1Programa de Pós-graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal De Uberlândia, Uberlândia, Brazil, 2Instituto de Medicina Social Hesio Cordeiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil, 3Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
Introduction: Ultra-processed food has been associated with several negative outcomes, but it is not clear whether it is related to bullying perpetration. Moreover, no previous study has investigated the potential role of deviant behaviors as a mediator of this association. Objective: We aimed to evaluate the association between ultra-processed food pattern and bullying, and the mediating effect of deviant behaviors, among school adolescents. Methods: We used data from a representative sample of 9th grade Brazilian adolescents (N=2,212) from the Sao Paulo Project for the social development of children and adolescents (SP-PROSO). Exploratory factor analysis was used to obtain the ultraprocessed food dietary pattern (exposure), through questions of frequency of consumption in the last week of several food. The outcomes were the types of bullying (any type, social exclusion, psychological/verbal aggression, physical aggression, property destruction, and sexual harassment). Deviant behaviors (mediator) were assessed through a score. Mediation analyses were carried out using logistic regression based on the KHB method. Results: The ultra-processed dietary pattern was associated with an increased probability of perpetrating bullying and, after adjusting for covariates, the mediating effect of deviant behaviors was found for all types of bullying perpetration, with a high mediation percentage for psychological/verbal aggression (40.1%). A small mediating effect of deviant behaviors was found for physical aggression (18.3%) and property destruction (18.2%). Conclusions: The ultra-processed dietary pattern is associated with bullying, and the association is mediated through deviant behaviors. Policies for preventing and managing delinquent behaviors and bullying among adolescents are required.
Keywords: ultra-processed food, bullying perpetration, school, adolescents.