Adherence to 24-hour movement guidelines and academic performance in adolescents.

OBJECTIVE: The aim of the study was to examine the association between meeting combinations of the Canadian 24-h movement guidelines and academic performance in adolescents. STUDY DESIGN: This cross-sectional study used the 2017 Ontario Student Drug Use and Health Survey, a survey representative of Ontario students in grades 7-12 attending publicly funded schools. A total of 10,160 students were included in the analysis. METHODS: Moderate to vigorous physical activity (MVPA), screen time, sleep duration, and academic performance were self-reported. A multiple linear regression model was used to examine differences in academic performance between adolescents meeting and those not meeting the combinations of movement guidelines (≥60 min/day of MVPA; ≤2 h/day of screen time; 9-11 h/night of sleep for ages 11-13 years, 8-10 h/night for ages 14-17 years, and 7-9 h/night for ages 18 years or older). Covariates included age, sex, ethnicity, subjective socio-economic status, body mass index z-score, and substance use. RESULTS: We found that 5.1% of students met all three movement guidelines, whereas 39.0% did not meet any. Middle school students who met all three guidelines or either the screen time or sleep guideline displayed better academic performance than those who met none of the guidelines. High school students who met the screen time and sleep guidelines displayed better academic performance than those who did not meet any guidelines. CONCLUSIONS: Adhering to screen time and sleep duration recommendations is associated with better academic performance among adolescents.

Use of social networking sites, electronic cigarettes, and waterpipes among adolescents.

OBJECTIVES: Electronic cigarettes (e-cigarettes) and waterpipes are gaining in popularity among adolescents in tandem with the increasing popularity of social networking sites (SNSs). The objective of this study was to examine the associations between the use of SNSs and e-cigarette and waterpipe use among adolescents, and to test whether these associations are independent of tobacco cigarette smoking. STUDY DESIGN: A province-wide school-based cross-sectional study. METHODS: Data were derived from the 2013 Ontario Student Drug Use and Health Survey. Our analyses included representative data from 2841 high school students across Ontario, Canada, who completed the questionnaire that included measures of lifetime use of e-cigarette and past-year use of waterpipe. RESULTS: Nearly 14.6% of students reported having smoked an e-cigarette in their lifetime and 12.2% reported having smoked a waterpipe in the past year. After adjusting for various covariates, daily use of SNSs of at least 1 h/day was associated with greater odds of e-cigarette use (odds ratios ranged from 3.31 for SNS use of 1 h/day to 3.43 for ≥3 h/day), while daily use of SNSs of at least 2 h was associated with waterpipe use (odds ratios of 3.28 for SNS use of 2 h/day and 2.83 for use of ≥3 h/day). The observed associations remained significant after further adjusting for tobacco cigarette smoking. CONCLUSIONS: The use of SNSs was positively associated with e-cigarette and waterpipe use, independent of tobacco cigarette smoking. These findings highlight the need for including SNSs in ongoing prevention and intervention efforts.

Perceptions and attitudes about body weight and adherence to the physical activity recommendation among adolescents: the moderating role of body mass index.

OBJECTIVE: We examined the associations between perceptions and attitudes about body weight and adherence to the physical activity recommendation (PAR) for adolescents to achieve ≥60 min/day of moderate-to-vigorous physical activity and tested whether body mass index (BMI) was a moderator of these relationships. STUDY DESIGN: Cross-sectional survey. METHODS: Self-reported data from Canadian adolescents (n = 4299) who participated in the 2013 Ontario Student Drug Use and Health Survey were analysed. RESULTS: Dissatisfaction with body weight was associated with lower odds of adherence to the PAR (odds ratio [OR]: 0.74; 95% confidence interval [CI]: 0.55-0.99). More specifically, those who perceived themselves as overweight/obese had lower odds of adherence to the PAR (OR: 0.59; 95% CI: 0.42-0.81) compared with those who think they were about the right weight. Those who were trying to gain weight were more likely to adhere to the PAR (OR: 1.92; 95% CI: 1.29-2.86) compared to those who were doing nothing about their body weight. BMI was a significant moderator of the association between dissatisfaction with body weight and adherence to the PAR. At low BMI, there were no differences in the adherence to the PAR between adolescents who were dissatisfied with their body weight or not. At high BMI, adolescents who were dissatisfied with their body weight were less likely to adhere to the PAR than those who were not dissatisfied with their weight. Results were not different between males and females. CONCLUSIONS: Results suggest that adolescents who are dissatisfied with their body weight have lower adherence to the PAR, particularly those who are overweight or obese.

Associations between meeting combinations of 24-h movement guidelines and health-related quality of life in children from 12 countries.

OBJECTIVES: To examine whether meeting vs not meeting movement/non-movement guidelines (moderate-to-vigorous physical activity [MVPA], screen time, sleep duration), and combinations of these recommendations, are associated with health-related quality of life (HRQoL) in children from 12 countries in five major geographic regions of the world and explore whether the associations vary by study site. STUDY DESIGN: Observational, multinational cross-sectional study. METHODS: This study included 6106 children aged 9-11 years from sites in Australia, Brazil, Canada, China, Colombia, Finland, India, Kenya, Portugal, South Africa, the United Kingdom, and the United States. Participants completed the KIDSCREEN-10 to provide a global measure of their HRQoL. Sleep duration and MVPA were assessed using 24-h accelerometry. Screen time was assessed through self-report. Meeting the recommendations was defined as ≥60 min/day for MVPA, ≤2 h/day for screen time, and between 9 and 11 h/night for sleep duration. Age, sex, highest parental education, unhealthy diet pattern score, and body mass index z-score were included as covariates in statistical models. RESULTS: In the full sample, children meeting the screen time recommendation, the screen time + sleep recommendation, and all three recommendations had significantly better HRQoL than children not meeting any of these guidelines. Differences in HRQoL scores between sites were also found within combinations of movement/non-movement behaviors. For example, while children in Australia, Canada, and USA self-reported better HRQoL when meeting all three recommendations, children in Kenya and Portugal reported significantly lower HRQoL when meeting all three recommendations (relative to not meeting any). CONCLUSIONS: Self-reported HRQoL is generally higher when children meet established movement/non-movement recommendations. However, differences between study sites also suggest that interventions aimed at improving lifestyle behaviors and HRQoL should be locally and culturally adapted.

Use of social networking sites and alcohol consumption among adolescents.

OBJECTIVES: Research indicates that screen time (e.g. TV viewing) is associated with alcohol consumption in adolescents; however, very little is known about the link between the use of social networking sites (SNSs) and alcohol intake in this age group. The purpose of this study was to examine the association between the use of SNSs and alcohol consumption among Canadian middle and high school students, and to test whether this link varies by sex and drinking frequency or intensity. STUDY DESIGN: School-based cross-sectional study. METHODS: Self-reported data on time spent on SNSs, alcohol consumption and sociodemographic characteristics were obtained from 10,072 participants within the 2013 cycle of the Ontario Student Drug Use and Health Survey, a province-wide survey of students in grades 7-12 (11-20 years old). RESULTS: Adolescent females who reported daily use of SNSs (≤2 hours/day or >2 hours/day) were more likely than those who use them infrequently or do not use them at all to report both occasional and regular alcohol consumption in the past 12 months, while adolescent males who reported daily use of SNSs were more likely than those who use SNSs infrequently or do not use them at all to report regular alcohol use in the past 12 months. The use of SNSs was also associated with report of binge drinking (defined as drinking five or more drinks on one occasion) in the past 4 weeks in both males and females. CONCLUSIONS: Results provide evidence that the use of SNSs is associated with alcohol consumption among adolescents. Differences between males and females in the reported associations warrant further investigations.

Lifetime experience of multiple common mental disorders and 19-year mortality: results from a Canadian population-based cohort.

AIMS: To examine the impact of multiple psychiatric disorders over the lifetime on risk of mortality in the general population. METHODS: Data came from a random community-based sample of 1397 adults in Atlantic Canada, recruited in 1992. Major depression, dysthymia, panic disorder, generalised anxiety disorder and alcohol use disorders were assessed using the Diagnostic Interview Schedule (DIS). Vital status of participants through 2011 was determined using probabilistic linkages to the Canadian Mortality Database. Cox proportional hazard models with age at study entry as the time scale were used to investigate the relationship between DIS diagnoses and mortality, adjusted for participant education, smoking and obesity at baseline. RESULTS: Results suggested that mood and anxiety disorders rarely presented in isolation - the majority of participants experienced multiple psychiatric disorders over the lifetime. Elevated risk of death was found among men with both major depression and dysthymia (HR 2.56; 95% CI 1.12-5.89), depression and alcohol use disorders (HR 2.45; 95% CI 1.18-5.10) and among men and women who experienced both panic disorder and alcohol use disorders (HR 3.80; 95% CI 1.19-12.16). CONCLUSION: The experience of multiple mental disorders over the lifetime is extremely common, and associated with increased risk of mortality, most notably among men. Clinicians should be aware of the importance of considering contemporaneous symptoms of multiple psychiatric conditions.

Cyberbullying victimisation and internalising and externalising problems among adolescents: the moderating role of parent-child relationship and child's sex.

AIMS: Previous research has found links between cyberbullying victimisation and internalising and externalising problems among adolescents. However, little is known about the factors that might moderate these relationships. Thus, the present study examined the relationships between cyberbullying victimisation and psychological distress, suicidality, self-rated poor mental health and substance use among adolescents, and tested whether parent-child relationship and child's sex would moderate these relationships. METHODS: Self-report data on experiences of cyberbullying victimisation, self-rated poor mental health, psychological distress, suicidality and substance use were derived from the 2013 Ontario Student Drug Use and Health Survey, a province-wide school-based survey of students in grades 7 through 12 aged 11-20 years (N = 5478). Logistic regression models adjusted for age, sex, ethnicity, subjective socioeconomic status and involvement in physical fighting, bullying victimisation and perpetration at school. RESULTS: Cyberbullying victimisation was associated with self-rated poor mental health (adjusted odds ratio (OR) 2.15; 95% confidence interval (CI) 1.64-2.81), psychological distress (OR 2.41; 95% CI 1.90-3.06), suicidal ideation (OR 2.38; 95% CI 1.83-3.08) and attempts (OR 2.07; 95% CI 1.27-3.38), smoking tobacco cigarette (OR 1.96; 95% CI 1.45-2.65), cannabis use (OR 1.82; 95% CI 1.32-2.51), and binge drinking (OR 1.44; 95% CI 1.03-2.02). The association between cyberbullying victimisation and psychological distress was modified by parent-child relationship and child's sex (three-way interaction term p < 0.05). The association between cyberbullying victimisation and psychological distress was much stronger among boys who have a negative relationship with their parents. CONCLUSIONS: Findings suggest that cyberbullying victimisation is strongly associated with psychological distress in most adolescents with the exception of males who get along well with their parents. Further research using a longitudinal design is necessary to disentangle the interrelationship among child's sex, parent-child relationship, cyberbullying victimisation and mental health outcomes among adolescents in order to improve ongoing mental health prevention efforts.

Use of social networking sites and perception and intentions regarding body weight among adolescents.

OBJECTIVE: Social networking sites (SNSs) not only offer users an opportunity to link with others but also allow individuals to compare themselves with other users. However, the link between the use of SNSs and the dissatisfaction with body weight is largely unknown. We investigated the associations between the use of SNSs and the perception of body weight and related behaviours among adolescent men and women. METHODS: The study sample consisted of 4,468 (48.5% women) 11-19-year-old Canadian students in grades 7 to 12 who participated in the 2013 Ontario Student Drug Use and Health Survey. RESULTS: Overall, 54.6% of students reported using SNSs for 2 h or less per day, 28.0% reported using them for more than 2 h d-1 and 17.4% reported infrequent or no use of SNSs (reference category). After adjustment for covariates, results showed that adolescent women who use SNSs for more than 2 h d-1 had greater odds of dissatisfaction with body weight (odds ratio = 2.02; 95% confidence interval [CI]: 1.30-3.16). More specifically, they were more likely to perceive themselves as overweight (relative risk ratio [RRR] = 2.20; 95% CI: 1.34-3.60) compared with those who reported infrequent or no use of SNSs. Conversely, men who use SNSs for 2 h or less per day presented a lower risk for perceiving themselves as overweight (RRR = 0.68; 95% CI: 0.47-0.98) but not those who use SNSs for more than 2 h d-1. Women who use SNSs for more than 2 h d-1 reported a greater likelihood of trying to lose weight (RRR = 2.52; 95% CI: 1.62-3.90). CONCLUSIONS: Our results showed that heavy use of SNSs is associated with dissatisfaction with body weight in adolescent women.

Social networking sites and mental health problems in adolescents: The mediating role of cyberbullying victimization.

BACKGROUND: Previous research has suggested an association between the use of social networking sites (SNSs) and mental health problems such as psychological distress, suicidal ideation and attempts in adolescents. However, little is known about the factors that might mediate these relationships. The present study examined the link between the use of social networking sites and psychological distress, suicidal ideation and suicide attempts, and tested the mediating role of cyberbullying victimization on these associations in adolescents. METHODS: The sample consisted of a group of 11-to-20-year-old individuals (n=5126, 48% females; mean±SD age: 15.2±1.9 years) who completed the mental health portion of the Ontario Student Drug Use and Health Survey (OSDUHS) in 2013. Multiple logistic regression analyses were used to test the mediation models. RESULTS: After adjustment for age, sex, ethnicity, subjective socioeconomic status (SES), and parental education, use of SNSs was associated with psychological distress (adjusted odds ratio, 95% confidence interval=2.03, 1.22-3.37), suicidal ideation (3.44, 1.54-7.66) and attempts (5.10, 1.45-17.88). Cyberbullying victimization was found to fully mediate the relationships between the use of SNSs with psychological distress and attempts; whereas, it partially mediated the link between the use of SNSs and suicidal ideation. CONCLUSION: Findings provide supporting evidence that addressing cyberbullying victimization and the use of SNSs among adolescents may help reduce the risk of mental health problems.