Evaluation of Grazing Behavior and Its Associations with Obesity, Emotion Regulation Difficulties, and Problematic Smartphone Use in Adolescents with Essential Hypertension

Background: This study aimed to compare grazing behavior scores between adolescents with essential hypertension (HTN) and controls. It also investigated the associations of grazing behavior with obesity, emotion regulation difficulties (ERD), problematic smartphone use, and screen time. Methods: This cross-sectional case–control study enrolled 60 adolescents with essential HTN and 60 controls selected via frequency matching based on age and sex, all aged 12–18 years. The diagnosis of essential HTN was confirmed using 24-h ambulatory blood pressure monitoring (ABPM). Grazing behavior, ERD, problematic smartphone use, screen time and body mass index (BMI) were assessed in all participants. Group comparisons and associations between grazing behavior and the study variables were analyzed. Results: The essential HTN and control groups were comparable with respect to age and sex distribution (p > 0.05). The mean BMI in the essential HTN group was 31.18 ± 6.81 kg/m2, which was significantly higher than that in the control group (23.35 ± 4.47 kg/m2) (p < 0.001). A significant positive correlation was found between total Grazing Questionnaire (GQ) scores and BMI (r = 0.252; p = 0.006), ERD (r = 0.187; p = 0.041), and problematic smartphone use (r = 0.315; p < 0.001). A statistically significant difference was observed between the essential HTN and control groups in total GQ scores [F(1, 117) = 4.85, p = 0.030, η2p = 0.040]. After adjustment for BMI, participants with hepatic steatosis had significantly higher total GQ scores (p = 0.019, η2p = 0.138), Grazing Behaviors subscale scores (p = 0.046, η2p = 0.107), and Uncontrollability subscale scores (p = 0.025, η2p = 0.123) than those without hepatic steatosis. Conclusions: Adolescents with essential HTN had higher grazing behavior scores than controls after adjustment for BMI. Grazing behavior was also associated with ERD and problematic smartphone use across the study sample. The findings regarding grazing behavior and hepatic steatosis warrant cautious interpretation, as the subgroup analysis was exploratory and included a relatively small number of participants.