MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.
Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Prev Chronic Dis. 2024 Oct 24;21:E82. doi: 10.5888/pcd21.240187.
The high prevalence of mental disorders among adolescents calls for community-based and population-level prevention strategies. Diet is an important intervention target for primary prevention of mental disorders among adolescents. We used data from a large longitudinal study of Canadian adolescents (aged 14-18 y) to examine prospective associations between diet and mental health outcomes.
We estimated the effect of diet (ie, consumption of vegetables and fruit and sugar-sweetened beverages [SSBs]) at baseline on depressive symptoms, anxiety symptoms, and psychological well-being (measured by the Center for Epidemiologic Studies Depression Scale-Revised, Generalized Anxiety Disorder 7 scale, and Flourishing Scale, respectively) and at 1-year follow-up in a sample of 13,887 Canadian secondary school students who participated in the 2017-2018 and 2018-2019 cycles of the Cannabis, Obesity, Mental health, Physical activity, Alcohol, Smoking, and Sedentary (COMPASS) behavior study. We applied linear mixed-effects methods informed by a directed acyclic graph. Sensitivity analyses assessed the robustness of the effect estimates to unmeasured confounding variables.
Baseline SSB consumption was associated with greater severity of depressive (β = 0.04; 95% CI, 0.01-0.06) and anxiety (β = 0.02; 95% CI, 0-0.05) symptoms, particularly among male students, and poorer psychological well-being (β = -0.03; 95% CI, -0.05 to -0.01) at follow-up. Baseline vegetables and fruit consumption was positively associated with psychological well-being (β = 0.06; 95% CI, 0.03-0.10) but not other mental health outcomes at follow-up.
Our results support the notion that diet should be part of comprehensive mental health prevention and promotion interventions to reduce the prevalence of mental health disorders among adolescents.
青少年精神障碍的高发率需要以社区和人群为基础的预防策略。饮食是预防青少年精神障碍的重要干预目标。我们利用加拿大青少年（14-18 岁）大型纵向研究的数据，研究了饮食与心理健康结果之间的前瞻性关联。
我们在一项名为 Cannabis、肥胖、心理健康、身体活动、酒精、吸烟和久坐（COMPASS）行为研究的 2017-2018 年和 2018-2019 年周期中，对 13887 名参与的加拿大中学生样本中，分别使用中心流行病学研究抑郁量表修订版、广泛性焦虑症 7 量表和繁荣量表来评估基线时饮食（即蔬菜和水果的摄入量以及含糖饮料的摄入量）对抑郁症状、焦虑症状和心理健康的影响，并在 1 年时进行了评估。我们应用了有向无环图（DAG）指导的线性混合效应方法。敏感性分析评估了对未测量的混杂变量的效应估计的稳健性。
基线 SSB 摄入量与抑郁（β=0.04；95%CI，0.01-0.06）和焦虑（β=0.02；95%CI，0-0.05）症状的严重程度增加有关，尤其是在男性学生中，且与心理健康水平降低（β=-0.03；95%CI，-0.05 至-0.01）有关。基线蔬菜和水果的摄入量与心理健康呈正相关（β=0.06；95%CI，0.03-0.10），但与 1 年后的其他心理健康结果无关。
我们的研究结果支持这样一种观点，即饮食应成为全面心理健康预防和促进干预的一部分，以降低青少年精神障碍的发病率。
