Association between junk food consumption and mental health in a national sample of Iranian children and adolescents: The CASPIAN-IV study

The relationship between dietary sugar consumption and anxiety disorders: A systematic review

High-sugar intake is a risk factor for chronic diseases such as cardiovascular disease and type 2 diabetes, but less is known about its role in anxiety disorders. This systematic review aimed to systematically synthesise and assess the existing evidence regarding the association between dietary sugars intake and anxiety disorders. Following PRISMA guidelines, a systematic search of PubMed, MEDLINE, Embase, APA PsycArticles and APA PsycINFO was conducted up to 19th August 2022. Study quality was assessed by the Newcastle-Ottawa scale (NOS) and the Cochrane risk of bias tool. Eleven studies (10 cross-sectional and 1 randomised controlled trial [RCT]) were included. Seven cross-sectional studies had very good quality or good quality, and the quality of the RCT was at low risk of bias. These studies examined sugar-sweetened beverages (n = 7), sugar-sweetened foods (n = 4) and/or added sugar (n = 5). The findings suggest a possible positive relationship of added sugar consumption with anxiety disorders, with age as a potential moderator in such association. No conclusions can be drawn on the associations between sugar-sweetened beverages, sugar-sweetened foods consumption and anxiety disorders. Due to the included studies being mostly cross-sectional, the conclusions drawn from the existing evidence should be interpreted with caution. The longitudinal design is warranted to investigate any causal relationship and the potential mechanisms underlying these heterogeneous results. The potential difference in effect at different ages observed in this review should be further examined.

Effects of Mediterranean and Western dietary patterns on perceived stress and mental distress

Compared to the Western diet, the Mediterranean diet has many known benefits for both mental health and physical health; however, little is known about the effect of these dietary patterns on perceived stress and mental distress. To assess the relationship between dietary patterns, perceived stress and mental wellbeing, an anonymous online questionnaire targeting adults 18 and older was distributed via several social media platforms and email listservs. The survey included demographic questions, the Food-Mood Questionnaire, the Perceived Stress Scale and the Kessler Psychological Distress scale (K-6). A total of 1591 participants completed the survey. The data was analyzed using Principal Component Analysis and Pearson Correlation Coefficient in SPSS version 28.0. The results showed significant negative correlations between perceived stress and mental distress with several components of the Mediterranean diet, such as whole grains, seafood, fruits, vegetables, and beans. Despite being attributed to the Western diet, meat produced a negative correlation with perceived stress and mental distress. However, significant positive correlations between perceived stress and mental distress and the Western diet, such as fast food and high glycemic index food, were detected. Our findings provide evidence that dietary patterns modulate the stress response and suggest that incorporating components of the Mediterranean diet is beneficial for mental wellbeing and stress reduction.

Association between ultra-processed dietary pattern and bullying: the role of deviant behaviors

Background

Ultra-processed foods have been associated with several negative outcomes, but it is not clear whether they are related to bullying perpetration. Moreover, no previous study has investigated the potential role of deviant behaviors as a mediator of this association. Our objective was to evaluate the association between ultra-processed dietary pattern and bullying, and the mediating effect of deviant behaviors in this association, among school adolescents.

Methods

We used data from a representative sample of 9th grade Brazilian adolescents (N = 2,212) from the São Paulo Project for the social development of children and adolescents (SP-PROSO). Exploratory factor analysis was used to obtain the dietary patterns, through questions of frequency of consumption in the last week of several foods. The ultra-processed dietary pattern was considered as exposure. The outcomes were the types of bullying (any type, social exclusion, psychological/verbal aggression, physical aggression, property destruction, and sexual harassment). Deviant behaviors (mediator) were assessed through a score. Mediation analyses were carried out using logistic regression based on the KHB method.

Results

After adjusting for covariates, the mediating effect of deviant behaviors was found in the association between ultra-processed dietary pattern and all the types of bullying perpetration, especially for psychological/verbal aggression (39.4%). A small mediating effect of deviant behaviors in the association of ultra-processed dietary pattern with physical aggression (17.7%) and property destruction (18.5%) was observed, but this effect explained only a small portion of the total effect of such association (significant direct effect).

Conclusion

The ultra-processed dietary pattern was associated with bullying, and the association was mediated through deviant behaviors. Policies and actions for improving the adolescent's diet and managing the adoption of deviant and bullying behaviors by this public are required.

"Food faddists and pseudoscientists!": Reflections on the history of resistance to ultra-processed foods

The term 'ultra-processed food' emerged in the 1980s, mostly used in reference to highly-processed convenience foods and snacks, often energy-dense, poor in nutrients, and inclusive of various synthetic additives such as emulsifiers, colors, artificial sweeteners, and/or flavor enhancers. Concern over such foods was part of the growing holistic and environmental health movements of the 1970-80s; yet, those who raised alarm about the encroachment of ultra-processed foods were often labeled, especially by industry and their powerful allies, as 'food faddists' and 'pseudoscientists'. Today, the topic of ultra-processed foods is generating massive personal, public, and planetary health interest. However, other than discussing the history of the NOVA food classification system, a useful tool that has allowed researchers to more accurately separate foods based on processing, most lay media and academic articles are ahistorical. That is, there is a tendency to present the term ultra-processed food(s) as a relatively new entrance into the lexicon, and by default, the idea that health-related pushback on ultra-processed foods is a relatively new phenomenon. This omission overlooks decades of determined advocacy and clinical work, much of it by pioneers within the holistic medicine (now integrative, functional, and lifestyle medicine) movement. Here in this reflection paper, the authors will use historical research and reporting to fill in the historical gap and articulate the saliency of why it matters.

How Do Anger and Impulsivity Impact Fast-Food Consumption in Transitional Age Youth?

Introduction

Consumption of fast food has been linked to psychiatric distress, violent behaviors, and impulsivity in adolescents. The relationship between eating fast food, anger, and impulsivity has not been widely investigated. The National Consortium on Alcohol and Neurodevelopment in Adolescence community-based cohort consists of 831 youth, half at elevated risk factors for substance use disorders during adolescence, followed annually.

Methods

Impulsivity using Urgency, Premeditation, Perseverance, and Sensation Seeking Impulsive Behavior scale from annual assessments was examined in relation to self-reported fast-food consumption frequency and mobile application questions of anger. This study tested the hypotheses that youth anger may be predicted by fast-food consumption frequency and impulsivity using multiple regression, in addition to whether adolescent fast-food consumption frequency may be predicted by anger and impulsivity.

Results

Among youth, higher anger levels and impulsivity predicted greater frequency of fast-food consumption, and greater fast-food consumption frequency and impulsivity predicted higher anger levels.

Conclusions

This study's longitudinal findings are consistent with those of other studies that have found fast-food consumption and anger associated with impulsivity and also reveal a bidirectional link between anger and fast-food consumption. These results may point attention to food selection considerations for those at risk of anger and poorer psychiatric outcomes.

Dietary habits, depression and obesity: an intricate relationship to explore in pediatric preventive strategies

Obesity and depression represent major health problems due to their high prevalence and morbidity rates. Numerous evidences elucidated the connections between dietary habits and the incidence or severity of depression. This overview aims to investigate the intricate relationship between dietary patterns and depression with the objective of elaborating preventive strategies for childhood obesity. Literature data recognized that there is a link between mood and food choices, with certain foods selected for their impact on the brain's reward centers. This behavior parallels the one observed in substance addiction, suggesting a specific neural mechanism for food addiction that contributes to overeating and obesity. It is important to note the significant correlation between obesity and depression, indicating a shared biological pathway influencing these conditions. Stress substantially affects also eating behaviors, often leading to increased consumption of pleasurable and rewarding foods. This can trigger a cycle of overeating, weight gain, and psychological distress, exacerbating mood disorders and obesity. In addition, consumption of certain types of foods, especially "comfort foods" high in fat and calories, may provide temporary relief from symptoms of depression, but can lead to long-term obesity and further mental health problems. Understanding these complex interactions is critical to developing preventive strategies focusing on dietary, emotional, and environmental factors, thereby reducing the risk of obesity and mood disorders.

Factors associated with consuming unhealthy food in school children: A population-based study from Hong Kong

Background and Aims

Unhealthy diets were found to be the main contributor to the overweight problem among adolescents. In this study, we aim to identify the factors causing unhealthy eating habits in adolescents.

Methods

School-aged children and adolescents participated in this cross-sectional observational study with additional school and parental consent. A self-administered survey was conducted by 30 primary schools and 25 secondary schools. Participants were asked about the frequency of consuming unhealthy food and the types of unhealthy food consumed. A descriptive analysis was performed to demonstrate the proportions of characteristics. The prevalence of the outcome among participants of various factors was also analyzed using separate binary regression models.

Results

A total of 4884 responses were collected. Among primary school students (grade 4, mean age: 10.06), people who (1) were actively gaining weight (aOR: 1.651, 95% CI 1.006-2.708, p = 0.047), (2) went to bed after 11 p.m. (aOR: 1.652, 95% CI 1.065-2.563, p = 0.025), (3) had more than 2 h of gaming (aOR: 2.833, 95% CI 1.913-4.195, p < 0.001), (4) suffered from self-report depressive symptoms (aOR: 1.753, 95% CI 1.233-2.493, p = 0.002) was more likely to consume unhealthy food. As for secondary school students (grade 3, mean age: 15.28), (1) males (aOR: 1.266, 95% CI 1.0004-1.601, p = 0.0496), (2) average-to-high socioeconomic status (Average: aOR: 1.471, 95% CI 1.115-1.941, p = 0.006; High: aOR: 2.253, 95% CI 1.585-3.202. p < 0.001), (3) having more than 2 h of gaming (aOR: 1.342, 95% CI 1.069-1.685, p = 0.011), (4) suffering from psychological distress (aOR: 1.395, 95% CI 1.051-1.852, p = 0.021) were associated with the increased odds of consuming unhealthy food.

Conclusion

Several lifestyle and health factors were significantly associated with unhealthy eating behaviors in school-aged children and adolescents in Hong Kong, sharing similarities with many other countries. In conjunction with implementing a policy that addresses factors for unhealthy eating habits, further research should investigate potential interventions targeting these factors to ultimately tackle the overweight and obesity concern for children and adolescents in Hong Kong.

Association Between Dietary Patterns and Bullying Among Adolescents in Sao Paulo-Brazil

Previous studies have assessed the association between food consumption and bullying perpetration, but most of them have not broadly assessed food consumption, neither the distinction between forms of bullying. The aim of the study was to evaluate the association between dietary patterns with bullying roles and its different types of bullying perpetration among adolescents. Data on a representative sample of ninth-grade students (N = 2,163; mean age = 14.8 years) taken from Sao Paulo Project for the social development of children and adolescents (SP-PROSO) were used. The independent variables were healthy and unhealthy dietary patterns obtained by exploratory factor analysis. The dependent variables were bullying role (victim-only, bully-only, bully-victim) and bullying perpetration (any type, social exclusion, psychological/verbal aggression, physical aggression, property destruction, sexual harassment). Multinomial and logistic regression models were performed for the total sample and stratified by sex (only for association with sexual harassment), adjusting for covariates. Adolescents who engaged in a healthy dietary pattern were less likely to be bullies (RR 0.67 [0.49, 0.92]), while adolescents with an unhealthy dietary pattern were more likely to be bully-victims (RR 1.29 [1.12, 1.48]). Unhealthy dietary pattern was associated with any type of bullying perpetration (OR 1.24 [1.12, 1.38]), mainly with sexual harassment and physical aggression. Boys who had an unhealthy dietary pattern were more likely to sexually harass another adolescent (OR 2.10 [1.20, 3.66]). In conclusion, adolescents who had a healthy dietary pattern were less likely to perpetrate bullying. Unhealthy dietary pattern was associated with bullying perpetration, especially with sexual harassment by boys.

Nutritional Criminology: Why the Emerging Research on Ultra-Processed Food Matters to Health and Justice

There is mounting concern over the potential harms associated with ultra-processed foods, including poor mental health and antisocial behavior. Cutting-edge research provides an enhanced understanding of biophysiological mechanisms, including microbiome pathways, and invites a historical reexamination of earlier work that investigated the relationship between nutrition and criminal behavior. Here, in this perspective article, we explore how this emergent research casts new light and greater significance on previous key observations. Despite expanding interest in the field dubbed 'nutritional psychiatry', there has been relatively little attention paid to its relevancy within criminology and the criminal justice system. Since public health practitioners, allied mental health professionals, and policymakers play key roles throughout criminal justice systems, a holistic perspective on both historical and emergent research is critical. While there are many questions to be resolved, the available evidence suggests that nutrition might be an underappreciated factor in prevention and treatment along the criminal justice spectrum. The intersection of nutrition and biopsychosocial health requires transdisciplinary discussions of power structures, industry influence, and marketing issues associated with widespread food and social inequalities. Some of these discussions are already occurring under the banner of 'food crime'. Given the vast societal implications, it is our contention that the subject of nutrition in the multidisciplinary field of criminology-referred to here as nutritional criminology-deserves increased scrutiny. Through combining historical findings and cutting-edge research, we aim to increase awareness of this topic among the broad readership of the journal, with the hopes of generating new hypotheses and collaborations.

Combination of sugar-sweetened beverage consumption, screen-based sedentary time, and sleep duration and their association with South Korean adolescents' mental health

Introduction

This study examines the combinations of sugar-sweetened beverage (SSB) consumption, screen-based sedentary time, and sleep duration and their association with adolescents' depressive symptoms and suicidal ideation.

Methods

This research followed a crosssectional study design. Secondary data analysis was conducted on the data collected from 21,046 high school students who had participated in the 17th Korea Youth Risk Behavior Web-Based Survey in 2021. A complex sampling analysis, including descriptive and logistic regression analyses, was conducted in SPSS Statistics 26.0.

Results

The combination of low SSB consumption, excessive screen-based sedentary time, and short sleep duration was associated with an increase in depressive symptoms. In addition, a combination of medium/high SSB consumption, appropriate/excessive screen-based sedentary time, and short sleep duration was associated with an increase in depressive symptoms. Finally, the combination of high SSB consumption, excessive screen-based sedentary time, and short sleep duration was associated with an increase in suicidal ideation.

Discussion

The findings demonstrate that healthcare providers should develop and conduct family-and school-based programs to restrict SSB consumption, screen-based sedentary behaviors, and sleep duration to improve adolescents' mental health.

Association between Western Dietary Patterns, Typical Food Groups, and Behavioral Health Disorders: An Updated Systematic Review and Meta-Analysis of Observational Studies

Western dietary patterns (WDP) and typical food groups may play a major role in the risk of behavioral health disorders. Nevertheless, the relationships between WDP, common food categories, and mental health disorders lack consistency and remain incompletely understood in relation to potential mechanisms. Therefore, the objective of the present study was conducted to synthesize available evidence linking WDP and typical food groups to these outcomes. Web of Science, PubMed, EMBASE, and MEDLINE were searched up to August 2023. Random effect meta-analyses were performed to obtain pooled odds ratio and the relative risk for the prevalence of outcomes and the incidence of outcomes, respectively. A total of 54 articles were included. WDP was associated with increased risk of both depression (1.19; 95% CI: 1.06-1.32) and depressive symptoms (1.20; 95% CI: 1.08-1.34). Except for high-fat dairy products, food groups are associated with an increased risk of anxiety, depression, and depressive symptoms. This review presents evidence to further understand the relationship between WDP, typical food groups, and the incidence of behavioral health disorders, and more randomized controlled trials and cohort studies are urgently required to confirm these findings and elucidate potential mechanisms.

Association between dietary intake and symptoms of depression and anxiety in pregnant women: Evidence from a community-based observational study

Dietary intake is considered as a crucial factor affecting mental health symptoms, particularly depression and anxiety symptoms, especially in the case of pregnant women. This study explored the role of dietary intake in depression and anxiety symptoms of pregnant women and provided evidence for primary care interventions. We enrolled 806 pregnant women in their third trimester from 14 communities in Hengyang City, Hunan Province, China, from July 2019 to September 2019. The Chinese version of the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder questionnaire-7 (GAD-7) were used to assess depression and anxiety symptoms. Dietary intake, demographic characteristics, BMI, and pregnancy characteristics were collected using a self-designed, structural questionnaire. A covariate-adjusted logistic regression was conducted to examine the relationship between mental health symptoms and dietary intake. The prevalence of anxiety and depression symptoms in our population were 7.7% (95% CI: 5.9%-9.5%) and 9.2% (95% CI: 7.2%-11.2%), respectively. Women consuming eggs and egg products once a week (OR: 3.688, 95% CI: 1.476-9.215) were more likely to have depression symptom than consumed eggs and egg products once or more per day. Consuming green leafy vegetable <2-3 times per month had a significantly greater risk for depression symptoms than consuming the same once or more per day (OR: 3.450, 95% CI: 1.145-10.393). Women who consumed eggs and egg products 2-3 times a week had an increased likelihood of experiencing anxiety symptoms (OR: 2.253, 95% CI: 1.049-4.837). Anxiety symptoms in women consuming green leafy vegetables <2-3 times per month probably increased by 3.988 times (95% CI: 1.327-11.985) compared with women consuming the same once or more per day. Consuming salted and smoked food <2-3 times per month was protective against anxiety symptoms (OR: 0.181, 95% CI: 0.040-0.828) than consuming the same every day. Implementing interventions to promote healthy dietary among pregnant women is crucial due to its association with mental health. However, future researches are warranted to confirm the reliability and causal association obtained in this study.

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.

Association of dietary behaviour and depression among adolescents in Malaysia: a cross-sectional study

BACKGROUND

Depression is on the rise and has become a significant concern for public health. Limited research has explored the connection between dietary patterns and depression. This investigation aimed to examine how dietary behaviours relate to depression among adolescents attending school in Malaysia.

METHODS

The study utilized data from the National School-Based Health Survey 2022, a nationwide survey involving school-going adolescents aged 13-17, with a total of 33,523 participants from 239 schools. To assess depression, the study employed the Patient Health Questionnaire (PHQ-9), considering a score of 10 or higher as indicative of depression. Dietary behaviours were assessed using a validated self-administered questionnaire adapted from the World Health Organization's Global School-based Student Health Survey. Descriptive analysis and complex sample logistic regression were carried out using SPSS version 26.0.

RESULTS

The study revealed a 26.9% overall prevalence of depression, with higher risks among female adolescents (AOR 2.71, 95% CI 2.51, 2.92) and those in higher grades. Malays (AOR 1.71, 95% CI 1.41, 2.07), Other Bumiputeras (AOR 1.69, 95% CI 1.32, 2.17), and Others (AOR 1.63, 95% CI 1.16, 2.30) had elevated odds of depression compared to Indians. Healthy dietary habits, like consuming less than two servings of fruits daily, correlated with depression (AOR 1.44 95% CI 1.35, 1.54). Additionally, unhealthy dietary behaviours such as fast food consumption (AOR 1.73 [95% CI 1.55, 1.93]) and carbonated soft drink intake (AOR 1.59 [95% CI 1.48, 1.70]) were positively associated with depression.

CONCLUSIONS

One out of every four Malaysian adolescents was identified to experience depression. Depression was linked to several factors, such as being female, belonging to higher grade levels, identifying as Malays, Other Bumiputeras, or belonging to other ethnicities, and participating in the consumption of fast food, carbonated soft drinks, and fruits. To address these observations, it is crucial to formulate effective public health programmes that prioritize adolescent mental health and encourage the adoption of healthy eating habits.

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.

Beyond Plants: The Ultra-Processing of Global Diets Is Harming the Health of People, Places, and Planet

Global food systems are a central issue for personal and planetary health in the Anthropocene. One aspect of major concern is the dramatic global spread of ultra-processed convenience foods in the last 75 years, which is linked with the rising human burden of disease and growing sustainability and environmental health challenges. However, there are also calls to radically transform global food systems, from animal to plant-derived protein sources, which may have unintended consequences. Commercial entities have moved toward this "great plant transition" with vigor. Whether motivated by profit or genuine environmental concern, this effort has facilitated the emergence of novel ultra-processed "plant-based" commercial products devoid of nutrients and fiber, and sometimes inclusive of high sugar, industrial fats, and synthetic additives. These and other ingredients combined into "plant-based" foods are often assumed to be healthy and lower in calorie content. However, the available evidence indicates that many of these products can potentially compromise health at all scales-of people, places, and planet. In this viewpoint, we summarize and reflect on the evidence and discussions presented at the Nova Network planetary health meeting on the "Future of Food", which had a particular focus on the encroachment of ultra-processed foods into the global food supply, including the plant-sourced animal protein alternatives (and the collective of ingredients therein) that are finding their way into global fast-food chains. We contend that while there has been much uncritical media attention given to the environmental impact of protein and macronutrient sources-meat vs. novel soy/pea protein burgers, etc.-the impact of the heavy industrial processing on both human and environmental health is significant but often overlooked, including effects on cognition and mental health. This calls for a more nuanced discourse that considers these complexities and refocuses priorities and value systems towards mutualistic solutions, with co-benefits for individuals, local communities, and global ecology.

Clustering of Obesogenic Behaviors Associated With Bullying Roles Among 100,794 Adolescents

Obesogenic behaviors have been individually associated with bullying during adolescence. However, physical activity, sedentary behavior, and diet manifest themselves in synergy and even behavioral profiles in which positive and negative behaviors coexist can be more positively associated with psychosocial outcomes. The present study aimed to analyze the association between clusters of obesogenic behaviors and different bullying roles in Brazilian adolescents. This cross-sectional study used data from the Brazilian School-based Health Survey-PENSE, 2015. A total of 100,794 male and female adolescents of the ninth-grade elementary school participated in the study. Students responded to an electronic questionnaire. Clusters of obesogenic behavior consisted of physical activity, exposure to sedentary behavior, and diet, and the different roles in bullying were: participant, victim, bully, and bully-victim. Binary logistic regression with 95% confidence intervals (CI) was used for data analysis (p < .05). Multiple adjustments and complex sampling procedures were employed. Adolescents in the cluster "Health-promoting sedentary behavior and Diet" had reduced chances of participating in bullying (odds ration [OR] = 0.70; 95% CI [0.64, 0.76]), of being a victim (OR = 0.87; 95% CI = 0.76-0.99), and being the bully (OR = 0.65; 95% CI [0.59, 0.71]); and those from the cluster "Health-promoting physical activity and Diet" had reduced chances of participating (OR = 0.81; 95% CI [0.76, 0.87]), being a victim of bullying (OR = 0.86; 95% CI [0.76, 0.98]), being the bully (OR = 0.79; 95% CI [0.72, 0.85]), and being a bully-victim (OR = 0.74; 95% CI [0.61, 0.90]), when compared to those from the "health-risk" cluster in the adjusted analysis. Clusters of obesogenic behavior may reduce adolescent bullying: victim, bully, and bully-victim benefit when exposed to healthier behavioral profiles. The school setting must recognize bullying as a problem and therefore simultaneously promote multi-component interventions to tackle physical activity, sedentary behavior, and eating behavior. Outcomes other than obesity should be acknowledged when promoting obesogenic behaviors.

Snacking behaviour and nutrients intake among 11-16 years-old students from two different boarding system schools

This study's main objective was to investigate the difference between snacking behaviors and dietary nutrient intake in boarding system students. A cross-sectional study was conducted at Beijing's closed and semi closed boarding management school. The snack consumption questionnaire collected snack consumption behaviors; three-day recall periods for food consumption data were collected through the canteen weighing method and 24-h dietary recall of students' intakes. For closed and semi closed boarding management schools, the percentage of never having snacking behaviors was 12.95% and 2.69% on weekdays and 2.16% and 4.19% on weekends. A higher proportion of respondents chose unhealthy snacks in closed boarding management schools. The main problems in closed boarding management schools were the excessively low percentage of energy from carbohydrates and the excessively high percentage of energy from fat. Both deficiency and excess energy supply ratios of protein, carbohydrate, and fat were present in semi-closed boarding management schools. There was a high risk of calcium, iron, zinc, magnesium, and selenium deficiency for most students in both management schools. The closed-school girls had the highest risk of suffering from iron deficiency. Vitamin A, vitamin B1, vitamin B2, vitamin C, and vitamin E deficiencies were severe in both schools, especially vitamin C, vitamin A, and vitamin B2 deficiencies in semi-closed boarding management schoolboys. Effective nutritional interventions should be taken to improve the nutritional status of both boarding management and school students.

The Synergetic Effect of Soft Drinks and Sweet/Salty Snacks Consumption and the Moderating Role of Obesity on Preadolescents' Emotions and Behavior: A School-Based Epidemiological Study

The consumption of ultra-processed foods (UPFs) is high along with the prevalence of emotional and behavioral problems among children and adolescents. The present study sought to investigate the synergetic effect of soft drinks and sweet/salty snacks consumption, and the moderating role of obesity on preadolescents' emotions and behavior. A cross-sectional study was conducted among 1728 Greek preadolescents aged 10-12 and their parents, during the school years 2014-2016. Parental and child characteristics were collected anonymously, through self-administered and validated questionnaires. Among others, soft drinks and sweet/salty snacks consumption was recorded, classifying preadolescents as low or at least moderate consumers, while anthropometric characteristics (height, weight, Body Mass Index (BMI)) were also recorded. Approximately 6 out of 10 preadolescents were characterized by at least moderate consumption of either sweet/salty snacks, or soft drinks, while 22.7% of the participants had at least moderate consumption of both soft drinks and sweet/salty snacks. Boys and preadolescents with a lower level of adherence to the Mediterranean diet, as well as those living in a more obesogenic family environment were more likely to be in the higher consumption groups. When compared to just either the moderate consumption of sweet/salty snacks, or the moderate consumption of soft drinks, the combination of both unhealthy eating habits was associated with significantly higher odds of both aggressiveness and loneliness, while the examined relationships were significantly stronger in overweight/obese children. The positive synergistic effect of soft drinks and sweet/salty snacks consumption on preadolescents' emotions of loneliness and aggressive behavior is even burdened by obesity status highlighting the urgent need for policymakers to take preventive measures to halt the detrimental consequences of UPFs consumption on health outcomes, particularly in overweight/obese children. The importance of the improvement of children's unhealthy eating habits by emphasizing the association between food intake and emotional and behavioral status is highlighted.

Association between university student junk food consumption and mental health

Background: On a global scale, the mental health consequences of eating habits among the general population are becoming a concern. Particular attention should be directed to the youthful population. Aims: Determine the relationship between university students' consumption of junk food and their levels of stress, anxiety, and depression. Method: University students were asked to complete: a demographic questionnaire, questions on junk food consumption, and depression anxiety stress scores (DASS-21). Body mass index measurements were taken. Logistic regressions were utilized to construct odds ratios (ORs) with 95% confidence intervals to identify the association between university students' consumption of junk food and their levels of stress, anxiety, and depression. Results: There were (N = 509), 66% females and 34% males, mean age was (M = 18.1 ± .5) years participated in this study. Daily consumption of junk food was significantly linked to stress (odds ratio [OR], 4.5; 95% confidence interval [CI], 2.5-8.3), anxiety (OR, 11.1; 95% CI, 6.2-20.1), and depression (OR, 7.9; 95% CI, 4.5-13.9). Conclusions: This is the first thorough study conducted in Egypt to examine the relationship between stress, anxiety, and depression, and junk food consumption among undergraduates at a private Egyptian university. Many college students struggle emotionally, and those who are emotionally troubled are more likely to participate in eating unhealthy food. Our research will be used to inform regional policies on adolescent nutrition and to create preventative strategies.

Differences in lifestyle between students of medical and biological fields of study in Poland

Students are a specific social group characterized by different lifestyle behaviours. The aim of the study was to determine whether there are lifestyle differences between students of medical and biological fields from three different universities in Poland. The research material consisted of answers from 1163 students (781 women and 382 men), aged 17.5– 26.0 from the medical faculty of the Wroclaw Medical University, biological faculties of the Cardinal Stefan Wyszynski University in Warsaw and the University of Lodz. The survey included questions regarding gender, socio-demographic situation, lifestyle and eating habits. Students also provided height and weight data, which was used for BMI calculation. Chi-square test and one-way ANOVA were used to indicate differences in BMI between students and to estimate differences in lifestyle between students from three different university centres. Medical students exhibited significantly lower BMI values compared to students from other academic centres. They also more often reported doing additional sports and assessed their overall level of physical activity significantly higher compared to students from other academic centres. Biology students reported to sleep longer and being more exhausted compared to medical students. Biology students tended to drink sugar-sweetened beverages and eat fast-food significantly more often than medical students. Students from the medical faculty in Wroclaw reported to smoke cigarettes less often compared to students from non-medical study. There were no significant differences in other studied factors, such as the use of alcohol, snacking between the meals and consumption of energy drinks. Overall, students of medical fields reported a healthier lifestyle compared to their peers from biological faculties, although this was not consistent for all examined factors.

Consumption of sugar-sweetened beverages and fast foods deteriorates adolescents' mental health

Introduction

Sugar-sweetened beverage (SSB) and fast-food consumption is significantly associated with adolescents' poor mental health. Furthermore, sugar-sweetened beverage and fast-food consumption might form clustered diet patterns with significant positive associations in adolescent high school students. Thus, the combined consumption of SSBs and fast foods may have more negative effects on mental health with synergetic effects than the sum of their independent consumption.

Methods

This study aimed to identify the effects of combining the consumption of sugar-sweetened beverages and fast foods on mental health, including stress, depressive symptoms, and suicidal ideation among Korean high school students. Secondary data from 24,006 high school students were analyzed from the 17th Korea Youth Risk Behavior Web-based Survey, 2021. For statistical analysis, complex sampling analysis using the SPSS Statistics 26.0 software was applied for descriptive statistics and logistic regression analysis.

Results

In Korean adolescents, combining more than medium consumption of sugar-sweetened beverages and fast foods was associated with more stress, depressive symptoms, and suicidal ideation than their independent consumption. In addition, combining high consumption of sugar-sweetened beverages and low to high consumption of fast foods might have dose-dependent negative effects on stress, depressive symptoms, and suicidal ideation in Korean adolescents.

Discussion

Based on the results of this study, healthcare providers in schools and communities might develop various interventions including school/community-based feeding programs and policies targeting the restriction of SSB and fast-food consumption to improve adolescents' mental health.

Relationship between dairy product intake and sense of coherence among middle and high school students in Japan

Despite the growing attention toward the effects of dairy intake on stress and mental health, its relationship to psychological constructs that affect mental health remains poorly understood. We conducted a cross-sectional study (Study 1) and a longitudinal study (Study 2) to examine the association between food intake and stress resilience in Japanese middle and high school students. In Study 1, 865 participants (412 males and 453 females) completed the questionnaires. In Study 2, 109 students (51 males and 58 females) participated each year from 2016 to 2018. Dietary intake was assessed using a brief self-administered diet history questionnaire. Stress resilience was evaluated using a 13-item sense of coherence (SOC) questionnaire. Correlation coefficients were calculated in Study 1 to investigate the relationship between food group intake and SOC. In Study 2, a cross-lagged panel model was tested using structural equation modeling to investigate the effect of dairy product consumption on SOC. Study 1 revealed that only dairy product intake positively correlated with SOC and other food intake indicated no significant relationship. Study 2 indicated that augmented dairy product intake was positively associated with SOC. Among all foods, only dairy products were associated with SOC in adolescents. Although the association was weak, the longitudinal study confirmed that dairy consumption was associated with SOC. Randomized controlled trials are necessary to examine the causal relationship.

The relationship between dietary patterns and aggressive behavior in adolescent girls: A cross-sectional study

BACKGROUND

There are few studies about the relationship between dietary patterns and aggression. The aim of this study was to assess the relationship between the main dietary patterns and aggression scores among adolescent girls in Iran.

METHODS

This cross-sectional study was conducted on 670 adolescent girls. The 168-item self-administered Semi-quantitative Food Frequency Questionnaire was used to evaluate dietary intake and to identify major dietary patterns, while factor analysis was applied. Aggression was evaluated by the validated Persian version of the Buss-Perry questionnaire. Statistical analysis was performed by crude and adjusted models.

RESULTS

Three main dietary patterns including healthy, fast food, and Western were identified. A significant positive association was found between more adherence to Western dietary pattern and the presence of a high aggression score (OR: 2.00; 95% CI: 1.32-3.05, p-_{trend =} .001); even after adjustment for potential confounders, these findings were significant.

CONCLUSION

Although Western dietary patterns were associated with increased aggression risk, there was no significant relationship between healthy and fast food dietary patterns and the prevalence of a high aggression score. Further studies, particularly longitudinal intervention studies, are required to clarify this relationship.

Ultra-Processed Foods and Drinks Consumption Is Associated with Psychosocial Functioning in Adolescents

Adolescents show one of the highest rates of ultra-processed foods and drinks (UPF) consumption, and studies indicate an association between their consumption and internalizing problems. We aim to investigate whether UPF consumption associates with dysfunctions in other psychosocial domains, as well as sex effects. In 560 Spanish adolescents (14-17 years old), we assessed the UPF products consumed in the previous day, fruits and vegetables consumption (servings/day), and physical activity (days/week). Psychosocial functioning (total and subscales) was assessed through the Pediatric Symptom Checklist-Youth self-report. Associations between UPF and psychosocial functioning were assessed using linear regression models, adjusting for sex, age, fruits and vegetables consumption, and physical activity. Sex-specific associations were also explored. Participants reported a daily consumption of 7.72 UPF servings per day, with male adolescents showing higher consumption than female adolescents. Consumption of fruits and vegetables and physical activity levels were lower than recommended. Psychosocial impairment was present in 26.2% of the participants. Higher UPF consumption was associated with higher presence of depressive symptoms and internalizing and externalizing problems in the whole sample and in male adolescents. The present study supports previous studies suggesting that UPF consumption may interact with mental health problems and indicates that these effects may go beyond internalizing problems.

The Association between Spicy Food Consumption and Psychological Health in Chinese College Students: A Cross-Sectional Study

BACKGROUND

Capsaicin is the main active ingredient in chili peppers and spicy food. Animal studies provide contradictory results on the role of capsaicin in psychiatric disorders. There are no epidemiological studies to investigate the relationship between spicy food consumption and psychological health.

METHODS

A cross-sectional online survey was conducted. Psychological health was assessed with the Depression Anxiety Stress Scale, and spicy food consumption was assessed as frequency, strength, and duration of consumption. Multivariable logistic regression was conducted to determine the associations between spicy food consumption and psychological symptoms.

RESULTS

Our sample comprised 1771 participants (male = 674, mean age = 21.97 years). The odds of having depressive, anxiety, and stress symptoms were 34.0%, 46.5%, and 19.1% in Chinese college students, respectively. After adjusting for a series of covariates, compared with non-consumers, the odds ratios (ORs) of depressive symptoms across spicy food consumption were 1.13 (95% CI: 0.87-1.46) for 1-2 days/week and 1.38 (95% CI: 1.02-1.86) for ≥3 days/week. With regard to anxiety symptoms, the ORs were 0.99 (95% CI: 0.78, 1.27) for 1-2 days/week and 1.50 (95% CI: 1.13-1.99) for ≥3 days/week. For stress symptoms, the ORs were 0.90 (95% CI: 0.66-1.23) for 1-2 days/week and 1.27 (95% CI: 0.89-1.80) for ≥3 days/week. The ORs for the depressive symptoms associated with different intensities of spicy food consumption were 1.00 (reference) for the reference group (non-consumers), 1.17 (95% CI: 0.90-1.52) for eating weakly spicy food, and 1.34 (95% CI: 1.01-1.78) for moderately to strongly spicy food.

CONCLUSION

The findings suggested a positive association between frequently spicy food consumption and depressive/anxiety symptoms in adolescents, and no such association was found for stress symptoms.

Association of sugar-sweetened beverage consumption with psychological symptoms among Chinese university students during the COVID-19 pandemic

BACKGROUND

Mental health of college students has become a public health issue of common concern worldwide. Especially during the COVID-19 pandemic, the problem has become even more acute. The aim of this study was to assess the association between sugar-sweetened beverages (SSB) consumption and psychological symptoms among Chinese college students in order to promote their mental health.

METHODS

The study population was 6,120 college students aged 19-22 years from Anhui, Henan and Xinjiang, China. Basic demographic information, covariates and SSB Consumption data were collected through a self-assessment questionnaire. The "Multidimensional Sub-health Questionnaire of Adolescents" was used to assess the psychological symptoms of college students. The Chi-square test, one-way ANOVA and logistic regression analysis were used to investigate the differences and associations between SSB consumption and psychological symptoms among Chinese college students.

RESULTS

The detection rate of psychological symptoms among Chinese college students was 8.1%. The detection rate of boys students was 9.4% and that of girls students was 7.1%, and the difference was statistically significant in comparison (χ 2-value was 11.08, p < 0.001). After controlling for covariates, Model 2 analysis showed that compared to SSB consumption <2 time/week, college students with SSB consumption ≥2 time/week (OR = 2.96, 95% CI: 2.36, 3.70) had a higher risk of psychological symptoms (p < 0.001). The same trend was found for emotional symptoms, behavioral symptoms, and social adaptation difficulties dimensions.

CONCLUSION

There is an association between SSB consumption and the occurrence of psychological symptoms among Chinese college students. Future measures should be taken to reduce both SSB consumption and the incidence of psychological symptoms.

Eating disorder and social anxiety symptoms in Iranian preadolescents: a network analysis

PURPOSE

Network studies of eating disorder (ED) symptoms have identified central and bridge symptoms in Western samples, yet few network models of ED symptoms have been tested in non-Western samples, especially among preadolescents. The current study tested a network model of ED symptoms in Iranian preadolescents (ages 9 to 13), as well as a model of co-occurring social anxiety disorder (SAD) and ED symptoms.

METHOD

Preadolescent boys (n = 405) and girls (n = 325) completed the Children Eating Attitudes Test-20 and Social Anxiety Scale for Children. We estimated two network models (ED and ED/SAD networks) and identified central and bridge symptoms, as well as tested if these models differed by sex.

RESULTS

We found that discomfort eating sweets were the most central symptoms in ED networks. Concern over being judged was central in networks including both ED and SAD symptoms. Additionally, concern over being judged was the strongest bridge symptoms. Networks did not differ by sex.

CONCLUSION

Future research is needed to test if interventions focused on bridge symptoms (i.e., concern over being judged) as primary intervention points target comorbid ED-SAD pathology in preadolescents at risk for ED and SAD.

LEVEL OF EVIDENCE

Level III; Evidence obtained from well-designed observational study, including case-control design for relevant aspects of the study.

Frequency of fruit consumption and savoury snacking predict psychological health; selective mediation via cognitive failures

While there is growing interest in the link between diet and psychological health, there is a surprising lack of studies investigating the precise associations between nutrient-rich foods (such as fruit and vegetables) versus nutrient-poor foods (such as energy-dense savoury and sweet snacks), and psychological health. Similarly, the psychological processes underpinning the relationship between dietary intake and psychological health remain unclear. Hence, the present study aimed to explore the relationship between dietary consumption and psychological health, with cognitive processes as a theoretical mediator. This cross-sectional online study included 428 healthy adults (53% female; mean age= 39.7, SD= 13.0), with participants completing a range of validated questionnaires measuring dietary habits and psychological health. Stepwise multiple regression revealed that more frequent consumption of fruit was associated with reduced symptoms of depression (β = -.109, p = 0.025) and greater positive psychological wellbeing (β = .187, p < 0.001). Conversely, more frequent savoury snacking was associated with increased anxiety (β = .127, p = 0.005). Further, mediation analyses revealed that more frequent consumption of savoury snacks was associated with increased symptoms of depression, stress, anxiety, and reduced psychological wellbeing, via an increase in cognitive failures (ps < 0.001). These results provide new insights on the independent associations between certain types of food and psychological health, and the psychological mechanisms that may mediate these. Further work is now required to establish causality and determine whether these may represent modifiable dietary targets that can directly (and indirectly) influence our psychological health.

Assessing adolescent diet and physical activity behaviour, knowledge and awareness in low- and middle-income countries: a systematised review of quantitative epidemiological tools

PURPOSE

Quantitative epidemiological tools are routinely used to assess adolescent diet and physical activity (PA) constructs (behaviour, knowledge, and awareness) as risk factors for non-communicable diseases. This study sought to synthesize evidence on the quantitative epidemiological tools that have been used to assess adolescent diet and PA constructs in low to middle-income countries (LMIC).

METHODS

A systematised review was conducted using 3 databases (EbscoHost, Scopus and Web of Science).

RESULTS

We identified 292 LMIC studies assessing adolescent diet and PA. Identified studies predominantly explored behavioural (90%) constructs with a paucity of studies investigating knowledge and awareness. The majority of studies used subjective (94%) and self-administered (78%) tools. Only 39% of LMIC studies used tools validated for their contexts.

CONCLUSIONS

The findings highlight the need for more contextual tools for assessing adolescent diet and PA in LMICs. Diet and PA measurement tools used in future research will need to incorporate measures of knowledge and awareness for a more comprehensive understanding of the epidemiology of diet and PA in adolescents. Furthermore, there is a need for more evidence on the reliability and validity of these tools for use, in both cross sectional and longitudinal studies, in LMIC contexts.

Adherence to the MIND dietary pattern and sleep quality, sleep related outcomes and mental health in male adults: a cross-sectional study

BACKGROUND

A large number of studies have investigated the association of the Mediterranean and DASH diets with psychological health as well as sleep related outcomes. However, only a few number of studies have examined the association of their newly proposed hybrid, Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) dietary pattern, with sleep quality and sleep related outcomes.

METHODS

This cross-sectional study was conducted on 400 male health professions (mean age 38.67 years). Dietary information was collected using a validated 168-item semi-quantitative food frequency questionnaire. The MIND score was computed based on major dietary components emphasized or minimized in this pattern. The higher the MIND score of a subject, the greater his adherence to the MIND pattern. Mental health was evaluated using the 21-item depression, anxiety, and stress scale (DASS-21). Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. Sleep-related outcomes (day-time sleepiness and insomnia) were also evaluated using standard questionnaires RESULTS: No significant associations were found between adherence to the MIND diet score and odds of stress, anxiety and depression either in the crude or multivariable-adjusted models (P > 0.05). Nevertheless, participants with the greatest adherence to the MIND diet had lower odds of poor sleep quality (OR for T3 vs. T1: 0.56 (95% CI: 0.34, 0.92), P-trend = 0.023). The results remained significant after full adjustment for confounding variables (P-trend = 0.042). Participants in the highest tertile of MIND diet had a 42% lower odds of daytime sleepiness in the crude and multivariable-adjusted model (P-trend < 0.05). Although no significant association was observed between adherence to the MIND diet and severity of insomnia in the crude model (P-trend = 0.055), the multivariable-adjusted model showed that the highest adherence to the MIND diet was associated with lower odds of insomnia (OR for T3 vs. T1: 0.54 (95% CI: 0.31, 0.93), P-trend = 0.031).

CONCLUSION

While no significant associations were found between adherence to the MIND diet and stress, anxiety and depression, greater adherence to the MIND diet were associated with lower odds of poor sleep quality and sleep-related outcomes.

Oral health-related quality of life, probable depression and probable anxiety: evidence from a representative survey in Germany

BACKGROUND

There is limited knowledge regarding the association between oral health-related quality of life and probable depression and anxiety. Our objective was to examine the association between oral health-related quality of life and probable depression and anxiety in the German population (stratified by sex).

METHODS

In sum, n = 3,075 individuals took part in a nationally representative survey (August/September 2021). The well-established Patient Health Questionnaire-9 (PHQ-9; cut-off of 10) and the Generalized Anxiety Disorder-7 (GAD-7; cut-off of 10) were used to quantify probable depression and anxiety, respectively.

RESULTS

The likelihood of probable depression was significantly associated with lower oral health-related quality of life in the total sample (OR: 1.21, 95% CI: 1.18-1.25) and in both women and men. Additionally, the likelihood of probable anxiety was significantly associated with lower oral health-related quality of life in the total sample (OR: 1.17, 95% CI: 1.14-1.21) and in both women and men.

CONCLUSIONS

Our study emphasized the association between lower oral health-related quality of life and probable depression as well as anxiety in the general adult population in Germany. Future longitudinal studies are required to confirm our findings.

Depression, dietary intake, and body image during coronavirus disease 2019 quarantine in Peru: An online cross-sectional study

Objective:

The coronavirus disease 2019 affects the psychological well-being of populations. In the same way, it can be a potential threat to body image. The aim of the study was to explore associations between depressive symptoms, dietary intake, and body image during coronavirus disease 2019 quarantine.

Methods:

An online cross-sectional study was conducted in 589 Peruvian adults, 297 men (50.4%) and 292 women (49.6%). The mean age was 30.2 ± 9.4 years (range: 18–59 years). Participants completed three questionnaires, including a food frequency questionnaire, the Body Shape Questionnaire, and the Patient Health Questionnaire-9. Moreover, sociodemographic data were collected. The data were analyzed using the statistical software IBM SPSS version 24, and the chi-square test was used. A significance level of 5% was considered.

Results:

A total of 37.7% and 43.6% of the women reported depressive symptoms and dissatisfaction with body image, respectively. Depressive symptoms were associated with dietary intake and dissatisfaction with body image (p < 0.05). Dissatisfaction with body image was associated with dietary intake (p < 0.01).

Conclusions:

Depressive symptomatology plays an important role in the dietary intake and body image of the study population. It is suggested to address these factors through the implementation of health campaign programs and personalized therapeutic interventions.

Junk food-induced obesity- a growing threat to youngsters during the pandemic

Introduction

Obesity has been declared an epidemic that does not discriminate based on age, gender, or ethnicity and thus needs urgent containment and management. Since the third wave of COVID-19 is expected to affect children the most, these children and adolescents should be more cautious while having junk foods, during covid situations due to the compromise of Immunity in the individuals and further exacerbating the organ damage.

Methodology

A PAN India survey organized by the Centre for Science and Environment (CSE) among 13,274 children between the ages 9–14 years reported that 93% of the children ate packed food and 68% consumed packaged sweetened beverages more than once a week, and 53% ate these products at least once in a day. Almost 25% of the School going children take ultra-processed food with high levels of sugar, salt, fat, such as pizza and burgers, from fast food outlets more than once a week. Children and adolescents who consume more junk food or addicted to such consumption might be even more vulnerable during the third wave, which will significantly affect the younger category.

Conclusion

There is an urgent need to spread awareness among children and young adults about these adverse effects of junk food. There is no better time than now to build a supportive environment nurturing children and young adults in society and promising good health.

Classification of psychiatric symptoms using deep interaction networks: the CASPIAN-IV study

Identifying the possible factors of psychiatric symptoms among children can reduce the risk of adverse psychosocial outcomes in adulthood. We designed a classification tool to examine the association between modifiable risk factors and psychiatric symptoms, defined based on the Persian version of the WHO-GSHS questionnaire in a developing country. Ten thousand three hundred fifty students, aged 6–18 years from all Iran provinces, participated in this study. We used feature discretization and encoding, stability selection, and regularized group method of data handling (GMDH) to classify the a priori specific factors (e.g., demographic, sleeping-time, life satisfaction, and birth-weight) to psychiatric symptoms. Self-rated health was the most critical feature. The selected modifiable factors were eating breakfast, screentime, salty snack for depression symptom, physical activity, salty snack for worriedness symptom, (abdominal) obesity, sweetened beverage, and sleep-hour for mild-to-moderate emotional symptoms. The area under the ROC curve of the GMDH was 0.75 (CI 95% 0.73–0.76) for the analyzed psychiatric symptoms using threefold cross-validation. It significantly outperformed the state-of-the-art (adjusted p < 0.05; McNemar's test). In this study, the association of psychiatric risk factors and the importance of modifiable nutrition and lifestyle factors were emphasized. However, as a cross-sectional study, no causality can be inferred.

Assessment of Adherence to the Healthy Food Pyramid in Pregnant and Lactating Women

There are numerous dietary recommendations during pregnancy. However, there are limited recommendations during the lactation period, a nutritionally vulnerable period for women. The Mediterranean Diet and adherence to the Healthy Food Pyramid (HFP) is considered as the standard for healthy eating. In this study, we investigated the differences in adherence to the HFP in pregnant, lactating, and non-pregnant/non-lactating (NPNL) women concerning sociodemographic factors. A sociodemographic and nutritional and lifestyle questionnaire (AP-Q) were used to assess adherence to the HFP, including lifestyle. The AP-Q score ranges from 0 to 10 meaning the higher the score, the greater the adherence to the HFP. Lactating women had the lowest AP-Q score (6.13 [5.31; 6.82]) compared to the pregnant (6.39 [5.56; 7.05]) and NPNL women (6.27 [5.43; 6.88]), while pregnant women had the highest scores. Maternal age was positively correlated with AP-Q score in pregnant (rho = 0.22; p-Value < 0.001) and lactating women (rho = 0.18; p-Value < 0.001), but not in NPNL women. Educational level and monthly income had a positive influence on the degree of adherence to the HFP. In conclusion, breastfeeding mothers of young age and low socioeconomic and educational level would be the target population to carry out nutritional interventions that improve their adherence to the HFP. The knowledge gained from this study can help to design recommendation guidelines and nutritional educational interventions for a given population.

Bullying and Being Bullied; How Much Can It Increase the Risk of Depression and Anxiety in Students? A Multilevel Fixed-effect Model Analysis

Background: School violence as a health issue is a global concern. One of the problems that affect the health and well-being of children at school is bullying. Objectives: In this study, we aimed to examine the association of depression and anxiety with bullying among 6 - 19-year-old students in Iran. Methods: This study was conducted in Tehran, Iran, in 2020. A multistage cluster sampling method was used, and 54,550 students aged six to 19 years of both sexes, from urban and rural areas, were selected. Standard questionnaires, according to the WHO recommendations, were used for data collection. Involvement in bullying in the past 12 months and anxiety and depression status in both bully and bullied students were investigated by standard questionnaires. To compare the psychiatric problems and violent behavior, the Wald chi-square test was applied. The multilevel fixed-effect model and logistic multivariate regression were used to adjust the multilevel effects and estimate the odds of anxiety and depression in both bully and bullied students. All statistical analyses were performed at a 95% significance level. Results: Of the total students, 50.9% were males, 29.45% were in the 6 - 10 age group, and 70.55% in the 11 - 19 age group. There was a significant difference in depression and anxiety between boys and girls in both age groups (P < 0.001). Amongst males, 11.7% of the students aged 6 - 10 and 11% of the students aged 11 - 19 and in females, 7.7% aged 6 - 10 and 10.4% aged 11 - 19 had at least four experiences of bullying to others in the last year. The odds ratios for depression in male bullies were 1.3 and 1.5 in 6 - 10 and 11 - 19 age groups, respectively. The odds ratios for depression in bullied males and females were 4.2 and 3.9 in 6 - 10 and 2.9 and 4.3 in 11 - 19 age groups, respectively. Bulling others increased the odds of anxiety to 1.7 and 1.9 in males and 2.1 and 1.9 in females in 6 - 10 and 11 - 19 age groups, respectively. In bullied students, the odds of anxiety were estimated at 2.9 and 2.2 in males and 3.4 and 2.2 in female students respectively, in 6 - 10 and 11 - 19 age groups. Conclusions: There was a significant positive association between psychological disorders (anxiety and depression) and bullying among 6 - 19-year-old students. Victims of bullying were more at risk of depression and anxiety. This health-threatening phenomenon should not be ignored.

The association between adherence to a dietary approaches to stop hypertension (DASH) diet and neuro-psychological function in young women

Background

The adherence to a Dietary Approaches to Stop Hypertension (DASH) diet may have a bidirectional relationship with mental wellbeing. We aimed to evaluate the association between compliance with a DASH diet and neuro-psychological function in young women.

Methods

In this cross-sectional study, a total of 181 girls aged between 18 and 25 years were recruited. The dietary intakes of study participants were evaluated using a valid and reliable food frequency questionnaire (FFQ) containing 65 food items. Neuropsychological function of participants was evaluated using standard questionnaires.

Results

As may be expected, individuals in the highest tertile (T3) of adherence to DASH diet (highest adherence) were found to consume more folate, fruits, vegetables, low fat dairy, nuts, legume, and seed, less sweetened beverage and sodium, compared to the participants in the lowest tertile (T1, lowest adherence). There was a significant negative correlation between cognitive function and consumption of red and processed meat (r = − 0.168; p < 0.05); quality of life score with dietary sodium (r = − 0.151; p < 0.01) and depression score with dietary vegetables (r = − 0.174; p < 0.05). In multivariate multinomial logistic regression analyses adjusted for age, BMI and energy intake, adherence to a DASH-style diet was associated with a lower stress score (OR = 0.70; 95%CI: 0.34–1.47, P = 0.067; T3 vs. T1) and difficulty with sleep initiation (OR = 0.46; 95%CI: 0.21–1.00, P = 0.017; T3 vs. T1).

Conclusion

Adherence to a DASH diet may be associated with reduced stress and difficulty with initiating sleep.

Diet and Economic Modelling to Improve the Quality and Affordability of the Australian Diet for Low and Medium Socioeconomic Households

Food costs are a barrier to healthier diet selections, particularly for low socioeconomic households who regularly choose processed foods containing refined grains, added sugars, and added fats. In this study, the objectives were to: (i) identify the nutrient density-to-cost ratio of Australian foods; (ii) model the impact of substituting foods with lower nutrient density-to-cost ratio with those with the highest nutrient density-to-cost ratio for diet quality and affordability in low and medium socioeconomic households; and (iii) evaluate food processing levels. Foods were categorized, coded for processing level, analysed for nutrient density and cost, and ranked by nutrient density-to-cost ratio. The top quartile of nutrient dense, low-cost foods included 54% unprocessed (vegetables and reduced fat dairy), 33% ultra-processed (fortified wholegrain bread and breakfast cereals <20 g sugars/100 g), and 13% processed (fruit juice and canned legumes). Using substitution modelling, diet quality improved by 52% for adults and 71% for children across all households, while diet affordability improved by 25% and 27% for low and medium socioeconomic households, respectively. The results indicate that the quality and affordability of the Australian diet can be improved when nutritious, low-cost foods are selected. Processing levels in the healthier modelled diets suggest that some ultra-processed foods may provide a beneficial source of nutrition when consumed within national food group recommendations.

The relationship between history of dietary nutrients intakes and incidence of aggressive behavior in adolescent girls: A case-control study

BACKGROUND & AIMS

Aggressive behavior (AB) progress to a major concern among adolescents. The present study is designed to assess possible association between dietary intake of macronutrient, some micronutrient, cholesterol, and antioxidants with AB in adolescent girls, from age 9-13 years old.

MATERIALS AND METHODS

In the case-control study, a total 212 primary school girls between 9 and 13 years of age were divided into two groups (106 with AB and 106 healthy) base on aggression score of the Buss-Perry questionnaire. A 147-item food frequency questionnaire (FFQ) was used to evaluate nutritional intake of subjects. Independent t-test and Mann-Whitney test was used to compare quantitative variables between the two groups according to the normality of data distribution. Chi-square test was used to compare categorical variables between case and control groups. Logistic regression models were used to assess possible association of nutrients intake with AB.

RESULTS

The consumption of more simple carbohydrate [odds ratios (OR): 14.53, confidence interval (CI): (13.23, 17.56)] total fat [OR: 13.31, CI: (8.50, 16.47)], SFAs [OR: 11.831, CI: (8.94, 15.36)], TFAs [OR: 9.10, CI: (6.87, 10.12)], and caffeine [OR: 16.26, CI: (14.53, 17.88)] significantly increase the occurrence of aggressive behaviors. Conversely, intake of fiber [OR: 0.997, CI: (0.012, 0.999)], W3 [OR: 0.991, CI: (0.040, 0.999)], and vitamin K [OR: 0.994, CI: (0.990, 0.999)] were marginal associated with reduced odds of AB.

CONCLUSIONS

The intake of caffeine, simple carbohydrate, total fat, SFAs, TFAs, could increase the occurrence of AB.

Food insecurity (hunger) and fast-food consumption among 180 164 adolescents aged 12-15 years from sixty-eight countries

Food insecurity has been shown to be associated with fast-food consumption. However, to date, studies on this specific topic are scarce. Therefore, the aim of the present study was to investigate the association between food insecurity and fast-food consumption in adolescents aged 12-15 years from sixty-eight countries (seven low-income, twenty-seven lower middle-income, twenty upper middle-income, fourteen high-income countries). Cross-sectional, school-based data from the Global School-based Student Health Survey were analysed. Data on past 30-d food insecurity (hunger) and fast-food consumption in the past 7 d were collected. Multivariable logistic regression and meta-analysis were conducted to assess associations. Models were adjusted for age, sex and BMI. There were 180 164 adolescents aged 12-15 years (mean age 13·8 (sd 1·0) years; 50·8 % boys) included in the analysis. Overall, severe food insecurity (i.e. hungry because there was not enough food in home most of the time or always) was associated with 1·17 (95 % CI 1·08, 1·26) times higher odds for fast-food consumption. The estimates pooled by country-income levels were significant in low-income countries (adjusted OR (aOR) = 1·30; 95 % CI 1·05, 1·60), lower middle-income countries (aOR = 1·15; 95 % CI 1·02, 1·29) and upper middle-income countries (aOR = 1·26; 95 % CI 1·07, 1·49), but not in high-income countries (aOR = 1·04; 95 % CI 0·88, 1·23). The mere co-occurrence of food insecurity and fast-food consumption is of public health importance. To tackle this issue, a strong governmental and societal approach is required to utilise effective methods as demonstrated in some high-income countries such as the implementation of food banks and the adoption of free school meals.

Association between Leisure Screen Time and Junk Food Intake in a Nationwide Representative Sample of Spanish Children (1-14 Years): A Cross-Sectional Study

Evidence on the association between new patterns of leisure screen time and junk food consumption in Spanish children at the national level is scarce. The aim of this study is to assess the relation between daily leisure screen time and the frequency of sweet, soft drink, fast food, and snack intake in a representative sample of Spanish children and adolescents aged from 1 to 14 years. We conducted a cross-sectional study using a representative sample of the Spanish population under 15 years recruited for the 2017 Spanish National Health Survey (n = 5480). We dichotomized sweet, soft drink, fast food, and snack intake (high/low) and categorized daily leisure screen time (0–59, 60–119, 120–179, and ≥180 min). We calculated crude prevalence ratios and adjusted prevalence ratios, and their 95% confidence intervals (95% CI), of high frequency of sweet, soft drink, fast food, and snack intake. Children spending at least one hour of daily leisure screen time had higher prevalence of high frequency of sweet and snack intake than children being exposed less than one hour. For soft drinks and fast food, prevalence of high frequency intake was significantly higher from two and three hours of exposure, respectively. Longer periods of screen exposure in Spanish children during their leisure time may be associated with poorer dietary behaviors. The negative effects of excessive screen time in pediatrics population should be further studied.

Mental Health Problems and the Associated Family and School Factors in Adolescents: A Multilevel Analysis

Objective: Mental health is one of the most important issues in adolescents’ life. Adolescents’ health is highly important, because of their role in the future. This study was conducted using multilevel analysis to investigate the risk factors at student and school levels.

Method: This was a cross sectional study for which 1740 students and 53 schools were selected between February and March 2018 in Qazvin, Iran. Multistage stratified cluster sampling was used for data collection. Mental health problems were measured by the Strengths and Difficulties Questionnaire (SDQ). Emotional symptom, conduct problem, hyperactivity, peer relationship problem, and prosocial behavior were the subscales. This study used multilevel analysis to determine the association between each of the questionnaire scales and students and schools variables. Results: The prevalence of the mental health problems was 16.2%. Conduct problem was more prevalent than others (21.1%). Overall, the score of mental health problems was significantly lower in boys’ schools, in adolescents with physical activity, and in families with high socioeconomic status. Hyperactivity and emotional symptoms were significantly higher in girls’ schools. While prosocial behavior and peer relationship problems were significantly higher in boys’ schools. The association between variables and the scales of mental health problems was different.Conclusion: Results indicated desirable physical activity and socioeconomic status are effective components in the adolescents’ mental health, and, mostly girls’ schools were more vulnerable than boys’ schools. Therefore, the educational authorities and health policymakers should consider this diversity to design interventional programs and pay more attention to the high-risk adolescents in different schools.

Western Diet Consumption During Development: Setting the Stage for Neurocognitive Dysfunction

The dietary pattern in industrialized countries has changed substantially over the past century due to technological advances in agriculture, food processing, storage, marketing, and distribution practices. The availability of highly palatable, calorically dense foods that are shelf-stable has facilitated a food environment where overconsumption of foods that have a high percentage of calories derived from fat (particularly saturated fat) and sugar is extremely common in modern Westernized societies. In addition to being a predictor of obesity and metabolic dysfunction, consumption of a Western diet (WD) is related to poorer cognitive performance across the lifespan. In particular, WD consumption during critical early life stages of development has negative consequences on various cognitive abilities later in adulthood. This review highlights rodent model research identifying dietary, metabolic, and neurobiological mechanisms linking consumption of a WD during early life periods of development (gestation, lactation, juvenile and adolescence) with behavioral impairments in multiple cognitive domains, including anxiety-like behavior, learning and memory function, reward-motivated behavior, and social behavior. The literature supports a model in which early life WD consumption leads to long-lasting neurocognitive impairments that are largely dissociable from WD effects on obesity and metabolic dysfunction.

Diet Quality and Physical Fighting Among Youth: A Cross-National Study

The predictors of engaging in physical violence appear to be quite diverse, covering an array of social and psychological risk factors. The present study expands upon this literature by exploring the link between diet quality and physical fighting during early adolescence using cross-national data from the 2005/2006 Health Behaviors of School Children (HBSC) survey. The results reveal that the rate of physical fighting was 40% higher among youths with lower quality diets, whereas the odds of frequent physical fighting were 68% higher, relative to youths with better diets. Ancillary analyses reveal that (a) the link between diet quality and physical fighting was significantly larger among females and (b) significant associations between diet quality and physical fighting were detected in 38 of the 40 countries examined. Strategies designed to improve diet quality among youth may have the added benefit of reducing the likelihood of physical fighting and its negative sequelae.

Association Between Eating Habits and Risk of Obstructive Sleep Apnea: A Population-Based Study

OBJECTIVE

The effect of dietary factors on OSA remains unclear. This study was to investigate the association of obstructive sleep apnea (OSA) with individual and overall effects of eating habits among adult Chinese.

METHODS

A total of 9733 participants were selected from the baseline survey of the Guangzhou Heart Study. OSA was ascertained by Berlin Questionnaire. Food consumption was collected using a food frequency questionnaire, and eating patterns were extracted by principal component analysis. Odds ratios (ORs) with 95% confidence intervals (95% CIs) were calculated by the logistic regression model.

RESULTS

After adjustment for confounders, fried food intake with ≥1/week was associated with an increased risk of OSA (OR: 1.77, 95% CI: 1.37-2.27), while fruit consumption of ≥1/day was associated with a 26% reduced risk of OSA (OR: 0.74, 95% CI: 0.62-0.88). Three eating patterns were defined and labeled as pattern I, II, and III. Eating pattern III which had higher factor loadings of animal innards, fried food, salted food, carbonate, and non-carbonated beverages was associated with an increased risk of OSA (OR: 1.30, 95% CI: 1.09-1.55) when comparing the highest with the lowest tertile of pattern score, after adjusting for confounders; every 1-unit increment of pattern III score was associated with an increased risk of OSA (OR: 1.09, 95% CI: 1.04-1.14). Neither pattern I nor pattern II was observed to be associated with OSA risk.

CONCLUSION

A higher frequency intake of fruits was associated with a reduced OSA risk and a diet with higher levels of consumption of animal innards, fried food, salted food, carbonated beverages, and non-carbonated beverages may increase the risk of OSA.

Soft Drink Consumption and Mental Health in Adolescents: A Longitudinal Examination

PURPOSE

Previous studies showed associations between soft drink consumption and mental health problems in adolescents, but the direction of these effects is unknown. This study examines the hypotheses that soft drink consumption predicts aggression and depressive symptoms over time and that these mental health problems predict soft drink consumption.

METHODS

Interviews were conducted with 5,147 children and their caregivers from three sites at child ages 11, 13, and 16. At each time point, youth reported on their frequency of consuming soft drinks, aggressive behavior, and depressive symptoms. An autoregressive cross-lagged path model tested reciprocal relationships between soft drink consumption, aggressive behavior, and depressive symptoms over time.

RESULTS

More frequent consumption of soft drinks was associated with more aggressive behavior at each time point and depressive symptoms at ages 11 and 13 (r = .04 to .18, p ≤ .002). After adjusting for covariates and stability of each behavior over time, soft drink consumption at ages 11 and 13 predicted more aggressive behavior at the next time point (β = .08 and .06, p < .001). Aggressive behavior at age 13 also predicted more soft drink consumption at age 16 (β = .06, p = .002). Soft drink consumption at age 13 predicted fewer depressive symptoms (β = -.04, p = .007), but depressive symptoms did not predict soft drink consumption.

CONCLUSIONS

More frequent consumption of soft drinks may contribute to aggressive behavior in adolescents over time; there is some support for reciprocal relationships. There is no evidence for soft drink consumption contributing to adolescents' depression. Future research should examine longitudinal effects over shorter intervals.

Childhood emotional and behavioral characteristics are associated with soda intake: A prospective study in Mexico City

OBJECTIVES

To evaluate whether childhood emotional and behavioral characteristics are associated with soda intake.

METHODS

The study population included 391 Mexico City adolescents enrolled in a birth cohort study. When children were between 6 and 12 years of age, the Behavioral Assessment System for Children (BASC)-2 was administered. Nondiet soda intake was measured concurrently and again when participants were of peripubertal ages via food frequency questionnaire. Linear regression models were run with soda mL/day (cross-sectional and change in soda over time) as the outcome and BASC composite scores as predictors (in separate models), adjusting for confounders.

RESULTS

At baseline, children were 8.3 (SD 1.3) years (49% males). Three scales out of 18 examined had statistically significant associations. Parent-reported adaptive skills were inversely associated with concurrent soda intake (β = -2.29 with 95% CI -4.27 to -0.31). Parent-reported internalizing problems (higher = more problems) were related to higher change in soda intake from childhood to adolescence (β = 5.83 with 95% CI 0.98-10.68; N = 191). Self-reported school problems were associated with a higher change in soda intake over time (β = 9.46 with 95% CI 2.10-16.82; N = 122).

CONCLUSIONS

Parent- and self-reported emotional and behavioral difficulties in childhood were associated with soda consumption and changes in soda consumption over time.

Exploring the association between mental wellbeing, health-related quality of life, family affluence and food choice in adolescents

Young people choose energy-dense, nutrient-poor diets, yet understanding of potential determinants is limited. Associations between food choices, mental wellbeing, health-related quality of life (HRQoL) and family affluence were explored to identify targets for intervention to promote dietary health and wellbeing in young people. Adolescents were recruited via post-primary schools in the UK and surveyed at two time-points when aged 13-14 years and 15-16 years. The questionnaire enquired about mental wellbeing using the Short Warwick-Edinburgh Mental Wellbeing Scale, HRQoL using the KIDSCREEN-10, socio-economic status using the Family Affluence Scale and food choice by Food Frequency Questionnaire (FFQ). With missing and anomalous cases excluded, the sample comprised 1208 cases. Factor analysis on the FFQ indicated five food choice factors: 'Junk Food'; 'Meat'; 'Healthy Protein'; 'Fruit/Vegetables'; 'Bread/Dairy'. Multivariate regression analysis indicated that frequent consumption of Junk Food was associated with being male and lower mental wellbeing. Frequent Meat intake was associated with being male and with lower HRQoL. Frequent choice of Bread/Dairy foods was more common among males and associated with higher wellbeing and greater affluence. Those who consumed Fruit/Vegetables frequently were more likely to be female, have higher HRQoL, higher mental wellbeing, and greater family affluence. These direct associations endured between time points. The dietary factors were not mutually exclusive. Those who frequently chose Junk Food were less likely to choose Fruit/Vegetables. Frequent choice of Meat was associated with more frequent choice of Junk Food and Healthy Protein. Intervention to improve dietary and psychological health in young people should target males, those in less affluent households, seek to reduce consumption of 'junk' food, and increase fruit and vegetable intake.

Violence and obesogenic behavior among adolescents aged 12-15 years from 62 countries: A global perspective

Exposure to violence may be associated with increased risk for obesogenic behavior among adolescents but studies providing a global perspective are lacking. The aim of this work was to assess the relationship between violence and obesogenic behaviors among young adolescents from 62 countries. Cross-sectional data from the Global School-based Student Health Survey 2009-2016 were analyzed. Information on violence (intentional injury, physical attack, physical fight) and obesogenic behavior (anxiety-induced sleep problems, low physical activity, sedentary behavior, fast-food consumption, carbonated soft-drink consumption) were self-reported. Associations were analyzed using meta-analysis based on country-wise multivariable logistic regression analyses. A total of 165,380 adolescents aged 12-15 years [mean (SD) age 13.8 (1.0) years; 50.9% boys] were included in the analysis. All types of violence were positively associated with higher odds for all types of obesogenic behavior with the exception of low physical activity. Associations were particularly pronounced for anxiety-induced insomnia. In contrast, intentional injury (OR = 0.72; 95%CI = 0.64-0.81) and physical fight (OR = 0.90; 95%CI = 0.86-0.95) were associated with lower odds for low physical activity. In this large global sample of adolescents, exposure to violence was associated with all obesogenic behaviors apart from low physical activity. Multidimensional government programs and policies addressing exposure to violence among young adolescents may lead to reduction in obesogenic behavior and hence curtail the global obesity epidemic.