Fruit and vegetable consumption and mental health across adolescence: evidence from a diverse urban British cohort study

Exploring the association between adolescent-perceived parental monitoring on dietary intake

Parenting practices such as parental monitoring are known to positively impact dietary behaviours in offspring. However, links between adolescent-perceived parental monitoring and dietary outcomes have rarely been examined and never in an Australian context. This study investigated whether adolescent-perceived parental monitoring is associated with more fruit and vegetable, and less sugar-sweetened beverages (SSB) and junk food consumption in Australian adolescents. Cross-sectional data was collected as part of baseline measurement for a randomised controlled trial in 71 Australian schools in 2019. Self-reported fruit, vegetable, SSB and junk food intake, perceived parental monitoring and sociodemographic factors were assessed. Each dietary variable was converted to "not at risk/at risk" based on dietary guidelines, binary logistic regressions examined associations between dietary intake variables and perceived parental monitoring while controlling for gender and socio-economic status. The study was registered in ANZCTR clinical trials. The sample comprised 6053 adolescents (Mage = 12.7, SD = 0.5; 50.6% male-identifying). The mean parental monitoring score was 20.1/24 (SD = 4.76) for males and 21.9/24 (SD = 3.37) for females. Compared to adolescents who perceived lower levels of parental monitoring, adolescents reporting higher parental monitoring had higher odds of insufficient fruit (OR = 1.03; 95% CI = 1.02-1.05) and excessive SSB (OR = 1.07; 95% CI = 1.06-1.09) intake, but lower odds of excessive junk food (OR = 0.96; 95% CI = 0.95-0.98) and insufficient vegetable (OR = 0.97, 95% CI = 0.96-0.99) intake. Adolescent dietary intake is associated with higher perceived parental monitoring; however, these associations for fruit and SSB differ to junk food and vegetable intake. This study may have implications for prevention interventions for parents, identifying how this modifiable parenting factor is related to adolescent diet has highlighted how complex the psychological and environmental factors contributing to dietary intake are.

Trends in psychosomatic symptoms among adolescents and the role of lifestyle factors

BACKGROUND

Adolescent mental health problems are on the rise globally, including in Sweden. One indicator of this trend is increased psychosomatic symptoms (PSS) over time. Lifestyle factors such as physical activity (PA), diet, smoking, and alcohol consumption may influence the time trends in PSS; however, the evidence base is scarce. The aim of this study was to investigate associations between time trends in PSS and lifestyle factors.

METHODS

The study was based on data collected from a nationally representative sample of 9,196 fifteen-year-old boys and girls in Sweden using the Health Behavior in School-aged Children (HBSC) symptom checklist. The sample comprised nearly equal proportions of girls (50.5%) and boys. The lifestyle factors examined in this study included PA, regular breakfast intake, consumption of fruits, vegetables, sweets, or soft drinks, smoking, and alcohol drunkenness. We used data from 2002 to 2018 and stratified by family affluence scale (FAS) to demonstrate how the associations varied among the FAS groups. We fitted separate regression models for the high- and low-FAS groups, where interaction terms between the year of survey and each lifestyle factor were used to estimate the level and direction of associations between the factors and trends in PSS.

RESULTS

There was a generally increasing trend in PSS mean scores from 2.26 in 2002 to 2.49 in 2018 (p <.001). The changes in each survey year compared to the average mean scores during the preceding years were significant in all years except 2010. Regular breakfast intake, daily fruit and vegetable consumption, and higher PA were associated with lower PSS mean scores, while smoking and drunkenness had opposite associations with PSS. The only significant interaction between survey year and the lifestyle factors was observed regarding drunkenness in the high FAS group, suggesting that the association between trends in PSS and the experience of getting drunk at least twice got stronger over time (B = 0.057; CI:0.016, 0.097; p <.01).

CONCLUSIONS

The results indicate increasing trends in PSS among young people in Sweden from 2002 to 2018, with a significant increase observed among adolescents in the high FAS group who reported getting drunk on at least two occasions.

Perceived Quality of Life Is Related to a Healthy Lifestyle and Related Outcomes in Spanish Children and Adolescents: The Physical Activity, Sedentarism, and Obesity in Spanish Study

BACKGROUND

Maintaining a healthy lifestyle is crucial for safeguarding the well-being and quality of life perception, appropriate growth, and development of children and adolescents, while also mitigating the risk of future adult-onset diseases.

OBJECTIVE

To assess associations between perceived quality of life and healthy lifestyle and related outcomes in Spanish children and adolescents.

METHODS

Cross-sectional analysis of 8-16-year-old children and adolescents (n = 3534) were included in the nationwide study of Physical Activity, Sedentarism, and Obesity in Spanish Youth (PASOS). Data were collected through (1) questionnaires on health-related quality of life (HRQoL), healthy lifestyle outcomes (dietary intake, physical fitness, sleep, and screen time), and (2) anthropometric measurements for weight status assessment. Data were analysed by logistic regression, using the health-related quality of life (HRQoL) as the grouping variable.

RESULTS

Participants with a lower HRQoL were those with a lower adherence to the MedDiet and lower achievement of the recommended daily intake of fruit and vegetables. They were also less likely to follow the recommendations for screen time and sleep (with the exception of the weekend) compared to participants with a higher HRQoL. Participants with a lower HRQoL showed a lower healthy weight status and poorer physical fitness than those with a higher HRQoL.

CONCLUSIONS

Healthy eating habits, healthy weight status (normal weight), appropriate sleep time, physical fitness, and limited screen time play a crucial role in the perceived quality of life in children and adolescents.

Relationship between fruit and vegetable consumption and internet addiction with insomnia and depression as multiple mediators during the COVID-19 pandemic: a three-wave longitudinal study in Chinese college students

BACKGROUND

The relationships between fruit and vegetable consumption (FV) and Internet addiction (IA) in college students still remained unknown together with the internal mechanisms. Given the limitations of previous cross-sectional design, longitudinal research was necessary to be conducted to explore more precise correlations. Using the three-wave data in a longitudinal design, this study aimed to explore the association between FV and IA among Chinese college students and potential multiple mediators of insomnia and depression during the COVID-19 pandemic.

METHODS

A total of 579 college students were recruited during three waves (T1: August 2020; T2: November 2020; T3: February 2021). FV (T1), insomnia (T2), depression (T2) and IA (T3) symptoms were reported. The descriptive statistics of the sociodemographic characteristics and correlation analyses of the study variables were calculated. The significance of the mediation effects was measured conducting a bootstrap method with SPSS PROCESS macro.

RESULTS

FV was negatively correlated with IA, and lower FV predicted higher risk of IA. Depression mediated the association between FV and subsequent IA. Insomnia and depression were multiple mediators, which in turn mediated the links between FV and subsequent IA.

CONCLUSIONS

The three-wave longitudinal study has revealed that FV had indirect effects on IA through individual mediating factor of depression and multiple mediating roles of insomnia and depression sequentially. The policy makers, educators and researchers should pay attention to the impact of the interventions from healthy diet, in order to optimize the coping strategies for preventing college students from IA.

Is health promotion in sports clubs associated with adolescent participants' fruit and vegetable consumption?

BACKGROUND

Although sports clubs' potential for health promotion is acknowledged, research on whether they promote healthy eating is limited. We aimed to evaluate Finnish youth sports clubs' health promotion orientation, as well as associations between sports clubs' health promotion orientation, coaches' nutritional discussions and sports club participants' (SPs') fruit and/or vegetable consumption.

METHODS

The cross-sectional study included 554 SPs aged 14-16 years, 275 club officials and 311 coaches. Participants replied to questionnaires about sports clubs' health promotion and their own health behaviours, including dietary habits. Health promotion orientation was estimated using a Health Promoting Sports Club (HPSC) index (range 0-22) and nutritional discussions and fruit and/or vegetable consumption as frequencies. A mixed-effects multivariable logistic regression was used to analyse the associations.

RESULTS

Most sports clubs (69%) had a high health promotion orientation, but the variation between the clubs was wide (HPSC index range 5-21). SPs' daily fruit and/or vegetable consumption was associated with female gender [odds ratio (OR) 3.48, 95% confidence interval (CI) 2.23-5.42, P < 0.001], better self-rated health (OR 3.26, 95% CI 1.13-9.41, P = 0.03), higher average school grades (OR 1.67, 95% CI 1.04-2.67, P = 0.03), and SPs' responses that their coach had often discussed nutrition (OR 2.11, 95% CI 1.41-3.14, P < 0.001).

CONCLUSION

Although sports clubs' orientation towards health promotion was mostly high, it seems not to be enough to promote healthy eating among adolescent participants. Instead, coaches' nutritional discussions were associated with adolescents' fruit and/or vegetable consumption.

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.

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.

Association between patterns of eating habits and mental health problems in Chinese adolescents: A latent class analysis

Objective

We aimed to investigate the association between different eating habit patterns and mental health problems among Chinese middle and high school students, and further to estimate the interaction effect of different grouping variables on eating habits.

Methods

One thousand three hundred and forty-eight adolescents from Jilin Province in China were involved in this cross-sectional study. Mental health and eating habits were assessed using General Health Questionnaire and questions on Nutrition Knowledge, Attitude and Practice, respectively. Latent class analysis (LCA) was performed to identify eating habit patterns. Binary logistic regression and generalized linear models were used to explore the association between eating habit patterns, energy-adjusted nutrient intakes and mental health problems. Interaction analysis was performed to analyze the association between eating habits and mental health in different groups.

Results

Based on the LCA results, a 3-class parallel model was identified: 648 adolescents (48.1%) were classified in class-1 “Healthy Eating Behavior/Eating at Home,” 452 adolescents (33.5%) in class-2 “Healthy Eating Behavior/Eating at School” and 248 adolescents (18.4%) in class-3 “Unhealthy Eating Behavior/Random Place.” Compared with class-1, participants in class-2 and class-3 were at higher risk of mental health problems, especially for class-3 (p < 0.05). The energy and nutrient intakes by different latent classes showed that adolescents who ate unhealthy had lower daily intake of energy, protein, carbohydrate, fiber, Vitamins and minerals (p < 0.05). The interaction between age, sleep duration and different eating habits was statistically significant (p for interaction < 0.1).

Conclusion

“Unhealthy eating behavior/random place pattern” was positively correlated with mental health problems of adolescents. The adolescents with health diet were accompanied by fewer mental health problems, especially for that eating at home. And there were interactions between eating habits and age, sleep duration on the mental health problems.

Potential of Probiotics as an Adjunct for Patients with Major Depressive Disorder

Major depressive disorder (MDD) is an enfeebling disease with a lifetime incidence of 20%. While accumulating studies implicate a correlation between the disease and gut microbiota, data show that not every patient responded to probiotic treatments. To comprehensively assess the potential role of probiotics in MDD, this study first summarizes the current pathological hypothesis of the disease from a life-stage perspective, focuses on the potential role of "depression gut microbiota." Currently available managements are then briefly summarized and novel bio-materials having potential therapeutic effects on MDD are also evaluated. To harness the positive effect of probiotics, prebiotics, and postbiotics, clinical evidence and their applications on MDD patients are listed. Factors that may counteract the pre/probiotic applications, such as diet, physiology, gender difference, and use of antibiotics and antidepressants are also discussed. The endocannabinoid (eCBs) system may be promising targets for probiotic therapy. More evidence is needed to demonstrate the hierarchical factors in the complex network driving the disease, and probiotic can be one promising adjunct for patients with MDD.

Inhibition of Human Monoamine Oxidases A and B by Specialized Metabolites Present in Fresh Common Fruits and Vegetables

Diets rich in fruits and vegetables are associated with better psychological wellbeing and cognitive functions, although it is unclear which molecules and mechanisms are involved. One potential explanation is the inhibition of monoamine oxidases (MAOs), which have been linked to several neurological disorders. The present study investigated the ability of kiwifruit to inhibit MAO-A and MAO-B, refining an in vitro assay to avoid confounding effects. Ultra-performance liquid chromatography/mass spectrometry (UPLC-QTOF) and nuclear magnetic resonance spectroscopy (NMR) were used to select individual kiwifruit metabolites for further analysis. Moreover, extracts of other common fruits and vegetables were screened to identify promising candidate inhibitors. Multiple extracts and compounds inhibited both enzymes, and the selective inhibition of MAO-B by the major kiwifruit specialized metabolite D-(−)-quinic acid was observed. These results suggest that fruits and vegetables contain metabolites that inhibit the activity of MAO-A and -B, offering a potential natural option for the treatment of neurological disorders, in which MAOs are involved.

Report of the intergovernmental panel on climate change: implications for the mental health policy of children and adolescents in Europe-a scoping review

Climate change is a worldwide challenge. Its consequences do encompass severe threats not only for the existence and somatic health, but also for the mental health of children and adolescents. Mental health can be impaired by three types of consequences. Direct consequences of climate change, such as natural disasters and indirect consequences, such as loss of land, flight and migration, exposure to violence, change of social, ecological, economic or cultural environment. Moreover, the increasing awareness of the existential dimension of climate change in children and adolescents can influence their well-being or challenge their mental health. Consequences of climate change for somatic health may interact with mental health or have psychological sequelae in children and adolescents. Based on the estimates by the United Nations Intergovernmental Panel on Climate Change, we have summarized current data on these differential pathways as to how climate change affects the mental health of children worldwide through selective literature research on Pubmed. Mental health sequelae of direct and indirect consequences of climate change, increased awareness and physical health problems caused by climate change are presented. We give insights into special vulnerabilities of children and adolescents and identify high-risk groups. As the "Fridays for Future" movement has been initiated in northern Europe, we will discuss these results with a focus on children and adolescents in Europe. The results indicate that climate change is a serious threat to children and adolescent mental health. Children´s rights, mental health and climate change should not continue to be seen as separate points; instead, they need to be brought together to address this major challenge determining the future of our children and their descendants.

Lifestyle Adjustments in Long-COVID Management: Potential Benefits of Plant-Based Diets

PURPOSE OF REVIEW

The SARS-CoV-2-pandemic has caused mortality and morbidity at an unprecedented global scale. Many patients infected with SARS-CoV-2 continue to experience symptoms after the acute phase of infection and report fatigue, sleep difficulties, anxiety, and depression as well as arthralgia and muscle weakness. Summarized under the umbrella term "long-COVID," these symptoms may last weeks to months and impose a substantial burden on affected individuals. Dietary approaches to tackle these complications have received comparably little attention. Although plant-based diets in particular were shown to exert benefits on underlying conditions linked to poor COVID-19 outcomes, their role with regard to COVID-19 sequelae is yet largely unknown. Thus, this review sought to investigate whether a plant-based diet could reduce the burden of long-COVID.

RECENT FINDINGS

The number of clinical trials investigating the role of plant-based nutrition in COVID-19 prevention and management is currently limited. Yet, there is evidence from pre-pandemic observational and clinical studies that a plant-based diet may be of general benefit with regard to several clinical conditions that can also be found in individuals with COVID-19. These include anxiety, depression, sleep disorders, and musculoskeletal pain. Adoption of a plant-based diet leads to a reduced intake in pro-inflammatory mediators and could be one accessible strategy to tackle long-COVID associated prolonged systemic inflammation. Plant-based diets may be of general benefit with regard to some of the most commonly found COVID-19 sequelae. Additional trials investigating which plant-based eating patterns confer the greatest benefit in the battle against long-COVID are urgently warranted.

Does diet play a role in the prevention and management of depression among adolescents? A narrative review

BACKGROUND

Depression is one of the major causes of illness and disability, while suicide is the second leading cause of death amongst adolescents. Although many factors determine the mental health of an individual, diet has been gaining popularity as a key modifiable factor in the prevention and management of depression. Nutritional Psychiatry is an emerging field where researchers suggest that the food we consume influences our mental well-being.

AIM

This review aims to explore the significance of diet, nutrient deficiencies, imbalances, and unhealthy dietary patterns in the prevention and management of unipolar depression or major depressive disorder among adolescents.

METHODS

Electronic databases such as PubMed, Scopus, Google Scholar, Science Direct, and MEDLINE were searched using keywords such as "mental health," "depression," "adolescents," "diet," "dietary pattern," and pertinent articles (N = 68) were retrieved and reviewed.

RESULTS

The Mediterranean and traditional diets rich in complex carbohydrates, omega-3 fatty acids, B-group vitamins and several amino acids have shown negative correlation with the incidence of depression. On the other hand, Western dietary patterns (sweetened beverages, processed/ junk food, and foods rich in saturated fatty acids), along with low consumption of fruits and vegetables have been linked to an increased risk of depression among adolescents.

CONCLUSION

Dietary modification can prove to be a cost-effective strategy for the prevention and treatment of depression among adolescents. Diet and nutrition need to be recognized as key modifiable targets for the prevention of mental disorders and nutritional medicine should be considered as an integral part of psychiatric treatment.

Influence of healthy lifestyle behaviors on life satisfaction in the aging population of Thailand: a national population-based survey

BACKGROUND

Understanding the influence of healthy lifestyle behaviors on population-level life satisfaction is few known in the aging population, especially in low- and middle-income countries in Asia. The objective of our study was to analyse the association of lifestyle behaviors with life satisfaction in a nationally-representative sample of older persons in Thailand.

METHODS

The sample was obtained from a baseline phase of a nationally-representative, longitudinal survey of the Thai population. The study employed a multistage sampling technique to recruit study participants age 60 years or older from the five geographic regions of Thailand. In this study, 1460 adults age 60 years or older from 3670 households successfully completed face-to-face interviews by trained staff with a structured questionnaire. Information on self-reported life satisfaction, lifestyle behaviors, and sociodemographic characteristics were collected via survey questionnaire. Life satisfaction was assessed using the Scale with Life Satisfaction (SWLS) [1 to 7] response. Binary logistic regression analysis was used in investigating the association between lifestyle behaviors and life satisfaction.

RESULTS

The median age of the participants was 68.1 (60-93 years). The overall mean life satisfaction score was 24.2 ± 5.6. Regular physical activity (at least 30 min per day) and sufficient fruit and vegetable (FV) intake (at least 400 g per day) were significantly associated with older people's life satisfaction (p ≤ 0.001 and p ≤ 0.10, respectively) after controlling all sociodemographic variables. Participants who had regular physical activity were 1.7 times as likely to be satisfied as those with less physical activity (95% CI 1.284-2.151). Participants with sufficient daily FV intake were 1.3 times as likely to be satisfied with life as those with insufficient daily FV (95% CI 0.994-1.723). Life satisfaction score also differed significantly by sociodemographic characteristics (sex, age, marital status, educational attainment) and presence of chronic disease.

CONCLUSIONS

To improve the life satisfaction of older persons, taking into account sociodemographic characteristics of the population and absence of chronic disease, the need for promotion of healthy lifestyle behaviors, especially regular physical activity and sufficient FV intake, must be recommended.

Health-Related Quality of Life, Blood Pressure, and Biochemical and Anthropometric Profile in Vegetarians and Nonvegetarians

Several studies have been carried out which mainly focus on the analysis of the lipid profile in vegetarians and nonvegetarians. However, few studies have been undertaken in this population oriented to quality of life and health. This study aimed to compare health-related quality of life, blood pressure, and biochemical and anthropometric profile in vegetarians and nonvegetarians. The study included 149 participants out of an initial sample of 162: 62 vegetarians and 87 nonvegetarians. Health-related quality of life was assessed with the SF-12 Health Questionnaire version 2 and was related with the lipid profile, glucose, blood pressure, anthropometric measures, and sociodemographic characteristics. Vegetarians presented better Body Mass Index (BMI) and waist circumference (WC), as well as higher LDL levels. No significant differences in HDL and TG concentrations were found. Serum glucose concentrations were significantly lower among vegetarians. Nonvegetarian males had higher diastolic pressure levels. Vegetarian women had significantly higher levels of systolic pressure. As for the physical health and mental health components of quality of life, no significant differences were found in vegetarian and nonvegetarian women and men. In conclusion, vegetarians presented a better anthropometric profile, lower glycaemia, and higher LDL levels but no significant differences in health-related quality of life compared with nonvegetarians.

Child Consumption of Whole Fruit and Fruit Juice Following Six Months of Exposure to a Pediatric Fruit and Vegetable Prescription Program

Public health recommendations suggest limiting child consumption of fruit juice in favor of whole fruit due to juice’s high sugar content, lack of fruit fiber, and potential for excess intake. However, replacing juice with whole fruit may be particularly challenging for low-income and minority children, who report the highest intake of 100% juice. To address access and affordability challenges among low-income children, researchers partnered with pediatricians in an urban food desert community, to introduce a fruit and vegetable prescription program (FVPP) that provided a $15 prescription for fresh produce to every child during each office visit. Participating vendors included a farmers’ market and local mobile market. This study assessed changes in daily consumption of total fruit and whole fruit among 108 pediatric patients following six months of exposure to the FVPP. Child-reported mean daily intake of whole fruit increased significantly from the baseline to the 6-month follow-up (p = 0.03): 44% of children reported an increased intake of at least ¼ cup per day, and 30% reported an increased intake of at least ½ cup per day. Changes in total fruit intake (including fruit juice) were not significant. Results suggest a pediatric FVPP may have meaningful impacts on children’s dietary behaviors, particularly with regard to the intake of whole fruits.