Critical Influence of Nutrition on Psychosocial Wellbeing in Childhood

The bidirectional relationship between diet and nutrition and social, emotional, and educational factors among European youth

Sadie Cathcart
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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.

Photo Credit: Laura Taylor, Flickr

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)

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7 COMMENTS

  1. It is wonderful to see the relationship between food and emotional experience outlined here. This relationship is very complex, as it’s well known that traumatic exposure dramatically impacts eating habits, and that food can take on a role as a comfort measure or be used as a means of controlling self or the environment (eating disorders), which would naturally lead to poorer nutritional habits for those who have been traumatized on the average. Additionally, poor diet is going to be associated with poverty and lower educational levels, which of course impact “mental health” variables assessed. A bidirectional relationship seems intuitive, but to really flesh this out requires looking at the relationship between psychosocial stressors and diet.

    One perhaps seemingly picky but actually kind of important critique: The use of terms like “patterns of overdiagnosis and overmedication” give credence to the idea that there is such a thing as optimum diagnosis or optimum medication, which is not actually possible given the subjective and socially-driven criteria used for “diagnosis” in the DSM, and the damage done by such arbitrary categorization of distress.

    More appropriate would be to say that we want to curb “The use of psychiatric drugs to mask the results of psychosocial stress and the likely causal link between nutrition and common expressions of psychosocial distress through mood and behavior as outlined in the article.” Or something like that…

    — Steve

    • I’d also like to see an addendum “dissing” those who’d use psych drugs to mask the results of biophysical stress, as well. There are two kinds of stress out there, Steve, and both may respond to proper nutrition-
      in the case of biophysical stress, some unusual supplementation (for some individuals).

      • Agreed. Not only do psych diagnoses end up leading to drugging healthy people for no reason, they also obscure actual physiological problems that CAN cause “symptoms” that are labeled as “mental illnesses.” Low thyroid, iron deficiencies, drug side effects, sleep problems, chronic pain, nutritional deficiencies and many other things can result in emotional/mental “symptoms” that could actually be resolved by a real analysis of the body.

        • I’ve experienced marked cognitive, psychiatric, and neurologic changes due to physiological problems: specifically thyroid autoimmunity, low iron, low iodine, celiac, and low b12. The b12 deficiency effects in particular were pretty drastic.

          My doctors and family wanted me to take psych drugs, but I refused to get on that roller coaster again. Instead, as each health issue was corrected directly, my mental and cognitive health improved. No emotional blunting, no addiction, no induced suicidality, no akathisia, no mania, no insomnia, no memory loss, no increased highs and lows…I just gradually felt sound again.

          It disturbs me that these sorts of health conditions are not on pychiatrists’ radar. They’re not screened for. I’ve only ever met one psychiatrist who was amenable to the idea that my thyroid trouble was causing anxiety and depression and that SSRIs were not the proper treatment. And even he wanted me to do electroshock as a quick, “non-drug” fix. He didn’t see the logical fallacy in that. He though he was helping.

    • Unfortunately, the diabetes guidelines have recently been manipulated and not because there is concern for the health of people. Again, it seems to be a function of the illness maintenance system to shore up profits since their cholesterol schemes have been disproven. It isn’t a coincidence that blood pressure guidelines have likewise been lowered to accomplish the same thing. It’s also ignored that anti psychotics increase the risk of diabetics, yet nothing is done to address this issue and the prescribing of them long term, even to young children, isn’t stopped. So, the CDC says we have a problem, which makes money for those entities involved and never does anything to truly prevent the problem. Quit allowing medicating with psyche meds and maybe, in two or three generations we’ll see some change.

      • Well, to address the diabetes problem, it might be necessary to reveal that “schizophrenics” don’t get diabetes at all (for practical purposes) when they aren’t medicated, which might also reveal (gasp!) that there might be some other beneficial physical effects that go along with this syndrome.