Association between food intake and mental health problems among preschoolers in China

Consumption patterns and eating behaviors of schoolchildren associated with mental health problems: a Brazilian nationwide study

BACKGROUND

Children's health should be analyzed in a broad context that considers different determinants. Few population-based studies have been conducted, especially with children about food consumption and eating behaviors associated with mental health. This study aimed to assess the association of consumption patterns and eating behaviors with mental health problems in Brazilian schoolchildren.

METHOD

The participants were children between 6 and 11 years old (n = 1967) from Brazilian schools and their parents. The child's food intake was assessed using the Questionnaire on Food Consumption for Brazilian Schoolchildren (QUACEB), and the Illustrated Questionnaire on Eating and Sedentary Behaviors (QUICAS) was used to assess eating behavior. The child's mental health was investigated using the Portuguese version of the Strengths and Difficulties Questionnaire. Principal component analysis was performed to identify consumption patterns and eating behaviors.

RESULTS

Children with higher consumption of ultra-processed foods, less healthy food diversity, and unhealthy eating behaviors (eating distractedly with screens, alone, at irregular times, snacks, or processed foods, and not participating in kitchen tasks before or after meals) had a 45% higher chance of having mental health problems (OR 1.45; CI 1.12-1.87).

CONCLUSIONS

There is an association between consumption patterns and eating behaviors with mental problems in Brazilian schoolchildren. Our results reinforce the importance of analyzing the set of health determinants.

Dietary diversity and development among early childhood children in rural China

Background

Early childhood is a critical period for cognitive development, heavily influenced by nutrition. Despite significant economic advancements, malnutrition and micronutrient deficiencies persist in many low- and middle-income countries, including China, where dietary diversity remains suboptimal. Existing research predominantly relies on correlational data, underscoring the need for more rigorous empirical evidence. This study aims to fill that gap by providing stronger empirical evidence on the relationship between dietary diversity and developmental outcomes in rural Chinese children.

Methods

We conducted a longitudinal cohort study of 1,207 children aged 6-23 months, drawn from 100 villages across 22 counties in rural China, with three follow-up rounds extending until the children reached 51-83 months of age. Cognitive and non-cognitive development, as well as key health indicators, were evaluated. Cognitive development was measured using the Bayley Scales of Infant and Toddler Development and the Wechsler Preschool and Primary Scale of Intelligence Fourth Edition. Non-cognitive development was assessed via the Ages and Stages Questionnaire: Social-Emotional and the Strengths and Difficulties Questionnaire. Health indicators included anemia, frequency of illness in the past 2 weeks, and four key anthropometric measures (height-for-age z-scores, weight-for-age z-scores, weight-for-height z-scores, and body mass index-for-age z-scores). Multiple linear regression models were applied to analyze the relationship between dietary diversity scores (DDS) and developmental outcomes, incorporating child fixed effects and adjustments for time-variant confounders. We accounted for the hierarchical structure of the data by clustering standard errors at the village level, which also reflects the township level.

Results

The regression analysis identified significant positive associations between DDS and cognitive (p < 0.01), as well as reduced illness incidence (p < 0.001) in children aged 6-54 months. Additionally, DDS demonstrated a strong positive effect on non-cognitive development (p < 0.001) in children 2 years and older. The associations between DDS, non-cognitive development (p < 0.01), and illnesses reduction (p < 0.001) remained robust under two-way fixed effects models.

Implications

To promote sustainable improvements in child development and health, policymakers should prioritize nutrition-focused interventions in rural areas. Community-based programs offering caregivers training and nutritional support, integrated within healthcare and social services infrastructures, are vital for ensuring families have the necessary resources enhance child wellbeing and long-term developmental outcomes.

Adhere to the Chinese dietary guidelines associated with better subjective well-being: evidence from a cross-sectional survey and a daily diary investigation

BACKGROUND

Subjective well-being (SWB) plays an essential role in general health. Although beneficial effects of selected micronutrients and foods on SWB have been reported, they do not reflect the impact of the habitual diet on SWB. Therefore, the purpose of this study is to investigate the association between adherence to the Chinese Dietary Guidelines (CDG) with SWB.

METHODS

This study combined a cross-sectional survey and a daily diary investigation. The cross-sectional survey was conducted on 1,433 students from 8 universities in southern China between October and November 2020. The daily diary investigation was conducted in November 2022, collecting 10-day daily data from 115 students at two universities in southern China over ten consecutive days, resulting in 1,020 valid matched daily responses. Adherence to the CDG was assessed by the China Prime Diet Quality Score (CPDQS), SWB was measured by the Index of Well-being (IWB) and the Affect Valuation Index (AVI). Correlation analysis, multiple regression analyses, and hierarchical regression were conducted to examine the associations of adherence to the CDG with its components, and SWB.

RESULTS

The cross-sectional survey revealed significant predictors of SWB, including adherence to the CDG (β = 0.24, p<0.001) and its components: cereals and tubers (β = 0.07, p = 0.024), vegetables and fruits (β = 0.11, p<0.001), dairy/soy/nuts (β = 0.11, p = 0.002), and condiments and alcoholic beverages (β = 0.08, p = 0.002). The daily diary investigation showed positive associations between adherence to the CDG (β = 0.19, p<0.001), and its components: vegetables and fruits (β = 0.11, p = 0.001), dairy/soy/nuts (β = 0.06, p = 0.009), animal source food (β = 0.06, p = 0.026), and condiments and alcoholic beverages (β = 0.07, p = 0.026), with higher levels of daily SWB.

CONCLUSIONS

Adherence to healthy dietary patterns such as the CDG, rather than focusing on individual components in isolation, is associated with better SWB. Furthermore, the consumption of CDG components had an impact on SWB, although the specific effects varied between the two studies. This study offers modest evidence supporting the role of the CDG in promoting positive mental health.

Association between screen time and physical activity on mental health among preschoolers: a cross-sectional study from Southwest China

BACKGROUND

Screen time and physical activity behaviors undergo development during early childhood and impact mental health. However, there is limited knowledge regarding the associations between physical activity, screen time, and mental health problems (MHP) in preschoolers. This study examines these associations using a large sample size and brief measures.

METHODS

A multistage cluster stratified sampling method was used to conduct an observational cross-sectional study of 19,015 Chinese preschoolers in 2020. Information on physical activity, and screen time was collected by a self-administered questionnaire; MHP was assessed by the parent-reported Strengths and Difficulties Questionnaire (SDQ). Logistic regression models were used to obtain the odds ratios (ORs) and 95% confidence intervals (95% CIs) of preschoolers' MHP associated with screen time, total physical activities, moderate to vigorous physical activity (MVPA), and outdoor physical activities.

RESULTS

A total of 19,015 participants from the 19,548 recruited population were included in the analyses (missing rate: 2.73%), 52.60% were boys. 64.01%, 57.96%, 35.98%, and 82.64% of preschoolers were reported to meet total physical activities, MVPA, and outdoor activities with screen time recommendations level. The results of multivariable-adjusted ORs (95% CIs) of preschoolers' MHP for comparisons of different levels of screen time (< 2 h/day, 2-4 h/day,≥4 h/day) show that screen time positively associated with MHP after adjusting for confounders (P < 0.05), but the association was not significant among girls with screen time ≥ 4 h/day. In addition, increased engagement in physical activity was reversely linked to MHP (P < 0.05). A stronger association between MHP and MVPA was observed in boys, however, this association was weakened when the total time spent engaging in MVPA exceeded two hours per day (P < 0.05).

CONCLUSION

Less physical activity and more screen time positively relate to MHP, but the relationship differs by type of physical activity, total time, and gender. These findings provide novel insights and evidence supporting for guidelines on physical activity, screen time, and improvement of mental health for preschoolers.