drinking (RR = 1.55). Over one in two (58%) girls reported dieting at baseline and four in five baseline dieters reported dieting 2 years later. Seven in ten girls were dieting at one or both time points. Baseline dieters were more likely to engage in a greater number of risky behaviours, regardless of what the actual behaviours were.


Dieting is longitudinally associated with engagement in other risky behaviours among adolescent girls. These findings suggest that dieting may be an early risk factor for engagement in other risky behaviours and highlight the need for comprehensive prevention strategies to target shared underlying drivers. In addition, attention is needed to the potential for well-meaning weight-related initiatives to promote dieting.


Adolescence Dieting Binge drinking Smoking Breakfast Longitudinal 



Nous avons étudié les associations transversales et longitudinales entre le fait de suivre un régime et d’autres comportements compromettants pour la santé chez les adolescentes. Les comportements étudiés étaient le tabagisme, l’hyperalcoolisation rapide et la pratique de sauter le petit-déjeuner, ainsi que les grappes de ces comportements.


Les données de 3386 adolescentes ontariennes ont été extraites de COMPASS, une étude en milieu scolaire qui recense les mesures autodéclarées du poids, du suivi d’un régime et d’autres facteurs liés à la santé. Des modèles de régression logistique multiniveaux ont servi à explorer les relations entre le suivi d’un régime au départ et le tabagisme, l’hyperalcoolisation rapide, la pratique de sauter le petit-déjeuner, et les grappes de ces comportements au départ et deux ans plus tard.


Les filles qui suivaient un régime au départ couraient un risque plus élevé de tabagisme et d’hyperalcoolisation rapide (RT = 1,8 et 1,5, respectivement) deux ans plus tard que les filles qui ne suivaient pas de régime. De plus, le suivi d’un régime était associé aux combinaisons de ces comportements, les risques les plus élevés étant le tabagisme/la pratique de sauter le petit-déjeuner (RT = 1,64) et le tabagisme/l’hyperalcoolisation rapide (RT = 1,55). Plus d’une fille sur deux (58%) a déclaré suivre un régime au départ, et quatre filles sur cinq qui suivaient un régime au départ en suivaient toujours un deux ans plus tard. Sept filles sur dix suivaient un régime au départ, au suivi ou les deux. Les filles qui suivaient un régime au départ étaient susceptibles de se livrer à un plus grand nombre de comportements à risque, tous comportements confondus.


Suivre un régime est longitudinalement associé aux comportements à risque chez les adolescentes. Ces constatations indiquent que suivre un régime peut être un facteur de risque précoce de se livrer à d’autres comportements à risque, d’où la nécessité d’avoir des stratégies de prévention globales pour cibler les vecteurs communs sous-jacents. En outre, il faut envisager la possibilité que des initiatives bien intentionnées liées au poids incitent à se mettre au régime.


Adolescence régime alimentaire hyperalcoolisation rapide tabagisme petit-déjeuner étude longitudinale 



Dr. Jess Haines of the University of Guelph provided valuable feedback on data analysis and interpretation. Amanda Raffoul was funded by a Queen Elizabeth II Graduate Scholarship in Science and Technology. Scott Leatherdale is a Chair in Applied Public Health Research funded by the Public Health Agency of Canada (PHAC) in partnership with Canadian Institutes of Health Research (CIHR). At the time that the analyses were conducted, Sharon Kirkpatrick was funded by a Capacity Development Award from the Canadian Cancer Society Research Institute (702855). The COMPASS study was supported by a bridge grant from the CIHR Institute of Nutrition, Metabolism, and Diabetes (INMD) through the “Obesity—Interventions to Prevent or Treat” priority funding award (OOP-110788; awarded to S. Leatherdale) and an operating grant from the CIHR Institute of Population and Public Health (IPPH) (MOP-114875; awarded to S. Leatherdale).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© The Canadian Public Health Association 2018

Authors and Affiliations

  • Amanda Raffoul
    • 1
  • Scott T. Leatherdale
    • 1
  • Sharon I. Kirkpatrick
    • 1
    Email author
  1. 1.School of Public Health and Health SystemsUniversity of WaterlooWaterlooCanada

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