# Sex-Based Differences in Lifestyle Behaviours, Self-Esteem, and Academic Performance: A Structural Equation Model in High-Socioeconomic-Status School-Aged Youth from Southern Spain

## TL;DR

The study finds that lifestyle behaviors like sleep, diet, and screen time affect self-esteem and academic performance differently in boys and girls.

## Contribution

The paper introduces a structural equation model revealing sex-specific behavioral patterns in high-SES youth.

## Key findings

- Screen time negatively affects physical activity and diet adherence in girls but not in boys.
- Self-esteem and diet adherence are positively linked to academic performance in girls but not in boys.
- Sleep time is positively associated with diet adherence and negatively with BMI.

## Abstract

What are the main findings?

Sleep time (SLT) was positively associated with Mediterranean diet (MD) adherence and negatively associated with body mass index (BMI). Both physical activity engagement (PA) and MD adherence were positively related to self-esteem (SE), while MD adherence and SE were positively associated with academic performance (AP). These associations remained consistent regardless of socioeconomic status (SES) groups.

Screen time (ST) emerged as a particularly influential factor among girls, showing negative associations with both PA and MD adherence. These patterns were not observed in boys.

While a positive association between PA and SE was evident in both sexes, this relationship was stronger in boys.

In the girls’ model, both MD adherence and SE were positively associated with AP, although this association was not found among boys.

What are the implications of the main findings?

Interventions should go beyond merely promoting healthy behaviours and include psychological factors such as SE.

Sex-specific tailoring of interventions is essential to address the distinct needs and patterns observed in boys and girls.

Early intervention is critical to prevent age-related declines in PA and AP.

Objectives: The present study aimed to examine the relationships between screen time (ST), sleep time (SLT), physical activity engagement (PA), Mediterranean diet (MD) adherence, body mass index (BMI), self-esteem (SE) and academic performance (AP) in high-socioeconomic-status (SES) school-aged youth in southern Spain. Methods: A descriptive, comparative, non-experimental and cross-sectional research study was conducted with a total sample of 217 Spanish students (13.88 ± 1.32). Structural equation modelling (SEM) was employed to analyse relationships between study variables as a function of sex. Results: SLT was positively associated with MD adherence and negatively related with BMI. Both PA and MD adherence were positively linked to SE, whilst MD adherence and SE were also positively related to AP. Regarding sex differences, ST was a stronger determinant among girls, showing negative associations with PA (β = −0.378; p < 0.001) and MD adherence (β = −0.315; p < 0.001), with this pattern not being observed in boys. PA was positively associated with SE in both sexes, but more strongly in boys (β = 0.332; p < 0.001) than in girls (β = 0.190; p = 0.034). In girls, both MD adherence (β = 0.295; p < 0.001) and SE (β = 0.224; p = 0.008) were positively associated with AP, with these associations not being found in boys. Conclusions: The findings underscore the complex interplay between lifestyle behaviours, psychosocial factors, and AP in school-aged youth. Regardless of SES, interventions should focus on reducing ST, promoting PA and MD adherence, and enhancing SE whilst considering sex-specific patterns.