Research

Anxiety, Depression, and Mental Health

Stress Management Methods in Children and Adolescents: Past, Present, and Future.

Journal of Hormone Research in Paediatrics, 2023

Zisopoulou Liza Varvogli, T., & Varvogli, L.

There is an increasing number of students both in elementary and secondary education suffering from anxiety and other stress-related disorders and illnesses. This narrative review summarizes evidence-based stress management techniques such as breathing practices or exercises, meditation, guided imagery, clinical hypnosis, cognitive behavioral therapy, behavioral therapy, third-wave therapies, interpersonal therapies, progressive muscle relaxation, autogenic training, biofeedback training, mindfulness, that is deemed to be effective to treat stress and a variety of stress-related disorders. 

The effects of yoga on mental health in school-aged children: A systematic review and narrative synthesis of randomized control trials

Journal of Clin Child Psychol Psychiatry, 2023

Kirti Khunti, Sadie Boniface, Emma Norris, Cesar M De Oliveira, and Nicola Shelton

A systematic review published in 2022 looks into 21 peer-reviewed randomized control trials that have investigated yoga as an intervention for improving mental health (anxiety, low mood, depression) in children. The population in the study included primary and secondary aged 5-16 years old. Yoga interventions included a combination of physical postures, breathing exercises, meditation or mindfulness practices, and relaxation techniques. Various measurement tools of mental health outcomes were used including Child Behaviour Checklist (CBCL) and the Perceived Stress Scale (PSS). The review concluded that there are positive effects of school-based intervention and the evidence for yoga therapies is encouraging.

Integrative Approaches to Stress, Anxiety, and Resilience.

Journal of Pediatric Annals, 2019

Brown, M. L.

Anxiety is one of the most common psychiatric conditions affecting adolescents and youth in the United States, with over 30% of adolescents having an anxiety disorder of any type. During the transitional period of adolescence, young people often experience higher stress levels. This article presents adequate coping strategies to deal with developmental challenges. Untreated anxiety can have a significant impact on the life of a child and can impact them into adulthood. This paper highlights integrative approaches such as mindfulness that can teach children to better manage symptoms of anxiety and build resilience throughout their lifetime. 

Adolescent connectedness: cornerstone for health and wellbeing.

Journal of Adolescent Wellbeing BMJ, 2022

Blum R W, Lai J, Martinez M, Jessee C.

The National Longitudinal Study of Adolescent Health in the United States, for example, found that adolescents who reported feeling connected to home or school at ages 12-17 years were as much as 66% less likely to experience health risk behaviors related to sexual health, substance use, and violence and to have better mental health in adulthood than less connected peers. Compared with less connected peers, adolescents who are connected to at least one parent experience fewer emotional problems, fewer suicide attempts, less conduct disorder, better school performance, higher self-esteem, and less involvement in violence and substance use. But the evidence is equally clear that family stress (as measured by parental unemployment, poverty, domestic violence, and substance abuse) undercuts parent-adolescent connectedness. Indicators of parent-adolescent connectedness include parents’ knowledge of the child’s friends and their parents, engagement in their adolescent’s learning, knowing their teachers, and monitoring academic performance. In addition, in families where connectedness is high adolescents feel that they can talk with their parents about concerns, turn to them for advice, feel close with at least one parent, and feel that their parents care about and understand them

Asthma

Active play exercise intervention in children with asthma: a PILOT STUDY.

Journal of BMJ Open, 2016

Westergren, T., Fegran, L., Nilsen, T., Haraldstad, K., Kittang, O. B., & Berntsen, S.

Children with asthma, particularly those who are newly diagnosed or have poor disease control, may be less physically active than healthy children. If untreated, up to 90% of children with asthma will experience symptoms of asthma following vigourous physical activity. Increasing physical fitness may increase exercise tolerance. This study involves a 6-week exercise intervention with children aged 10-12 years to determine if increased physical activity may be beneficial for children with asthma. The participants participated in 60 minutes of active play exercise twice weekly. The study found that the average attendance rate was 90%, children reported increased health-related quality of life, and the children reported no limitations by asthma or serious asthma attacks

Alternative Therapies, 2014

Journal of Training and Asthma 18

Tahan, F., Hatice, Gungor, E., & Bicici, E.

A randomized control trial study published in 2014 examined the beneficial effects of yoga on exercise-induced bronchoconstriction (EIB) which is marked by narrowing of airways during or after exercise, causing difficulty in breathing. In the study, asthmatic children aged 6-17 years old attended one-hour yoga training sessions twice per week for 3 months, where they performed breathing exercises, physical postures, and meditation. The research team observed a significant improvement in maximum forced expiratory volume 1% (FEV1%) fall following the yoga challenge. The study concluded that yoga can be a beneficial complementary therapy for children with asthma, especially when combined with medication

Diet and asthma, allergic rhinoconjunctivitis and atopic eczema symptom prevalence: an ecological analysis of the International Study of Asthma and Allergies in Childhood

Journal of European Respiratory, 2001

Ellwood P1, Asher MI, Björkstén B, Burr M, Pearce N, Robertson CF.

An observational study published in 2001 investigated the relationship between diet and the prevalence of asthma, allergic rhinoconjunctivitis, and atopic eczema symptoms. The participants were children from 56 countries around the world who were 13–14 years of age. The study found that a diet high in fruits and vegetables was associated with a lower prevalence of allergic rhinoconjunctivitis, and atopic eczema symptoms, while a diet in fast food was associated with a higher prevalence of these symptoms

Effect of a combined exercise program on physical fitness, lung function, and quality of life in patients with controlled asthma and exercise symptoms: A randomized controlled trial.

Journal of Pediatric Pulmonology, 2020

Sanz-Santiago, V., Diez-Vega, I., Santana-Sosa, E., Lopez Nuevo, C., Iturriaga Ramirez, T., Vendrusculo, F. M., Donadio, M. V. F., Villa Asensi, J. R., & Pérez-Ruiz, M.

A randomized control study published in 2020 investigated the benefits of exercise training for asthma. The participants were children and adolescents ages 7 to 17 years old who had a confirmed diagnosis of asthma. The study was conducted for 12 weeks involving exercise training, which included aerobic exercise, strength training, and stretching for 3 days a week for 60 minutes. Ventilatory threshold, peak oxygen consumption, and test duration presented greater improvements in the intervention group. Improvements were also observed in leg press, hamstring curl, high row, low row, and quadriceps leg extension.

Effect of fresh fruit consumption on lung function and wheeze in children.

Journal of European Respiratory, 1997

D G Cook, I M Casey, P H Whincup, O Papacosta, S Chirico, K R Bruckdorfer, M Walker. Thorax.

A cross-sectional study published in 1997 examined the relationship between fruit consumption and lung function in children. The participants were children ages 8-11 years old from England and Wales. The study found that forced expiratory volume in one second (FEV1) was positively associated with the frequency of fresh fruit consumption

Autism Spectrum Disorder

Comprehensive Nutritional and Dietary Intervention for Autism Spectrum Disorder—A Randomized, Controlled 12-Month Trial.

Journal of Nutrients, 2018

Adams, J. B., Audhya, T., Geis, E., Gehn, E., Fimbres, V., Pollard, E. L., Mitchell, J., Ingram, J., Hellmers, R., Laake, D., Matthews, J. S., Li, K., Naviaux, J. C., Naviaux, R. K., Adams, R. L., Coleman, D. M., & Quig, D. W.

A randomized control study published in 2018 investigated the effectiveness of a comprehensive nutritional and dietary intervention. Participants were children and adults with autism spectrum disorder (ASD) ages 3-58 years. The treatment began with administering a special vitamin/mineral supplement to participants, and additional treatments were added sequentially, including essential fatty acids, Epsom salt baths, carnitine, digestive enzymes, and a healthy gluten-free, casein-free, soy-free (HGCSF) diet. The study concluded that there was a significant improvement in nonverbal intellectual ability in participants who were given the dietary intervention (treatment group) compared to those that were not given the intervention (non-treatment group). The treatment group had significantly greater increases in carnitine, vitamins A, B2, B5, B6, B12, folic acid, and coenzyme Q10. 

A randomized trial to test the effectiveness of art therapy for children with asthma.

Journal of Allergy and Clinical Immunology, 2010

Anya Beebe, MA, LPC, Erwin W. Gelfand, MD, Bruce Bender

Art therapy has been used to help children cope with chronic illnesses but has not been tested with children who have asthma. In this randomized controlled trial with 22 children with asthma, the active art therapy group participated in 60-minute art therapy sessions once a week for 7 weeks. Sessions were designed for expression, discussion, and problem-solving in response to the emotional burden of chronic illness. Children were scored for problem-solving skills, communication, quality of life, and anxiety. The study concluded that children with asthma have decreased anxiety and increased quality of life. 

Constipation

Iyengar yoga for adolescents and young adults with irritable bowel syndrome.

Journal of Pediatric Gastroenterology and Nutrition, 2014

Evans S, Lung KC, Seidman LC, Sternlieb B, Zeltzer LK, Tsao JC.

A randomized control trial study published in 2015 investigated the effectiveness of Iyengar yoga as a complementary therapy for adolescents and young adults between 14 and 26 years of age with irritable bowel syndrome (IBS). The intervention included 75-minute Iyengar yoga sessions twice per week for 6 weeks and included a variety of yoga postures including breathing exercises and relaxation techniques. Relative to controls, adolescents (14–17 years) assigned to yoga reported significantly improved physical functioning, whereas young adults (18–26 years) assigned to yoga reported significantly improved IBS symptoms, global improvement, disability, psychological distress, sleep quality, and fatigue.

Preschool physical activity and functional constipation: the Generation R study.

Journal of Pediatric Gastroenterology and Nutrition, 2013

Driessen LM, Kiefte-de Jong JC, Wijtzes A, de Vries SI, Jaddoe VW, Hofman A, Raat H, Moll HA.

A cross-sectional observational study published in 2013 investigated the association between physical activity levels and functional constipation in 165 preschool-aged children from the Netherlands. The study found that higher levels of physical activity in preschool-aged children were associated with a lower risk of functional constipation. Specifically, children who were more physically active had a 31% lower risk of functional constipation compared to children who were less active. The study also found that the relationship between physical activity and functional constipation was stronger in girls than in boys.

Headaches

Headache, eating and sleeping behaviors and lifestyle factors in preadolescents and adolescents: preliminary results from an Italian population study

Journal of Neurological Science, 2012

F Moschiano, P Messina, D D'Amico, L Grazzi, F Frediani, G Casucci, F d'Onofrio, A Demurtas, E Beghi, G Bussone

A cross-sectional population-based study published in 2012 assessed the possible association between headaches and specific habits and lifestyle factors. Participants were preadolescent and adolescent students aged 8-17 years from Italy. Based on a self-administered questionnaire, the study found a clear association between headaches and irregular intake of meals (especially irregular breakfast), and sleep disturbance. Thus, a correction of eating and sleeping behaviours could support the management of young patients with headaches in clinical practice.

Relationship of childhood headaches with preferences in leisure time activities, depression, anxiety, and eating habits: A population-based, cross-sectional study

Journal of Cephalalgia, 2015

Ömer Bektaş 1, Cağatay Uğur 2, Zeynep Bıyıklı Gençtürk 3, Ayla Aysev 2, Özlem Sireli 2, Gülhis Deda 4

A cross-sectional study published in 2015 investigated the association between childhood headaches and various factors such as leisure time activities, depression, anxiety, and eating habits. Participants were children between the ages of 9 and 18 years from the Spanish region of La Rioja. The study found that the prevalence of recurrent headaches was 39.4% and the prevalence of migraine was 10.3%. Subjects with migraine mostly preferred sedentary activities and less exercise in their leisure time, compared to the general population. The conclusion was that children should be directed to engage in more physical activity to manage childhood headaches.

Primary headache in Italian early adolescents: correlation with stress and school social support

Journal of Epidemiologia e psichiatria sociale, 2006

Massimo Santinello, Alessio Vieno, Pier Antonio Battistella

A cross-sectional observational study published in 2006 investigated the relationship between primary headaches (i.e., migraine and tension-type headaches) and stress and school social support in early adolescents ages 11-15 years in Italy. In a self-administered questionnaire, the overall prevalence of frequent headaches (at least once a week) was 40.5%. Boys were found to be less at risk than girls and the prevalence increased with age. Moreover, school demands (positively) and teacher support (negatively) showed a significant association with the outcome of fewer primary headaches, highlighting the need to foster resilience in adolescents.

Type 1 Diabetes

Position of the Academy of Nutrition and Dietetics: Vegetarian Diets

Journal of the Academy of Nutrition and Dietetics, 2016

Vegetarian/vegan diets meet protein requirements with legumes and soy. Iron intake is similar, but lower serum ferritin is advantageous. Vegans need iodine sources to avoid iron deficiency. Zinc intake is mostly normal for vegetarians. Calcium and vitamin D intake may vary. Vitamin B-12 must be supplemented for vegans. Plant-based diets linked to lower BMI. Vegans show improved heart health, reduced diabetes risk, and lower cancer incidence. Processed red meat increases colorectal cancer risk. Bone density differences are insignificant. Vegetarian diets have lower environmental impact than meat-based diets. Replacing beef with beans reduces environmental footprint. Animal farms contribute significantly to water pollution.

Fruit and vegetable intake and risk of type 2 diabetes mellitus: meta-analysis of prospective cohort studies

BMJ, 2014

Min Li, Yingli Fan, Xiaowei Zhang, Wenshang Hou, Zhenyu Tang

WHO recommends over 400g of combined fruits and vegetables daily for T2 diabetes prevention. Green leafy vegetables (GLV) are suggested for their possible beneficial effect. Fruit intake is linked to lower diabetes risk, though not total intake. GLV increase could lower risk. Fiber-rich fruits/vegetables enhance insulin sensitivity, while antioxidants and magnesium in them protect against diabetes. Low energy density and fullness-inducing properties of fruits/vegetables prevent overeating and contribute to diabetes risk reduction.

Association of plasma biomarkers of fruit and vegetable intake with incident type 2 diabetes: EPIC-InterAct case-cohort study in eight european countries

BMJ, 2020

Ju-Sheng Zheng et al

Plasma vitamin C and carotenoids serve as biomarkers of fruit and vegetable intake. Meta-analysis reveals a positive link between intake and biomarker concentrations. UK study found higher plasma vitamin C associated with lower type 2 diabetes risk. Higher fruit/vegetable intake corresponds to higher biomarker levels. Increased intake reduces T2 diabetes risk by regulating weight, glucose-insulin balance, inflammation, and gut microbiota, regardless of recommended thresholds or supplement use.

Growth of Vegetarian Children: The Farm Study

Pediatrics, 1989

Joan M. O’Connell, MHS, Michael J. Dibley, MB BS, Janet Sierra, RN, Barbara Wallace PhD, James S. Marks, MD, MPH, and Ray Yip, MD, MPH

A study of 404 vegetarian children aged 4 months to 10 years living in The Farm community showed slightly lower weight for age data compared to reference population, with greater differences in height for age between 1-3 years. Vegan children's growth was similar to the reference population. In adult vegetarians, no significant differences were found in height and weight compared to control subjects. The growth of The Farm children, while somewhat lower than the reference population, did not display significant abnormalities.

Daily Intake and Acne Vulgaris: A Systematic Review and Meta-Analysis of 78,529 Children, Adolescents, and Young Adults

Nutrients, 2018

Christian R. Juhl, Helle K. M. Bergholdt, Iben M. Miller, Gregor B. E. Jemec, Jorgen K. Kanters, and Christina Ellervik

Acne, a common inflammatory skin disease, is influenced by sebum production driven by insulin-like growth factor (IGF-1) and androgens. Dairy intake, especially milk and cheese, is associated with higher odds of acne due to IGF-1 promotion. Acne prevalence varies by country, age, and obesity. A low-glycemic-load diet improves acne symptoms. Kitavan Islanders and Ache Hunter-Gatherers, who avoid dairy and high-glycemic foods, show no acne. Acne is linked to the modern mTORC1-driven diseases like obesity and insulin resistance.