Kara Loewen (left) and Paul Veugelers, professor, School of Public Health (right).
A healthy lifestyle is a proven determinant of children's physical health, and research now shows the more lifestyle recommendations kids meet, the better off their mental health, as well.
"Previous research suggested that certain lifestyle behaviours may be associated with mental health, so we designed this study to focus on that specifically," explained Paul Veugelers, a professor in the School of Public. "The association became apparent."
Kara Loewen, research coordinator and lead author, said the study is innovative for a couple reasons. "Previous studies looked at how meeting a single lifestyle recommendation, such as sleep or screen time, affects kids' mental health. Our study looked at the adherence to nine lifestyle behaviours, and their cumulative effect."
The lifestyle behaviours included meeting recommended guidelines for:
- consuming fruits and vegetables, grain products, milk and alternatives, saturated fats, and sugar according to Canada's Food Guide (pre-2019) and other international dietary guidelines,
- meeting recommendations for physical activity, hours of sleep, and sedentary behaviour each day based on Canadian 24-hour Movement Guidelines.
Loewen also explained the unique data opportunity they had. "More than 3,400 students, age 10 and 11 years old, were surveyed along with their parents and schools to determine if they met these nine lifestyle recommendations."
"We then linked directly to the health data records of the kids for the following four years and tracked their physician visits for mental health reasons."
Kids made visits to their physician for internalizing mental health disorders such as anxiety and depression, or externalizing disorders that include Attention Deficit Hyperactivity Disorder and other conduct disorders.
The results showed there is, indeed, an association. Children who met 4-6 of the lifestyle recommendations made 39 per cent fewer mental health visits to their physician than kids who met only 1-3. Meeting 7-9 of the recommendations resulted in 56 per cent fewer visits.
"Each additional lifestyle recommendation met was associated with a 15 per cent reduction in mental health visits," stated Loewen.
Overall, kids were meeting an average of only 5.3 of the nine recommendations.
While the study looked at the cumulative effect of the recommendations, Loewen said there were two specific behaviours that stood out to her. "Most kids are not meeting recommendations for physical activity and screen time, which leads to sedentary behaviour. It's hard to untangle these, considering the prevalence of smart phones and tablets in our culture."
She also added her concern that only 30 per cent of the kids surveyed were eating the recommended amount of fruits and vegetables daily.
"There is no silver bullet here, though," warned Loewen. "We can't say if kids would only adhere to this one guideline, or a certain combination of guidelines, they can best avoid a mental health diagnosis."
Veugelers agrees that a holistic approach to kids' health is necessary and makes recommendations to help achieve that.
"Children spend most of their waking hours in school and it's the ideal place to promote healthy habits to all kids, not just those at risk," he said. School health programs that limit access to unhealthy foods and promote physical activity in the curriculum are just two ways to do that.
"It's hard for parents to make sure their children are meeting all the requirements," added Loewen. "When kids have these messages reinforced at school, it supports parents in making small manageable changes over time that will lead to better health."
Lastly, Veugelers says there's an important clinical application for this research. "All of these guidelines are established recommendations for physical health. There is no risk to physicians to encourage patients and their parents to comply with the guidelines when the outcome could be improved mental health."