Depressive symptoms and observed eating in youth

Changing eating to manage weight or shape: A cross-sectional and prospective study of the prevalence and correlates in a large Canadian adolescent cohort

OBJECTIVE

The present study examined reports of changing eating to manage weight/shape over one year among adolescents. It also tested how changing eating for weight/shape was associated with physical activity (resistance training, moderate-to-vigorous physical activity; MVPA) and mental health (depressive symptoms, flourishing), and whether weight perceptions moderated these associations.

METHODS

Participants were Canadian adolescents (N = 20,614, Mage ± SD = 14.4 ± 1.3, 52.9% girls) who completed self-report surveys in the 2020-2021 and 2021-2022 waves of the COMPASS study. Separate multilevel models were tested for each outcome.

RESULTS

Approximately 30% of adolescents reported changing their eating to manage weight/shape at least once a week. More days of changing eating were associated with significantly higher depressive symptoms and lower flourishing cross-sectionally (b = 0.51, b = -0.27) and over time (b = 0.35, -0.20); the flourishing association over time was weaker for adolescents who perceived themselves as overweight relative to about right. More days of changing eating were also associated with more MVPA and resistance training cross-sectionally (b = 2.81, b = 0.19) and over time (b = 1.28, b = 10). The relationship between changing eating and MVPA over time was stronger for adolescents who perceived themselves as overweight relative to about right; whereas the cross-sectional relationship between changing eating and resistance training was weaker.

CONCLUSIONS

Reports of changing eating to manage weight/shape were associated with divergent health outcomes; research into how and to what extreme adolescents are changing eating to manage weight/shape, and identity factors that may contribute to these differences, is warranted.

Social desirability bias is related to children's energy intake in a laboratory test meal paradigm

Dietary intake is notoriously difficult to measure in children. Laboratory test meals address some of the methodological concerns of self-report methods, but may also be susceptible to social desirability bias, referring to the tendency for individuals to adjust their behaviors in order to be perceived more positively. The aim of the current study was to evaluate whether social desirability bias was associated with children's energy intake during a laboratory test meal, and whether this association varied by food type (total caloric intake, snack food intake, fruit/vegetable intake) and sex. A total of 82 children (M age = 9.45 ± 0.85; 50 % girls; 84.1 % rural; 85.4 % White) completed several surveys, including the Children's Social Desirability Scale and had their body composition measured. At lunchtime, they were granted access to a multi-array test meal (>5000 kcal). After adjusting for lean mass, fat mass, depressive symptoms, and parental food restriction, children who reported higher social desirability bias consumed fewer calories from snack foods (B = -11.58, p = .009, semi-partial correlation = -0.28). Boys with higher social desirability bias consumed less calories from fruits and vegetables (B = -6.47, p = .010, semi-partial correlation = -0.411); this association was not significant in girls. The desire to be perceived in a positive manner may influence children's eating behaviors in experimental paradigms. Replication studies with larger, more diverse pediatric samples are needed, as are strategies to reduce the effects of social desirability bias on test meal intake in order to enhance the validity of this dietary assessment approach.

The burden of psychological distress and unhealthy dietary behaviours among 222,401 school-going adolescents from 61 countries

We aimed to calculate the sex-specific prevalence of psychological distress and unhealthy eating habits among adolescents across countries and regions, and to explore their potential associations. We used data from the Global School-Based Health Survey (GSHS) for 61 countries. Psychological distress was defined based on the existence of ≥ 2 factors from the following: loneliness, anxiety, suicide ideation, suicide planning, and suicide attempt. Four unhealthy dietary behaviours were examined: inadequate fruit intake, inadequate vegetable intake, daily consumption of soft drinks, and weekly fast-food consumption. We used random-effects meta-analysis to estimate the overall and regional pooled prevalence. Mixed-effect multilevel logistic regressions were used to estimate adjusted odds ratios (aORs) of unhealthy dietary behaviours in relation to psychological distress. Among 222,401 school-going adolescents (53.3% girls), the prevalence of psychological distress was 17.9%, with girls reporting higher than boys (20.8% vs. 14.9%). Adolescents in the African region reported the highest prevalence (22.5%), while those in the South-East Asia region reported the lowest (11.3%). The prevalence of inadequate fruit intake, inadequate vegetable intake, daily soft drink consumption, and weekly fast-food consumption was 37.0%, 28.5%, 50.0%, and 57.4% respectively. Psychological distress was associated with inadequate fruit intake (pooled aOR = 1.19, 95% CI 1.17-1.23), inadequate vegetable intake (pooled OR = 1.19, 1.16-1.22), daily consumption of soft drinks (pooled aOR = 1.14, 1.12-1.17), and weekly consumption of fast food (pooled aOR = 1.12, 1.09-1.15). Our findings indicate a substantial variance in the burden of psychological distress and unhealthy dietary behaviours across different regions. Adolescents experiencing psychological distress were more likely to have unhealthy dietary habits.

Mediating effect of physical sub-health in the association of sugar-sweetened beverages consumption with depressive symptoms in Chinese college students: A structural equation model

BACKGROUND

Although previous findings with small samples indicated that sugar-sweetened beverages (SSB) consumption was associated with depressive symptoms in adolescents, the mediating effect of physical sub-health in the association is unknown.

METHODS

A survey was conducted among freshmen from 11 provinces in China. A food frequency questionnaire was used to collect dietary behavior, and patient health questionnaire-9 items was used to assess depressive symptoms. A generalized linear model was used to analyze the association between SSB consumption, physical sub-health and depressive symptoms. The structural equation model was used to analyze the mediating effect of physical sub-health.

RESULTS

Of the 31,856 participants, 36.5 % had positive depressive symptoms. After adjusting for variables, carbonate beverages (β = 0.11; 95%CI: 0.07-0.15; P = 0.000) and milk tea (β = 0.07; 95%CI: 0.01-0.13; P = 0.021) consumption was associated with depressive symptoms in boys. Carbonate beverages (β = 0.09; 95%CI: 0.05-0.13; P = 0.000), tea beverages (β = 0.09; 95%CI: 0.04-0.13; P = 0.000), and milk tea (β = 0.08; 95%CI: 0.04-0.11; P = 0.000) consumption was associated with depressive symptoms in girls. The mediating effect of physical sub-health accounted for 81.3 % of the total effect in the mediating model of SSB associated with depressive symptoms.

LIMITATIONS

Retrospective survey has certain information bias. Association observed in the cross-sectional study is uncertain.

CONCLUSIONS

The present study suggests that the consumption of SSB associated with depressive symptoms in Chinese college students, and physical sub-health plays a complete mediating role in the association.

Junk food consumption and psychological distress in children and adolescents: a systematic review and meta-analysis

Background: Available evidence indicates that junk foods, defined as unhealthy foods with high-calorie and low-nutrient value, negatively affect mental and metabolic health of children. This study aimed to conduct a meta-analysis to clarify the association between junk food consumption and psychological distress in children and adolescents.Methods: A systematic literature search of relevant documents published in PubMed, Web of Science, and SCOPUS was conducted up to 2022. All observation studies which assessed association of junk foods and psychological distress in children and adolescents were included. Random-effect model was used to pool odds ratio (OR) and 95% confidence interval (CI) from individual studies. Subgroup meta-analysis was performed based on junk foods categories (sweet drinks, sweet snacks and snacks).Results: Data of 17 included articles on junk foods consumption in relation to depression, stress, anxiety, sleep dissatisfaction and happiness in children and adolescents were included in this systematic review. According to random effect model, the pooled OR in the highest vs. the lowest category of junk foods was 1.62 (95% CI: 1.35-1.95) for depression, 1.34 (95% CI: 1.16-1.54) for stress, 1.24 (95% CI: 1.03-1.50) for anxiety, 1.17 (95% CI: 1.05-1.30) for sleep dissatisfaction and 0.83 (95% CI: 0.75-0.92) for happiness. In subgroup meta-analysis, there were significant associations between different types of junk foods and psychological distress (P < 0.05).Conclusion: This meta-analysis showed that junk foods consumption was associated with increased odds of psychological distress in children and adolescents. These findings support the current recommendation of decreasing junk foods intake.

Association Between Emotional Eating, Sociodemographic Characteristics, Physical Activity, Sleep Duration, and Mental and Physical Health in Young Adults

BACKGROUND

Emotional eating (EmE) is one of the most common eating behaviors maladaptive among young adults, however, in the Peruvian context, it remains unexplored.

OBJECTIVE

The aim of the study was to determine the association between negative EmE, sociodemographic characteristics, physical activity, sleep duration, and mental and physical health in young adults.

METHODS

A cross-sectional study was conducted in 400 young Peruvian adults living in three regions of Peru (coast, jungle, and highlands). An online survey was used to collect information on sociodemographic characteristics, physical activity, sleep duration, depressive symptoms, anxiety, hypertension, and negative EmE. In addition, self-reported anthropometric data were collected to calculate body mass index (BMI).

RESULTS

Approximately 55.8% of women presented negative EmE. Logistic regression analysis revealed that participants aged 30-39 years were less likely to have negative EmE in both female and male gender, OR; 0.24, 95% CI; 0.08-0.66, p<0.01 and OR; 0.40, 95% CI; 0.16-0.97, p<0.05, respectively. Perform physical activity 3 to 4 times 5.22 (95% CI: 1.31-20.78), 1 to 2 times a week 5.77 (95% CI: 1.91-17.44), and never 15.18 (95% CI: 3.90-59.00) were associated with negative EmE. Moreover, sleeping less than 7 hours per day (OR; 2.26, 95% CI; 1.04-4.90), depressive symptoms (OR = 6.29, 95% CI: 1.27-31.19), anxiety (OR = 14.13, 95% CI: 2.46-80. 97, p<0.01), hypertension (OR = 7.58, 95% CI: 1.24-46.17), and BMI ≥25 (overweight/obese) (OR = 1.51, 95% CI: 1.66-3.41) were associated with negative EmE.

CONCLUSION

The findings show that there is an association between negative EmE, sociodemographic characteristics, physical activity, sleep duration, and mental and physical health in young adults.

Increased Consumption of Ultra-Processed Food Is Associated with Poor Mental Health in a Nationally Representative Sample of Adolescent Students in Brazil

The objective of this study was to analyze the association between ultra-processed food (UPF) consumption and mental health symptoms in a nationally representative sample of the Brazilian adolescent student population. Cross-sectional analyses with data from the National School-Based Health Survey (PeNSE 2019) were performed. Self-reported information was obtained for the frequency of five mental health symptoms in the last month and the consumption of thirteen UPFs in the last 24 h. Generalized linear models adjusting for the main confounders were performed for each sex. Of the 94,767 adolescent students (52.4% girls) included, 8.1% of the boys and 27.2% of the girls reported "almost always" or "always" having at least four of the five mental health symptoms. In the fully adjusted models, compared to the boys who consumed ≤3 UPF, those consuming ≥6 UPF reported more frequent symptoms of poor mental health (ß-coefficient = 0.27 [0.03, 0.51]; p-for-trend = 0.005). A similar association was observed in girls (ß-coefficient = 0.31 [0.13, 0.50]; p-for-trend = 0.001). In conclusion, in this large sample of adolescent students from an entire country, the higher the consumption of UPF was, the higher the frequency of reported symptoms of poor mental health. These findings remained significant regardless of sociodemographic and lifestyle factors, self-perceived body image, and bullying victimization.

Psychological distress and unhealthy dietary behaviours among adolescents aged 12-15 years in nine South-East Asian countries: a secondary analysis of the Global School-Based Health Survey data

It is unclear whether there is any association between psychological distress and unhealthy dietary habits among adolescents in low- and middle-income countries. We aimed to estimate the prevalence of these factors in South-East Asia region and investigate their associations. We used data from the Global School-based Health Survey for nine South-East Asian countries. Psychological distress was defined by presence of ≥ 2 factors from loneliness, anxiety, suicide ideation, suicide planning and suicide attempt. We assessed inadequate fruit intake, inadequate vegetable intake, daily soft drink and weekly fast-food consumption. We used random-effects meta-analysis to estimate pooled prevalence. Logistic regressions were used to estimate OR of unhealthy dietary behaviours for psychological distress. Among 30 013 adolescents (56 % girls) aged 12-15 years, the prevalence of psychological distress was 11·0 %, with girls reporting slightly higher than boys (11·8 % v. 10·1 %). The prevalence of inadequate fruit intake, inadequate vegetable intake, daily soft drink consumption and weekly fast-food consumption was 42 %, 26 %, 40 % and 57 %, respectively. Psychological distress was associated with inadequate fruit intake (pooled OR = 1·20, 95 % CI 1·03, 1·40), inadequate vegetable intake (pooled OR = 1·17, 1·05, 1·31) and daily soft drink consumption (pooled OR = 1·14, 1·03, 1·26); but not with weekly fast-food consumption (pooled OR = 1·13, 0·96, 1·31). We observed substantial cross-country variations in prevalence and OR estimates. In conclusion, South-East Asian adolescents have significant burden of psychological distress and unhealthy dietary behaviours, with those having psychological distress are more likely to have unhealthy dietary behaviours. Our findings will guide preventative interventions and inform relevant policies around adolescent nutrition in the region.

Parent Intention to Enroll in an Online Intervention to Enhance Health Behavior Change among Youth Treated with Psychotropic Medication Who Are Overweight or Obese: An Elicitation Study

Youth who are prescribed psychotropic medication are disproportionally affected by overweight/obesity (OW/OB), yet few interventions have been tailored to their needs. To develop new interventions, it is important to address the needs, preferences, and intentions of target users. Qualitative methods within the theory of planned behavior (TPB) framework were used in this study to identify salient beliefs which may influence attitudes associated with parents’ intentions to participate in a future online intervention designed to develop behavioral health coaching skills among parents and guardians. Twenty parents and guardians of youth with OW/OB who were taking psychotropic medications, and were eligible for the study, were recruited through TurkPrime. Parents and guardians identified key salient beliefs consistent with the theory of planned behavior including behavioral beliefs (e.g., access and convenience), normative beliefs (e.g., family), and control beliefs (e.g., cost) that may influence their decision to enroll in a future, parent-oriented intervention. The results of this study suggest important salient beliefs which may be included in future research, as well as specific preferences which may be used to guide the development of a future intervention. Future work should focus on the creation of a salient belief quantitative measure and assess the relationships of these beliefs to attitudinal constructs and behaviors.

Race/ethnicity moderates associations between depressive symptoms and diet composition among U.S. adults

OBJECTIVE

Although depression is associated with poorer overall diet quality, few studies have examined its association with levels of particular macronutrients, and none have examined moderation by race/ethnicity. The present study examined (a) associations between depressive symptom severity and nine indices of diet composition and (b) whether race/ethnicity moderates these associations.

METHOD

Participants were 28,940 adults (mean age = 49 years, 52% female, 52% nonwhite) from NHANES 2005-2018. Depressive symptom severity was measured using the Patient Health Questionnaire-9 (PHQ-9). Nine diet composition indices were derived from the average of two 24-hr dietary recalls (e.g., total energy, total fat, saturated fat, total carbohydrate, sugar, fiber, and protein).

RESULTS

Separate linear regression analyses revealed that PHQ-9 total was positively associated with saturated fat and sugar and negatively associated with protein and fiber. Moderation by race/ethnicity was observed (interaction ps < .05). Among non-Hispanic Whites, PHQ-9 total was positively associated with sugar and negatively associated with protein and fiber. Among non-Hispanic Blacks, PHQ-9 total was positively associated with total energy, total fat, saturated fat, monounsaturated fat, polyunsaturated fat, total carbohydrate, and sugar. Among Mexican Americans, PHQ-9 was positively associated with saturated fat. Among other Hispanics, PHQ-9 total was negatively associated with fiber, protein, and total, monounsaturated, and polyunsaturated fat.

CONCLUSIONS

Findings from this large, nationally representative sample demonstrate that associations between depressive symptom severity and diet composition vary by race/ethnicity. Critically, an unhealthy diet composition pattern may be one mechanism explaining the excess risk of obesity and cardiometabolic diseases in individuals with depression, especially in non-Hispanic Blacks. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Adherence to Mediterranean Diet, Alcohol Consumption and Emotional Eating in Spanish University Students

(1) Introduction: The university period may increase the risk of different unhealthy habits, such as low adherence to the Mediterranean diet, high alcohol consumption and eating in response to specific emotions. The aim of this study was to detect early-risk alcohol consumption and alcohol dependence (ADS), the degree of adherence to the Mediterranean diet and emotional eating in university students of the Madrid community. (2) Methods: For each individual, anthropometric parameters, the Alcohol Use Disorders Identification Test (AUDIT), AUDIT-Consumption (AUDIT-C), the Mediterranean Diet Adherence Screener (MEDAS) and the Emotional Eater Questionnaire (EEQ) were assessed. (3) Results: A total of 584 university students aged 20.5 (sex ratio = 0.39) were enrolled in a cross-sectional study. In total, 63.6% of students showed low adherence to the Mediterranean diet, with no differences by sex (64.3% female versus 61.5% male, p = 0.19). According to the AUDIT questionnaire, 26.2% of participants were categorized as high-risk drinkers and 7.7% as ADS. About 38.6% of the students were categorized as eating very emotionally or eating emotionally, and 37.2% were categorized as low emotional eaters. A weak positive correlation was observed between the EEQ and BMI in female students (rho= 0.15, p = 0.03). (4) Conclusions: University students in our sample showed a low adherence to the Mediterranean diet, an important high-risk alcohol consumption and low emotional eating.

Fat and Carbohydrate Interact to Potentiate Food Reward in Healthy Weight but Not in Overweight or Obesity

Prior work suggests that actual, but not estimated, energy density drives the reinforcing value of food and that energy from fat and carbohydrate can interact to potentiate reward. Here we sought to replicate these findings in an American sample and to determine if the effects are influenced by body mass index (BMI). Thirty participants with healthy weight (HW; BMI 21.92 ± 1.77; M ± SD) and 30 participants with overweight/obesity (OW/OB; BMI 29.42 ± 4.44) rated pictures of common American snacks in 120-kcal portions for liking, familiarity, frequency of consumption, expected satiety, healthiness, energy content, energy density, and price. Participants then completed an auction task where they bid for the opportunity to consume each food. Snacks contained either primarily carbohydrate, primarily fat, or roughly equal portions of fat and carbohydrate (combo). Replicating prior work, we found that participants with HW bid the most for combo foods in linear mixed model analyses. This effect was not observed among individuals with OW/OB. Additionally, in contrast with previous reports, our linear regression analyses revealed a negative relationship between the actual energy density of the snacks and bid amount that was mediated by food price. Our findings support altered macronutrient reinforcement in obesity and highlight potential influences of the food environment on the regulation of food reward.

Noncommunicable Disease Risk Factors Among Adolescent Boys and Girls in Bangladesh: Evidence From a National Survey

Objectives

To assess the prevalence of noncommunicable disease (NCD) risk factors and the factors associated with the coexistence of multiple risk factors (≥ 2 risk factors) among adolescent boys and girls in Bangladesh.

Methods

Data on selected NCD risk factors collected from face to face interviews of 4,907 boys and 4,865 girls in the national Nutrition Surveillance round 2018-2019, was used. Descriptive analysis and multivariable logistic regression were performed.

Results

The prevalence of insufficient fruit and vegetable intake, inadequate physical activity, tobacco use, and being overweight/obese was 90.72%, 29.03%, 4.57%, and 6.04%, respectively among boys; and 94.32%, 50.33%, 0.43%, and 8.03%, respectively among girls. Multiple risk factors were present among 34.87% of boys and 51.74% of girls. Younger age (p < 0.001), non-slum urban (p < 0.001) and slum residence (p < 0.001), higher paternal education (p = 0.001), and depression (p < 0.001) were associated with the coexistence of multiple risk factors in both boys and girls. Additionally, higher maternal education (p < 0.001) and richest wealth quintile (p = 0.023) were associated with the coexistence of multiple risk factors in girls.

Conclusion

The government should integrate specific services into the existing health and non-health programs which are aimed at reducing the burden of NCD risk factors.

The effect of sociodemographic characteristics of university students on emotional eating behavior

PURPOSE

This descriptive study was conducted for the purpose of determining the effect of sociodemographic characteristics of university students on emotional eating behavior.

DESIGN AND METHODS

The study was completed with a total of 537 students. A descriptive questionnaire and the Emotional Eating Scale were used. Descriptive statistics, correlation, and regression analyses were used.

FINDING

It was found that emotional eating was positively correlated with body mass index and weight. It was determined that variables such as will, anger, body mass index, and weight were predictors of emotional eating.

PRACTICAL IMPLICATIONS

Emotional eating is a coping response with negative emotions. It is suggested that will is the most important factor affecting emotional eating. Thus, psychological dimension of wrong eating habit should definitely be addressed.

Development of MacroPics: A novel food picture set to dissociate the effects of carbohydrate and fat on eating behaviors

Emerging evidence suggests that fat and carbohydrate interact to potentiate the reward value of food (DiFeliceantonio et al., 2018). The primary goal of the current study was to develop a novel picture set to facilitate research into the effects of macronutrient composition on food choice and eating behavior. Toward this aim, we developed "MacroPics." In Experiment 1, we photographed 120-kcal portions of 60 snack foods falling into one of the three macronutrient categories: (1) mostly carbohydrate, (2) mostly fat, or (3) a combination of fat and carbohydrate. Sixty-one participants rated the images for liking, familiarity, frequency of consumption, healthiness, estimated energy content (in kcal), and expected satiation. A subset of these images consisting of 36 items was then selected in an iterative process to minimize differences in ratings between the macronutrient categories while simultaneously ensuring similar within-category variability on a number of food characteristics (e.g., energy density, portion size, retail price) and visual properties (e.g., color, complexity, visual area). In Experiment 2, an independent sample of 67 participants rated the pictures of the final 36-item MacroPics. Both experiments reveal similar participant ratings across categories for item liking, familiarity, frequency, healthiness, and estimated energy content. Protein content was higher in the fat compared to the carbohydrate and combination categories, leading to higher ratings of estimated satiety and energy density for fatty foods. Item and macronutrient category characteristics of the final MacroPics set are reported.

Interaction effects of co-consumption of fast food and sugar-sweetened beverages on psychological symptoms: Evidence from a nationwide survey among Chinese adolescents

BACKGROUND

Although fast food and sugar-sweetened beverages (SSBs) consumption have been closely linked to childhood and adolescent obesity, the data regarding their co-consumption and relationship to mental health remains controversial.

METHODS

A multi-centered population-based survey was conducted among Chinese adolescents from grades 7 to 12. Data about participants' consumption of fast foods and SSBs were obtained from self-reported questionnaires. Psychological symptoms were assessed using the Multi-dimensional Sub-health Questionnaire of Adolescents (MSQA). The association between co-consumption of fast food and SSBs and psychological symptoms was assessed using quantile regression analysis, adjusting for covariates.

RESULTS

Approximately one-fifth of the 14,500 participants reported psychological symptoms. The regression coefficient (β) value increased as the quantile of fast food, SSBs, and co-consumption increased in the quantile regression model, and the model had an excellent goodness-of-fit (F = 192.51, p < 0.001). In the interaction model, fast food and SSBs in combination were associated with greater odds of psychological symptoms (aOR = 1.90, 95% CI: 1.69, 2.12). The synergy index, relative excess risk of interaction, and attributable proportions were 1.86 (95% CI: 1.17, 2.96), 0.4 (95% CI: 0.20, 0.63), and 0.22 (95% CI: 0.11, 0.33), respectively.

LIMITATIONS

Information bias is inevitable in self-reported data among participants. The ability to assess causal relationships is reduced by a cross-sectional study design.

CONCLUSIONS

Our findings suggest that co-consumption of fast food and SSBs was cross-sectionally associated with mental health problems among adolescents.

Does food intake mediate the association between mindful eating and change in depressive symptoms?

OBJECTIVE

To examine mediation by (i) diet quality and (ii) diet quantity in the associations of mindful eating domains with 3-year change in depressive symptoms.

DESIGN

Depressive symptoms were measured with the Center for Epidemiologic Studies Depression scale at baseline and 3-year follow-up. Four mindful eating domains (Focused Eating; Eating in response to Hunger and Satiety Cues; Eating with Awareness; Eating without Distraction) were measured with the Mindful Eating Behavior Scale. Food intake was measured with a 238-item FFQ. Diet quality was defined as the Mediterranean Diet Score (MDS). Diet quantity was defined as total energy intake (kcal/d; 1 kcal = 4·184 kJ). Mediation analyses with percentile-corrected bootstrap confidence intervals were conducted to calculate indirect effects.

SETTING

Longitudinal Aging Study Amsterdam.

PARTICIPANTS

Adults aged 55 years or above (n 929).

RESULTS

Diet quality (MDS) did not mediate associations of any of the four mindful eating domains with change in depressive symptoms. In contrast, total energy intake did mediate the associations with change in depressive symptoms for the mindful eating domains Eating with Awareness (indirect effects fully adjusted models: B = -0·014, 95 % CI -0·037, -0·002) and Eating without Distraction (B = -0·013, 95 % CI -0·033, -0·001), but not for the other two domains. Post hoc multiple mediation analyses showed similar results.

CONCLUSIONS

Higher scores on two mindful eating domains were associated with a decrease in depressive symptoms through lower total energy intake. Diet quantity, but not diet quality, could be a possible underlying mechanism in the associations between mindful eating and change in depressive symptoms.

Association Between Screen Time, Fast Foods, Sugar-Sweetened Beverages and Depressive Symptoms in Chinese Adolescents

OBJECTIVE

Although previous studies have shown that screen time (ST), fast foods (FFs) and sugar-sweetened beverages (SSBs) consumption are associated with depressive symptoms in adolescents, research on these associations in Chinese adolescents is scarce. This study aimed to examine the association between ST, FFs, SSBs and depressive symptoms in Chinese adolescents, and explore the mediating effects of FFs and SSBs in the association between ST and depressive symptoms.

METHODS

This school-based nationwide survey was carried out among 14,500 students in four provinces of China. The Children's Depression Inventory was used to assess the participants' depressive symptoms. ST, FFs and SSBs consumption was measured by a self-reported questionnaire. The Bayesian multiple mediation model was used to analyze the mediation effect.

RESULTS

ST, FFs and SSBs, were more likely to be associated with depressive symptoms, and ORs (95%CI) was 1.075 (1.036-1.116), 1.062 (1.046-1.078) and 1.140 (1.115-1.166), after we adjusted for sociodemographic variables. Additionally, in Bayesian multiple mediation model, direct effect, mediating effect, total effect, the ratio of mediating effect to total effect was 0.125, 0.034, 0.159, and 0.214, respectively. All path coefficients of the three mediation paths are statistically significant (p < 0.05).

CONCLUSIONS

Our study demonstrates that ST, FFs and SSBs consumption are associated with depressive symptoms in Chinese adolescents. It is likely that FFs and SSBs partially mediate the association between ST and depressive symptoms by chain-mediating effects.

Executive Function and Dysregulated Eating Behaviors in Pediatric Obesity

Objective

To examine the association between caregiver proxy report of executive function (EF) and dysregulated eating behavior in children with obesity.

Methods

Participants were 195 youth with obesity aged 8-17 years, and their legal guardians. Youth height, weight, demographics, depressive symptoms, eating behaviors, and EF were assessed cross-sectionally during a medical visit. Analyses of covariance, adjusted for child age, gender, race/ethnicity, standardized BMI, depressive symptoms, and family income were used to examine differences in youth EF across caregiver and youth self-report of eating behaviors.

Results

Youth EF differed significantly by caregiver report of eating behavior but not youth self-report. Post hoc analyses showed that youth with overeating or binge eating had poorer EF than youth without these eating behaviors.

Conclusions

Executive dysfunction, as reported by caregivers, in youth with obesity may be associated with dysregulated eating behaviors predictive of poor long-term psychosocial and weight outcomes. Further consideration of EF-specific targets for assessment and intervention in youth with obesity may be warranted.

Obesity in Adolescents with Psychiatric Disorders

PURPOSE OF REVIEW

This narrative review synthesized recent research related to obesity in adolescents with psychiatric disorders, with a focus on epidemiology, mechanisms, and weight management approaches. The paper reviews literature on depressive and anxiety disorders, bipolar disorder, and schizophrenia spectrum and other psychotic disorders.

RECENT FINDINGS

Depression has a bidirectional relationship with obesity. Bipolar disorder and schizophrenia spectrum disorders, and their treatments, increase the risk of developing obesity. Mechanisms underlying this weight gain include lifestyle and environmental factors and psychiatric medications, though emerging evidence has also suggested the role of genetic and neuroendocrine processes. Evidence about the most effective treatments for obesity in adolescents with psychiatric disorders remains limited. Adolescents with psychiatric disorders are at high risk for obesity. Close monitoring for increases in weight and cardiometabolic risk factors with use of antipsychotic and mood-stabilizing medications is recommended. Clinical trials are needed that test the efficacy of weight management strategies for this population.

Body weight status is not a predictive factor of depressive symptoms in Polish adolescents aged 13-18 years

Depression and unhealthy weight status are among the most common concerns in adolescent boys and girls. Research results on the relationship between depression and weight status are contradictory. The aim of the present study was to assess the association between body weight status and depressive symptoms among Polish adolescent boys and girls. The cross-sectional survey was carried out on adolescents attending lower and higher secondary schools located in three medium-sized cities and one big agglomeration in Poland. Anthropometric measurements, such as body height and weight, were performed. Beck Depression Inventory-II (BDI-II) was used to assess depressive symptoms. The total sample consisted of 624 boys and 910 girls aged 13-18 (the mean age was 16.4 ± 1.8) participated in the study. Of them, 73.3% had a healthy weight status, 12.9% were classified as thin, 11.4% were overweight and 2.5% were obese. The prevalence of depression based on BDI-II was 20.2% in boys and 34.9% in girls. The Kruskal–Wallis test revealed a lack of association between the body weight status and total scores of depressive symptoms after controlling for age (p=0.98 and p=0.4 for boys and girls, respectively). The multiple regression analysis revealed that gender and age differentiated the depressive symptoms (for gender: ß=0.19; SE=0.38; p<0.001 and for age: ß=0.05; SE=0.1; p<0.05). Age and gender explained 3.5% of the total variance of depressive symptoms. The study did not confirm the association between the body weight status and depression in adolescence.

Mindfulness and laboratory eating behavior in adolescent girls at risk for type 2 diabetes

Mindfulness-based intervention has become increasingly popular to address disinhibited eating in obesity and type 2 diabetes (T2D). Theoretically, present-moment attention promotes the ability to recognize and respond to internal hunger cues and to differentiate physiological hunger from other stimuli. Yet, there is limited research describing the relationship of mindfulness with disinhibited eating patterns in adolescents. In this study, we evaluated the relationship of dispositional mindfulness to laboratory eating in 107 adolescent (12-17 years) girls at risk for T2D. Adolescents reported dispositional mindfulness, were evaluated for recent loss-of-control-eating (LOC-eating) by interview, and participated in two successive, standardized laboratory test meals to assess eating when hungry as well as eating in the absence of hunger (EAH). Adolescents rated state appetite throughout the test meal paradigms. In analyses adjusting for body composition and other possible confounds, mindfulness was inversely related to caloric intake during the EAH paradigm. Mindfulness did not relate to energy intake when hungry. Instead, there was a significant interaction of reported LOC-eating by state hunger, such that girls with recent, reported LOC-eating and high state hunger consumed more calories when hungry, regardless of mindfulness. Findings suggest that in girls at risk for T2D, mindfulness may play a role in disinhibited eating. A propensity for LOC-eating may be most salient for overeating in a high hunger state.

Emotional Symptoms and Dietary Patterns in Early Adolescence: A School-Based Follow-up Study

OBJECTIVE

To examine the relationship between early emotional symptoms and dietary patterns over 3 years in a school-based sample.

DESIGN

Three-year longitudinal prospective study.

SETTING

Thirteen schools in Reus, Spain.

PARTICIPANTS

From a sample of 562 preadolescents with and without emotional symptoms, 165 were observed and were classified as either showing (n = 100) or not showing emotional symptoms (n = 65).

MAIN OUTCOME MEASURE

Emotional symptoms were assessed at baseline and after 1 and 3 years. In the third year, data were collected on food consumption, adherence to the Mediterranean diet (MD), and physical activity.

ANALYSIS

Dietary patterns were created by principal component analysis. Multivariate logistic regression was conducted with P < .05 considered significant.

RESULTS

Girls with emotional symptoms scored significantly lower in assessments for MD (score of 5.41 ± 2.19) and physical activity (score of 4.97 ± 2.05) than did girls who had no emotional symptoms (scores: MD, 6.19 ± 1.67; physical activity: 5.86 ± 1.94). Approximately 39.68% of girls with emotional symptoms showed high adherence to a sweet and fatty food pattern. After adjusted logistic regression, girls with emotional symptoms were 4 times as likely to have high adherence to a sweet and fatty food pattern (odds ratio, 4.79; 95% confidence interval, 1.55-15.10). No differences were observed among boys.

CONCLUSIONS AND IMPLICATIONS

Girls with emotional symptoms during early adolescence have high adherence to a pattern rich in sweet and fat foods and low adherence to MD, and engage in low levels of physical activity. These findings highlight the importance of managing emotional distress to prevent it from having a negative effect on eating behavior.

Is there an association between diet and depression in children and adolescents? A systematic review

This review critically evaluates previous studies investigating the association between dietary intake of children and young people and depression and related mental health problems. A systematic literature search was conducted using electronic databases such as PsycINFO, MEDLINE, PubMed and Cochrane. A total of twenty studies were identified that met inclusion criteria and were subsequently rated for quality. The studies used a range of methods to measure dietary intake and mental health. Important potential confounding variables (e.g. socio-economic status) were often not included or controlled. There were also inconsistencies in the use of key constructs, which made comparisons between studies difficult. Despite some contradictory results, overall there was support for an association between healthy dietary patterns or consumption of a high-quality diet and lower levels of depression or better mental health. Similarly, there was a relationship between unhealthy diet and consumption of low-quality diet and depression or poor mental health. However, where significant relationships were reported, effect sizes were small. Future research on the relationship between diet and mental health in young people should use more clearly defined constructs to define diet and include or control for important confounders.

The relation between intra- and interpersonal factors and food consumption level among Iranian adolescent girls

Background:

Poor nutrition habits in adolescent girls endanger their health and are followed by serious systemic diseases in adulthood and negative effects on their reproductive health. To design health promotion programs, understanding of the intra- and interpersonal associated factors with treatment is essential, and this was the aim of this study.

Materials and Methods:

This cross-sectional study was conducted on 193 adolescent girls of age 11-15 years. Random cluster selection was used for sample selection. Food group consumption pattern was assessed by food frequency questionnaire. Also, perceived susceptibility/severity and nutritional attitude as intrapersonal factors and social support as interpersonal factor were assessed. The relationship between food group consumption level and nutritional attitude and perceived treat (susceptibility/severity) as intrapersonal factors and perceived social support as interpersonal factor were assessed by linear multiple regression and analysis of variance (ANOVA).

Results:

Results showed that the level of sweetmeat food consumption was related to perceived social support (P = 0.03) and nutritional attitude (P = 0.01) negatively. In addition, an inverse and significant association was found between the level of junk food intake and informational perceived social support (P = 0.004). The association between the level of fast food intake and the perceived parental social support for preparation of healthy food was negatively significant (P = 0.03). Breakfast consumption was related to nutritional attitude (P = 0.03), social support (P = 0.03), and perceived severity (P = 0.045).

Conclusions:

Results revealed that perceived social support and nutritional attitude are the important and related factors in dietary intake among girls, and promotion of social support and modification of nutritional attitude may lead to healthy nutritional behaviors among them.

Longitudinal study of psychopathological, anthropometric and sociodemographic factors related to the level of Mediterranean diet adherence in a community sample of Spanish adolescents

Objective

The Mediterranean diet (MD) pattern has important health benefits; however, it seems that Spanish school-aged children have been abandoning this healthy pattern recently. We aimed to identify psychopathological, anthropometric and sociodemographic factors that may influence the risk of low MD adherence.

Design

Longitudinal study in three phases. MD adherence was assessed using the Krece Plus food questionnaire and psychopathological symptoms using the Screen for Childhood Anxiety Related Emotional Disorders, Children’s Depression Inventory, Youth’s Inventory-4 and Eating Disorder Inventory-2. Anthropometric data were collected in the first and third phases.

Settings

All five representative areas in Reus, Spain.

Subjects

Adolescents (n241).

Results

Regardless of past and current BMI, socio-economic status was a protective factor for low MD adherence (OR=0·805,P=0·003) and a risk factor for high BMI (OR=0·718,P=0·002; OR=0·707,P=0·001). Regardless of socio-economic status, depression was involved with risk of low adherence (OR=1·069,P=0·021). Girls with lower MD adherence presented significantly higher scores for eating disorders measured using the Eating Disorder Inventory-2 (low adherence, mean 18·9 (sd13·5); high adherence, mean 8·9 (sd9·0),P=0·020) and the Youth Inventory-4 (low adherence, mean 5·2 (sd4·3); medium adherence, mean 3·6 (sd3·2),P=0·044). They also presented higher depression symptoms (low adherence, mean 17·7 (sd9·6); medium adherence, mean 12·3 (sd7·2),P=0·01) than girls with high adherence.

Conclusions

The results highlight the influence of psychosocial factors on levels of MD adherence. These factors need to be taken into account when developing prevention and health promotion initiatives.

Depressed affect and dietary restraint in adolescent boys' and girls' eating in the absence of hunger

Data suggest that depressed affect and dietary restraint are related to disinhibited eating patterns in children and adults. Yet, experimental research has not determined to what extent depressed affect acutely affects eating in the absence of physiological hunger (EAH) in adolescents. In the current between-subjects experimental study, we measured EAH in 182 adolescent (13-17 y) girls (65%) and boys as ad libitum palatable snack food intake after youth ate to satiety from a buffet meal. Just prior to EAH, participants were randomly assigned to view either a sad or neutral film clip. Dietary restraint was measured with the Eating Disorder Examination. Adolescents who viewed the sad film clip reported small but significant increases in state depressed affect relative to adolescents who viewed the neutral film clip (p < .001). Yet, there was no main effect of film condition on EAH (p = .26). Instead, dietary restraint predicted greater EAH among girls, but not boys (p < .001). These findings provide evidence that adolescent girls' propensity to report restrained eating is associated with their greater disinhibited eating in the laboratory. Additional experimental research, perhaps utilizing a more potent laboratory stressor and manipulating both affective state and dietary restraint, is required to elucidate how state affect may interact with dietary restraint to influence EAH during adolescence.

Depressive symptoms are associated with excess weight and unhealthier lifestyle behaviors in urban adolescents

BACKGROUND

Adolescence is a critical period for the development of depressive symptoms and obesity. This study examined the association of depressive symptoms with standardized BMI (BMI z-score), lifestyle behaviors, and self-efficacy measures in a sample of urban adolescents.

METHODS

A school-based study was conducted among adolescents (N=1508) enrolled from 11 public schools. Depressive symptoms were assessed with Kandel's depressive symptoms scale for adolescents. Fruit and vegetable intake and intake of energy-dense foods were assessed by a short food frequency questionnaire. Sedentary behavior and physical activity (PA) were obtained by self-report. Height and weight were measured directly and BMI z-scores were calculated. Mixed-effects models were used to examine the association of depressive symptoms with BMI z-score and lifestyle behaviors, accounting for clustering at school level and adjusting for confounders. Self-efficacy measures were evaluated as potential mediators.

RESULTS

The sample was 53% female, 75% Hispanic, and 82% US born, with a mean age of 13.9 years. Higher depressive symptoms were associated with higher BMI z-score (β=0.02; p=0.02), intake of energy-dense foods (β=0.42; p<0.001), and sedentary behavior (β=0.48; p<0.001), but lower PA (β=-0.03; p=0.01). There was an interaction by gender in the association of depressive symptoms and PA. Self-efficacy mediated the association of depressive symptoms and PA.

CONCLUSIONS

Obesity prevention and treatment programs should consider addressing the role of negative emotions as part of their preventive strategies.

Dietary intake and nutritional risk in Mediterranean adolescents in relation to the severity of the eating disorder

Objective

To assess the relationship between the degree of severity of eating disorders (ED) and energy and nutrient intakes and nutritional risk in a mixed-sex adolescent population without clinical symptoms.

Design

Cross-sectional study.

Setting

Data were collected in schools.

Subjects

Adolescents (n 495) aged 14·2 (sd 1·0) years. The Eating Attitudes Test was used to detect adolescents at risk of ED (rED) and a structured interview based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, was used to diagnose eating disorder not otherwise specified (EDNOS). Dietary intake was quantified using the 24 h recall method over three days and the probability of inadequate intake was determined.

Results

Females presented lower intakes of energy, macronutrients and micronutrients (Ca, Fe, Mg, K, P, Na, thiamin, vitamins E, C, B6, B12, pantothenic acid, folic acid) because the severity of their ED was greater. These lower dietary intakes led to nutritional risk (for Ca, Fe, Mg, P, vitamins A, D, B6) in more than 80 % and 60 % of females with EDNOS and rED, respectively. The multiple linear regression models showed that the rED and EDNOS groups presented a lower energy intake of 1597·4 kJ/d (381·8 kcal/d) and 3153·0 kJ/d (753·6 kcal/d), respectively. In contrast, little difference was observed in the nutritional intakes of males.

Conclusions

The female adolescents showed lower energy and nutrient intakes as the ED became more severe, which led to energy, vitamin and mineral deficiencies in a high percentage of females with ED. These nutritional risks could hinder adequate physical and psychological development and lead to chronic ED.