Health Behavior, Health-Related Quality of Life, and Mental Health Among Canadian Children: A Population-Based Cohort Study

Abstract

Objective: Studies that have reported the associations of diet quality, physical activity (PA), sedentary behavior (SB), and health-related quality of life (HRQoL) with mental health among children and adolescents are predominantly cross-sectional in design. Very few studies have examined the longitudinal relationship of mental health with health behavior and HRQoL among children. This study aimed to investigate the associations of diet quality, PA, SB, and HRQoL among children with mental health disorders throughout childhood.Methods: We linked data from grade five students aged primarily 10 and 11 years who participated in the Raising Healthy Eating and Active Living (REAL) Kids Alberta survey in 2012 in the Canadian province of Alberta with their administrative health care data from birth to 2012. Mental health outcomes included internalizing disorder and attention deficit and hyperactivity disorder (ADHD) defined by the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) or Tenth Revision, Canadian version (ICD-10-CA). The HRQoL was measured by the EQ-5D-Y, a five-dimensional descriptive system for children and youth. We applied negative binomial regressions to examine the associations between health behaviors, HRQoL, and mental health.Results: Of the 1,352 participating students, 12.31 and 8.32% had a diagnosis of internalizing disorders and ADHDs, respectively, during childhood from birth to the ages of 10–11 years. Students in the highest tertile for diet quality, relative to the lowest tertile, were 56% less likely to have diagnoses of internalizing disorders (incidence rate ratio, IRR = 0.44, 95% CI = 0.23–0.85). Students engaged in less PA (vs. more PA) were more likely to be diagnosed for internalizing disorders (IRR = 1.98, 95% CI = 1.19–3.30). Poorer diet quality, low PA, excessive use of computers/video games, and watching TV were significantly associated with more diagnoses of ADHDs. Children who experienced some or a lot of problems in “feeling worried, sad, or unhappy” and “having pain or discomfort” were more likely to receive diagnoses of internalizing disorders and ADHDs, respectively.Conclusions: These observed associations suggest that health promotion programs targeting promoting diet quality, PA, and HRQoL and reducing SB among children may contribute to improving mental health.

The association between sugar-sweetened beverages and milk intake with emotional and behavioral problems in children with autism spectrum disorder

“…A few studies showed that compared to TD children, children with ASD aged 4–10 years have less frequent milk intake ( 24 , 25 ). Two studies indicated that meeting recommendations for milk and alternative in childhood was associated with fewer health care encounters for mental illnesses, such as depressive episodes, mood disorder, general anxiety disorder, attention-deficit/hyperactivity disorder (ADHD), and so on ( 26 , 27 ). Therefore, it's reasonable to speculate that milk intake was negatively associated with emotional and behavioral problems, and there were interactive effects between SSBs and milk intake on emotional and behavioral problems in children with ASD.…”

Physical activity and the development of general mental health problems or attention-deficit hyperactivity disorder (ADHD) symptoms in children and adolescents: A cross-lagged panel analysis of long-term follow-up epidemiological data

“…Several longitudinal studies showed a long-term relationship between PA and psychological constructs, but the results are inconsistent (Wu et al, 2018 , 2021 ; Doré et al, 2019 , 2020 ; Kleppang et al, 2019 ; Loewen et al, 2019 ; Gómez-Baya et al, 2020 ; Hamer et al, 2020 ; Isaksson et al, 2020 ; Kandola et al, 2020 ; van Woudenberg et al, 2020 ; Bowe et al, 2021 ). To illustrate some results, Nigg et al concluded that PA may not be a preventive component for mental health problems, but mental health problems can be a risk factor for lower activity at preadolescent ages (Nigg et al, 2021 ).…”

“…A growing number of studies provide information that PA may be a promising factor within a treatment program for ADHD symptoms (Halperin et al, 2014 ; Khalife et al, 2014 ; Cerrillo-Urbina et al, 2015 ; Rommel et al, 2015 ; Ng et al, 2017 ; Ahn et al, 2018 ; Wu et al, 2018 , 2021 ; Biddle et al, 2019 ; Neudecker et al, 2019 ; Miklós et al, 2020 ; Vysniauske et al, 2020 ; Mercurio et al, 2021 ). Biddle et al concluded from systematic reviews and meta-analyses that PA leads to better cognitive results and academic achievement (Biddle et al, 2019 ).…”

Internalizing and externalizing mental health problems affect in-school adolescent’s health-related quality of life in eastern Ethiopia: A cross-sectional study

“…Adolescents’ mental health issues are becoming a significant global public health concern, significantly burdening the existing healthcare system [ 1 , 2 ]. Mental illness negatively affects adolescents, their parents, and surrounding families, especially regarding health-related quality of life (HrQoL) [ 3 , 4 ].…”

“…Although HrQoL is commonly used to influence health and welfare policy, it is understudied in community settings, especially among adolescents experiencing mental health issues at an increasing rate [ 17 , 18 ]. Therefore, a better understanding of the link between mental health issues and health-related quality of life in adolescents is a top priority, with significant implications for improving HrQoL in the face of mental health issues [ 2 ].…”