The association study between dietary behaviors, lifestyle patterns and comorbid depressive and anxiety symptoms in Yunnan adolescents aged 12–19, Southwest China: a largescale cross-section screen and a propensity score matching analysis
TL;DR
Healthy dietary, sleep patterns, and digital device usage should be carefully monitored as part of adolescent mental health interventions in Yunnan Province in Southwest China.
Abstract
Background The purpose of this study is to explore the association of dietary behaviors and other lifestyle habits with the presence of comorbid depressive and anxiety symptoms in adolescents aged from 12 to 19 years old in Yunnan Province in Southwest China. Methods We conducted a complex, multi-stage stratified, probability sampling design in 57,031 participants from 253 multi-center of 129 counties of Yunnan in 2023. Participants with complete information on basic demographic information, dietary behaviors, lifestyle patterns (incuding sleep duration, screen time, and exercises etc.,), and who participated in the survey and assessed depressive and anxiety symptoms using standardized measures. Propensity score matching was performed to reduce imbalance in prespecified measured covariates between comparison groups. Multivariable logistic regression models were used to examine the association. Results The detection rate of total participants in the comorbid depressive and anxiety symptoms was 12.72%. And the detection rate of females in the comorbid depressive and anxiety symptoms group (15.51%) was notably higher than that of males (9.73%). After controlling for potential confounding effects through multiple logistic regression analyses, and after PSM, sedative medication misuse (OR = 4.613, 95% CI 3.734–5.699), the use of electronic devices in dark environments at night (always using: OR = 3.538, 95% CI 3.111–4.023), computer use exceeding 2 h daily (OR = 1.719, 95% CI 1.499–1.971), insufficient sleep (OR= 1.600, 95% CI 1.456–1.757), smoking (OR = 1.469, 95% CI 1.339–1.612) and alcohol consumption (OR = 1.706, 95% CI 1.572–1.851) were positive association. Consuming breakfast (OR = 0.450, 95% CI 0.380–0.532), vegetables (OR = 0.712, 95% CI 0.587–0.864), and fruits (OR = 0.705, 95% CI 0.618–0.805), the computer use < 2 h daily (OR = 0.866, 95% CI 0.801–0.936) and watching TV < 2 h (OR = 0.771, 95% CI 0.706–0.843) were negative association. Conclusions Healthy dietary, sleep patterns, and digital device usage should be carefully monitored as part of adolescent mental health interventions. And longitudinal, culturally responsive, and comprehensive interventions addressing individual behaviors, family dynamics, and community-level factors are urgently needed.