Psychological distress leads to reduced physical activity and fitness in children: the Australian longitudinal LOOK study

Direct and indirect associations between mental health and motivational indicators with physical activity among Lithuanian adolescents

Background

Considering the low engagement of contemporary adolescents in physical activity (PA), apparently, PA still has a low priority for adolescents, who are the only ones making decisions and performing behavior. So, analysis of more proximal factors that lay on the personal and interpersonal levels as well as psychological mechanisms forming PA behavior is important.

Methods

The population-based cross-sectional study included 4,924 5th to 12th-grade school students. Among them, 50.9% were girls. The mean age of study participants varied from 11 to 19 years [mean 14.08 (2.21)]. Moderate-to-vigorous physical activity was measured by four items out of the IPAQ-SF questionnaire. Psychological well-being was assessed using The World Health Organization Five Well-Being Index (WHO-5) 5-item questionnaire. Psychological distress has been assessed by Kessler's six-item scale. Social support in terms of family and friends social support has been assessed by a 13-item subscale of Sallis' Support for Exercise Survey. Body mass index (BMI) was calculated by dividing body mass (kg) by height-squared (m2).

Results

Higher motivation for MVPA was predicted by higher family (β = 0.653) but not friends'support and both mental health indicators - higher psychological well-being (β = 0.049) and lower psychological distress (β = -0.078) were linked to higher motivation for physical activity, regardless the covariates. Higher motivation (β = 0.137), greater psychological well-being (β = 0.580) with the greatest magnitude, and lower psychological distress (β = -0.293) contributed to the greater MVPA.

Conclusion

Family but not friends' support for physical activity, greater psychological well-being, and lower psychological distress have direct and indirect effects on greater moderate-to-vigorous physical activity in adolescents.

Instrumented measures of sedentary behavior and physical activity are associated with depression among children and adolescents: a systematic review and dose-response meta-analysis of observational studies

Background

Higher sedentary behavior (SB) and lower physical activity (PA) are associated with negative physical and mental health outcomes. SB and PA can be objectively assessed using inertial sensors to evaluate body movements. This study aimed to quantify the association between instrumented measures of SB (i-SB) and PA (i-PA) and depression among children and adolescents using a systematic review and meta-analysis of observational studies.

Methods

An electronic search was conducted on six databases up to May 12, 2024. A dose-response meta-analysis was conducted to determine the association between i-SB and i-PA and depression, expressed as odds ratios (ORs) and 95% confidence intervals (CIs).

Results

Five cross-sectional and 11 longitudinal studies comprising 26,109 participants met the inclusion criteria. Comparing the most sedentary with the least sedentary groups of participants resulted in a pooled ORs of 1.05 (95% CI 0.94-1.16). Comparing the least active with the most active groups of participants resulted in pooled ORs of 0.93 (95% CI 0.84-1.07), 0.89 (95% CI 0.79-1.00), 0.83 (95% CI 0.66-0.99), and 0.73 (95% CI 0.58-0.89) for light, moderate-to-vigorous (MV), vigorous, and total PA, respectively. Robust error meta-regression analyses showed clear dose-response relationships between i-SB and i-MVPA and depression.

Conclusion

Both i-SB and i-PA were significantly associated with risk of depression in children and adolescents, which may become non-significant after mutual adjustment for i-PA and i-SB.

Systematic review registration

[https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=546666], identifier [CRD42024546666].

Depressive Symptoms and Their Longitudinal Impact on Physical Activity and Sedentary Behaviors Among Mexican-Heritage Youth

The purpose of this study is to examine the longitudinal impact of depressive symptoms on physical activity (PA) levels, sedentary behavior, and screen time among first-generation, Mexican-heritage youth. Mexican-heritage families were recruited by promotoras de salud from colonias in Hidalgo County, Texas. Participants (n = 200 youth, 116 families in final sample) completed at-home, interviewer-administered surveys once during the summer (June-July) and once during the fall (August-December). Youth PA and sedentary behaviors were assessed using a validated 7-day recall instrument. The validated Center for Epidemiology Studies-Depression Child scale was used to assess depression symptoms. Linear mixed-effects models were used to analyze the relationships of PA and sedentary behavior with depressive symptoms. Results showed that those depression symptoms were significantly associated with decreased number of self-reported minutes of sitting and screen time over time in the full sample and among male youth. Depression symptoms also significantly decreased the number of self-reported active and moderate to vigorous PA minutes over time among male youth. Researchers can build on our findings by identifying the mechanisms driving the relationships between depression and PA/sedentary behavior. Public health-programing efforts should intentionally consider the impact that depressive symptoms have on PA.

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

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

Mindfulness is associated with reduced barriers to exercise via decreasing psychological distress in help-seeking young adults: A cross-sectional brief report

AIM

Mental illness is common among young people. Exercise has benefits for mental health; however, young people experience a range of barriers to engaging in physical activity, one of which is psychological distress. Mindfulness is a modifiable factor that can reduce distress and may, in turn, reduce perceived barriers to physical activity. The aim of this work was to explore associations between dispositional mindfulness, psychological distress and barriers to engaging in physical activity.

METHODS

We used cross-sectional survey data from young adults aged 15-25 years who attended youth mental health services (headspace centres). Demographic, mindfulness, exercise barriers and wellbeing data were collected.

RESULTS

Mediation analysis showed that greater dispositional mindfulness reduced perceived barriers to exercise via reductions in psychological distress among 88 help-seeking young Australians.

CONCLUSION

Interventions to increase dispositional mindfulness may be helpful in reducing psychological distress and lessening barriers to exercise engagement, therefore promoting mental health among young people experiencing mental health symptoms.

Physical activity during the SARS-CoV-2 pandemic is linked to better mood and emotion

The SARS-CoV-2 pandemic may negatively impact mood and emotion. Physical activity may protect against mood disturbance and promote positive affect. This study asked if physical activity before, during, or the change in physical activity with the pandemic, impacted affect and mood during the pandemic. US adult residents (18-74 years; N = 338) were surveyed from 29 April to 3 June 2020. Physical activity before and during the pandemic was assessed with the Physical Activity Rating survey. The Positive and Negative Affect Schedule measured affect and the Profile of Moods Questionnaire assessed mood. Comparisons between physically inactive and active participants by Analysis of Covariance found greater vigour in participants classed as physically active before the pandemic. Positive affect, vigour and esteem-related affect were greater in participants physically active during the pandemic. Multiple linear regression revealed relationships between the change in physical activity and mood. Change in physical activity positively associated with positive affect (b = 1.06), esteem-related affect (b = 0.33) and vigour (b = 0.53), and negatively associated with negative affect (b = -0.47), total mood disturbance (b = -2.60), tension (b = -0.31), anger (b = -0.24), fatigue (b = -0.54), depression (b = -0.50) and confusion (b = -0.23). These data demonstrate that physical activity during the pandemic, and increased physical activity relative to before the pandemic, related to better mood.

Psychological Distress Among Asian Indians and Non-Hispanic Whites in the United States

Introduction

The prevalence of psychological distress (PD) among Asian Indians is unknown. This study estimated and compared moderate-serious PD in Asian Indians and non-Hispanic Whites (NHWs) in the United States.

Methods

We used a cross-sectional design using the National Health Interview Survey (2012-2017). Adult (age >18 years) NHWs and Asian Indians (N=2,218) were included. PD was measured using the six-item Kessler (K6) scale. We used multivariable logistic regression to determine the association of Asian Indian ethnicity with PD.

Results

In the analysis, 19.9% of NHWs and 11.0% of Asian Indians reported moderate-serious PD. Asian Indians were less likely to report PD in both unadjusted (unadjusted odds ratio=0.50; 95% confidence interval [CI]=0.42-0.58) and fully adjusted (adjusted odds ratio=0.7; 95% CI 0.59-0.82) models.

Conclusions

Asian Indians had a lower prevalence of PD than NHWs, likely due to multiple protective factors such as high socioeconomic status and lower multimorbidity.

The association of stress and physical activity: Mind the ecological fallacy

Psychological stress and physical activity are interrelated, constituting a relevant association to human health, especially in children. However, the association’s nature remains elusive, i.e., why psychological stress predicts both decreased and increased physical activity. To test whether effects vary as a function of the level of analyses, we derived intensive longitudinal data via accelerometers and stress questionnaires from 74 children across 7 days as they went about their daily routines (n = 513 assessments). Multilevel modelling analyses revealed that between children, higher psychological stress predicted decreased physical activity (standardized beta coefficient = −0.14; p = 0.046). Concurrently, within those children, higher psychological stress predicted increased physical activity across days (standardized beta coefficient = 0.09; p = 0.015). Translated to practice, children who experienced more stress than others moved less, but children were more active on days when they experienced heightened stress. This suggests that the analyses level is crucial to the understanding of the association between psychological stress and physical activity and should be considered to receive unequivocal results. If replicated, e.g., including high-frequency sampling and experimental manipulation in everyday life for in-depth insights on underlying mechanisms and causality, our findings may be translated to individually tailored (digital) prevention and intervention strategies which target children’s distress-feelings despite impairing their heightened physical activity in stressful situations and identify tipping points of chronic stress phases. Therefore, we especially call for more intensive longitudinal data approaches to tackle thus far neglected within-subject issues in the field of physical activity, sport and exercise research.

Healthier Minds in Fitter Bodies: A Systematic Review and Meta-Analysis of the Association between Physical Fitness and Mental Health in Youth

BACKGROUND

Physical fitness is an important marker of current and future health status, yet the association between physical fitness and indicators of mental health in youth has not been systematically reviewed and meta-analyzed.

OBJECTIVE

The aim of this work was to systematically review and meta-analyze the association between physical fitness components (i.e. cardiorespiratory fitness, muscular fitness, speed-agility, flexibility and fitness composite) and mental health indicators (i.e. psychological well-being and psychological ill-being) in preschoolers, children and adolescents.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

Systematic searches were conducted in PubMed, Web of Science and Scopus from database inception to May 2020.

ELIGIBILITY CRITERIA

Studies (cross-sectional, longitudinal and intervention designs) were included if they measured at least one physical fitness component and one mental health indicator in healthy youth (2-18 years).

RESULTS

A total of 58 unique studies (52 cross-sectional, 4 longitudinal and 4 intervention studies) met all eligibility criteria and were included. There was a significant positive overall association between physical fitness and mental health in children and adolescents (pooled r = 0.206, p < 0.001). We found suggestive evidence of moderation by age group, fitness components and socioeconomic status (all p < 0.08). No relevant studies focusing on preschoolers were identified. Evidence based on longitudinal and intervention studies was limited.

CONCLUSION

We observed a small to medium sized positive association between physical fitness and overall mental health in youth. However, as the majority of studies were cross-sectional, additional longitudinal and intervention studies are needed to provide evidence of causation.

TRIAL REGISTRATION

PROSPERO registration number CRD42017080005.

Lifestyle habits and depressive symptoms in Norwegian adolescents: a national cross-sectional study

Background

This study’s purpose was to examine the association between a broad range of lifestyle habits and depressive symptoms in Norwegian adolescents.

Methods

This study was based on national, self-reported, cross-sectional data from the Ungdata Surveys, conducted in 2017–2019. The target group comprised 244,250 adolescents (ages 13–19). Binominal logistic regression was used to analyse the association between lifestyle habits (physical activity, social media use, gaming, dietary habits, smoking, smokeless tobacco, alcohol intoxication) and depressive symptoms. The outcome measure was defined as a high level of depressive symptoms (≥80th percentile). Separate analyses were performed for boys and girls, and all models were adjusted for perceived family economy, parental higher education and age.

Results

The odds of having depressive symptoms were significantly lower among those who reported being physically active at least 3 times per week (OR; boys: 0.81, girls: 0.83), used social media ≤3 h per day (OR; boys: 0.65, girls: 0.70), engaged in gaming ≤3 h per day (OR; boys: 0.72, girls: 0.77), were non-smokers (OR; boys: 0.74, girls: 0.72) and had not experienced alcohol intoxication during the previous 12 months (OR; boys: 0.66, girls: 0.67). Furthermore, the results indicated a significant inverse association between depressive symptoms and high consumption of a range of healthy food items and low consumption of unhealthy food and beverages among girls. Similar tendencies were found among boys (OR; 0.77–0.91). Finally, higher adherence to healthy lifestyle habits was associated significantly with lower odds of having depressive symptoms among both genders (OR; boys: 0.40, girls: 0.52).

Conclusions

A healthier lifestyle was associated with lower odds of having depressive symptoms. Additional research is needed to confirm a possible causal relationship.

A Psychophysiological Examination of the Mutability of Type D Personality in a Therapeutic Trial

Abstract. Identifying the associations between health and personality has been a focus for psychophysiological research. Type D personality is associated with predisposition to physical and psychological ill-health. This statistician-blind parallel-group controlled trial (intervention group vs. waiting list control group) examined the impact of Havening Techniques on the Type D constituents of negative affect (NA) and social inhibition (SI). One hundred twenty-five adult (18+ years) participants in the United Kingdom (72 females, 53 males) completed the Type D Scale-14 (DS14) measure of Type D personality at baseline (T1), 24-hours (T2), and at 1-month (T3). Forty participants in the treatment group received additional stress biomarker assessment of heart rate, blood pressure, and salivary cortisol. Type D caseness remained stable in the waiting list participants ( n = 57). In the treatment group ( n = 68); NA, SI, and total scores decreased from T1 to T2 ( p < .001, p < .001, and p < .001, respectively), and from T2 to T3 ( p = .004, p < .001, and p < .001, respectively), significantly transmuting to non-caseness ( p < .001 for T1 to T2; p = .025 for T2 to T3). Between T1 and T2, decreases in cortisol ( p < .001), diastolic blood pressure ( p < .001), and systolic blood pressure ( p < .001) were demonstrated. Heart rate fell nonsignificantly between T1 and T2 ( p = .063), but significantly from T1 to T3 ( p = .048). The findings of this study indicate the potential mutability of the psychophysiological illness-prone characteristics of Type D personality.

Association between cardiorespiratory fitness and depressive symptoms in children and adolescents: A systematic review and meta-analysis

Background Higher cardiorespiratory fitness (CRF) is associated with lower depressive symptoms in adults. However, no systematic review with meta-analysis assessed the cross-sectional associations between CRF and depressive symptoms in children and adolescents. Therefore, this meta-analysis assessed the relationship between CRF and depressive symptom in these populations. Methods Cross-sectional data evaluating the correlation between CRF and depression were searched, from database inception through 21/05/2020, on PubMed, PsycINFO, Web of Science, and SPORTDiscus. Age, sex, CRF and depression assessments, and correlations were extracted. A random-effects meta-analysis was conducted, and the potential sources of heterogeneity were also explored through meta-regression analysis. Results Across 14 effects of 11 unique studies, including a total of 7,095 participants (median age=12.49) with nearly equal sex distribution (median=53% females), it was found that higher CRF was associated with lower depressive symptoms in children and adolescents (r =-0.174, 95%CI -0.221 to -0.126, p<0.001, I²=75.09, Q value=52.19). No moderators were identified. Conclusion Available evidence supports the notion that higher CRF is inversely associated with depressive symptoms in children and adolescents. Physical activity and exercise interventions targeting improving CRF should be promoted for these populations. Further studies, including clinical populations, should be conducted to assess objective measures of aerobic fitness and body composition, while controlling for puberty status, to better characterize this association.

Longitudinal Association between Sport Participation and Depressive Symptoms after a Two-Year Follow-Up in Mid-Adolescence

Sport participation has been advocated as a strategy to improve adolescents’ mental health. However, how these variables evolve during the adolescent years is uncertain. The objective of the present work was to examine the longitudinal associations of sports participation and depressive symptoms in adolescents. Participants were 525 Spanish adolescents (50.3% boys), aged between 12 and 15 years old (M = 13.45, SD = 0.69). They were enrolled in 18 secondary schools located in Andalusia (Spain) in the first two academic years of Compulsory Secondary Education. Data were collected in three waves, separated by one year, by administering self-report measures of depressive symptoms and sport participation. Repeated measures analyses of variance were conducted to examine the change in depressive symptoms and sport participation, and a latent growth curve model was tested to examine the change in depressive symptoms controlling initial sport participation and gender. At each wave, more frequent sport participation was related to lower depressive symptoms. Two years after the first assessment, adolescents became more depressed but not more active. Less active adolescents had more depressive symptoms in each assessment time. At all moments of assessment, girls were less active and reported more depressive symptoms. Moreover, girls had a higher increase in depressive symptoms than boys. Promotion of physical activity (PA) as a mental health strategy needs to consider gender differences as boys and girls have different patterns of presentation of depressive symptoms throughout adolescence.

Recurrent depression in childhood and adolescence and low childhood socioeconomic status predict low cardiorespiratory fitness in early adulthood

BACKGROUND

Cardiorespiratory fitness (CRF) strongly influences health, but very little is known about the childhood determinants of adult CRF. Our longitudinal study investigated whether childhood psychopathology and socioeconomic status (SES) were related to adult CRF in 1647 Finnish male military conscripts.

METHODS

Childhood psychopathology was assessed at the age of eight using the Rutter and Children's Depression Inventory questionnaires. Parental education and family structure were used to assess childhood SES. In late adolescence, depressive symptoms were assessed with the Beck Depression Inventory and smoking with a questionnaire. CRF in early adulthood was examined with the Cooper's 12-minute run test.

RESULTS

General linear models showed that low parental education (p=0.001), depressive symptoms in childhood (p=0.035) and late adolescence, smoking, underweight, and overweight/obesity (all p<0.001) independently predicted lower CRF. The interaction between depressive symptoms in childhood and adolescence was significant (p=0.003). In adolescents with depressive symptoms, childhood depressive symptoms (p=0.001) and overweight/obesity (p<0.001) predicted lower CRF. In adolescents without depressive symptoms, conduct problems in childhood predicted lower CRF in the initial models, but the effect disappeared after taking into account smoking and body mass index. Mediational analysis confirmed these results.

LIMITATIONS

We lacked data on physical activity and only studied males at three time-points.

CONCLUSIONS

Recurrent depression in childhood and adolescence and low SES in childhood predict lower adult CRF. Conduct problems in childhood predict lower CRF, but the effect is mediated by overweight/obesity and smoking. Psychiatric treatment for children and adolescents should promote physical activity, particularly for children with low SES.

Mobile and wearable technology for monitoring depressive symptoms in children and adolescents: A scoping review

BACKGROUND

There has been rapid growth of mobile and wearable tools that may help to overcome challenges in the diagnosis and prediction of Major Depressive Disorder in children and adolescents, tasks that rely on clinical reporting that is inherently based on retrospective recall of symptoms and associated features. This article reviews more objective ways of measuring and monitoring mood within this population.

METHODS

A scoping review of peer-reviewed studies examined published research that employs mobile and wearable tools to characterize depression in children and/or adolescents. Our search strategy included the following terms: (1) monitoring or prediction (2) depression (3) mobile apps or wearables and (4) children and youth (including adolescents), and was applied to five databases.

RESULTS

Our search produced 829 citations (2008- Feb 2019), of which 30 (journal articles, conference papers and abstracts) were included in the analysis, and 2 reviews included in our discussion. The majority of the evidence involved smartphone apps, with very few studies using actigraphy. Mobile and wearables captured a variety of data including unobtrusive passive analytics, movement and light data, plus physical and mental health data, including depressive symptom monitoring. Most studies also examined feasibility.

LIMITATIONS

This review was limited to published research in the English language. The review criteria excluded any apps that were mainly treatment focused, therefore there was not much of a focus on clinical outcomes.

CONCLUSIONS

This scoping review yielded a variety of studies with heterogeneous populations, research methods and study objectives, which limited our ability to address our research objectives cohesively. Certain mobile technologies, however, have demonstrated feasibility for tracking depression that could inform models for predicting relapse.

Academic Stress and Physical Activity in Adolescents

The issue of work-related mental health needs to be addressed at the school level. The aim of this study was to explore the associations between academic stress (AS) of adolescent boys and girls and their physical activity (PA) during recesses and after school and to propose measures to promote the adoption of lifelong healthy working habits. Adolescents from 16 schools in the Czech Republic and 6 schools in Poland participated in the study (187 boys and 339 girls). Monitoring of PA and cognitive stress was conducted during one school day. We used ActiTrainer accelerometers to monitor PA and physical inactivity. Data on time of PA and self-reported AS in school lessons were collected using recording sheets. We split the participants into two groups: those without a self-reported stressor and those who indicated one or more stressors. Differences in overall PA during recesses, as well as after-school PA, between boys with and without AS were not statistically significant for any PA characteristics. We observed similar results for girls. Repeated measures ANOVA confirmed that differences in PA (steps/hour) during recesses following particular lessons between participants with and without AS were not statistically significant in boys or girls (F (4,1612) = 1.83, p=0.121 , η p 2=0.005). It is noteworthy that girls with AS were statistically significantly more likely to meet the 6000 steps after school time recommendation (39%) than girls without AS (18%; p < 0.001). The study did not confirm the assumption that adolescents reporting AS have less PA during recesses or even after school than adolescents without AS. However, the overall low PA of adolescents during recesses and after school highlights the need to compensate for AS by adequate PA. This is especially true for adolescents with recurrent AS in several consecutive lessons.

Depression, stress and vascular function from childhood to adolescence: A longitudinal investigation

BACKGROUND

Psychological distress is associated with risk markers for cardiovascular disease, including increased arterial stiffness and high blood pressure, but it's unclear when these first manifest. This study aims to investigate the effect of psychosocial stress and depression on arterial stiffness and blood pressure in a cohort study of Australian children followed through to adolescence.

METHOD

Depression and psychosocial stress in 520 young people (265 boys; M age = 11.6 y) were assessed via the Children's Depression Inventory and Children's Stress Questionnaire respectively. Carotid-femoral pulse wave velocity was assessed using applanation tonometry, with further assessments of supine brachial blood pressure and percent body fat (dual x-ray absorptiometry). All measures were repeated four years later at age 16-years.

RESULTS

We found no cross-sectional or longitudinal evidence that children self-reporting higher levels of psychosocial stress or depressive symptoms had greater arterial stiffness. Children reporting an increase in depressive symptoms had an increase in diastolic blood pressure and mean arterial pressure over time. An effect was also evident for pulse pressure, where higher pulse pressure was found in children with lower psychosocial stress at baseline and in children self-reporting a decrease in stress between baseline and follow-up.

CONCLUSIONS

Findings from the current study contribute to the scant paediatric literature but only provide limited support for any influence of psychological factors on blood pressure. Depressive symptoms in apparently healthy adolescents may exert some influence on later risk for cardiovascular disease via increases in diastolic blood pressure and mean arterial pressure, but these effects were small.

Do self-reported stress and depressive symptoms effect endothelial function in healthy youth? The LOOK longitudinal study

BACKGROUND AND AIMS

Endothelial dysfunction is thought to be an early indicator of risk for cardiovascular disease and has been associated with both stress and depression in adults and adolescents. Less is known of these relationships in younger populations, where the origins of CVD is thought to manifest. This study examined the effects of questionnaire derived psychosocial stress and depressive symptoms on endothelial function among children, following them through to adolescence.

METHOD

Participants were 203 grade 2 children (111 girls; M age = 7.6 ± 0.3 years) from the LOOK longitudinal study, who were followed through to adolescence (16 years). Self-reported psychosocial stress and depression were assessed using the validated Children's Stress Questionnaire and a modified and validated version of the Children's Depression Inventory respectively; endothelial function was assessed using EndoPAT 2000 system at follow-up only; and adjustments were made for fitness, pubertal development and socioeconomic status.

RESULTS

Although all relationships occurred in the hypothesised direction, no cross-sectional or prospective evidence of early symptoms of psychological stress or depression being associated with endothelial dysfunction was found among our asymptomatic cohort of adolescents (all p > .05).

CONCLUSIONS

In contrast to previous findings in adolescents, our data provided little evidence of any relationship between current or previous psychosocial stress or depression and endothelial function in 16-year-old boys and girls. However, our data need to be interpreted alongside the potential limitations in the sensitivity associated with self-report methods for detecting psychological distress of children.

Prevention of diabetes in overweight/obese children through a family based intervention program including supervised exercise (PREDIKID project): study protocol for a randomized controlled trial

BACKGROUND

The global pandemic of obesity has led to an increased risk for prediabetes and type-2 diabetes (T2D). The aims of the current project are: (1) to evaluate the effect of a 22-week family based intervention program, including supervised exercise, on insulin resistance syndrome (IRS) risk in children with a high risk of developing T2D and (2) to identify the profile of microRNA in circulating exosomes and in peripheral blood mononuclear cells in children with a high risk of developing T2D and its response to a multidisciplinary intervention program including exercise.

METHODS

A total of 84 children, aged 8-12 years, with a high risk of T2D will be included and randomly assigned to control (N = 42) or intervention (N = 42) groups. The control group will receive a family based lifestyle education and psycho-educational program (2 days/month), while the intervention group will attend the same lifestyle education and psycho-educational program plus the exercise program (3 days/week, 90 min per session including warm-up, moderate to vigorous aerobic activities, and strength exercises). The following measurements will be evaluated at baseline prior to randomization and after the intervention: fasting insulin, glucose and hemoglobin A1c; body composition (dual-energy X-ray absorptiometry); ectopic fat (magnetic resonance imaging); microRNA expression in circulating exosomes and in peripheral blood mononuclear cells (MiSeq; Illumina); cardiorespiratory fitness (cardiopulmonary exercise testing); dietary habits and physical activity (accelerometry).

DISCUSSION

Prevention and identification of children with a high risk of developing T2D could help to improve their cardiovascular health and to reduce the comorbidities associated with obesity.

TRIAL REGISTRATION

ClinicalTrials.gov, ID: NCT03027726 . Registered on 16 January 2017.

Patterns of electronic cigarette use and level of psychological distress

BACKGROUND

Psychological distress has been correlated with higher levels of nicotine dependence. To date, the possible association between individuals' levels of psychological distress and e-cigarette use has not been investigated, despite the dramatic growth of e-cigarette use in the US. We examined this possible association using a nationally representative sample of US adults.

METHODS

A total of 36,697 adults from the 2014 National Health Interview Survey (NHIS) were included. The Kessler 6 scale was used to measure psychological distress. Multivariate logistic regression analysis was conducted to assess the association between level of psychological distress and e-cigarette use.

RESULTS

Both e-cigarette and cigarette use varied according to level of psychological distress as well as multiple socio-demographic characteristics. In a multivariate model, psychological distress was significantly associated with the following groups: (a) exclusive e-cigarette ever-use (aOR = 3.7; 95% CI = 1.6, 8.6), (b) current dual use of e-cigarettes and cigarettes (aOR = 4.6; 95% CI = 3.1, 6.7), (c) former cigarette use and ever use of e-cigarette (aOR = 3.2; 95% CI = 2.2, 4.8) and (d) current use of cigarettes only (aOR = 2.1; 95% CI = 1.7, 2.6).

CONCLUSION

These are the first data to demonstrate that, as is true for cigarettes, e-cigarette use is associated with increased levels of psychological distress. Further large-scale, longitudinal studies are needed to determine the direction of this relationship and to evaluate the long-term positive and negative consequences of such use.