Sleep, fruit/vegetable consumption, social media use influence adolescent mental health

Mental health during childhood and adolescence was linked to adolescent health behaviors, according to results of a cohort study published in JAMA Network Open.

“Although lifestyle behaviors have been recognized as novel targets for prevention of mental health conditions, there is also potential for mental health status to act as a determinant of an individual’s ability to engage in healthful lifestyle behaviors,” Erin Hoare, PhD, of the Centre for Diet and Activity Research at University of Cambridge in the U.K., and colleagues wrote. “As an example, depression is characterized by low motivation, low energy and loss of pleasure in daily activities, and this has been found to be associated with adverse outcomes in daily behaviors, such as dietary choices, physical activity and sleep. This potentially reciprocal association holds important public health implications, particularly regarding the highly elevated rates of cardiometabolic comorbidities associated with poor mental health.”

Because lifestyle behaviors are largely modifiable, unlike numerous other mental disorder risk factors, they are appealing targets for intervention, the researchers noted. Specifically, social media use has become highly prevalent among youth, and although researchers have debated its association with mental health, they have found evidence for its association with internalizing and externalizing problems. Further, sleep has emerged as a health behavior of focus.

In the current study, Hoare and colleagues sought to evaluate the associations between parent-reported mental health problems during childhood, as well as self-reported mental health problems in adolescence, and health behaviors during adolescence. They analyzed data collected in 2008 and 2015 of 9,369 young people born between 2000 and 2001 who were included in the U.K. population-representative longitudinal Millennium Cohort Study. The first wave analyzed included data on parent-reported mental health issues for children at age 7 and the second wave analyzed included data on self-reported mental health problems, as well as health behaviors, for the same participants at age 14. Parents reported mental health problems using the Strengths and Difficulties Questionnaire, and youth reported mental health problems using the Short Mood and Feelings Questionnaire. Health behaviors at age 14 served as the primary outcome. Youth also reported sleep duration, fruit/vegetable/soft drink consumption and social media use using recall on a typical day. The investigators calculated regression models for each lifestyle variable and change in mental health from ages 7 to 14 served as the exposure variable. Further, they weighted data to account for the potential clustering of region of sampling, and they adjusted for nonresponse.

Results showed a lower likelihood of having 9 hours of sleep or greater (OR = 0.39; 95% CI, 0.34-0.45) and of consuming fruit (OR = 0.55; 95% CI, 0.46-0.65) and vegetables (OR = 0.66; 95% CI, 0.52-0.83), as well as greater social media use (beta = 0.62; 95% CI, 0.49-0.75) among adolescents who self-reported mental health problems at age 14 vs. those who did not have mental health problems at either measured time point. Moreover, participants with mental health problems at both times points had a lower likelihood of achieving 9 hours of sleep or greater (OR = 0.68; 95% CI, 0.51-0.9), consuming fruit (OR = 0.39; 95% CI, 0.26-0.58) and vegetables (OR = 0.57; 95% CI, 0.35-0.91), as well as increased social media use (beta = 0.63; 95% CI, 0.34-0.91).

“These findings are particularly important for public health and clinical practice, given that health behaviors can deteriorate and become habitual during adolescence, and it is also a known time for the first emergence of mental health problems that continue into adulthood,” Hoare and colleagues wrote.