Department of Hygiene, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria; Institute of Highway Engineering and Transport Planning, Graz University of Technology, Graz, Austria; Research Group "Health and Quality of Life in a Green and Sustainable Environment", SRIPD, Medical University of Plovdiv, Plovdiv, Bulgaria.
Institute of Highway Engineering and Transport Planning, Graz University of Technology, Graz, Austria.
Environ Res. 2023 Sep 15;233:116452. doi: 10.1016/j.envres.2023.116452. Epub 2023 Jun 18.
Background The exposome approach can be a powerful tool for understanding the intertwining of social, physical, and internal influences that shape mental health and cognitive development throughout childhood. To distil conceptual models for subsequent analyses, the EU-funded project Early Environmental quality and Life-course mental health effects (Equal-Life) has conducted literature reviews on potential mediators linking the exposome to these outcomes. We report on a scoping review and a conceptual model of the role of restorative possibilities and physical activity. Methods Peer-reviewed studies published since the year 2000 in English, on the association between the exposome and mental health/cognition in children/adolescents, and quantitatively investigating restoration/restorative quality as a mediating variable were considered. Database searches were last updated in December 2022. We used an unstructured expert-driven approach to fill in gaps in the reviewed literature. Results Five records of three distinct studies were identified, indicating a scarcity of empirical evidence in this newly developing research area. Not only were these studies few in numbers, but also cross-sectional, lending only tentative support to the idea that perceived restorative quality of adolescent's living environment might mediate the association between greenspace and mental health. Physical activity emerged as a mediator leading to better psychological outcomes in restorative environments. We provide a critical discussion of potential caveats when investigating the restoration mechanism in children and propose a hierarchical model including restoration, physical activity, and relational dynamics between children and their environment, including social context, as well as restorative environments other than nature. Conclusions It is justified to further explore the role of restoration and physical activity as mediators in the association between early-life exposome and mental health/cognitive development. It is important to consider the child perspective and specific methodological caveats. Given the evolving conceptual definitions/operationalizations, Equal-Life will attempt to fill in a critical gap in the literature.
外显组学方法可以成为理解社会、身体和内部影响交织在一起，塑造儿童期心理健康和认知发展的有力工具。为了提炼出后续分析的概念模型，欧盟资助的项目“早期环境质量和生命过程心理健康影响（Equal-Life）”对潜在中介因素进行了文献综述，这些因素将外显组学与这些结果联系起来。我们报告了一项范围综述和一个关于恢复可能性和身体活动作用的概念模型。
我们考虑了自 2000 年以来以英文发表的关于外显组学与儿童/青少年心理健康/认知之间关联的同行评议研究，以及定量调查恢复/恢复质量作为中介变量的研究。数据库搜索最后更新于 2022 年 12 月。我们使用了一种无结构的专家驱动方法来填补综述文献中的空白。
确定了三个不同研究的五份记录，表明这个新发展的研究领域实证证据稀缺。这些研究不仅数量少，而且都是横断面研究，仅初步支持这样一种观点，即青少年生活环境的感知恢复质量可能在绿地与心理健康之间的关联中起中介作用。身体活动作为一种中介因素，在恢复环境中产生更好的心理结果。我们对在儿童中调查恢复机制时的潜在注意事项进行了批判性讨论，并提出了一个分层模型，包括恢复、身体活动以及儿童与其环境之间的关系动态，包括社会背景，以及除自然之外的恢复环境。
有理由进一步探索恢复和身体活动作为早期生活外显组学与心理健康/认知发展之间关联的中介作用。考虑到儿童的观点和具体的方法注意事项很重要。鉴于不断发展的概念定义/操作化，Equal-Life 将试图填补文献中的一个关键空白。
