A new analysis finds that children who eat healthfully are more likely to be happy, and those who are happy are more likely to eat healthfully. Interestingly, these links were independent of weight.

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Childhood weight and well-being appear to be linked.

Childhood overweight and obesity is a growing problem in the United States and elsewhere.

Around 1 in 3 U.S. children and teenagers are overweight or obese. Levels have, worryingly, tripled since the 1970s.

Being overweight often goes with a number of health problems, but it also has psychological effects. Children who are overweight are more prone to low self-esteem, negative body image, and depression.

Due to the size of this issue, much research is focused on trying to understand the psychology behind becoming overweight, as well as on the impact of being overweight on children’s psychological well-being.

One such study is the Identification and Prevention of Dietary- and Lifestyle-Induced Health Effects in Children and Infants Study. This prospective cohort study was set up with the aim of preventing obesity in children and understanding the factors that contribute to it.

Recently, a team from the Sahlgrenska Academy of the University of Gothenburg in Sweden used data from this study to look at the links between psychological well-being and weight in children.

The study included 7,675 children aged 2–9 from eight European countries. These were Belgium, Cyprus, Estonia, Germany, Hungary, Italy, Spain, and Sweden.

At the start of the study, parents completed a questionnaire that detailed how often specific foods were eaten each week. There were 43 food items to choose from in total.

From all of this information, every child was assigned a Healthy Dietary Adherence Score (HDAS). The HDAS score captures information about the child’s adherence to a healthful diet. It takes into account behaviors such as avoiding sugary and fatty foods and eating fresh vegetables and fruit.

Also, the children’s well-being was assessed at the start and end of the 2-year trial period. This included information regarding self-esteem, emotional problems, and relationships with parents and peers. Height and weight were also captured at the start and end of the study.

Once the data had been analyzed, a clear pattern emerged, linking diet to psychological well-being. The findings were recently published in the journal BMC Public Health.

“We found that in young children aged 2–9 years, there is an association between adherence to healthy dietary guidelines and better psychological well-being, which includes fewer emotional problems, better relationships with other children, and higher self-esteem, 2 years later,” says corresponding study author Dr. Louise Arvidsson.

Our findings suggest that a healthy diet can improve well-being in children.”

Dr. Louise Arvidsson

The authors report that higher levels of self-esteem at the start of the study were associated with a higher HDAS after 2 years, and that the associations between HDAS and well-being were not affected by the child’s weight, which was unexpected.

Dr. Arvidsson says, “It was somewhat surprising to find that the association between baseline diet and better well-being 2 years later was independent of children’s socioeconomic position and their body weight.”

The current study is the first to have examined links between HDAS scores and well-being.

They also found that eating 2–3 portions of fish per week was associated with better self-esteem, as well as no emotional problems or issues with peers. Consuming wholemeal products was also linked with an absence of peer problems.

Interestingly, the associations went in both directions. For instance, children with a better sense of well-being ate fruits, fats, and sugars in line with recommendations, and those with better self-esteem had lower sugar intakes.

As other researchers have suggested, emotions can regulate eating and eating can regulate emotions.

The findings are interesting, but, as ever, the researchers mention some limitations. The study was observational and relied on self-reported data, for example, meaning that cause and effect cannot be ascertained.

Also, the children with poorer diets and lower self-esteem were more likely to drop out of the study, making conclusions a little less easy to draw.

More work needs to be done. As Dr. Arvidsson says, “The associations we identified here need to be confirmed in experimental studies including children with clinical diagnosis of depression, anxiety, or other behavioral disorders rather than well-being as reported by parents.”

Because obesity in children is such an urgent issue, no doubt further studies will be waiting in the wings.