This brief report tests the mediating effect of self-esteem in the relationship between body dissatisfaction and symptoms of depression and anxiety. A sample of 409 adolescents (females = 58.4%) aged between 14 and 18 years completed the Rosenberg Self-Esteem Scale, the Contour Drawing Rating Scale, the Multidimensional Anxiety Scale for Children, and the Center for Epidemiologic Studies Depression Scale. Overall, results for the indirect effects analysis were significant for both anxiety and depression, which confirmed the mediating role of self-esteem. Thus, a negative perception of one’s body image has the effect of lowering self-esteem, which in turn increases psychological distress.

Long-term adherence to principles of the Mediterranean diet (MedDiet) following a nutritional intervention promoting the Mediterranean food pattern in Canadian men and women is not known. Moreover, gender differences in dietary and metabolic profile in such an intervention context has never been addressed. Objective was to determine gender differences in long-term effects of a 12-week nutritional intervention program promoting the adoption of the MedDiet and based on the Self-Determination Theory (SDT) on dietary intakes, eating behaviors, anthropometric and metabolic variables, in men and women presenting cardiovascular risk factors. Sixty-four men and 59 premenopausal women were recruited. The 12-week nutritional program used a motivational interviewing approach and included individual and group sessions. A food frequency questionnaire was administered to evaluate dietary intakes from which a Mediterranean score (Medscore) was derived and the Three-Factor Eating Questionnaire allowed assessment of eating behaviors. Measurements were performed at baseline and after the 12-week nutritional intervention, and then at 3 and 6-month post intervention. No gender difference was observed in changes in the Medscore during the nutritional intervention and follow-up. However, the Medscore returned towards baseline values during follow-up in men and women (P <0.0001). Men reported larger decreases in red and processed meat and larger increases in whole fruit intakes than women (P = 0.03 and P = 0.04, respectively). Men showed a greater decrease in habitual susceptibility to disinhibition than women (P = 0.03). A gender by time interaction was found for waist circumference, i.e. men had lower waist circumference at the end of the intervention as well as at follow-up than at baseline while women’s waist circumference decreased in response to the intervention only (P = 0.05). As for metabolic variables, changes observed in total-cholesterol (C) to HDL-C ratio, triglyceride levels and triglycerides to HDL-C ratio were more pronounced in men than in women after the intervention as well as at follow-up (P ≤0.03). Our results indicate that the 12-week nutritional intervention based on the SDT leads to more pronounced beneficial changes in long-term dietary intakes in men than in women and to greater improvements in metabolic profile in men. Current Controlled Trials NCT01852721 .