Associations between lifestyle behavior change during the COVID-19 pandemic and mental health among French adolescents: Insights from the EXIST pilot study

Background: It is unclear whether changes in physical activity (PA) or sugar consumption during the COVID-19 pandemic relate to mental health among adolescents. This study identified profiles of change in PA and sugar consumption during the COVID-19 pandemic, and estimated associations between these profiles and anxiety, depression and wellbeing among French adolescents. Methods: Data were from the cross-sectional school-based EXIST pilot study conducted one year after the end of the first lockdown. Adolescents provided data on lifestyle behavior changes and mental health during the pandemic using self-report questionnaires. We used latent class analysis to identify profiles of change in PA 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 PA and decreased sugar consumption" (21.8%), 2) "PA and sugar consumption stable over time" (36.1%), 3) "decreased PA and increased sugar consumption" (28.4%), and 4) "consistently low PA and stable sugar consumption over time" (13.7%). Compared to adolescents in profile 1, odds of depression 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: Unfavorable changes in PA and sugar consumption during the COVID-19 pandemic may have contributed to deteriorating adolescents' mental health. Future studies should assess long-term effects of the pandemic on PA and sugar consumption, and whether any long-term changes are associated with adolescent mental health.