Associations between lifestyle change during the COVID-19 pandemic and mental health in adolescents

BACKGROUND: It is unclear whether changes in physical activity or sugar consumption during the COronaVIrus Disease (COVID)-19 pandemic relate to later mental health among adolescents. This study identified profiles of change in physical activity and sugar consumption during the COVID-19 pandemic, and estimated associations between these profiles and later anxiety, depression and wellbeing among adolescents. METHODS: Data were from the EXIST cross-sectional pilot study conducted in schools in northeastern France, one year after the end of the first lockdown (May-June 2021). Adolescents provided data on lifestyle behavior changes during lockdown and mental health using self-report questionnaires. We used latent class analysis to identify profiles of change in physical activity and sugar consumption, and conducted multinomial logistic regression to estimate associations between these profiles, and mental health. RESULTS: Among 380 adolescents (52.5% male; 13.5±0.6 years), we identified four change profiles: 1) “increased physical activity and decreased sugar consumption” (21.8%), 2) “physical activity and sugar consumption stable over time” (36.1%), 3) “decreased physical activity and increased sugar consumption” (28.4%), and 4) “consistently low physical activity and stable sugar consumption over time” (13.7%). Compared to adolescents in profile 1, odds of depression one year after the end of the first lockdown were higher among adolescents in profile 3 (OR [95%CI]= 2.42[1.17; 4.99]) and profile 4 (OR = 3.16; [1.39; 7.19]). Associations were similar for wellbeing, but profiles were unrelated to anxiety. CONCLUSIONS: Unhealthy changes in physical activity and sugar consumption during the COVID-19 pandemic may have contributed to deteriorating later mental health of adolescents. Future studies should assess long-term effects of the pandemic on physical activity and sugar consumption, and whether any long-term changes are associated with adolescent mental health. KEY MESSAGES: • A total of 42% of adolescents experienced unhealthy changes in physical activity and sugar consumption during the COVID-19 pandemic. • Unhealthy changes in physical activity and sugar consumption during the COVID-19 pandemic may have contributed to deteriorating later mental health of adolescents.