Çocuk ve ergen psikiyatri polikliniğine başvuran olguların beden kitle indeksi, beslenme tutum ve davranışları: duygusal ve davranışsal sorunlarla ilişkisi

Year 2021, Volume: 14 Issue: 2, 402 - 415, 01.04.2021

Ömer Başay , Bürge Kabukcu Başay , Cihan Erbay Onur Coşkun Burçin Sağıroğlu

https://doi.org/10.31362/patd.852842

Cited By: 2

Abstract

Amaç: Çocuk ve ergenlerdeki ruhsal bozukluk belirtileriyle beden kitle indeksi ve beslenme tutum ve davranışları arasında ilişkiler bulunmaktadır. Bu çalışmanın amacı Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları polikliniklerine başvuran olguların beden kitle indeksi, beslenme tutum ve davranışlarını değerlendirmek ve bu tutum ve davranışlarla duygusal ve davranışsal sorunlar arasındaki ilişkiyi incelemektir.
Gereç ve yöntem: Çocuk ve ergen psikiyatrisi polikliniklerine başvuran 11-16 yaş arası 169 kişi çalışmaya katılmıştır. Katılımcıların içe yönelim ve dışa yönelim sorunları Güçler ve Güçlükler Anketi (GGA) Ergen Formu ile, beslenme tutum ve davranışları Beslenme Tutum Ölçeği (BTÖ) ve Beslenme Davranış Ölçeği (BDÖ) ile değerlendirilmiştir. Çalışmaya katılan gönüllülerin kilo ve boyları ölçülerek beden kitle indeksleri hesaplanmıştır.
Bulgular: Çalışmaya katılanların %9,5’i obez, %10,1’i aşırı kilolu, %65,5’si normal kilolu olarak saptanmıştır. BTÖ ve BDÖ toplam puan ortalamaları sırasıyla 8,29±2,85 ve -1,69±4,79’dir. BTÖ toplam puanı ile GGA davranış sorunları puanı (r=-,233, p=0,003); hiperaktivite puanı (r=-,344, p<0,001) ve toplam güçlük puanı (r=-,281 p<0,001) arasında negatif yönlü bir ilişki mevcuttur. BDÖ toplam puanı ile GGA sosyal davranışlar puanı arasında pozitif yönlü (r=,216, p=0,005) bir ilişki bulunmuştur.
Sonuç: Çocuk ve ergen psikiyatri polikliniklerine başvuran çocuk ve ergenlerde sağlıksız beslenme tutum ve davranışları fazladır. Dışa yönelim sorunları ve toplam duygusal-davranışsal güçlük arttıkça; sosyal davranışlar azaldıkça sağlıksız beslenme artmaktadır. Beslenme tutum ve davranışları ile psikiyatrik faktörlerin ilişkisinin belirlenmesi hem beslenme hem de ruhsal sorunların anlaşılması ve önlenmesi konusunda yol gösterici olabilir.

Keywords

diyet alışkanlıkları, içeyönelim sorunları, dışayönelim sorunları, ruh sağlığı

Supporting Institution

Yok

Project Number

Yok

Thanks

Çalışmaya katılmayı kabul eden çocuk ve ergenlere ve ailelerine teşekkür ederiz.

Body mass index, nutrition attitude and behavior of the cases who applied to child and adolescent psychiatry outpatients: the relation with emotional and behavioral problems

Abstract

Purpose: There are relationships between mental disorder symptoms in children and adolescents with body mass index, and nutritional attitudes and behaviors. The aim of this study was to evaluate the body mass index, nutritional attitudes and behaviors of the cases who admitted to child and adolescent psychiatry outpatient clinics and to examine the relationship between these attitudes and behaviors and emotional and behavioral problems.
Materials and methods: 169 subjects aged 11-16 years who applied to child and adolescent psychiatry outpatients participated in the study. Participants' internalizing and externalizing problems were evaluated with the Strength and Difficulties Questionnaire (SDQ) Adolescent Form, nutritional attitude and behaviors with Nutrition Attitude Scale (NAS) and Nutrition Behavior Scale (NBS). Body mass indexes were calculated by measuring the weight and height of the volunteers participating in the study.
Results: 9.5% of the participants in the study were found to be obese, 10.1% overweight and 65.5% normal weight. The total mean scores of NAS and NBS were 8.29±2.85 and -1.69±4.79, respectively. There was a negative correlation between total NAS score and SDQ behavioral problems score (r=-.233, p=0.003); hyperactivity score (r=-.344, p<0.001) and total difficulty score (r=-.281 p<0.001). A positive relationship was found between total NBS score and SDQ social behavior score (r=.216, p=0.005)
Conclusion: Children and adolescents who admitted to child and adolescent psychiatry outpatient clinics have many unhealthy eating attitudes and behaviors. Unhealthy nutrition increases as the externalizing problems and total emotional and behavioral difficulties increase and as the social behaviors decrease. Determining the relationship between nutritional attitudes and behaviors and psychiatric factors can be a guide for understanding and preventing both nutritional and mental problems.

Keywords

dietary habits, internalizing problems, externalizing problems, mental health

Project Number

Yok

References

• 1. WHO | Why does childhood overweight and obesity matter? Available at: https://www.who.int/news-room/q-a-detail/noncommunicable-diseases-childhood-overweight-and-obesity. Accessed December 14, 2020
• 2. Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: A systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384:766-781. https://doi.org/10.1016/S0140-6736(14)60460-8
• 3. Türkiye’de Obezitenin Görülme Sıklığı. Available at: https://hsgm.saglik.gov.tr/tr/obezite/turkiyede-obezitenin-gorulme-sikligi.html. Erişim tarihi 15 Aralık 2020
• 4. Gracious BL, Cook SR, Meyer AE, Chirieac MC, Malhi N, Fischetti AT, et al. Prevalence of overweight and obesity in adolescents with severe mental illness: A cross-sectional chart review. J Clin Psychiatry. 2010;71:949-954. https://doi.org/10.4088/JCP.09m05033gre
• 5. Vieweg WVR, Kuhnley LJ, Kuhnley EJ, Anum EA, Sood B, Pandurangi A, et al. Body mass index (BMI) in newly admitted child and adolescent psychiatric inpatients. Prog Neuro-Psychopharmacology Biol Psychiatry. 2005;29:511-515. https://doi.org/10.1016/j.pnpbp.2005.01.001
• 6. Erickson SJ, Robinson TN, Farish Haydel K, Killen JD. Are overweight children unhappy? Body mass index, depressive symptoms, and overweight concerns in elementary school children. Arch Pediatr Adolesc Med. 2000;154:931-935. https://doi.org/10.1001/archpedi.154.9.931
• 7. Britz B, Siegfried W, Ziegler A, Lamertz C, Herpertz-Dahlmann BM, Remschmidt H, et al. Rates of psychiatric disorders in a clinical study group of adolescents with extreme obesity and in obese adolescents ascertained via a population based study. Int J Obes. 2000;24:1707-1714. https://doi.org/10.1038/sj.ijo.0801449
• 8. Sagar R, Gupta T. Psychological Aspects of Obesity in Children and Adolescents. Indian J Pediatr. 2018;85:554-559. https://doi.org/10.1007/s12098-017-2539-2
• 9. Lamertz CM, Jacobi C, Yassouridis A, Arnold K, Henkel AW. Are obese adolescents and young adults at higher risk for mental disorders? A community survey. Obes Res. 2002;10:1152-1160. https://doi.org/10.1038/oby.2002.156
• 10. Wardle J, Williamson S, Johnson F, Edwards C. Depression in adolescent obesity: Cultural moderators of the association between obesity and depressive symptoms. Int J Obes. 2006;30:634-643. https://doi.org/10.1038/sj.ijo.0803142
• 11. Wardle J, Cooke L. The impact obesity on psychological well-being. Best Pract Res Clin Endocrinol Metab. 2005;19:421-440. https://doi.org/10.1016/j.beem.2005.04.006.
• 12. Sutaria S, Devakumar D, Yasuda SS, Das S, Saxena S. Is obesity associated with depression in children? Systematic review and meta-analysis. Arch Dis Child. 2019;104:64-74. https://doi.org/10.1136/archdischild-2017-314608
• 13. Xie B, Ishibashi K, Lin C, Peterson D V., Susman EJ. Overweight trajectories and psychosocial adjustment among adolescents. Prev Med (Baltim). 2013;57:837-843. https://doi.org/10.1016/j.ypmed.2013.09.008
• 14. Bjertnaes AA, Fossum IN, Oma I, Bakken KS, Arne T, Holten-Andersen MN. A Cross-Sectional Study of the Relationship Between Mental Health Problems and Overweight and Obesity in Adolescents. Front Public Heal. 2020;8:334. https://doi.org/10.3389/fpubh.2020.00334
• 15. Otçeken-Kurtaraner M. Obezitesi olan ve olmayan 14 - 17 yaş aralığındaki ergenlerin ruhsal süreçlerinin, beden algıları,aile özellikleri ve beslenme alışkanlıkları yönünden incelenmesi. Yayımlanmamış yüksek lisans tezi. İstanbul Bilim Üniversitesi, Sosyal Bilimler Enstitüsü, İstanbul, 2012.
• 16. Kivimäki M, Singh-Manoux A, Batty G, Shipley M, Singh-Manoux A. Common mental disorder and obesity ― Insight from 4 repeat measures over 19 years : The prospective Whitehall II cohort study. BMJ 2009;339:b3765. https://doi.org/10.1136/bmj.b3765
• 17. Kutlu R, Çivi S. Özel Bir İlköğretim Okulu Öğrencilerinde Beslenme Alışkanlıklarının Ve Beden Kitle İndekslerinin Değerlendirilmesi. Fırat Tıp Derg. 2009;14:18-24. 18. Moreno LA, Rodríguez G, Fleta J, Bueno-Lozano M, Lázaro A, Bueno G. Trends of dietary habits in adolescents. Crit Rev Food Sci Nutr. 2010;50:106-112. https://doi.org/10.1080/10408390903467480
• 19. Kann L, McManus T, Harris WA, Shanklin SL, Flint KH, Hawkins J, et al. Youth Risk Behavior Surveillance United States, 2015. MMWR Surveill Summ. 2016;65:1-174. https://doi.org/10.15585/mmwr.ss6506a1
• 20. Koca T, Akcam M, Serdaroglu F, Dereci S. Breakfast habits, dairy product consumption, physical activity, and their associations with body mass index in children aged 6–18. Eur J Pediatr. 2017;176:1251-1257. https://doi.org/10.1007/s00431-017-2976-y
• 21. Savige GS, Ball K, Worsley A, Crawford D. Food intake patterns among Australian adolescents. Asia Pac J Clin Nutr. 2007;16:738-747. https://doi.org/10.6133/apjcn.2007.16.4.22
• 22. Emmett PM, Jones LR. Diet, growth, and obesity development throughout childhood in the Avon Longitudinal Study of Parents and Children. Nutr Rev. 2015;73:175-206. https://doi.org/10.1093/nutrit/nuv054
• 23. León-Muñoz LM, García-Esquinas E, Soler-Vila H, Guallar-Castillón P, Banegas JR, Rodríguez-Artalejo F. Unhealthy eating behaviors and weight gain: A prospective study in young and middle-age adults. Obesity. 2016;24:1178-1184. https://doi.org/10.1002/oby.21477
• 24. Jacka FN, Rothon C, Taylor S, Berk M, Stansfeld SA. Diet quality and mental health problems in adolescents from East London: A prospective study. Soc Psychiatry Psychiatr Epidemiol. 2013;48:1297-1306. https://doi.org/10.1007/s00127-012-0623-5
• 25. Jacka FN, Kremer PJ, Berk M, de Silva-Sanigorski AM, Moodie M, Leslie ER, et al. A prospective study of diet quality and mental health in adolescents. PLoS One. 2011;6:24805. https://doi.org/10.1371/journal.pone.0024805
• 26. Jacka FN, Kremer PJ, Leslie ER, Berk M, Patton GC, Toumbourou JW, et al. Associations between diet quality and depressed mood in adolescents: Results from the Australian Healthy Neighbourhoods Study. Aust N Z J Psychiatry. 2010;44:435-442. https://doi.org/10.3109/00048670903571598
• 27. Kohlboeck G, Sausenthaler S, Standl M, Koletzko S, Bauer CP, Von Berg A, et al. Food intake, diet quality and behavioral problems in children: Results from the GINI-plus/LISA-plus studies. Ann Nutr Metab. 2012;60:247-256. https://doi.org/10.1159/000337552
• 28. Moon SJ, Kim JW, Kim HJ, Lee DK. Association between Dietary Habits and Mental Health in Korean Adolescents: A Study Based on the 10th (2014) Adolescent Health Behavior Online Survey. Korean J Fam Pract. 2017;7:66-71. https://doi.org/10.21215/kjfp.2017.7.1.66
• 29. Del-Ponte B, Quinte GC, Cruz S, Grellert M, Santos IS. Dietary patterns and attention deficit/hyperactivity disorder (ADHD): A systematic review and meta-analysis. J Affect Disord. 2019;252:160-173. https://doi.org/10.1016/j.jad.2019.04.061
• 30. Trapp GSA, Allen KL, Black LJ, Ambrosini GL, Jacoby P, Byrne S, et al. A prospective investigation of dietary patterns and internalizing and externalizing mental health problems in adolescents. Food Sci Nutr. 2016;4:888-896. https://doi.org/10.1002/fsn3.355
• 31. O’Neil A, Quirk SE, Housden S, Brennan SL, Williams LJ, Pasco JA, et al. Relationship between diet and mental health in children and adolescents: A systematic review. Am J Public Health. 2014;104:e31–e42. https://doi.org/10.2105/AJPH.2014.302110
• 32. Goodman R. The Strengths and Difficulties Questionnaire: a research note. J Child Psychol Psychiatry. 1997;38:581-586.
• 33. Güvenir T, Özbek A, Baykara B, Arkar H, Şentürk B, İncekaş S. Güçler Ve Güçlükler Anketi̇ni̇n (GGA) Türkçe Uyarlamasının Psi̇kometri̇k Özelli̇kleri̇. Çocuk ve Gençlik Ruh Sağliği Derg. 2008;15:65-74.
• 34. Arvidson C. Children’s Cardiovascular Health Promotion Attitude Scale: an Instrument Development . Denton, TX, USA.: Texas Woman’s University; 1990.
• 35. Haney MÖ, Bahar Z. Çocuk Kalp Sağlığını Geliştirme Tutum Ölçeği’nin Geçerlik ve Güvenirliği. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektron Derg. 2014;7:92-97.
• 36. Edmundson E, Parcel GS, Feldman HA, Elder J, Perry CL, Johnson CC, et al. The effects of the child and adolescent trial for cardiovascular health upon psychosocial determinants of diet and physical activity behavior. Prev Med (Baltim). 1996;25:442-454. https://doi.org/10.1006/pmed.1996.0076
• 37. Öztürk M, Erdoğan S. Çocukların beslenme alışkanlıklarının sağlık davranışı etkileşim modeline göre incelenmesi. Yayınlanmamış doktora tezi. İstanbul Üniversitesi Sağlık Bilimleri Enstitüsü, İstanbul, 2010.
• 38. Yılmaz A, Kocotaş S. Obesity Prevalence, Nutritional Behaviors and Physical Activity Levels in the Secondary School Students. J Public Heal Nurs. 2019;1:66-83.
• 39. Dündar C, Öz H. Obesity-related factors in Turkish school children. Sci World J. 2012;2012;5. https://doi.org/10.1100/2012/353485
• 40. Mannan M, Mamun A, Doi S, Clavarino A. Prospective associations between depression and obesity for adolescent males and females - A systematic review and meta-analysis of longitudinal studies. PLoS One. 2016;11:e0157240. https://doi.org/10.1371/journal.pone.0157240
• 41. Tronieri JS, Wurst CMC, Pearl RL, Allison KC. Sex Differences in Obesity and Mental Health. Curr Psychiatry Rep. 2017;19:29. https://doi.org/10.1007/s11920-017-0784-8.
• 42. Jensen KG, Correll CU, Rudå D, Klauber DG, Stentebjerg-Olesen M, Fagerlund B, et al. Pretreatment cardiometabolic status in youth with early-onset psychosis: Baseline results from the TEA trial. J Clin Psychiatry. 2017;78:e1035-46. https://doi.org/10.4088/JCP.15m10479
• 43. Goldstein BI, Blanco C, He JP, Merikangas K. Correlates of Overweight and Obesity Among Adolescents With Bipolar Disorder in the National Comorbidity Survey–Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry. 2016;55:1020-1026. https://doi.org/10.1016/j.jaac.2016.08.010
• 44. Li Y, Xie X, Lei X, Li Y, Lei X. Global prevalence of obesity, overweight and underweight in children, adolescents and adults with autism spectrum disorder, attention‐deficit hyperactivity disorder: A systematic review and meta‐analysis. Obes Rev. 2020;21:e13123. https://doi.org/10.1111/obr.13123
• 45. Muthuri SK, Francis CE, Wachira LJ, Leblanc AG, Sampson M, Onywera VO, et al. Evidence of an overweight/obesity transition among school-aged children and youth in Sub-Saharan Africa: a systematic review. PLoS One. 2014;9(3):e92846.
• 46. Metinoğlu İ, Pekol S, Metinoğlu Y, Üniversitesi K, Boyner F, Yüksekokulu S, et al. Kastamonu’da 10-12 Yaş Grubu Öğrencilerde Obezite Prevalansı ve Etkileyen Faktörler. Acıbadem Üniversitesi Sağlık Bilim Derg. 2012;3:117-123.
• 47. Uğuz AM, Bodur S. Konya il merkezindeki ergenlik öncesi ve ergen çocuklarda aşırı ağırlık ve şişmanlık durumunun demografik özelliklerle ilişkisi. Genel Tıp Derg. 2007;17:1-7.
• 48. Cagan O, Unsal A. Study Of The Relatıonshıp Between Nutrıtıonal Attıtude Of Prımary School Students And Chıld Feedıng Attıtude Of The Parents. Res Commun Pyschology, Psychiatry Behav. 2017;3:1-5.
• 49. Reynolds KD, Baranowski T, Bishop DB, Farris RP, Binkley D, Nicklas TA, et al. Patterns in Child and Adolescent Consumption of Fruit and Vegetables: Effects of Gender and Ethnicity across Four Sites. J Am Coll Nutr. 1999;18:248-254. https://doi.org/10.1080/07315724.1999.10718859
• 50. Wah CS. Gender differences in eating behaviour. Int J Bus Econ Man. 2016;4:116-121.
• 51. Galmiche M, Déchelotte P, Lambert G, Tavolacci MP. Prevalence of eating disorders over the 2000-2018 period: A systematic literature review. Am J Clin Nutr. 2019;109:1402-1413. https://doi.org/10.1093/ajcn/nqy342
• 52. Ivanova MR, Bakova D, Semerdjieva M, Torniova B, Tilov B, Raikova E. Disordered Eating Attitudes and Behaviors: Gender Differences in Adolescence and Young Adulthood. J Womens Heal Care. 2017;06:368. https://doi.org/10.4172/2167-0420.1000368
• 53. Keskin K, Alpkaya U, Çubuk A, Öztürk Y, lisans Y, Üniversitesi M, ve ark. 2-14 Yaş Çocukların Fiziksel Aktivite Düzeyleri ile Beslenme Davranışları Arasındaki İlişkinin İncelenmesi. İÜ Spor Bilimleri Dergisi 2017;7:34-43.
• 54. Akil M, Top E. Obesity Awareness and Nutrition Behavior of Children Students in Uşak Province, Republic of Turkey. J Gizi dan Pangan. 2019;14:1-8. https://doi.org/10.25182/jgp.2019.14.1.1-8
• 55. Cetinkaya AC, Tayhan A, Özmen D, Uyar F. Beden Kitle İndeksleri Ve Beden Algılarına Göre Adölesanların Yaşam Biçimlerinin İncelenmesi. Anadolu Hemşirelik ve Sağlık Bilim Derg. 2017;20:160-169.
• 56. Yıldırım S, Uskun E, Kurnaz M. Bir İl Merkezinde Liselerde Eğitim Gören Öğrencilerin Yeme Tutumları ve İlişkili Faktörler. J Pediatr Res. 2017;4:149-155. https://doi.org/10.4274/jpr.97659
• 57. Popkin, B. M., & Gordon-Larsen, P. (2004). The nutrition transition: worldwide obesity dynamics and their determinants. Int J Obes Relat Metab Disord. 2004 ;28 (Suppl 3):2-9. https://doi.org/10.1038/sj.ijo.0802804.
• 58. Tanrıverdi D, Savaş E, Gönüllüoğlu N, Kurdal E, Balık G, Üniversitesi G, et al. Lise Öğrencilerinin Yeme Tutumları, Yeme Davranışları ve Benlik Saygılarının İncelenmesi Determination of High School Students’ Eating Attitudes, Eating Behavior and Self-Esteem. Gaziantep Med J Gaziantep Tıp Derg. 2011;17:33-39.
• 59. Monzani A, Ricotti R, Caputo M, Solito A, Archero F, Bellone S, et al. A Systematic Review of the Association of Skipping Breakfast with Weight and Cardiometabolic Risk Factors in Children and Adolescents. What Should We Better Investigate in the Future? Nutrients. 2019;11:387-410. https://doi.org/10.3390/nu11020387
• 60. Adolphus K, Lawton CL, Champ CL, Dye L. The effects of breakfast and breakfast composition on cognition in children and adolescents: A systematic review. Adv Nutr. 2016;7:590-612. https://doi.org/10.3945/an.115.010256
• 61. Zipp A, Eissing G. Studies on the influence of breakfast on the mental performance of school children and adolescents. J Public Heal. 2019;27:103-110. https://doi.org/10.1007/s10389-018-0926-4
• 62. Aygün Ö, Karayağız Muslu G. Vegetable and Fruit Consumption Behaviours of Secondary and High School Students. Turkish J Fam Med Prim Care. 2017;11:245-255. https://doi.org/10.21763/tjfmpc.359809
• 63. Erdoğan EG, Akın B. The relationship of body mass indexs in high school students with socio demographic and nutritional characteristics. J Hum Sci. 2017;14:1571-1589. 64. Savaşhan Ç, Sarı O, Aydoğan Ü, Erdal M. İlkokul çağındaki çocuklarda obezite görülme sıklığı ve risk faktörleri. Araştırma Türk Aile Hek Derg. 2015;19:14-21. https://doi.org/10.15511/tahd.15.01014
• 65. Holubcikova J, Kolarcik P, Madarasova Geckova A, Van Dijk JP, Reijneveld SA. Lack of parental rule-setting on eating is associated with a wide range of adolescent unhealthy eating behaviour both for boys and girls. BMC Public Health. 2016;16:359-367. https://doi.org/10.1186/s12889-016-3002-4
• 66. Agranat-Meged AN, Deitcher C, Goldzweig G, Leibenson L, Stein M, Galili-Weisstub E. Childhood obesity and attention deficit/hyperactivity disorder: A newly described comorbidity in obese hospitalized children. Int J Eat Disord. 2005;37:357-359. https://doi.org/10.1002/eat.20096
• 67. Luppino FS, De Wit LM, Bouvy PF, Stijnen T, Cuijpers P, Penninx BWJH, et al. Overweight, obesity, and depression: A systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry. 2010;67:220-229. https://doi.org/10.1001/archgenpsychiatry.2010.2.
• 68. Ren L, Xu Y, Guo X, Zhang J, Wang H, Lou X, et al. Body image as risk factor for emotional and behavioral problems among Chinese adolescents. BMC Public Health. 2018;18:1179-1189. https://doi.org/10.1186/s12889-018-6079-0
• 69. ter Bogt TFM, van Dorsselaer SAFM, Monshouwer K, Verdurmen JEE, Engels RCME, Vollebergh WAM. Body Mass Index and Body Weight Perception as Risk Factors for Internalizing and Externalizing Problem Behavior Among Adolescents. J Adolesc Heal. 2006;39:27-34. https://doi.org/10.1016/j.jadohealth.2005.09.007
• 70. Archero F, Ricotti R, Solito A, Carrera D, Civello F, Di Bella R, et al. Adherence to the Mediterranean Diet among School Children and Adolescents Living in Northern Italy and Unhealthy Food Behaviors Associated to Overweight. Nutrients. 2018;10:1322. https://doi.org/10.3390/nu10091322
• 71. Yannakoulia M, Brussee SE, Drichoutis AC, Kalea AZ, Yiannakouris N, Matalas AL, et al. Food Consumption Patterns in Mediterranean Adolescents: Are There Differences between Overweight and Normal-Weight Adolescents? J Nutr Educ Behav. 2012;44:233-239. https://doi.org/10.1016/j.jneb.2010.02.005
• 72. Oellingrath IM, Svendsen M V., Hestetun I. Eating patterns and mental health problems in early adolescence - A cross-sectional study of 12-13-year-old Norwegian schoolchildren. Public Health Nutr. 2013;17:2554-2562. https://doi.org/10.1017/S1368980013002747
• 73. Øverby N, Høigaard R. Diet and behavioral problems at school in Norwegian adolescents. Food Nutr Res. 2012;56:e17231. https://doi.org/10.3402/fnr.v56i0.17231
• 74. Howard AL, Robinson M, Smith GJ, Ambrosini GL, Piek JP, Oddy WH. ADHD is associated with a ‘Western’ dietary pattern in adolescents. J Atten Disord. 2011;15:403-411. https://doi.org/10.1177/1087054710365990
• 75. San Mauro Martín I, Blumenfeld Olivares JA, Garicano Vilar E, Echeverry López M, García Bernat M, Quevedo Santos Y, et al. Nutritional and environmental factors in attention-deficit hyperactivity disorder (ADHD): A cross-sectional study. Nutr Neurosci. 2018;21:641-647. https://doi.org/10.1080/1028415X.2017.1331952
• 76. Rios-Hernandez A, Alda JA, Farran-Codina A, Ferreira-Garcia E, Izquierdo-Pulido M. The mediterranean diet and ADHD in children and adolescents. Pediatrics. 2017;139:e20162027. https://doi.org/10.1542/peds.2016-2027
• 77. Nigg JT, Johnstone JM, Musser ED, Long HG, Willoughby M, Shannon J. Attention-deficit/hyperactivity disorder (ADHD) and being overweight/obesity: New data and meta-analysis. Clin Psychol Rev. 2016;43:67-79. https://doi.org/: 10.1016/j.cpr.2015.11.005
• 78. Brandley ET, Holton KF. Breakfast Positively Impacts Cognitive Function in College Students With and Without ADHD. Am J Heal Promot. 2020;34:668-671. https://doi.org/10.1177/0890117120903235
• 79. Khalid S, Williams CM, Reynolds SA. Is there an association between diet and depression in children and adolescents? A systematic review. Br J Nutr. 2016;116:2097-2108. https://doi.org/10.1017/S0007114516004359.
• 80. Kim TH, Choi J young, Lee HH, Park Y. Associations between Dietary Pattern and Depression in Korean Adolescent Girls. J Pediatr Adolesc Gynecol. 2015;28:533-537. https://doi.org/10.1016/j.jpag.2015.04.005
• 81. Zahedi H, Kelishadi R, Heshmat R, Motlagh ME, Ranjbar SH, Ardalan G, et al. Association between junk food consumption and mental health in a national sample of Iranian children and adolescents: The CASPIAN-IV study. Nutrition. 2014;30:1391-1397. https://doi.org/10.1016/j.nut.2014.04.014
• 82. Hong SA, Peltzer K. Dietary behaviour, psychological well-being and mental distress among adolescents in Korea. Child Adolesc Psychiatry Ment Health. 2017;11:56-68. https://doi.org/10.1186/s13034-017-0194-z
• 83. Renzaho AMN, Kumanyika S, Tucker KL. Family functioning, parental psychological distress, child behavioural problems, socio-economic disadvantage and fruit and vegetable consumption among 4-12 year-old Victorians, Australia. Health Promot Int. 2011;26:263-275. https://doi.org/10.1093/heapro/daq054
• 84. Buja A, Grotto G, Brocadello F, Sperotto M, Baldo V. Primary school children and nutrition: lifestyles and behavioral traits associated with a poor-to-moderate adherence to the Mediterranean diet. A cross-sectional study. Eur J Pediatr. 2020;179:827-834. https://doi.org/10.1007/s00431-020-03577-9
• 85. Farhangi MA, Dehghan P, Jahangiry L. Mental health problems in relation to eating behavior patterns, nutrient intakes and health related quality of life among Iranian female adolescents. PLoS One. 2018;13: e0195669. https://doi.org/10.1371/journal.pone.0195669
• 86. Bou Khalil R, Fares N, Saliba Y, Tamraz J, Richa S. The effect of methylphenidate on appetite and weight. Encephale. 2017;43:577-581. https://doi.org/10.1016/j.encep.2017.01.007
• 87. Correll CU, Manu P, Olshanskiy V, Napolitano B, Kane JM, Malhotra AK. Cardiometabolic risk of second-generation antipsychotic medications during first-time use in children and adolescents. JAMA - J Am Med Assoc. 2009;302:1765-1773. https://doi.org/10.1001/jama.2009.1549
• 88. Williamson VG, Dilip A, Dillard JR, Morgan-Daniel J, Lee AM, Cardel MI. The influence of socioeconomic status on snacking and weight among adolescents: A scoping review. Nutrients. 2020;12:167.