Dietary patterns and internalizing symptoms in children and adolescents: A meta-analysis

Adherence to the Mediterranean Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay (MIND) diet and trajectories of depressive symptomatology in youth

BACKGROUND

The rising prevalence of youth depression underscores the need to identify modifiable factors for prevention and intervention. This study aims to investigate the protective role of Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet on depressive symptoms in adolescents.

METHODS

Participants were identified from the Adolescent Brain Cognitive Development study. Adherence to the MIND diet was measured by the Child Nutrition Assessment or the Block Kids Food Screener. Depressive symptoms were measured annually using the Child Behavior Checklist's depression subscale. We utilized regression analyses and cross-lagged panel modeling (CLPM) to examine longitudinal associations. Additional analyses adjusted for polygenic risk scores for depression, and changes in Body Mass Index (BMI) and waist-to-height ratio.

RESULTS

Of the 8459 children (52.3 % male; mean age 10.9 [SD, 0.6] years), 2338 (27.6 %) demonstrated high MIND diet adherence, while 2120 (25.1 %) showed low adherence. High adherence was prospectively associated with reduced depressive symptoms (adjusted β, -0.64, 95 % CI, -0.73 to -0.55; p < 0.001) and 46 % lower odds of clinically relevant depression (adjusted odds ratio, 0.54, 95 % CI, 0.39 to 0.75; p < 0.001) at two-year follow-up. CLPM analyses showed significant cross-lag paths from MIND diet scores to less depressive symptoms across three time points. These associations persisted independently of changes in BMI and waist-to-height ratios, and were not significantly moderated by genetic predisposition to depression.

CONCLUSIONS

Higher adherence to the MIND dietary pattern was longitudinally associated with decreased risk of depressive symptoms in adolescents. Promoting MIND diet may represent a promising strategy for depression prevention in adolescent populations.

Dietary Pattern and Depressive Outcomes in Children and Adolescents: Systematic Review and Meta-analysis of Observational Studies

CONTEXT

Research suggests that dietary pattern plays an important role in mental health and constitutes a modifiable risk factor for depression.

OBJECTIVE

The aim of this systematic review and meta-analysis was to evaluate the association between dietary patterns and depressive outcomes in adolescents.

DATA SOURCES

Medline/PubMed, Lilacs, EMBASE, PsycINFO, and PsycARTICLES, gray literature up to March 2024 were searched; the reference lists were also verified. Observational studies in participants with a mean age ⩽19 years reporting associations between dietary patterns and clinical depression or depressive symptoms were searched. Overall, 21 studies were included in this systematic review.

DATA EXTRACTION

Data from eligible articles were extracted by 2 reviewers.

DATA ANALYSIS

Odds ratios (ORs) and confidence intervals (CIs) were determined under a random-effects model. The risk of bias assessment was conducted by 2 independent researchers using the Joanna Briggs Institute Critical Appraisal Checklist tool.

RESULTS

The qualitative results revealed that a higher unhealthy diet score was positively associated with depressive symptoms, while a healthy diet was negatively associated with depressive symptoms. In the study that included adolescents with a clinical diagnosis of depression, the relationship between inflammatory dietary pattern tertiles and depression was attenuated after all covariates were adjusted for. The meta-analysis to evaluate the association between depressive symptoms and a posteriori dietary patterns found that the "healthy" dietary pattern decreased depressive symptoms in adolescents (OR: 0.69; 95% CI: 0.44, 0.95). There was no statistically significant association between depressive symptoms and "unhealthy" and "snacks" patterns (OR: 1.20 [95% CI: 0.95, 1.46]; OR: 1.20 [95% CI: 0.70, 1.48]) dietary patterns.

CONCLUSION

The results identified that a healthy dietary pattern decreased depressive symptoms in adolescents. However, considering the high heterogeneity and the low level of certainty of the evidence, these results should be interpreted with caution.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42020159921.

Association between dietary habits and emotional and behavioral problems in children: the mediating role of self-concept

Introduction

Increasing research has focused on the influence of diet on mental health and well-being. This study aimed to investigate dietary habits status and their associations with emotional and behavioral problems (EBPs) in pre-teen children, as well as explore the mediating effect of child self-concept in the associations between healthy dietary habits and EBPs.

Methods

A cross-sectional survey using stratified random sampling was conducted to recruit third-grade children and their caregivers. Dietary habits and self-concept were assessed with self-administrated questionnaires in children. Information on children's EBPs was collected through questionnaires completed by their caregivers. Multilevel logistic regression models were used to estimate the associations between dietary habits and self-concept and EBPs, respectively. The mediation analysis was employed to test the mediating role of self-concept in the association between dietary habits and EBPs.

Results

Of 1,126 caregiver-child dyads (Mean age of children: 9.53, 52.8% boys) included, only 37.4 and 54.2% of children met the healthy standard of milk/soy milk and fruit, respectively. Healthy fresh fruit (odds ratio [OR] = 0.57, 95% confidence intervals [CI] 0.40-0.78) and vegetables intake (OR = 0.54, 95% CI 0.38-0.76) were associated with a higher self-concept while frequent consumption of sweet foods (OR = 1.58, 95% CI 1.05-2.36) and street foods (OR = 1.61, 95% CI 1.14-2.28) were associated with a lower self-concept. Children who had unhealthy sugar-sweetened beverages intake were at an elevated risk of EBPs (OR = 1.41, 95% CI 1.03-1.95). Moreover, the relationship between healthy dietary habits and EBPs was mediated by self-concept (indirect effect β = -0.09, p < 0.001, total effect β = -0.13, p < 0.001), the proportion of mediation was 29%.

Conclusion

This study revealed that the dietary habits of pre-adolescents need improvement, and dietary habits of certain foods, such as fresh fruits and sugar-sweetened beverages, were significantly associated with child mental health. Furthermore, dietary practices were related to the reduced EBPs through an enhanced self-concept. The findings provide an evidence base for developing dietary improvement strategies for pre-adolescent children in families, schools, and other health service settings, thereby contributing to the United Nations' Sustainable Development Goals related to zero hunger and good health and well-being.

Association Between Food Habits with Mental Health and Executive Function in Chilean Children and Adolescents

OBJECTIVE

To determine the association between foods habits with mental health (i.e., anxiety, depression, and stress) and executive function (i.e., attention, inhibition, working memory, and cognitive flexibility) in Chilean children and adolescents.

METHODS

A cross-sectional study with 498 children and adolescents (52.6% female) aged 10-17 years participated. The Krece Plus questionnaire (Food habits), Depression Anxiety Stress Scales (DASS-21, metal health), and the CogniFit (executive functions) test were used to assess the study variables.

RESULTS

The poor and moderate food habits groups reported higher prevalence of extremely severe anxiety (poor, 40.8%; moderate, 41.4%; good, 21.6%; p = 0.013) and extremely severe depression (poor, 20.4%; moderate, 21.3%; good, 5.7%; p < 0.001). The food habits were linked inversely to anxiety (β -0.07, 95%CI -0.11 to -0.03, p = 0.001), depression (β -0.08, 95%CI -0.12 to -0.04, p < 0.001), stress (β -0.07, 95%CI -0.11 to -0.02, p = 0.004), and total score of negative mental health (β -0.03, 95%CI -0.04 to -0.01, p < 0.001).

CONCLUSIONS

The food habits were inversely associated with negative metal health in Chilean children and adolescents, where the good food habits group reported better mental health in all dimensions.

Risk factors for depression symptoms in adolescents: A population-based study

OBJECTIVES

To ascertain the prevalence of depressive symptoms and identify related risk factors among adolescents.

METHODS

A cross-sectional survey was carried out using an online questionnaire completed by 1,413 adolescents from Central Java and Yogyakarta Provinces، Indonesia. The validated Indonesian version of the Children's Depression Inventory (CDI) was used to evaluate depressive symptoms.

RESULTS

Symptoms of depression were identified in 28.5% of participants. Multivariate analysis revealed important risk factors, including female gender (OR 3.962, 95% CI 2.684-5.849), having mother who is a housewife (OR 4.155, 95% CI 1.424-12.126) or works in labor/farming/self-employment (OR 3.665, 95% CI 1.216-11.051), residing with a biological father (OR 5.386, 95% CI 1.458-19.894) or non-parental guardians (OR 1.826, 95% CI 1.059-3.146), and lack of siblings (OR 1.459, 95% CI 1.057-2.013). Behavioral factors such as abnormal sleep duration (<6 hours or >8 hours per night, OR 3.750, 95% CI 2.833-4.964), smoking (OR 4.272, 95% CI 2.110-8.649), frequent consumption of sugary beverages (>3 times/week, OR 2.472, 95% CI 1.623-3.765), and chronic illnesses requiring regular medication (OR 2.057, 95% CI 1.177-3.595) were also strongly linked to depressive symptoms.

CONCLUSION

This study reveals the increased prevalence of depressive symptoms in adolescents and highlights the complex interplay of demographic, behavioral, and social determinants. Findings emphasize the necessity for targeted, evidence-based interventions to enhance adolescent mental health.

The effect of fruits and vegetables on children's mental and cognitive health: A systematic review of intervention studies and perspective for future research

OBJECTIVES

To synthesize evidence from fruit and vegetable intervention studies investigating mental or cognitive health outcomes (or both) in children ≤10 y. Our aim was to understand the efficacy of such interventions in improving measures of cognitive performance or mental health and to identify successful intervention elements to inform future research.

METHODS

We conducted a systematic search of the Cochrane, Embase, PubMed, and CINAHL databases for articles published before August 2022 (PROSPERO registration no. CRD42022356571). A narrative synthesis was conducted according to the Synthesis Without Meta-Analysis guidelines.

RESULTS

Of the 4686 articles identified, only 7 of the 17 full texts screened were included in the final review. No studies investigated the efficacy of interventions using "whole" fruits or vegetables. Six studies examined the effects of blueberries using drinks made from fresh (1 cup) or freeze-dried (30 g) blueberries and one study evaluated a mulberry powder-based drink. Sample sizes ranged from 14 to 54, and most studies were acute interventions with outcomes measured in a 2- to 3-h window (n = 6). Through a narrative synthesis of direction of responses, measures of executive function appeared sensitive to intervention effects in both acute and longer-term settings. Some concerns of risk of bias were evident, according to the RoB 2 tool, related to incomplete reporting of methodological aspects.

CONCLUSIONS

The studies identified through this systematic review could not directly address the planned research question, resulting in poor certainty of evidence. Future research with whole fruit and vegetable interventions could better inform population health strategies for improved mental and cognitive health outcomes in children.

Association of Children's Dietary Inflammatory Index with Depression and Anxiety Symptoms in Adolescents: Mediating Role of Inflammation and Cardiometabolic Risk Factors

Background

Evidence is scarce on the mechanisms involved in the relationship between dietary inflammatory index and mental health in adolescents. This study aimed to assess the association between children-DII (C-DII) and depressive and anxiety disorder symptoms in adolescents and to explore whether inflammation and cardiometabolic risk factors mediate this association.

Methods

The study was conducted at the Ankara City Hospital Pediatrics Polyclinic and 304 adolescents. In cross-sectional study, adolescents were asked general information questions. Anthropometric measurements were performed and some biochemical parameters and inflammation (C-reactive protein (CRP)) were obtained. The C-DII score was calculated from 24-h dietary recalls. Depression and anxiety levels of the participants were assessed by self-report. Structural equation modelling analyzed how cardiometabolic risk factors and inflammation mediate the relationship between mental health and dietary inflammation.

Results

C-DII scores were positively associated with depression and anxiety score (β [95% confidence interval (CI)] = 0.224 [0.08-0.25] for depression; 0.923 [0.04-1.67] for anxiety). Except for dietary inflammation with anxiety in girls, these relationships remained statistically significant in all subgroups by sex. It was determined that CRP partially mediated the relationship between dietary inflammation and depression and anxiety. It was determined that body mass index (BMI)-z score and waist circumference (WC) mediated the relationship between dietary inflammation and depression scores.

Conclusions

Our findings indicate that the higher pro-inflammatory potential of diet is associated with a higher risk of depression and anxiety, and this association may be mediated by CRP for depression and anxiety, WC, and BMI-z score for only depression. Further research is required to verify our findings and clarify the latent mechanism in larger populations.

A personalised nutrition intervention for adolescent depression: a mixed-methods feasibility pilot study

Randomised controlled trials have demonstrated the benefit of diet modification to improve diet quality in the treatment of adult major depressive disorder (MDD). However, research examining nutritional interventions for adolescents with MDD is sparse. This pilot study examined the feasibility of a personalised nutrition intervention for adolescents with MDD. Ten adolescents with MDD and their parents recruited from a tertiary care setting participated in an 8-week, single-arm mixed-methods study. Feasibility was assessed using five criteria (demand, acceptability, implementation, adaptation and limited efficacy testing) alongside qualitative interviews. The intervention involved four bi-weekly virtual nutrition counselling sessions with a stepped approach to dietary change, menu planning, grocery delivery and educational eHealth messages. Study participants sought positive changes in diet, health and lifestyle for adolescents and family-wide benefits. Recruitment challenges included concerns about managing mood fluctuations, anticipated dietary restrictions and the potential time and effort required for diet adherence. Feedback based on interviews emphasised moderate to high acceptability, satisfaction with menu planning and counselling and recognition of the benefits of trying new foods and sustaining positive dietary changes beyond the study. Improvements in depression symptoms (Cohen's d = 0·36, 95 % CI (-0·24, 3·36)), parent food modeling (Cohen's d = 0·24, 95 % CI (-0·43, 1·16) and the family food environment (Cohen's d = 0·61, 95 % CI (-0·04, 2·61)) were observed. This nutrition intervention was feasible for adolescents with MDD and was acceptable to both parents and depressed adolescents. These preliminary data suggest that further examination of the intervention and its potential benefits on depression symptoms and family food dynamics are warranted.

Association Between Diet and Mental Health Outcomes in a Sample of 13,887 Adolescents in Canada

Introduction

The high prevalence of mental disorders among adolescents calls for community-based and population-level prevention strategies. Diet is an important intervention target for primary prevention of mental disorders among adolescents. We used data from a large longitudinal study of Canadian adolescents (aged 14-18 y) to examine prospective associations between diet and mental health outcomes.

Methods

We estimated the effect of diet (ie, consumption of vegetables and fruit and sugar-sweetened beverages [SSBs]) at baseline on depressive symptoms, anxiety symptoms, and psychological well-being (measured by the Center for Epidemiologic Studies Depression Scale-Revised, Generalized Anxiety Disorder 7 scale, and Flourishing Scale, respectively) and at 1-year follow-up in a sample of 13,887 Canadian secondary school students who participated in the 2017-2018 and 2018-2019 cycles of the Cannabis, Obesity, Mental health, Physical activity, Alcohol, Smoking, and Sedentary (COMPASS) behavior study. We applied linear mixed-effects methods informed by a directed acyclic graph. Sensitivity analyses assessed the robustness of the effect estimates to unmeasured confounding variables.

Results

Baseline SSB consumption was associated with greater severity of depressive (β = 0.04; 95% CI, 0.01-0.06) and anxiety (β = 0.02; 95% CI, 0-0.05) symptoms, particularly among male students, and poorer psychological well-being (β = -0.03; 95% CI, -0.05 to -0.01) at follow-up. Baseline vegetables and fruit consumption was positively associated with psychological well-being (β = 0.06; 95% CI, 0.03-0.10) but not other mental health outcomes at follow-up.

Conclusion

Our results support the notion that diet should be part of comprehensive mental health prevention and promotion interventions to reduce the prevalence of mental health disorders among adolescents.

Original article: adolescent dietary patterns derived using principal component analysis and neuropsychological functions: a cross-sectional analysis of Walnuts Smart Snack cohort

A balanced diet is relevant for neuropsychological functioning. We aimed to analyze the association between dietary patterns and neuropsychological outcomes in a sample of healthy adolescents of the Walnuts Smart Snack (WSS) cohort from Barcelona city. We performed principal components analysis (PCA) to determine dietary patterns in the adolescent sample using a food frequency questionnaire (60 items). Multiple linear regression models were performed to analyze the association between PCA dietary patterns with neuropsychological outcomes: Strengths and Difficulties (SDQ) externalizing and internalizing scores, Attention Network Test (ANT) Impulsivity Index and Emotional Recognition Task (ERT) scores. We additionally adjusted the models for child sex, age, body mass index (BMI), physical activity and maternal education. Six dietary patterns were identified in PCA analyses. "low consumption of calorie-dense foods" dietary pattern had a negative association (protective) with the both SDQ outcomes (p value < 0.001) and "Nuts" dietary pattern showed a negative (protective) association with impulsivity index( β 1 = -24.60, 95% CI = -36.80, -12.41, p value < 0.001). Overall, our main results suggest that healthy dietary patterns, including higher intakes of "nuts" and a preference of "low consumption of calorie-dense foods" dietary patterns, could provide a beneficial association with neuropsychological functions during the adolescence period. The associations may include improvements of externalizing and internalizing problem symptoms, and impulsivity.

The Role of Dietary Patterns and Nutritional Supplements in the Management of Mental Disorders in Children and Adolescents: An Umbrella Review of Meta-Analyses: Le rôle des habitudes alimentaires et des suppléments nutritionnels dans la prise en charge des troubles mentaux chez les enfants et les adolescents : une méta-revue de méta-analyses

OBJECTIVE

In recent years, the relationship between nutrition and mental health has gained considerable interest. We identified, synthesized, and appraised all meta--analyses of randomized controlled trials (RCTs) and observational studies reporting on the efficacy of dietary patterns and nutrient supplements in the prevention and treatment of mental disorders in children and adolescents.

METHODS

Systematic research in MEDLINE, PsycINFO, Scopus, and Cochrane Database of Systematic Reviews was completed on 8 January 2024.

RESULTS

Our research found 24 meta-analyses: 14 on RCTs, 8 on observational studies, and 2 combining both. Emerging evidence suggests that omega-3, in particular eicosapentaenoic acid, and Vitamin D may have adjunctive benefits in the treatment of attention deficit hyperactivity disorder (ADHD), while no evidence was found for autism spectrum disorder (ASD). Observational data also indicated that prenatal folic acid supplementation (>400 μg daily) was associated with a reduced risk of ASD in offspring. In terms of dietary habits, several meta-analyses of observational data revealed that healthy dietary patterns (rich in fruits, vegetables, and fibre, low in saturated fats) during the prenatal period, childhood, and adolescence were linked to a significantly reduced risk of internalizing disorders and externalizing disorders. Conversely, unhealthy dietary habits (high in sugars, saturated animal fats, and industrial foods, low in fruits, vegetables, and fibre) are associated with an elevated risk of these mental health issues. However, the number of available studies on dietary interventions for the treatment of depression, ASD, and ADHD was limited, and the results obtained were either nonsignificant or contradictory.

CONCLUSION

Our findings emphasize the need to establish clear causal relationships between dietary habits and the risk of mental illness in children and adolescents. Moreover, further investigation of the benefits observed with some nutrient supplements (such as omega-3 and vitamin D for ADHD) through larger-scale RCTs is imperative to establish more robust conclusions.

Depressive Disorder and Dermatological Autoimmune Diseases

Depressive disorders are a growing problem worldwide. They are also characterized by high comorbidity, including from the circle of dermatological diseases. Autoimmune diseases seem to be particularly correlated with depressive comorbidity, raising the question of their possible common pathomechanism. The PubMed database was searched, focusing on results published after 2016. A particular reciprocal correlation of depressive disorders with psoriasis, atopic dermatitis, alopecia areata, impetigo, lupus and systemic scleroderma was found. One possible explanation for the co-occurrence of the above diseases is that the inflammatory theory may be applicable to depression, the various elements of which also apply to autoimmune diseases.

The role of lifestyle factors in the association between early-life stress and adolescent psycho-physical health: Moderation analysis in two European birth cohorts

OBJECTIVE

Early-life stress (ELS) is an established risk factor for a host of adult mental and physical health problems, including both depression and obesity. Recent studies additionally showed that ELS was associated with an increased risk of comorbidity between mental and physical health problems, already in adolescence. Healthy lifestyle factors, including physical activity, sleep and diet have also been robustly linked to both emotional and physical wellbeing. However, it is yet unclear whether these lifestyle factors may moderate the association between ELS and psycho-physical comorbidity.

METHODS

We investigated whether (a) participation in physical activity, (b) sleep duration, and (c) adherence to a Mediterranean diet, moderated the relationship between cumulative ELS exposure over the first 10 years of life and psycho-physical comorbidity at the age of 13.5 years. Analyses were conducted in 2022-2023, using data from two large adolescent samples based in the UK (ALSPAC; n = 8428) and The Netherlands (Generation R; n = 4268).

RESULTS

Exposure to ELS was significantly associated with a higher risk of developing comorbidity, however this association was not modified by any of the three lifestyle factors investigated. Only physical activity was significantly associated with a reduced risk of comorbidity in one cohort (ORALSPAC [95%CI] = 0.73 [0.59;0.89]).

CONCLUSIONS

In conclusion, while we found some evidence that more frequent physical activity may be associated with a reduction in psycho-physical comorbidity, we did not find evidence in support of the hypothesised moderation effects. However, more research is warranted to examine how these associations may evolve over time.

Factors and pathways of non-suicidal self-injury in children: insights from computational causal analysis

Background

Non-suicidal self-injury (NSSI) has become a significant public health issue, especially prevalent among adolescents. The complexity and multifactorial nature of NSSI necessitate a comprehensive understanding of its underlying causal factors. This research leverages the causal discovery methodology to explore these causal associations in children.

Methods

An observational dataset was scrutinized using the causal discovery method, particularly employing the constraint-based approach. By integrating machine learning and causal inference techniques, the study aimed to determine direct causal relationships associated with NSSI. The robustness of the causal relationships was evaluated using three methods to construct and validate it: the PC (Peter and Clark) method, Fast Causal Inference (FCI) method, and the GAE (Graphical Autoencoder) method.

Results

Analysis identified nine nodes with direct causal relationships to NSSI, including life satisfaction, depression, family dysfunction, sugary beverage consumption, PYD (positive youth development), internet addiction, COVID-19 related PTSD, academic anxiety, and sleep duration. Four principal causal pathways were identified, highlighting the roles of lockdown-induced lifestyle changes, screen time, positive adolescent development, and family dynamics in influencing NSSI risk.

Conclusions

An in-depth analysis of the factors leading to Non-Suicidal Self-Injury (NSSI), highlighting the intricate connections among individual, family, and pandemic-related influences. The results, derived from computational causal analysis, underscore the critical need for targeted interventions that tackle these diverse causative factors.

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.

Negative Association of Lignan and Phytosterol Intake with Stress Perception during the COVID-19 Pandemic-A Polish Study on Young Adults

BACKGROUND

There has been an increasing global prevalence of depression and other psychiatric diseases in recent years. Perceived stress has been proven to be associated with psychiatric and somatic symptoms. Some animal and human studies have suggested that consuming foods abundant in lignans and phytosterols may be associated with lower levels of stress, depression, and anxiety. Still, the evidence is not yet strong enough to draw firm conclusions. Thus, we investigated the association between dietary intake of these phytochemicals and the level of stress experienced by adult individuals.

METHODS

Diet was assessed using self-reported 7-day dietary records. The intakes of lignans and phytosterols were estimated using databases with their content in various food products. The Perceived Stress Scale (PSS) was implemented to measure the level of perceived stress. A logistic regression analysis was used to test for associations.

RESULTS

The odds of elevated PSS were negatively associated with dietary intake of total phytosterols, stigmasterol, and β-sitosterol, with evidence of a decreasing trend across tertiles of phytochemicals. The analysis for doubling the intake reinforced the aforementioned relationships and found protective effects against PSS for total lignans, pinoresinol, and campesterol.

CONCLUSIONS

Habitual inclusion of lignans and phytosterols in the diet may play a role in psychological health. To address the global outbreak of depression and other mental health issues triggered by stress, it is important to take a holistic approach. There is a need to develop effective strategies for prevention and treatment, among which certain dietary interventions such as consumption of products abundant in lignans and phytosterols may play a substantial role.

The impact of 12 modifiable lifestyle behaviours on depressive and anxiety symptoms in middle adolescence: prospective analyses of the Canadian longitudinal COMPASS study

BACKGROUND

Unhealthy lifestyle behaviours are becoming increasingly common and might contribute to the growing burden of mental disorders in adolescence. We examined the associations between a comprehensive set of lifestyle behaviours and depression and anxiety in middle adolescents.

METHODS

School-based survey responses were collected from 24,274 Canadian high school students at baseline and 1-year follow-up (average age 14.8 and 15.8 years, respectively). Using linear mixed-effects models, we examined prospective associations of adherence to recommendations for vegetables and fruit, grains, milk and alternatives, meat and alternatives, sugar-sweetened beverages [SSB], physical activity, screen time, sleep, and no use of tobacco, e-cigarettes, cannabis, and binge drinking at baseline with the depressive and anxiety symptoms (measured by CESD-R-10 and GAD-7 scales, respectively) at follow-up.

RESULTS

Adherence to recommendations was low overall, particularly for vegetables and fruit (3.9%), grains (4.5%), and screen time (4.9%). Students adhering to individual recommendations, particularly for meat and alternatives, SSB, screen time, sleep, and no cannabis use, at baseline had lower CESD-R-10 and GAD-7 scores at follow-up. Adhering to every additional recommendation was associated with lower CESD-R-10 (β=-0.15, 95% CI -0.18, -0.11) and GAD-7 scores (β=-0.10, 95% CI -0.14, -0.07) at follow-up. Assuming cumulative impact, this might translate into 7.2- and 4.8-point lower CESD-R-10 and GAD-7 scores, respectively, among students adhering to 12 vs. 0 recommendations over four years of high school.

CONCLUSIONS

The results highlight the preventive potential of population-based approaches promoting healthy lifestyle behaviours, particularly those with the lowest prevalence, as a strategy to improve mental health in adolescence.

Plant-based dietary patterns and their association with mood in healthy individuals

Background: Healthy, plant-based dietary patterns, particularly the Mediterranean diet (MD), have been associated with positive effect on mood symptoms and have been proposed to help prevent age-related cognitive decline. However, to date no study has investigated which existing plant-based dietary pattern might be most likely to be associated with better mood in the general population. The aim of this study was to evaluate the relationship between different plant-rich dietary patterns and current mood in healthy individuals across a broad age range. Methods: We evaluated 333 healthy participants aged 8-79, who previously participated in dietary intervention studies. Current mood was assessed with the Positive and Negative Affect Schedule (PANAS) questionnaire, standardised by Z scores. Dietary patterns were estimated using food consumption data obtained from the European Prospective Investigation into Cancer (EPIC) Food Frequency Questionnaires (FFQ), and included the Plant-based Diet Index (PDI), Dietary Approaches to Stop Hypertension Diet (DASH), Mediterranean-DASH Diet Intervention for Neurodegenerative Delay (MIND), Original Mediterranean Diet (oMED) and Alternate Mediterranean Diet (aMED). Results: PDI, DASH, oMED and aMED diet scores were all significantly associated with positive mood (rs = 0.12-0.16), but not with negative mood. Linear regression models suggested that after adjusting for potential confounders (sex and age), only the oMED and aMED diet scores were still significantly associated with positive mood (β = 0.119, p = 0.031 and β = 0.111, p = 0.048, respectively). Furthermore, the relationship between PDI diet scores and positive mood was only significant in children (β = 0.663, p = 0.003), pointing to a potential moderating effect of age in the relationship between PDI and positive mood. Conclusion: Adherence to oMED and aMED diets is associated with better mood in healthy adults, while the PDI diet might be more specifically associated with positive mood in children.

Associations between Demographic Characteristics, Lifestyle Factors and School-Related Conditions and Symptoms of Mental Health Problems in Norwegian Upper Secondary School Students

Background: The purpose of this study was to evaluate the associations between demographic characteristics, lifestyle factors and school-related conditions, and symptoms of mental health problems in Norwegian upper secondary school students following the COVID-19 pandemic. Methods: In this cross-sectional study design we used a binary logistic regression model to evaluate potential associations between the predictors and dependent variable. Results: The following six predictors had a statistically significant impact on symptoms of mental health problems; gender effect of being a girl (p < 0.001), self-perceived body image (p < 0.001), sleep problems (p < 0.001), dietary habits (p = 0.033), school satisfaction (p = 0.013), and satisfaction with physical education (PE) class participation (p = 0.025). Conclusions: Being a girl was associated with a 315% higher probability of reporting symptoms of mental health problems than boys, whereas one unit increase in sleep problems showed a 192% higher probability of symptoms of mental health problems. Furthermore, a one unit increase on the respective beneficial predictors’ scales was associated with the following percentage having a lower probability of reporting symptoms of mental health problems; self-perceived body image (59%), dietary habits (58%), school satisfaction (82%), and satisfaction with PE class participation (68%).