An increase in psychosomatic symptoms among adolescents has recently been reported. Few studies have examined the relation between food intake and psychosomatic symptoms. The aim was to study the association between food intake and overall psychosomatic burden and separate psychosomatic symptoms.

In this cross-sectional study, we used data from 6248 girls and 7153 boys in south-east Sweden who turned 16 years of age during the academic years 2009/2010 to 2015/2016 and responded to a health questionnaire at the school health services. The association between overall healthy food intake and a low psychosomatic burden was calculated as odds ratios (95% confidence interval) and stratified for other lifestyle habits and gender.

Sixty-nine per cent of the boys and 35% of the girls had a low psychosomatic burden. There was a positive association between an overall healthy food intake and a low psychosomatic burden (P<0.0001), regardless of other lifestyle habits and gender. An overall healthy food intake was also positively associated with a lower frequency of the separate psychosomatic symptoms of concentration difficulties, sleep difficulties, a poor appetite or dizziness (P<0.0001).

A healthy food intake seems to be associated with a low psychosomatic burden among adolescents. Further knowledge is needed to explore whether an improved food intake can reduce psychosomatic symptoms and enhance mental health.

Poor dietary habits in adolescents contribute to the development of non-communicable diseases in adulthood. While family influence by parenting style, food parenting practice and household income on adolescent eating habits has been well-established, other family factors such as parental health conditions as well as the impact on dietary knowledge and attitudes in adolescents are underexplored. This study aimed to evaluate the relative importance of family factors on adolescent healthy eating using the knowledge, attitudes, and practices (KAP) model.

A cross-sectional online survey was conducted among parent-adolescent dyads recruited from a previous cohort study and secondary schools in Hong Kong. Adolescent healthy eating was assessed by a locally developed and validated KAP of Healthy Eating Questionnaire (KAP-HEQ). It evaluated knowledge on dietary recommendations, health outcomes and food choice; attitudes on outcome expectation, food preference, and self-efficacy; and practices on meal pattern and healthy/unhealthy food consumption. Parents reported on family factors including their KAP of healthy eating (KAP-HEQ), parenting style (Parenting Style and Dimensions Questionnaire), attitudes towards adolescent eating habit, food parenting practices, and family demographic characteristics such as employment status and household income. Multivariable linear regression was used to estimate the family influence on adolescent healthy eating.

Two hundred seven dyads of parents (mean age = 46.14 years, 85.02% mothers, 80.19% married, 60.87% attained senior secondary education or above) and adolescents (mean age = 15.21 years, 48.31% female) completed the survey. Positive associations were found between dyad knowledge (β = 0.28, p < 0.001), dyad attitudes (β = 0.22, p < 0.001), and between adolescent practices and food parenting practices (β = 0.18, p < 0.001) and parental employment status (part-time vs unemployed: β = 4.08, p < 0.05). Negative associations were identified between adolescent attitudes and authoritative parenting style (β = -0.11, p < 0.05) and household size (β = -3.19, p < 0.05), and between adolescent practices and higher parental education levels (senior secondary or above vs primary or below: β = -2.86, p < 0.05).

The study found positive effects of parental dietary knowledge, attitudes, and food parenting practices on adolescent KAP of healthy eating. Interventions to enhance these three family facilitators should be included in strategies for promoting KAP of healthy eating among adolescents.

Engaging in regular physical activity and a healthy diet, in line with World Health Organisation (WHO) recommendations, have robust benefits on physical and mental health. One way to influence behaviour change is by improving the effectiveness of health communication. This study of 190 participants explored the effectiveness of message framing and temporal focus on behavioural intention to increase physical activity and improve diet. In this cross-sectional between-subjects design, ANCOVAs were conducted to investigate the main effects of message frame, message focus and the interaction effects on behavioural intentions with respect to diet and PA. Furthermore, regression analyses were used to determine the predictors of behavioural intentions (including perceived stress and BMI). Previous research suggests that BMI moderates responses to gain-framed messages, while stress impairs impulse control and affects dietary choice, making them critical variables in understanding behaviour change. Therefore, BMI and stress are included in the study because both factors could influence health behaviours and the effectiveness of message framing. There were no significant main effects or two-way interactions for the frame of focus on intentions to be more physically active. However, there was a significant three-way interaction between temporal focus, message frame and stress, such that people with higher perceived stress had a greater intention to improve their diet when the message was gain-farmed and had a focus on short-term rather than long-term gains. Furthermore, BMI was a significant predictor of both diet and intentions to be more physically active. The findings highlight the need for more research on the potential efficacy of message framing in health communication for preventive behaviours.

Mental health disorders affect 15% of youth aged 10-19 years globally, typically emerging before age 15. While school-based peer-led programs show promise in improving physical health behaviours by leveraging existing social networks, reducing stigma, and demonstrating high implementation feasibility, their effectiveness for mental health outcomes remains unclear. This systematic review examined controlled trials of school-based, peer-led lifestyle interventions (physical activity, diet, or sleep) reporting mental health outcomes in adolescents aged 10-19 years. Six electronic databases were searched up to March 28, 2024. Seven studies met inclusion criteria, encompassing 7,060 adolescents from 151 schools across the UK, USA, Canada, and Norway. Interventions varied in frequency and duration, with six focusing on physical activity and one on diet. Meta-analyses revealed no significant effects for psychological difficulties (MD = 0.60, 95% CI -3.52 to 4.72; p = 0.32, k = 2), self-efficacy for physical activity (SMD = 0.18, 95% CI -3.08 to 3.44; p = 0.61, k = 2), or wellbeing (SMD = 0.0, 95% CI -2.94 to 2.94; p = 1.0, k = 2). These findings, while requiring cautious interpretation, highlight the pressing need for more comprehensive and rigorous research to better understand the impact of peer-led interventions on mental health outcomes.

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.

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.

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).

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.

The family is a crucial contributor to mental health and physical well-being. While bidirectional relationships between physical activity, diet, sleep, and mental well-being are well-documented, the influence of the family on these behaviours is less explored. This study aimed to examine the relationships between family resilience and individual lifestyle behaviours in community-dwelling adults, focusing on the roles of a supportive family health climate and reduced biobehavioural reactivity. Data were collected from 200 family dyads in Singapore through questionnaires assessing family resilience, health climate related to physical activity and nutrition, individual lifestyle behaviours (physical activity, diet, sleep), and demographics. Structural equation modelling was used to explore the connections between family resilience and individual lifestyle behaviours, particularly how family health climate and biobehavioural reactivity mediate these relationships. Participants included 200 dyads with a mean age of 42 years (SD = 15.18; range 15-85), 62.7% female and 67.3% with tertiary education. 85.5% were Chinese households and 83% lived in public housing. Family resilience was associated with increased engagement in physical activity, diet quality, and sleep quality, with higher engagement linked to lower biobehavioural reactivity and a healthier family health climate. Significant mediation effects were observed, with family resilience positively influencing physical activity (total indirect effect: β = .164, p < .001) and diet quality (β = .113, p = .004) through family health climate, while negatively impacting sleep quality (β = -.168, p < .001) mediated by biobehavioural reactivity. This study highlights that family dynamics significantly influence individual physical activity, dietary habits, and sleep quality, thereby enhancing health outcomes. Specifically, family resilience promotes healthier lifestyle behaviours by fostering a supportive family health climate and reducing biobehavioural reactivity. Interventions aimed at strengthening family resilience may thus provide a cost-effective strategy for improving population health.

Children's diets affect multiple health outcomes. Dietary indices are a useful tool for quantifying the quality of the overall diet, but their performance may differ among children of different ages and in understudied populations.

This analysis aimed to validate 2 dietary indices and examine their associations with physical body measures among 2-8-y-old children of the United States-Affiliated Pacific region.

Data were collected on children (n = 2359) from 5 jurisdictions of the children's healthy living randomized control trial in independent cross-sectional cluster samples over 3-time points. Anthropometric measurements were taken, and dietary intakes were ascertained from 2 d of dietary records completed by caregivers. The Healthy Eating Index (HEI)-2020 and dietary approaches to stop hypertension (DASH) scores were calculated using a simple scoring algorithm, their construct validity and performance were evaluated, and associations with nutrient intake, body measures, and obesity status were examined using covariate-adjusted means and unconditional logistic regression.

We observed a wide range of variation in DASH (9-38 points) and HEI-2020 (10-94.7 points), clear separation of mean component scores by quintile of the total score, and multiple dimensions for each index. Significant trends in polyunsaturated and saturated fat were observed from the lowest to the highest quintile of HEI-2020 (12% higher and 21% reduction, respectively) but not for DASH. Significant differences by quintile of DASH and HEI-2020 were found for mean body mass index z-score among 6-8-y-olds and for waist circumference among boys and 6-8-y-olds. The odds of obesity exhibited statistically significant downward trends across quintiles of HEI-2020 among all participants and in all sexes and age groups, and across quintiles of DASH among all participants, boys and 6-8-y-olds.

We found that HEI-2020 is a better measure of dietary intake than DASH in this population of 2-8-y-old children of the United States-Affiliated Pacific region.

Standard treatment for substance use disorders (SUDs) rarely incorporates a dietary intervention. The purpose of this research is to explore how nutrition might influence early recovery outcomes. Participants (N = 33) self-selected into the 10-week treatment (whole food, plant-based diet) or control group (standard treatment center diet). Both received weekly nutrition education lessons to complement the diet. At baseline, week 3, and week 10, participants completed assessments to track mental health markers. Mean values were calculated for Healthy Eating Index-2015 (HEI-2015) and Plant-based Diet Indices (PDI). Semi-structured interviews were gathered and analyzed using grounded theory. The intervention group had significantly higher scores for HEI-2015 and PDI scores (all P's < .001). For all psychosocial outcomes, there was a statistically significant effect of time (P's < .001-.02), but not by condition. A significant condition by time interaction was seen with the Rosenberg Self-Esteem outcome (P = .043). Resilience at 10-weeks was significantly higher in the high PDI group (P = .031). Qualitative data showed that all participants found meaning and value in the experience. Early addiction treatment outcomes show modest but important effects of whole food plant-based nutrition and suggest value in further exploration of its use in SUD treatment.

Background: Adolescence is a pivotal developmental stage marked by physiological and behavioral changes that significantly influence dietary habits and long-term health outcomes. Objectives: This study aimed to examine the associations between socio-demographic characteristics, psychological factors, and dietary behaviors among school-aged children and adolescents in Romania. Methods: A cross-sectional study was conducted using a structured, self-administered questionnaire completed by 662 children and adolescents aged 6 to 18 years, enrolled in primary, middle, and high schools across urban and rural areas. The questionnaire evaluated nutritional intake, meal patterns, hydration habits, physical activity, screen time, and psychological factors such as fatigue, stress, and mood fluctuations. Body mass index (BMI) was calculated based on self-reported height and weight. Results: The analysis reveals significant gender differences in body mass index (BMI), weight-loss behaviors, and family structure. Female adolescents were more likely to be underweight (18.27%) compared to male adolescents (10.82%), while overweight prevalence was higher among male adolescents (18.66%) than female adolescents (11.68%) (χ2 = 11.457, p = 0.009). Dietary patterns varied significantly across age groups, with high-school-aged children demonstrating lower vegetable consumption and increased autonomy over food choices. Primary school children exhibited higher intake of carbonated beverages (OR = 0.185, p = 0.002 for high school; OR = 0.116, p < 0.001 for middle school), whereas teenagers showed a preference for structured meals and lower fast-food intake. Meat consumption frequency correlated with greater diversity in protein sources (χ2 = 48.77, p < 0.001), while chaotic eating behaviors were more prevalent among middle and high-school-aged children (OR = 2.291, p = 0.032 for middle school; OR = 2.225, p = 0.030 for high school). Hydration habits played an essential role in dietary quality, with school-age children consuming ≥ 3 L of water daily exhibiting healthier eating patterns (OR = 7.146, p = 0.001). Additionally, psychological factors such as fatigue and stress were significantly associated with unhealthy dietary choice. Conclusions: These findings highlight the need for targeted nutritional education, school-based interventions, and family-focused strategies to improve adolescent health behaviors.

Depression is not uncommon among older adults with heart diseases and is related to poor prognosis at clinical setting. We aim to explore the association between plant-based diets and depression in older adults with heart disease and further investigate the mediating role of sleep disturbances in this relationship.

A cross-sectional sample of 2039 older adults with heart diseases were recruited from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). Each individual completed assessments on dietary frequency, depression, sleep quality and duration. Plant-based diet index (PDI), healthy plant-based diet index (hPDI) and unhealthy plant-based diet index (uPDI) were calculated. Logistic regression models and restricted cubic spline curves (RCS) were employed to explore the relationship between plant-based diets and depression in older adults with heart disease. Meanwhile, mediation analysis was used to investigate the mediating roles of sleep quality and sleep duration.

The higher the PDI (OR: 0.56, 95% CI: 0.36-0.88) and the hPDI (OR: 0.39, 95% CI: 0.24-0.62), the lower the risk of depression in older adults with heart disease. Conversely, the higher the uPDI, the higher the risk of depression (OR: 1.76, 95% CI: 1.07-2.92). RCS further confirmed a negative linear dose-response relationship between PDI, hPDI and depression in older adults with heart disease, and a positive trend was found between uPDI and depression. Notably, sleep quality (Indirect effect: -0.031, mediated proportion: 61%) partially mediated the relationship between PDI and depression. In the sex-based subgroup analysis, uPDI was only associated with a higher risk of depression in females.

This is the first study to suggest a significant negative relationship between plant-based diets and depression in older adults with heart disease. Sleep quality plays a mediating role in the association between plant-based diets and depression. Optimizing the dietary structure and improve sleep quality may help reduce the risk of depression in older adults with heart disease.

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

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

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 from eligible articles were extracted by 2 reviewers.

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.

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.

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.

PROSPERO registration no. CRD42020159921.

Background and Objectives: Adolescence is a critical period of physical and mental development, yet allergic diseases are often poorly managed. Factors such as sleep deprivation, obesity, smoking, and mental stress can worsen allergic conditions and complicate treatment. This study examines the environmental, behavioral, and psychosocial factors influencing allergic diseases in Korean adolescents using data from the Korean National Health and Nutrition Examination Survey (KNHNES). Materials and Methods: From the 25,534 participants in the Fifth KNHNES, 1630 adolescents (aged 13-18 years) were selected. We analyzed demographic and lifestyle factors, including gender, age, housing type, family size, economic status, obesity, tobacco and alcohol use, sleep duration, and physical activity. Psychosocial factors such as stress perception, suicidal ideation, depressive symptoms, mental health counseling, and self-rated health were also examined. Results: The prevalence rates of allergic diseases were 23% for allergic rhinitis (AR), 11% for atopic dermatitis (AD), and 9.8% for asthma (AS), with 35.8% of adolescents having at least one allergic condition. Smoking was significantly associated with AS (odds ratio [OR] 1.753, p = 0.006), while shorter sleep durations increased AR risk (p = 0.000). Male adolescents had a lower risk of AD (OR 0.706, p = 0.046), and high economic status was inversely correlated with AD (OR 0.445, p = 0.006). Positive self-rated health was linked to lower AS risk (OR 0.447, p = 0.000). AR was significantly associated with male gender (OR 1.391, p = 0.045), high economic status (OR 1.784, p = 0.026), and high stress perception (OR 1.479, p = 0.013). Conclusions: Low self-rated health and high stress perception have been identified as risk factors for allergic diseases during adolescence. Integrating psychosocial counseling with medical treatment may improve management and outcomes.

This study examined factors influencing health behaviours among 13-17-year-olds in Surrey, focusing on rising obesity rates and socioeconomic disparities using a whole systems approach to capture both the stakeholders' voice and the young people's voices.

The research involved two components: a survey of youth service providers (e.g., teachers, youth workers; n = 35) and focus groups with adolescents (n = 27).

The survey revealed challenges faced by stakeholders, including insufficient training, environmental factors (e.g., schools, social media, food systems), and limited support from parents and healthcare professionals. The focus groups identified two key themes: (1) domains of care, for example diet and how availability and cost of food affects food choices, and (2) barriers and solutions, addressing financial, structural, and emotional obstacles to and facilitators of a healthy lifestyle. Transcending these themes was the key role of health inequalities linked to income, geography, and gender.

This study underscores the complexity of adolescent health behaviours and calls for a multi-level, coordinated approach to address inequalities and foster supportive environments for healthier choices.

Previous studies suggest that early-life stress (ELS) induced by early maternal separation and isolation (MS) stress during the stress hyporesponsive period (SHRP) leads to increased curiosity-like and increased risky decision-making behaviour in adolescence. Evidence suggests that dietary interventions early in adolescence could play an important role in mitigating the detrimental effects of MS stress on risky decision-making behaviour. Hence, the present study hypothesized that nutritional supplements such as saturated fat (SFA) and/or polyunsaturated fat (PUFA) would be beneficial in ameliorating the impact of MS stress on risky decision-making behaviour when incorporated into the diet during early adolescence. NC and MS rats were subjected to the Risky Decision-Taking Task (RDTT) to assess the rats' ability to make decisions under risky conditions. The results showed that MS rats took less time to cross the risky zone to collect a large reward. However, when an SFA-rich and PUFA-rich diet was provided, the latency of the MS rats increased. Similarly, MS stress-induced reduction in risk assessment was restored to normal with the SFA and PUFA-rich diet. Risk-index (RI) values also showed a similar trend with reduced RI values in MS, but nutritional supplementation increased the RI values making it comparable to that NC. Correlation analysis has further revealed a direct correlation between the anxiety-like behaviour and the risk-taking tendency in MS rats and not in the NC group. SFA-rich diet led to a positive correlation between anxiety-like and risk-taking behaviour. These findings thus support the hypothesis that PUFA- and SFA-rich diet may be introduced at adolescence to mitigate MS-stress induced increased risky decision-making behaviour due to a deficit in risk assessment.

Although previous studies demonstrated an association between fast food intake and anxiety symptoms in adolescents, this relationship has not been studied in Chinese multi-ethnic adolescents. The purpose of this study is to investigate the aforementioned association and the potential moderating effect of regulatory emotional self-efficacy (RESE) among Chinese multi-ethnic adolescents.

A cluster random sampling of 8500 middle school students from 11 counties in Yunnan province was conducted. The Depression Anxiety Stress Scale-21 was utilized to assess anxiety symptoms, while the food frequency questionnaire was employed to gather data on eating behaviors. The association between fast food intake, RESE, and anxiety symptoms was analyzed using generalized linear models. The moderating effect of RESE on the association between fast food intake and anxiety symptoms was examined using structural equation models.

The positive rate of anxiety symptoms in middle school students was 48.5 % (4120/8500). The positive rate of depressive symptoms in females (53.3 %, 2301/4316) was higher than that in males (43.5 %, 1819/4184). Chinese fast food intake (males vs females: β = 0.26, 95%CI:0.14-0.39; β = 0.16, 95%CI:0.02-0.29), expressing positive affect (β = -0.04, 95%CI:-0.07-0.01; β = -0.06, 95%CI:-0.10-0.03) and managing anger/irritation affect (β = -0.11, 95%CI:-0.14-0.08; β = -0.16, 95%CI:-0.19-0.12) was associated with anxiety symptoms in males and females (all P < 0.05). Takeaway fast food intake (β = 0.19, 95%CI:0.02-0.35) and managing despondency/distress affect (β = -0.08, 95%CI:-0.12-0.04, P < 0.001) was associated with anxiety symptoms in females (all P < 0.05). RESE significantly inversely moderated the association between fast food intake and anxiety symptoms (all participants: β = -0.11; males: β = - 0.08; females: β = - 0.14; all P < 0.01).

Association observed in the cross-sectional study is uncertain and need to be confirmed in cohort studies.

Our findings suggest that fast food intake may be associated with an increased risk of anxiety symptoms among Chinese multi-ethnic adolescents, while good RESE can potentially mitigate this risk.

Food environments surrounding schools have a strong influence on the adolescent's food choices. Moreover, the prevalence of diet-related chronic diseases is higher in regional than metropolitan areas in Australia. Understanding school food environments in these different settings is crucial for informing future strategies to improve adolescent health.

Google Street View was used to identify food outlets within 1.6 km around all secondary schools in Wagga Wagga and Blacktown in New South Wales which were selected as regional and metropolitan case study areas. Based on food outlet type, healthfulness categories were assigned, and Chi-squared tests were performed. The Health Advisory Panel for Youth at the University of Sydney (HAPYUS) were engaged to obtain their perspectives on findings.

Unhealthful food outlets were consistently most prevalent around schools in Wagga Wagga and Blacktown over 17 years. In 2023, these were predominantly restaurants (19.4% vs. 21.1%), cafés (16.8% vs. 11.1%), fast-food franchise outlets (15.1% vs. 17.4%) and independent takeaway stores (14.1% vs. 9.6%). No significant difference in healthfulness between regional and metropolitan areas was found. Youth advisors recognised price and social reasons as major contributors to food choices.

Google Street View was used as a novel resource to examine school food environments in regional and metropolitan areas which have remained consistently unhealthful for nearly two decades. SO WHAT?: Unhealthful school food environments may encourage poor diets and exacerbate rates of adolescent overweight and obesity. Critical government action is needed to improve school food environments.

Girls' physical activity and healthful eating behaviors decline throughout adolescence. These trajectories may be linked to the underdevelopment of exercise and healthful eater identities. Youth programs might consider prioritizing identity development as an innovative health promotion strategy, especially during the formative preadolescent life stage.

This study examines healthful identities and behaviors among a sample of preadolescent girls who participated in SPLASH, a multicomponent youth program consisting of identity development ("I am an exerciser"; "I am a healthy eater"), physical activity, and healthful eating.

SPLASH was piloted in a community-based recreational facility in the Midwest United States. Participants had differing levels of program access: all girls (N = 32, age = 10.6 ± 0.8) attended a 1-week summer day camp, and a subset (n = 16) received supplementary access to a 10-week eHealth program. Using a feasibility framework, we examined SPLASH's (1) preliminary efficacy, (2) implementation, and (3) acceptability.

Girls' exercise identities and behaviors improved following camp participation. At follow-up, those in the camp-plus-eHealth group reported greater improvements in physical activity enjoyment relative to girls in the camp-only group.

SPLASH is a promising identity-focused health promotion program for preadolescent girls. Community support and family engagement facilitated this pilot study. Programmatic impact should be assessed in additional communities.

The first signs of mental health issues in dentistry manifest as early as undergraduate training, thus it is essential to delve into the concept of resilience to equip those studying and working in dentistry with the resources to cultivate a positive mindset.

A focus group was conducted with a homogenous purposive sample of eight undergraduate dental profession students from all 3 years of study at the University of Portsmouth Dental Academy (UPDA). The six-phase Braun and Clarke's thematic analysis was adopted to interpret patterns in data.

Four themes of: 'definition of resilience'; 'factors enhancing resilience'; 'factors challenging resilience' and 'developing resilience in dentistry'; and 23 subthemes were identified. Students defined resilience as an ability to bounce back from adversity and perceived it as a dynamic and contextual phenomenon that fluctuated due to an interplay of personal, social and environmental factors.

The findings of this study showed undergraduate dental profession students' perceptions of resilience, factors influencing it and strategies to develop it. These findings may inform the curriculum of resilience training programmes targeted towards this population.

Eating disorders (EDs) are rising among adolescents. BMI, diet, and physical activity influence ED risk, but their interactions are complex and vary by population. Considering sociocultural changes, this study investigated the prevalence and risk factors for EDs in Romanian adolescents. We evaluated demographic factors, BMI, dietary behaviors, physical activity (PA), and previous specialist consultations using the Eating Attitudes Test-26 (EAT-26) and assessed the psychometric properties of the EAT-26 in this population.

A cross-sectional study included 423 youths aged 13 to 20 from Cluj-Napoca. Participants completed an online survey on demographics, BMI, diet, physical activity, and previous health consultations. ED risk was assessed using the EAT-26. Confirmatory and exploratory factor analyses were conducted on the EAT-26, and binary logistic regression identified predictors of ED risk.

The prevalence of ED risk was 26.5%, with females having 1.61 times higher odds than males. Consulting a weight or mental health specialist increased the odds of increased ED risk (OR = 3.76). Higher BMI showed a trend in the unadjusted model (OR = 1.06). An initial CFA of the EAT-26 showed a suboptimal fit. Over 60% of the sample reported frequent consumption of ultra-processed foods.

Our findings highlight a significant ED risk in Romanian youth, filling a critical gap in regional public health evidence. Despite limitations due to the cross-sectional design and self-reported data, the results stress the need for measures promoting balanced diets, positive body image, and improved mental health access to reduce the growing prevalence of adolescent ED risk in Romania.

Mild metabolic acidosis may adversely affect cardiovascular risk factors, and diet-dependent acid-base load may impair mental health and sleep quality. The aim of this study was to investigate the effects of dietary acid load (DAL) on cardiometabolic risk factors, psychological resilience, and sleep quality in adolescents with obesity.

Obese adolescents participated in the study. Biochemical parameters, anthropometric measurements and blood pressures were measured. Three-day retrospective food intake records were collected from the adolescents, and potential renal acid load (PRAL), net endogenous acid production (NEAP), and DAL were derived from food intake records. Psychological resilience was assessed by the Child and Youth Resilience Measure (CYRM-12) and sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI).

A total of 205 adolescents with obesity (105 males, 100 females) aged 13-18 years participated. Body mass index, fat mass, fat percentage, fasting insulin, triglyceride, systolic blood pressure, homeostasis model assessment for insulin resistance (HOMA-IR) and PSQI scores were significantly higher and psychological resilience levels were significantly lower in high tertiles of DAL (p<0.05). Adolescents in the lowest tertile of DAL scores had higher consumption of whole grains, vegetables, dairy, legumes, and higher intakes of potassium and calcium than adolescents in the highest tertile of the DAL scores (p<0.05). Red meat, and white meat consumption and sodium intake were higher in adolescents in the high tertiles (p<0.05). Energy intakes were found to be significantly lower in the first tertile of PRAL and DAL scores compared to the other tertiles (p<0.05). A linear regression model ahowed an increase in NEAP, PRAL and DAL scores led to a decrease in psychological resilience score and an increase in PSQI and HOMA-IR scores (p<0.05).

High DAL was associated with high cardiometabolic risk, insulin resistance, and low psychological resilience and poor sleep quality.

We aimed to assess the association of health locus of control with anxiety and depression, and explore the mediating effects of health risk behaviors. A multi-stage cluster random sampling method was used among Chinese college students. Logistic regression models were used to explore the associations of health locus of control with anxiety and depression. Structural equation models were used to explore the mediation roles of health risk behaviors in the associations of health locus of control with anxiety and depression. A total of 3,951 college students were included in this study. Internality was associated with lower prevalence of depression (OR = 0.94, 95% CI, 0.91-0.97), powerful others externality was also associated with lower prevalence of anxiety and depression (0.92, 0.88-0.96; 0.93, 0.89-0.96), while chance externality was associated with higher risk of anxiety and depression (1.13, 1.08-1.18; 1.24, 1.20-1.28). The mediated proportion of health risk behaviors in associations of internality, powerful others externality, chance externality with anxiety was 7.55%, 2.37% and 2.18%, respectively. The mediated proportion of health risk behaviors in associations of powerful others externality, chance externality with depression was 10.48% and 2.14%, respectively. Health locus of control is associated with anxiety and depression that are mediated by health risk behaviors.

Youth suicide, a major cause of death, is linked to poverty and other adverse experiences. Evidence of its association with food insecurity is unclear due to inadequate controls for household income in previous research. This cross-sectional study used independent reports of household income, food insecurity, and suicidal behaviours to examine these associations in a population-based sample.

The 2019 Canadian Health Survey on Children and Youth surveyed 6735 youth (15-17 years), gathering data on sadness/hopelessness, suicidal ideation, and suicide attempts. Adults provided information on household food insecurity using a multi-item scale and about diagnosed mood disorders in youth. Household income data were provided by government tax records. We used Poisson regressions to estimate the relative risk (RR) of each suicidal behaviour attributed to household food insecurity, adjusting for household income and other covariates.

Approximately one in five (19.8%) youth experienced marginal (5.2%), moderate (7.9%), or severe (3.3%) food insecurity. Moderate or severe food insecurity was associated with increased risks of sadness/hopelessness, mood disorder, suicide ideation, and suicide attempts (RRs 1.30-2.17) after controlling for household income differences and other covariates. Generally, more severe food insecurity was positively associated with suicide behaviours.

Household food insecurity is associated with youth suicidal behaviours, independently of household income. Its underlying pathway to youth mental health includes social and psychological factors that require targeted policy intervention.

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.

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.

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).

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.

Psychosocial problems are widely affecting the population around the world and worsening in university students. Timely access to psychosocial counseling and support remained challenging. Hence, implementing a digital-based approach to psychosocial counseling services could potentially improve access and efficiency for students in need. However, limited evidence on the intention to use digital-based psychosocial counseling and its predictors among university students in Ethiopia. This study aimed to assess the intention to use digital-based psychosocial counseling and its predictors among students at the University of Gondar, Northwest Ethiopia.

A cross-sectional study was conducted on 759 students from 28 March until 28 April 2023 at the University of Gondar, Northwest, Ethiopia. Proportional allocation was done, and the participants were selected using stratified random sampling. The median score was used as a cutoff point. The student who scores median and above on intention to use construct was considered as intended to use digital-based psychosocial counseling otherwise unintended. The interviewer-administered questionnaire, adapted from the unified theory of acceptance and use of technology model and kobo collect app, was employed to collect the data. Data were exported to SPSS 20 for descriptive analysis and Analysis of Moment and Structure version 23 for structural equation modeling analysis to assess the significance of relationships between variables using a path coefficient and a p-value of <0.05.

A total of 750 (98.8%) responded to complete all the questionnaires. The proportion of intention to use digital-based psychosocial counseling was 54.9%, (95% CI: 51.3%-58.5%). A structural equation modeling shows that performance expectancy (β = 0.510, p-value < 0.001), effort expectancy (β = 0.082, p-value = 0.003), and social influence (β = 0.307, p-value < 0.001) had a direct relationship with intention to use digital-based psychosocial counseling. Gender (β = 0.545, p-value < 0.001) was moderate performance expectancy.

The study has shown a promising intention to use digital-based psychosocial counseling among university students. Performance expectancy, effort expectancy, and social influence had a positive effect on the intention to use digital-based psychosocial counseling. Thus, the implementers need to give priority to enhancing and creating awareness for students related to how to use digital-based counseling.

Mental health problems often arise during adolescence and early adulthood, affecting up to 25% to 30% of young people. Enhancing the ability to identify children and adolescents at increased risk of mental health problems and uncover factors that promote mental health from childhood to adolescence is important.

To investigate if cumulative lifestyle behaviors from childhood to adolescence are associated with perceived stress and depressive symptoms in adolescence.

Prospective cohort study in Finland using baseline data collected between October 2007 and November 2009 and 8-year follow-up data collected between December 2015 and December 2017 as part of the Physical Activity and Nutrition in Children (PANIC) study of children aged 6 to 9 years. Data were analyzed from January to February 2024.

Cumulative physical activity (PA), sedentary behavior (SB), sleep, and diet quality from childhood to adolescence. PA and screen time (ST) assessed by a questionnaire; PA at different intensities, SB, and sleep duration assessed by a combined movement and heart rate sensor; diet quality assessed by 4-day food records and the Baltic Sea Diet Score computed at baseline, 2-year follow-up, and 8-year follow-up examinations.

Perceived stress assessed by the Finnish version of the Cohen Perceived Stress Scale, and depressive symptoms by the Beck Depression Inventory at 8-year follow-up examinations. Linear regression analyses were used to evaluate associations between cumulative lifestyle behaviors over 8 years with the outcomes.

Altogether, 187 adolescents (97 boys [51.9%]; mean age, 15.8 [0.4] years) had valid data on self-reported lifestyle behaviors, and 170 adolescents had valid data on device-assessed lifestyle behaviors. Perceived stress scores ranged from 2 to 33 and depressive symptoms scores from 0 to 31. Self-reported total PA and supervised exercise were inversely associated with perceived stress (standardized regression coefficient [β] = -0.15; 95% CI, -0.31 to -0.01 and β = -0.15; 95% CI, -0.29 to -0.01, respectively) and depressive symptoms (β = -0.17; 95% CI, -0.31 to -0.02 and β = -0.14; 95% CI, -0.29 to -0.0, respectively). Total ST (β = 0.27; 95% CI, 0.13 to 0.41), computer use (β = 0.16; 95% CI, 0.01 to 0.30), and mobile device use (β = 0.28; 95% CI, 0.16 to 0.41) were positively associated with perceived stress. Total ST (β = 0.30; 95% CI, 0.15 to 0.44) and mobile device use (β = 0.33; 95% CI, 0.19 to 0.46) were positively associated with depressive symptoms.

This cohort study of Finnish children and adolescents found that higher PA and lower ST from childhood were associated with perceived stress and depressive symptoms in adolescence. These findings emphasize reducing screen time and increasing PA to promote mental health in youth.

Depression is a common mental health disorder.

The objective of this study was to explore the association between diet quality, as measured by the Healthy Eating Index 2020 (HEI-2020), and depression symptoms among US adolescents and young adults aged 12 to 29 years.

The study design was a cross-sectional secondary data analysis.

Data from the first 24-hour dietary recall for adolescents and young adults aged 12 to 29 years in the National Health and Nutrition Examination Survey from 2015 to March 2020 (n = 4750) were analyzed.

Depression was defined as a score ≥10 on the Patient Health Questionnaire, reflecting moderate or severe symptoms in the previous 2 weeks.

HEI-2020 total (range, 0-100) and component scores were calculated for those with and without depression. Predicted HEI-2020 scores were estimated from linear regression models, adjusting for age, gender, race and Hispanic origin, family income, and seeing a mental health professional in the past year. Statistical analyses accounted for the complex sample design.

The prevalence of depression among adolescents and young adults was 7.8% (95% CI 6.3% to 9.5%). Total HEI-2020 score was 45.9 (95% CI 45.0 to 46.7) out of 100 on a given day during 2015 to March 2020. Among young people with depression, total HEI-2020 score was lower than among those without depression (41.7 vs 46.2; P < .001). After adjustment for covariates, the difference was attenuated, but remained significant. In adjusted analyses, HEI-2020 component scores were lower for those with depression compared with those without depression for the adequacy components: total fruits (1.4 vs 1.7; P = .03), whole fruits (1.2 vs 1.7; P < .01), total vegetables (2.1 vs 2.6; P < .01), greens and beans (0.8 vs 1.2; P < .01), and total protein foods (3.6 vs 4.0; P = .02) out of a maximum score of 5. There were no statistically significant differences observed for whole grains, dairy, seafood and plant proteins, fatty acids, saturated fats, refined grains, sodium, or added sugars.

Overall diet quality is low among young people. Diet quality, especially consumption of fruits, vegetables, and protein foods was lower among young people with depression compared with those without depression.

This review aims to emphasise the impact of poor nutrition on children's health and psychological well-being, urging those involved in childhood obesity or nutrition services to broaden their intervention approach. Poor nutrition and childhood obesity affect physical and psychological health. The stress of living with obesity further impacts quality of life, well-being and self-esteem. Children living with obesity may experience adverse childhood events and stress, and young people are able to recall the impact of psychosocial issues such as experiencing stigma and discrimination. Food is often a coping mechanism for managing negative emotions, perpetuating cycles of emotional coping and unhealthy eating behaviours. UK guidelines recommend family-based, multi-component weight management interventions for children living with obesity. Interventions mainly target health behaviours and utilise behaviour change techniques attempting to directly improve diet and physical activity as behavioural outcomes. Whilst these interventions may show some improvements in psychological well-being, there is limited consideration or understanding of the underlying mechanisms of action which indirectly influence engagement and the sustainability of the behaviour change. Lack of attention and inclusion of psychosocial variables in intervention implementation may help explain the variable effectiveness reported across childhood obesity interventions. In conclusion, enhancing the effectiveness of childhood obesity interventions requires a broader approach that fully incorporates psychosocial factors. Those responsible for commissioning, designing and implementing these interventions should adopt a holistic approach that addresses psychological and emotional needs while incorporating underlying mechanisms of action. This shift in focus could result in more sustainable and comprehensive treatment for childhood obesity.

While the connection between risk factors and suicidality (suicide attempts and ideation) and physical self-harm is well established, the preventive roles of social bonding and dietary patterns remain underexplored. This study, based on the 2021 National Ungdata Surveys in Norway among middle and high school students (N = 15,430), can provide novel and context-specific insights into comparable environments. The results indicated a 5% suicide attempt rate, 18.3% prevalence of physical self-harm, and 26.7% suicidal ideation in the sample. The prevalence was higher among girls, students with low socioeconomic status, middle schoolers, and non-religious individuals. Logistic regression models for suicide attempts showed that substance use and victimization (sexual harassment and bullying) were significant predictors of suicide attempts. Elevated depressive symptoms and the use of pain relievers increased the risk. For suicidal ideation, victimization and depressive symptoms were significant predictors. Concerning physical self-harming behavior, substance use and risky behaviors increased odds, whereas binge drinking had varying effects. Victimization variables and health measures were also significant predictors. Dietary patterns, social bonding measures, and self-motivation were found to be protective factors, as they decreased the likelihood of suicidal and self-harming behaviors, highlighting the critical role of strong social connections, healthy dietary habits, and well-being.

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.

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.

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.

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.

While the physical health effects of obesity are well-characterized, an emerging branch of research has shown that obesity additionally plays a critical role in one's mental health. Young adults, in a pivotal transition phase in their lives, may be particularly prone to the concurrent effects of obesity and adverse mental health outcomes. The purpose of this review is to comprehensively examine existing data regarding the connection between obesity and two widely validated measures of mental health: psychological distress and depression. The connection between mental health outcomes and obesity is mediated by a complex interplay between biological and sociocultural factors, which is explored in this review with particular focus on younger adults aged 20-39. Further, the impact of several demographic factors including race/ethnicity, gender, and immigration status are examined closely. To our knowledge, this review is one of the first efforts to integrate existing knowledge between obesity and mental health, with particular regard for young adults and the impact of other key sociodemographic characteristics. This review has important implications at the interface of two of the most pressing public health crises in the United States.

School food policies in Australia have the potential to positively impact healthy eating in schools. While the policies are reviewed regularly, it is unknown if revised school food policies have incorporated the recommendations from a 2020 review of nutrition policies in publicly funded institutions. This review aims to examine the current state of Australian school food policy environment, including national-level guidelines, food safety, allergy, and anaphylaxis management policies.

School food policy documents were identified by searching the federal government, and Departments of Health and Education websites of Australian jurisdictions. The L'Abbé framework for monitoring and evaluation of nutrition policies guided the data analysis.

Eleven policies/guidelines from Australian national and state/territory governments were reviewed in 2023. Four state/territory policies had major updates since 2020. The consistency of nutrition standards improved across five jurisdictions, although a common nutrient classification system would have allowed better comparison. Implementation guides/tools and supporting resources were provided in all policies although their comprehensiveness varied. Policy monitoring and evaluation guide/tools, and local food procurement were incorporated in two additional policies. School principals were responsible for policy implementation and schools for independent compliance monitoring.

Continued improvement in monitoring and evaluation plans, policy review timelines, and support systems for schools is needed to enhance implementation and impact of school food policies. External stakeholder support may help school leadership in more effective policy implementation. SO WHAT?: Limited progress in incorporating recommendations into current school food policies calls for additional support and strategies to enhance policy implementation and monitoring.

Obesity is a major global public health challenge affecting all countries and communities. The link between obesity and various types of physical morbidities has been widely acknowledged in different studies. Despite the immense impact of obesity on mental health, its full effect on the areas has not been as explored as the impact on physical health has been. Following an extensive review of various recent studies, the objective of this study is to evaluate the correlations and effects of obesity on mental health disorders, in addition to reflecting on the significance of assessing the correlation. The other objective of this study is to evaluate obesity prevalence in mentally ill individuals. We believe that the realization of these objectives will address the existing literature gaps within the population of mentally ill persons in addition to aiding with the necessary preventive knowledge that will enable the provision of optimum mental and physical health. Therefore, this study entailed the performance of a systematic review of several online databases, including Scopus, Web of Sciences, PubMed, Google Scholar, and MEDLINE. This systematic review also utilized an increasingly robust methodology based on the Cochrane guidelines and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Thus, the inclusion criteria stipulated that only studies published between 2010 and 2024 and published in the English language were to be included in this systematic review. The quality of the included studies was assessed using an appraisal tool for cross-sectional studies. As a result, 12 studies met the inclusion criteria for this systematic review and were reviewed. The findings indicate that the prevalence rate of obesity in individuals with mental health disorders surpasses the prevalence of the condition within the general population, suggesting that mentally ill persons are at a higher risk of developing obesity, even as one of the major side effects of psychiatric treatment is excessive weight gain. Individuals with personality disorders, including borderline personality disorder, avoidant personality disorder, dependent personality disorder, and antisocial personality disorder, among others, presented the highest prevalence rate of obesity compared to those with psychosis. Prospective studies should focus on evaluating the various mitigating factors that underlie the weight gain and obesity development that occur across mental health disorders.

Global research has reported that the number of children and adolescents suffering from mental health issues has increased over the past decades. In Jordan, there has been a growing interest in investigating mental health among these groups in the most recent decade; nevertheless, only a few studies have covered behavioral and emotional problems. This study aimed to estimate the prevalence of behavioral and emotional problems among children and adolescents in Jordan and investigate their associated factors.

A large-scale, national, school-based cross-sectional study was conducted between December 2022 and April 2023 on children and adolescents living in Jordan aged between 8 and 18 years. The study included public schools, private schools, UNRWAs schools, Zaatrai camp schools, and non-formal education centers. The Strengths and Difficulties Questionnaire was used to measure behavioral and emotional problems.

About 13.9% of the children had abnormal difficulty scores, and they suffered the most from emotional symptoms (17.9%). Syrian children in refugee camps had the highest rate of total difficulty (19.3%). In the adolescents, 19.7% had high levels of total difficulty, where conduct problems were the most reported (17.6%), and Syrian adolescents in refugee camps were highly affected (22.2%). The number of traumatic events, physical activity, problematic internet use, and family affluence were significantly associated with an increased risk of having behavioral and emotional problems in both the children and adolescents.

A significant proportion of children and adolescents struggle with emotional and behavioral problems in Jordan, and serious efforts are needed to enhance the status of mental health for adolescents and children.

The purpose of the current review was to detail changes in children's diet, eating behavior, and weight in the context of the COVID-19 pandemic.

Global changes in children's diets and eating behavior occurred during the pandemic. Both undernutrition and obesity were prominent concerns. Obese children and those from low socioeconomic status families were particularly vulnerable. The COVID-19 pandemic increased longstanding global concern about child nutrition, both undernutrition and obesity. The pandemic and extended home confinement were associated with changes in children's food consumption, eating behavior, and ultimately weight. These changes were related to factors beyond food intake itself and included decreased physical activity, altered routines and schedules, sleep behaviors, and social concerns, among others. The findings have implications for both public health and clinical practice.

Unhealthy diet-related behaviors and poor diet quality during childhood and adolescence are the main factors contributing to noncommunicable diseases such as obesity, dyslipidemia, diabetes, hypertension, and cardiometabolic syndrome. Unhealthy diet-related behaviors can become lifelong habits associated with mental health problems, including depression, anxiety, attention deficit hyperactivity disorder, and substance abuse issues such as smoking, drinking, and other chemical compounds. Children and adolescents are in the developmental stages of brain structure, function, and neurotransmission systems, which can make them more susceptible to substance abuse (tobacco, alcohol, and drugs). Thus, mental health problems and substance use in children and adolescents may originate from unhealthy diet-related behaviors and poor diet quality. Here we reviewed the impact of diet-related behaviors and diet quality on children's and adolescents' physical and mental health and substance use by scrutinizing the 2021 Korean Youth Risk Behavior Survey (54,848 participants) and other relevant studies.

Lesbian, gay, bisexual, trans, queer/questioning, plus young people have a higher risk of poor mental health in comparison to cisgendered heterosexual young people, and they underutilise mental health services and support. In addition, there is a paucity of research conducted in United Kingdom examining mental health early intervention provision for lesbian, gay, bisexual, trans, queer/questioning, plus young people.

To produce a model of what works for early intervention mental health support for lesbian, gay, bisexual, trans, queer/questioning, plus young people and increase understanding of lesbian, gay, bisexual, trans, queer/questioning, plus young people's access to, navigation of, and engagement with mental health support.

This was a multi-methods theory-led case study evaluation with three distinct stages: (1) a meta-narrative review of existing literature to develop a theoretical framework to explain effective mental health support for lesbian, gay, bisexual, trans, queer/questioning, plus young people; (2) an online and offline service mapping exercise to locate current mental health early intervention support for lesbian, gay, bisexual, trans, queer/questioning, plus young people in the United Kingdom in order to produce a service typology; and (3) a theory-led case study evaluation of 12 case study sites selected from the service typology produced in stage 2, to establish the components of appropriate quality, early intervention mental health support for lesbian, gay, bisexual, trans, queer/questioning, plus young people.

Stage 1 produced an interdisciplinary theoretical framework indicating that early intervention mental health support for lesbian, gay, bisexual, trans, queer/questioning, plus youth must prioritise addressing normative environments that marginalise youth, lesbian, gay, bisexual, trans, queer/questioning, plus identities and mental health problems. Stage 2 mapping found 111 services, the majority in urban settings in England. There was an absence of mainstream National Health Service support that specifically addressed the needs of lesbian, gay, bisexual, trans, queer/questioning, plus young people. The majority of lesbian, gay, bisexual, trans, queer/questioning, plus youth mental health support was provided by voluntary/community organisations. Stage 3 case study evaluation found that an intersectional, youth-rights approach is the most appropriate way to deliver early intervention mental health support for lesbian, gay, bisexual, trans, queer/questioning, plus young people. Youth rights should underpin mental health support to address the multiple marginalisation, isolation and stigmatisation that lesbian, gay, bisexual, trans, queer/questioning, plus young people may experience and to enable them to make informed independent decisions about their own bodies and lives, and for the right to freedom of safe self-expression to be upheld. The model that we have produced contains 13 principles that are necessary to the provision of mental health support, and to improve access to, engagement with, and navigation of mental health services.

In the United Kingdom, a rights-based approach to mental health service provision is not prominent. In addition, at the time of writing, lesbian, gay, bisexual, trans, queer/questioning, plus young people are facing active legislative and policy attacks on their human rights. This study provides the first large-scale theory-led evaluation of early intervention mental health support for lesbian, gay, bisexual, trans, queer/questioning, plus young people with common mental health problems. The resulting intersectional, youth-rights approach provides evidence on ways of improving lesbian, gay, bisexual, trans, queer/questioning, plus young people's mental health. Further research on the implementation of an intersectional, youth-rights approach to early intervention mental health support for lesbian, gay, bisexual, trans, queer/questioning, plus young people with mental health problems is required.

This study is registered as PROSPERO CRD42019135722.

This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: 17/09/04) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 47. See the NIHR Funding and Awards website for further award information.

Adopting a plant-based diet (PBD) has environmental sustainability benefits and has been shown to improve overall health and quality of life, yet for most people a diet shift towards a plant-based one remains a challenge, due to personal and environmental obstacles. Important independent decisions on self-care and nutritional habits occur in the first year of enrollment for college students. This cross-sectional quantitative study aims to examine the association between health beliefs, motivators, barriers, self-efficacy, and mental health status and following a more PBD in college students. A total of 449 Californian public university and junior college students completed an online survey. A stepwise multiple regression model was used to predict the level of intention to follow a PBD. Self-efficacy (β = 0.28, P < .001), motivators (β = 0.33, P < .001), and barriers (β = -0.19, P < .001) significantly predicted and accounted for 35% of the variance in intention to follow a PBD. The results reveal that greater self-efficacy, higher motivation, and fewer barriers predicted higher intention to follow a PBD. Beliefs did not add significantly to following a PBD.

Anorexia nervosa (AN) is a psychiatric disorder with a high mortality rate and significant prevalence in the paediatric population. Preliminary reports during the COVID-19 pandemic suggested an increased incidence of AN among children and adolescents. The objective of this study was to analyse new cases of AN before, during, and after the pandemic, with a particular focus on the physical manifestations of the disease.

This single-centre, retrospective study included new AN cases from the hospital database of a regional paediatric hospital (a reference centre for AN) between 2013 and 2023. Data analysed included the duration of the disease, body mass index (BMI), weight loss, length of hospitalisation, laboratory markers (leukopenia, anaemia, hypoproteinaemia, hyperferritinaemia, hypophosphataemia, dyslipidaemia, and hypothyroxinaemia) and clinical features of malnutrition (such as amenorrhea bradycardia, pericardial effusion, and cortical/subcortical atrophy).

This study was conducted in a Polish regional hospital. We analysed 228 hospitalized female patients aged 10 to 18 years diagnosed with AN, focusing on clinical characteristics, biochemical markers, and the impact of the COVID-19 pandemic. The COVID-19 pandemic was shown to have a significant impact, with longer hospitalisations observed during and after the pandemic and a lower BMI on admission post-pandemic compared to pre-pandemic. In addition, nutritional treatment became more prevalent over time while biochemical markers such as anaemia, hypothyroidism, hypophosphataemia, and dyslipidaemia were statistically more common post-pandemic.

This study demonstrates a significant impact of the COVID-19 pandemic on the clinical course and hospitalisation patterns of paediatric patients with AN. These findings suggest that the pandemic may have exacerbated disease severity and altered treatment approaches, emphasizing the need for enhanced clinical management and follow-up strategies for AN in the paediatric population during such health crises.

This study aimed to estimate the prevalence of psychosocial, emotional, and behavioral problems and their symptoms among children and adolescents in Jordan, assess their quality of life, and examine mental health help-seeking behavior.

A large-scale school-based national survey was conducted in Jordan among children and adolescents aged 8 to 18 years (grades 3 to 12) from the host and refugee populations, utilizing a multi-stage stratified cluster sampling technique to select a nationally representative sample. Two versions of structured questionnaires were used: proxy parent version for students in grades 3 to 6 (8-11 years) and self-report version for students in grades 7 to 12 (12-18 years). The study questionnaires employed internationally recognized and validated tools in English, which were translated into Arabic.

A total of 8,000 (3,433 (42.9%) boys, 4,567 (57.1%) girls) and (3,593 (44.9%) children, 4,407 (55.1%) adolescents) were included. About 24.5% of children had anxiety symptoms (18.0% of Jordanians, 34.5% of Syrian camp refugees, 33.7% of Syrian urban refugees, and 24.7% of Palestinian camp refugees) and 16.6% of children had major depressive disorder symptoms (11.0% of Jordanians, 25.4% of Syrian camp refugees, 25.0% of Syrian urban refugees, and 14.0% of Palestinian camp refugees). Almost 13.9% of children and 19.7% of adolescents had abnormal levels of total emotional and behavioral difficulties. Nearly 16.5% of children and 35.0% of adolescents had poor overall health-related quality of life. When experiencing a personal or emotional problem, only 28.1% of children's parents would seek help for their children and 19.7% of adolescents would seek help for themselves.

The study revealed a high prevalence of various mental health issues' symptoms, particularly among refugees and female adolescents. Intention to seek help is relatively low, suggesting that children and adolescents' mental health needs are not being widely met. It is crucial to implement integrated and coordinated plans and programs that effectively target multiple factors that impact children and adolescents' mental health, while also respecting the prevailing cultural context. A key aspect of promoting the mental well-being of children and adolescents in Jordan is the inclusive involvement of refugees and individuals from other nationalities.

There is scarce literature concerning 'children in need' at a European level (including Greece), particularly regarding energy balance-related behaviors (EBRBs) associated with overweight and obesity. This scoping review aimed to synthesize evidence on the EBRBs associated with overweight and obesity among 'children in need' in Greece and their key determinants.

Inclusion criteria included children (0-18 years) who were 'in need', living with overweight or obesity, residing in Greece, and which included data on EBRBs and their potential determinants. APA PsychInfo, CINAHL, Cochrane CENTRAL, EMBASE, MEDLINE, as well as grey literature (in Greek/English), were searched (without publication date limitations). Data was extracted using an adapted Joanna Briggs Institute tool.

Seven studies were identified (n = 141-7,283 participants), highlighting prevalent EBRBs, categorized into groups; nutrition (lower diet quality, poor dietary habits, higher intake of carbohydrates, sugar sweetened beverage consumption, low adherence to the Mediterranean diet pattern, lack of daily breakfast consumption), sleep (low sleep duration), and sedentary behaviors / physical activity (television in children's bedrooms, high screen time, low physical activity, high sedentary time). Key determinants included low parental education, food culture, food preparation by grandmothers, the home environment, parental dietary choices, and lower socioeconomic status, etc. CONCLUSION: This review identified specific EBRBs associated with overweight and obesity affecting children in need in Greece and their determining factors. These findings should guide future research, tailored intervention programs, and public health policies (i.e. the European Child Guarantee Strategy) targeted at this understudied priority population of children in need, in Greece. Review registration number: Open Science Framework: https://osf.io/w7qdu.

Globally, more than 13 % of adolescents have clinically significant mental health problems, with anxiety and depression comprising over 40 % of cases. Despite the high prevalence of anxiety disorders among youth, dietary research has been focused on youth with depression, resulting in a significant knowledge gap regarding the impact of anxiety on adolescent diet quality. Adolescents with diagnosed anxiety disorders and healthy controls were included in this study. Anxiety symptoms were measured using the Screen for Child Anxiety-Related Disorders. Diagnosis of anxiety disorder was determined using the Kiddie Schedule for Affective Disorders and Schizophrenia interview. Five diet quality indices were scored from FFQ. Diet quality indices associated with anxiety symptoms in the correlation matrix were interrogated using multiple linear regression modelling. All models were adjusted for depression. One hundred and twenty-eight adolescents (mean age 14·8 years (sd: 2·1); 66·4 % female) were included in this cross-sectional analysis. Although healthy controls and outpatient participants had similar unhealthy dietary index subscale scores, outpatient participants had lower healthy index scores. Higher anxiety symptoms were associated with lower healthy dietary indices in univariate analysis; after adjusting for comorbid depression; however, anxiety symptoms were no longer associated with dietary indices following adjustment for multiple testing (P = 0·038 to P = 0·077). The association between anxiety symptoms and a poor diet is attenuated by depression. The results of this study support the need for an integrated approach to the assessment of mental and physical well-being and further research aimed at understanding the unique contribution of depression to healthy dietary patterns.