Critical Influence of Nutrition on Psychosocial Wellbeing in Childhood

Shedding light on the largely unexamined relationship between diet and psychosocial experience, new research from Arvidsson and team evaluates links between nutrition and wellbeing among children. Their results, reported in BMC Public Health, indicate a bidirectional relationship, suggesting that healthy diets predict emptional health and vice versa.

Although this topic has received attention in prior research, results have been mixed, and chronology has not always been factored into the equation. The unique contribution of the latest research is its consideration for the order of influential variables (i.e., self-esteem, emotional and peer concerns, adherence to healthy dietary guidelines, and their relationships according to shifts over time). Due to the longitudinal nature of their investigation, the researchers were able to treat dietary and well-being variables as both predictors and outcomes in their study.

Findings by Arvidsson et al. suggested that healthy dietary adherence patterns were connected to both higher self-esteem and fewer emotional and peer problems in a large sample of 2 to 9-year-olds. Similarly, high levels of self-esteem at the onset of the study were found to be related to higher levels of dietary adherence after a two-year period. Authors conducted analyses to determine the role of weight in outcomes over a two-year period and found that shifts were comparable in both average weight and overweight children.

Consideration for non-pharmacological approaches in support of children in and out of school would be incomplete without attention to diet. Because many children throughout the US eat at least two meals, five days each week in school and nutrition has been linked to academic outcomes, it would behoove school administrators and more broad-level policymakers to consider the ways in which appropriate attention to student diets could prevent more expensive and invasive interventions related to student mental health concerns.

Past research has solidified the influence of diet and nutrition on positive psychological outcomes and academic performance in adolescence, but fewer studies have thoroughly examined this influence in pre-teens and young children. In a 2013 Mad in America featured piece, Bonnie Kaplan and Julia Rucklidge highlighted the relative infancy of the exploration of diet and mental health, noting, “…any professional who graduated over ten years ago could potentially be completely unfamiliar with this body of research.” Kaplan and Rucklidge identified that research had linked poor nutrition with increased depressive symptoms and anxiety in children and adults alike, but research is only beginning to tap into nuances of dietary patterns, nutrient intake, and nutrient status. In another article, they noted that nutrition is typically given little to no attention in medical training programs.

Arvidsson and colleagues refrained from considering academic outcomes in relation to adherence to healthy dietary guidelines, but abundant research has supported the link between social-emotional factors and academic outcomes. Thus, it would be appropriate to infer that the implications of this study extend outside of the in-home experiences of students and into schools. The school represents the source of meals for many students throughout the US, particularly in urban communities, and a place in which the effects of nutrition are immediately felt. Diet, as it impacts the social-emotional experience of students and self-esteem, may ultimately influence school climate.

Arvidsson and team were able to use a European sample of children (N = 7,675) from an eight-country cohort study, the Identification and Prevention of Dietary- and Lifestyle-Induced Health Effects in Children and Infants Study (IDEFICS), for their investigation. The purpose of the IDEFICS was to evaluate an intervention targeting overweight youth, as well as to assess the multifactorial characteristics influencing excess weight in childhood. Citing a recent IDEFICS-informed publication reporting links between overweight in childhood and poor health-related quality of life, authors provide a reasonable justification for their focus on chronology.

A Healthy Dietary Adherence Score (HDAS) in the form of a parent-report questionnaire was used to indicate dietary variables. Additionally, four social-emotional factors, including self-esteem, parent relations, and emotional and peer problems, were evaluated using the Kinder Lebensqualität Fragebogen (KINDL). Participant weights were measured at baseline, as well as post-intervention at the two-year mark, and categorized dichotomously as average weight or overweight. Additional covariates investigated included parental education level and income brackets.

Findings from this study closely align with past patterns detected in adolescent eating habits and psychosocial functioning. Additionally, concerning baseline and diet at follow-up, the researchers report the following results:

• “Associations were established between baseline indicators of well-being and components included in the HDAS
• Better self-esteem at baseline was associated with sugar intake in accordance with the guidelines (limited intake of refined sugars)
• Good parent relations was associated with fruit & vegetable consumption according to guidelines (400–500 g per day)
• Fewer emotional problems was associated with fat intake according to the guidelines (reduced intake, especially of saturated fat)
• Fewer peer problems was associated with consumption of fruits & vegetables according to guidelines.”

Perhaps the most surprising takeaway from work by Arvidsson and team is the fact that the bidirectional relationships identified were insensitive to participant weight. Patterns visible in relationships between psychosocial well-being and diet were similar across average weight and overweight participants, suggesting that nutrition, naturally, is an essential consideration in the daily experiences of all children.

As we become increasingly aware of patterns of overdiagnosis and overmedication and begin to identify relationships between healthy-eating and positive psychosocial outcomes, perhaps we should consider lifestyle, exercise and dietary shifts as first-line interventions. Although healthy eating may require drastic adjustments in social systems and family functioning (and in some cases, poor diet is, unfortunately, a product of an inability to afford nutritious options), it may ultimately curb physical- and mental-healthcare-related costs for families and schools alike.

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Arvidsson, L., Eiben, G., Hunsberger, M., Bourdeaudhuij, I. D., Molnar, D., Jilani, H… Lissner, L. (2017). Bidirectional associations between psychosocial well-being and adherence to healthy dietary guidelines in European children: prospective findings from the IDEFICS study. BMC Public Health, 17(1). (Link)