Relationships between Nutrition and Physical Activity, and the Symptoms of Insomnia, Depression and Anxiety among Adolescents in South China During COVID-19 Pandemic

Abstract

COVID-19 has caused mental health issues among adolescents. This study aimed to explore the related factors of nutrition, physical activity (PA), and symptoms of insomnia, depression and anxiety, and to investigate associations between the two lifestyle behaviors (insolated or combined) with symptoms of insomnia, depression and anxiety. Cross-sectional data of 1,756 middle school students from a survey conducted in May 2020 was used. The t-tests or c2 tests were used to determine the related factors of nutrition, PA, and symptoms of insomnia, depression and anxiety across the subgroups when appropriate. Logistic regression analysis was used to explore the relationships between nutrition and PA, and symptoms of insomnia, depression and anxiety. Girls, rural students, left-behind, sibling, students with low family income or excessive fear had worse lifestyle or mental status. Both poor nutrition and inactive PA were related to higher odds of reporting symptoms of insomnia, depression and anxiety. Students with both poor nutrition and inactive PA tended to report insomnia symptoms (OR = 2.16) and depressive symptoms (OR = 2.57) than those with only one behavior or neither of them after controlling for confounding factors. The present study indicates the importance of helping adolescents to pursue a healthier lifestyle.

Exploring the impact of COVID-19 on the movement behaviors of children and youth: A scoping review of evidence after the first year

“…Results consistently showed reported decreases in PA time in children and youth, and this was demonstrated repeatedly in both longitudinal 66 , 67 , 68 , 69 , 70 , 72 , 73 , 74 , 75 , 77 and cross-sectional designs. 78 , 80 , 84 , 92 , 102 , 103 , 107 , 109 , 114 , 117 , 118 This result was echoed by those of other studies using similar constructs, including exercise time, 100 , 104 , 115 energy expenditure, 79 and MVPA. 116 , 121 , 122 , 123 However, 3 longitudinal research studies reported decreases in sports-related PA 65 , 73 , 77 but not in school and leisure-time PA, 73 habitual activity, 65 and nonorganized sports-related PA. 65 It is worth noting that although studies consistently identified overall decreases in PA, there were groups of children and youth in some studies who reported stability 125 or an increase 65 , 132 in unstructured PA. Several studies reported changes in the proportion of children and youth meeting PA guidelines.…”

“…At the individual level, several effects were noted regarding gender, age, and prepandemic behavior. Unsurprisingly, boys were engaged in more PA during COVID-19 than girls, on average, 75 , 80 , 84 , 85 , 87 , 90 , 91 , 117 , 132 although 2 cross-sectional studies 130 , 131 reported no differences in PA time between boys and girls, and a third study 82 reported more vigorous PA in boys but more light-to-moderate PA in girls. There were inconsistent findings related to which gender's movement behaviors were most impacted by COVID-19 restrictions.…”

“…Due to pandemic restrictions, it is unsurprising that online child/parent-reported questionnaires comprised the majority of PA measures. Of the studies, 37 used validated self-report measures of PA or related constructs, including the International Physical Activity Questionnaire (IPAQ), 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 PAQ-Adolescents, 67 , 68 , 74 , 75 Global-PAQ, 69 Godin Leisure Time Exercise questionnaire, 86 , 87 24-h PA recall, 88 , 89 Pediatric Functional Activity Brief Scale, 90 , 91 Youth Activity Profile Questionnaire, 70 ecological momentary assessments, 66 MoMo PA Questionnaire, 65 or other validated questionnaires. 73 , 92 Two studies designed and validated new questionnaires for children in lockdown, 93 , 94 and 3 studies used device-based measures of PA, including accelerometry 73 and pedometry.…”

“…Parental support and coparticipation were correlated with greater PA and outdoor time. 117 Greater PA levels were reported for children and youth from 2-parent homes, 105 multichild homes, 131 , 133 higher-income households, 84 , 133 and homes with set routines and task schedules. 105 On the contrary, lower activity levels during COVID-19 were found in homes where all adults were working from home.…”

Detrimental Health Behaviour Changes among Females Living in Rural Areas during the COVID-19 Pandemic

“…However, unhealthy changes to diet were reported in a recent study in Scotland and these changes were associated with low mood [ 41 ]. In another study of high school students in China, poor nutrition during the COVID-19 pandemic was higher among girls than boys, and in rural areas compared with urban areas, and was thought to be due to higher levels of stress among girls and lower socioeconomic status of rural areas [ 42 ].…”