Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Nov 3, 2023
Date Accepted: Jul 8, 2024
Meal timing and depression among Chinese children and adolescents: cross-sectional study
ABSTRACT
Background:
Depression in children and adolescents is a rising concern in China. Dietary behavior is a critical determinant of mental health. Meal timing, the schedule of meal consumption, has been related to several metabolic disorders. However, the effect of meal timing on mental health is scarce, particularly in children and adolescents who are in a critical period of physical and psychological development.
Objective:
This research examined the relationship between meal timing and depression in children and adolescents in China.
Methods:
Children and adolescents from grades one to nine were recruited from 16 districts in Shanghai, China, from January 3rd to January 21st, 2020. Ten schools attended the study. A survey was distributed to the students and their parents to collect the demographic information and health related information. Depression was measured by the Children's Depression Inventory-short form (CDI-S). Breakfast consumption was analyzed as a binary outcome. Participants were defined as breakfast consumers if they never skipped breakfast in the week. They were otherwise defined as breakfast skippers if they skipped breakfast at least once per week. A similar categorization was applied to analyze food intake proximal to bed. Daily eating window were calculated using the last food intake time frame - the first food intake time frame. Participants were classified into eating window less than 10 hours, 10 to 12 hours, and more than 12 hours groups. The logistic regression model was used to compute the odds ratios (OR) and 95% confidence intervals.
Results:
A total of 6874 participants were included in the analysis. Participants who skip breakfast were associated with 2.70 times higher risk of depression (OR=2.70, 95%CI: 2.24-3.26, P<.001). Depression was 1.28 times higher in participants who ate before bed than participants who never ate before bed (OR= 1.28, 95%CI: 1.08-1.50, P<.001). The risk of depression is 1.37 times higher if the eating time window was shorter than 10 hours (OR= 1.37, 95%CI: 1.08-1.73, P=.009) and 1.23 times higher if the eating time window was longer than 12 hours (OR= 1.23, 95%CI: 1.01-1.50, P=.042). The lowest risk of depression was observed at 11.5 hours. Subgroup analysis showed such relationships remained significant in adolescents aged 10 years or older. In children, only skipping breakfast was associated with higher odds of depression (OR=2.77, 95%CI: 1.94-3.96, P<.001).
Conclusions:
Breakfast skipping and eating before bed significantly increase the risk of depression occurrence. The optimal daily eating window to lower the risk of depression is 11.5 hours in children and adolescents. Daily eating windows longer than 12 hours or shorter than 10 hours are associated with elevated occurrence of depression. Current findings advocate evidence-based dietary strategies to implement the prevention and treatment of depression in children and adolescents
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