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Association of breakfast, total diet quality, and mental health in adolescents: a cross-sectional study of HBSC in Greece

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Abstract

The emerging field of nutritional psychiatry offers proof that diet quality can be changed to reduce one’s risk of developing mental illness. What you eat has a big impact on teenage mental health, and the quality and frequency of breakfast, as well as the different food groups, can affect adolescent mental health. In this study, regression models were employed to analyze four indicators (self-rated health, body satisfaction, life satisfaction, and eight symptoms) of mental health problems as well as demographic factors (gender, age, body mass index, affluence class, physical activity), with forest plots displaying the regression connections. This study, a descriptive cross-sectional survey of 3480 adolescents aged 11 to 15 years, chosen data from the 2018 Greek Health Behaviour in School-aged Children (HBSC) International Study for secondary analysis. The data revealed that high levels of four indicators of mental health (self-rated health, body satisfaction, life satisfaction, and eight symptoms) were significantly related to breakfast quality, total dietary patterns. Students reporting poor total food quality, for example, were more predictive of self-assessment when unhealthy (2.286 95% CI 1.851–2.824), and the largest connections with eating a “bad” breakfast were discovered when the eight symptoms of mental status were the worst (− 0.869 95% CI: − 1.300, − 0.439); physical activity may enhance the positive relationship of diet quality on mental health, while obesity weakens this positive relationship; and age patterns varied by gender, with girls and older individuals showing a higher risk of diet quality and mental health.

  Conclusions: The findings revealed that each of the four indices of general mental health was correlated with teenage breakfast and overall diet quality. Physical activity and weight were shown to be moderating factors, and obesity had the biggest impact on psychological risk. Gender, age, and family economic inequality were potential explanations for the rise in psychological symptoms. Researchers are urged to focus more on nutritional psychiatry research and look into psychological perception disparities in the future.

What is Known:

• There is a potential correlation between adolescent dietary patterns or quality and mental health.

• Factors such as age, gender, socio-economic status, body weight and physical activity all have an impact on diet and mental health outcomes.

What is New:

• There have been no studies of the ability to simultaneously predict breakfast quality and overall diet quality for broadly defined mental health complaints [positive (life satisfaction), neutral (body satisfaction, self-rated health) and negative (eight symptoms: depressed mood, irritability, nervousness, difficulty sleeping, dizziness, headache, stomachache and backache)].

• Differences in overall diet quality trends between demographic subgroups remain unclear.

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Availability of data and materials

The HBSC International Coordinating Centre is based at the University of Glasgow, UK. Data from the HBSC study can be obtained from the HBSC Data Management Centre in accordance with the HBSC data access policy. Further information on accessing HBSC data is available at https://www.uib.no/en/hbscdata.

Abbreviations

BMI:

Body mass index

C.I:

Confidence intervals

HBSC:

Health Behaviour in School-aged Children study

OR:

Odds ratio

Ref:

Reference

SES:

Socio-economic status

Sd:

Standard deviation

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Acknowledgements

The HBSC survey is a collaborative project of the WHO Regional Office for Europe. The authors would like to thank the contribution of the principal investigators and team members of each participating HBSC country. The international coordinator of the 2017/18 survey was Joanna Inchley (University of Glasgow). The international Data Bank manager was Oddrun Samdal (University of Bergen, Norway). We thank all adolescents and schools who participated in each survey and country.

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Author notes

  1. Liying Liu and Chaofan Guo contributed equally to this work.

Authors and Affiliations

  1. School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, 030001, China

    Liying Liu & Fangfang Lang

  2. Shanxi Provincial People’s Hospital (Fifth Hospital of Shanxi Medical University), Taiyuan, Shanxi, 030012, China

    Chaofan Guo

  3. Shanxi Children’s Hospital (Shanxi Maternal and Child Health Hospital), Taiyuan, Shanxi, 030013, China

    Yaqiong Yan

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Contributions

L.L. and C.G. contribute equally and have equal authorship roles. Conceptualization and design of the study, L.L. and C.G.; data analysis, C.G. and F.L.; writing—original draft preparation, L.L., C.G., and F.L.; writing—review and editing, C.G., F.L., and Y.Y.; supervision, F.L. and Y.Y.; all authors have read and agreed to the published version of the manuscript.

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Correspondence to Yaqiong Yan.

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Active parental consent was given for every adolescent participant in accordance to the study protocol.

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The authors declare no competing interests.

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Communicated by Peter de Winter

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Liu, L., Guo, C., Lang, F. et al. Association of breakfast, total diet quality, and mental health in adolescents: a cross-sectional study of HBSC in Greece. Eur J Pediatr 182, 5385–5397 (2023). https://doi.org/10.1007/s00431-023-05180-0

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