Lifestyle risk behaviours among adolescents: a two-year longitudinal study of the impact of the COVID-19 pandemic

Abstract

ObjectiveTo examine changes in the prevalence of six key chronic disease risk factors (the “Big 6”), from before (2019) to during (2021) the COVID-19 pandemic, among a large and geographically diverse sample of adolescents, and whether differences over time are associated with lockdown status and gender.DesignProspective cohort study.SettingThree Australian states (New South Wales, Queensland and Western Australia) spanning over 3000 km.Participants983 adolescents (baseline Mage=12.6, SD=0.5, 54.8% girl) drawn from the control group of the Health4Life Study.Primary outcomesThe prevalence of physical inactivity, poor diet (insufficient fruit and vegetable intake, high sugar-sweetened beverage intake, high discretionary food intake), poor sleep, excessive recreational screen time, alcohol use and tobacco use.ResultsThe prevalence of excessive recreational screen time (prevalence ratios (PR)=1.06, 95% CI=1.03 to 1.11), insufficient fruit intake (PR=1.50, 95% CI=1.26 to 1.79), and alcohol (PR=4.34, 95% CI=2.82 to 6.67) and tobacco use (PR=4.05 95% CI=1.86 to 8.84) increased over the 2-year period, with alcohol use increasing more among girls (PR=2.34, 95% CI=1.19 to 4.62). The prevalence of insufficient sleep declined across the full sample (PR=0.74, 95% CI=0.68 to 0.81); however, increased among girls (PR=1.24, 95% CI=1.10 to 1.41). The prevalence of high sugar-sweetened beverage (PR=0.61, 95% CI=0.64 to 0.83) and discretionary food consumption (PR=0.73, 95% CI=0.64 to 0.83) reduced among those subjected to stay-at-home orders, compared with those not in lockdown.ConclusionLifestyle risk behaviours, particularly excessive recreational screen time, poor diet, physical inactivity and poor sleep, are prevalent among adolescents. Young people must be supported to find ways to improve or maintain their health, regardless of the course of the pandemic. Targeted approaches to support groups that may be disproportionately impacted, such as adolescent girls, are needed.Trial registration numberAustralian New Zealand Clinical Trials Registry (ACTRN12619000431123)

The psychosocial consequences of covid-19 in adolescents with nonsuicidal self-injury

“…Second, we examined if NSSI independently was associated with covid-19 related stress, even when other variables were controlled for. There is recent empirical support that adolescent girls might be more negatively impacted by the covid-19 pandemic, with a more risky life style [ 8 ], more stress [ 1 ] and increased presentation to health care for self-harm, irrespective of intent [ 48 ], but our results did not support any sex differences in how covid-19 was perceived when symptoms of depression, anxiety and ER difficulties were taken into account.…”

“…Although less burdened by somatic complications caused by the virus, factors such as societal restrictions, closed schools and family distress have contributed to the lives of children and adolescents being severely affected by covid-19 [ 5 , 6 ]. In adolescents, elevated levels of depression, anxiety and stress, for example, have been found during the pandemic [ 1 , 4 , 7 ], as well as increased risk behaviors [ 8 ].…”

A healthy lifestyle text message intervention for adolescents: protocol for the Health4Me randomized controlled trial

“…Crosssectional data from a sample of 983 adolescents indicated increases of excessive recreational screen time (86 to 94%) and insufficient fruit intake (20 to 30%). As well, this data indicated proportions of adolescents engaging in insufficient physical activity (82%) and vegetable intake (84%) remained concerning [3]. The intersection of risk factors for both obesity and mental health demonstrates the need for holistic programs which provide support to improve lifestyle risk factors.…”

“…Research has established associations between several lifestyle risk factors, including physical activity, nutrition, sedentary behaviour and sleep that are contributing to the declining physical and mental health status of adolescents [2,3]. Adolescents in high income countries, like Australia are not meeting national guidelines for these risk factors.…”

Swedish High School Students’ Drug and Alcohol Use Habits throughout 2020

“…Worldwide, COVID-19 restrictions were actualized, and behaviors (including risk behaviors) naturally changed as students adapted to the new environment. Many researchers predicted and reported negative long-term consequences among children and adolescents—particularly excessive recreational screen time, poor diet, physical inactivity, and poor sleep, but also increases in substance use, the prevalence of psychiatric disorders, and suicidal thoughts [ 38 , 39 , 40 , 41 , 42 ]. However, a few reported that restrictions actually resulted in decreases in alcohol consumption and norm-breaking behaviors and that adolescents showed resilience [ 25 , 43 , 44 ].…”