From Healthy Eating to Positive Mental Health in Adolescents: A Moderated Mediation Model Involving Stress Management and Peer Support

Background: Adolescent mental health is a growing public health concern, with increasing prevalence of anxiety, depression, and emotional dysregulation. While nutrition is a recognized factor in physical health, its role in mental well-being, especially through holistic models, remains underexplored. Objectives: This study examines a moderated mediation model in which perceived healthy eating (self-rated diet quality) was associated with positive mental health (PMH) in adolescents, mediated by stress management and moderated by peer social support. Methods: A cross-sectional study was conducted with a sample of 505 adolescents aged 13 to 15 years (mean age 13.62). Using PROCESS Model 14, we tested a moderated mediation model where perceived nutrition served as the predictor, stress management as the mediator, and PMH as the outcome. Peer support was included as a moderator of the mediation pathway. Gender, age, nationality and educational variables were controlled for in the analysis. Results: The model explained 36% of the variance in PMH. Perceived healthy eating was significantly associated with better stress management (B = 0.20, p < 0.001), which in turn was related to higher levels of PMH (B = 6.38, p < 0.001). Peer support played a moderating role between stress management and PMH. Conclusions: These findings underscore the importance of promoting nutritional awareness and adolescents’ self-perception of healthy eating to support both physical and emotional well-being. Interventions should adopt a holistic approach that integrates emotional regulation strategies and leverages peer influence to enhance mental health outcomes. Given the alarming rates of mental health issues in youth, nutrition-based programs that incorporate psychosocial components may offer a promising avenue for prevention and promotion.