The Role of Life Style Behaviors on Depressive Symptoms in Children during the COVID-19 Pandemic




Depressive symptoms, Fruit & vegetable, Physical activity, Screen time, COVID-19


Background: The lifestyle behaviors such as consumption of fruit and vegetables, along with time spent in physical activities and screen time are crucial for weight management, and improving these behaviors may be a key role in increasing mental health. This study aimed to investigate the role of lifestyle behaviors on depressive symptoms in children during the Covid-19 pandemic.

Methods: This was a descriptive correlational study. The statistical population included male and female elementary school students (grades 4-6) in public schools in the eastern cities of Mazandaran province in 2020, among which 530 people were selected by random cluster sampling. Data collection tools included questionnaires of children's physical activity, fruit and vegetable consumption, children's depression, Screen time, and socioeconomic status. Data were analyzed using Mann-Whitney U, Kruskal-Wallis, Spearman correlation coefficient, and multiple linear regression tests.

Results: The findings showed that just 13.3% of children had sufficient consumption of fruits and vegetables and 57.6% of students sufficient physical activity did not addition, screen time was increased with age and be more in females. Regression analysis showed that the consumption of fruits and vegetables and physical activity both have the inverse effect on depressive symptoms, with the coefficient of effect -0.191 and -0.21 respectively; while screen time has a positive effect with an effective coefficient of 0.25 (Pvalue<0.05).

Conclusion: It seems that in addition to physical activity and consumption of fruits and vegetables, the important role of Screen time in the design of interventions to promote mental health in children, especially during the outbreak of Covid-19 should be considered.

Keywords: Depressive symptoms, Fruit and vegetable, Physical activity, Screen time, COVID-19.


1. Shen K, Yang Y, Wang T, Zhao D, Jiang Y, Jin R, Zheng Y, Xu B, Xie Z, Lin L, Shang Y. Diagnosis, treatment, and prevention of 2019 novel coronavirus infection in children: experts’ consensus statement. World journal of pediatrics. 2020 Jun; 16(3):223-31.
2. Pombo A, Luz C, Rodrigues LP, Ferreira C, Cordovil R. Correlates of children's physical activity during the COVID-19 confinement in Portugal. Public Health. 2020 Dec 1; 189:14-9.
3. Lange KW, Nakamura Y. Lifestyle factors in the prevention of COVID-19. Global Health Journal. 2020 Nov 9.
4. Rocha, N. P., Milagres, L. C., Longo, G. Z., Ribeiro, A. Q., & Novaes, J. F. D. Association between dietary pattern and cardiometabolic risk in children and adolescents: a systematic review. Jornal de pediatria. 2017: 93(3), 214-222.
5. Donnelly, J. E., Hillman, C. H., Castelli, D., Etnier, J. L., Lee, S., Tomporowski, P. & Szabo-Reed, A. N. Physical activity, fitness, cognitive function, and academic achievement in children: a systematic review. Medicine and science in sports and exercise. 2016: 48(6), 1197.
6. Pescatello, L.S., Arena, R., Reibe, D., & Tompson, P. (2014). ACSM’s guidelines for exercise testing and prescription. 9th Ed. Lippincott Williams & Wikins.
7. Batista, M. B., Romanzini, C. L. P., Barbosa, C. C. L., Blasquez Shigaki, G., Romanzini, M., & Ronque, E. R. V. Participation in sports in childhood, adolescence, and physical activity in adulthood: A systematic review. Journal of sports sciences. 2019: 37(19), 2253-2262.
8. Dunton GF, Do B, Wang SD. Early effects of the COVID-19 pandemic on physical activity and sedentary behavior in children living in the US. BMC Public Health. 2020 Dec; 20(1):1-3.
9. Wang, X., Ouyang, Y., Liu, J., Zhu, M., Zhao, G., Bao, W., & Hu, F. B. Fruit and vegetable consumption and mortality from all causes, cardiovascular disease, and cancer: systematic review and dose-response meta-analysis of prospective cohort studies. Bmj. 2014: 349, g4490.
10. World Health Organization (WHO). Promoting fruit and vegetable consumption around the world. Available from: 2019.
11. Daly, C. M., Foote, S. J., & Wadsworth, D. D. Physical Activity, Sedentary Behavior, Fruit and Vegetable Consumption and Access: What Influences Obesity in Rural Children?. Journal of community health. 2017: 42(5), 968-973.
12. Faienza, M. F., Wang, D. Q., Frühbeck, G., Garruti, G., & Portincasa, P. The dangerous link between childhood and adulthood predictors of obesity and metabolic syndrome. Internal and emergency medicine. 2016: 11(2), 175-182.
13. Morrison, K. M., Shin, S., Tarnopolsky, M., & Taylor, V. H. Association of depression & health related quality of life with body composition in children and youth with obesity. Journal of affective disorders. 2015: 172, 18-23.
14. Wang G, Zhang Y, Zhao J, Zhang J, Jiang F. Mitigate the effects of home confinement on children during the COVID-19 outbreak. The Lancet. 2020 Mar 21; 395(10228):945-7.
15. Ghosh R, Dubey MJ, Chatterjee S, Dubey S. Impact of COVID-19 on children: special focus on the psychosocial aspect. Minerva Pediatrica. 2020 Jun 1; 72(3):226-35.
16. Lissak G. Adverse physiological and psychological effects of screen time on children and adolescents: literature review and case study. Environ Res. 2018; 164:149-157.
17. Huang Y, Li L, Gan Y, Wang C, Jiang H, Cao S, Lu Z. Sedentary behaviors and risk of depression: a meta-analysis of prospective studies. Translational psychiatry. 2020 Jan 22;10(1):1-10.
18. Ahn, S., & Fedewa, A. L. A meta-analysis of the relationship between children’s physical activity and mental health. Journal of pediatric psychology. 2011: 36(4), 385-397.
19. Rodriguez-Ayllon, M., Cadenas-Sanchez, C., Estevez-Lopez, F., Munoz, N. E., Mora-Gonzalez, J., Migueles, J. H., ... & Catena, A. Role of physical activity and sedentary behavior in the mental health of preschoolers, children and adolescents: a systematic review and meta-analysis. Sports medicine. 2019: 1-28.
20. Ocean, N., Howley, P., & Ensor, J. Lettuce be happy: A longitudinal UK study on the relationship between fruit and vegetable consumption and well-being. Social Science & Medicine. 2019: 222, 335-345.
21. Lange KW. Diet, exercise, and mental disorders − public health challenges of the future. Mov Nutr Health Dis. 2018: 2, 39-59.
22. Hosseini, M., Carpenter, R. G., Mohammad, K., & Jones, M. E. Standardized percentile curves of body mass index of Iranian children compared to the US population reference. International journal of obesity. 1999: 23(8), 783-786.
23.Yu, H. J., Li, F., Hu, Y. F., Li, C. F., Yang, X. H., Yuan, S., ... & He, Q. Q. Associations of physical activity and fruit and vegetable intake with well-being and depressive symptoms among obese schoolchildren in Wuhan, China: a cross-sectional study. BMC public health. 2018:18(1), 986.
24. Biddle, S. J., Ciaccioni, S., Thomas, G., & Vergeer, I. Physical activity and mental health in children and adolescents: An updated review of reviews and an analysis of causality. Psychology of Sport and Exercise. 2019: 42, 146-155.
25. Saghafian, F., Malmir, H., Saneei, P., Milajerdi, A., Larijani, B., & Esmaillzadeh, A. Fruit and vegetable consumption and risk of depression: accumulative evidence from an updated systematic review and meta-analysis of epidemiological studies. British journal of nutrition. 2018: 119(10), 1087-1101.
26. Kingsbury, M., Dupuis, G., Jacka, F., Roy-Gagnon, M. H., McMartin, S. E., & Colman, I. Associations between fruit and vegetable consumption and depressive symptoms: evidence from a national Canadian longitudinal survey. J Epidemiol Community Health. 2016: 70(2), 155-161.
27. Wallace, T. C., Bailey, R. L., Blumberg, J. B., Burton-Freeman, B., Chen, C. O., Crowe-White, K. M., ... & Murray, R. Fruits, vegetables, and health: A comprehensive narrative, umbrella review of the science and recommendations for enhanced public policy to improve intake. Critical reviews in food science and nutrition. 2020: 60(13), 2174-2211.
28. Rooney, C., McKinley, M. C., & Woodside, J. V. The potential role of fruit and vegetables in aspects of psychological well-being: a review of the literature and future directions. Proceedings of the Nutrition Society. 2013: 72(4), 420-432.
29. Brazendale K, Beets MW, Weaver RG, Pate RR, Turner-McGrievy GM, Kaczynski AT, Chandler JL, Bohnert A, von Hippel PT. Understanding differences between summer vs. school obesogenic behaviors of children: the structured days hypothesis. International Journal of Behavioral Nutrition and Physical Activity. 2017 Dec; 14(1):1-4.
30. Calcaterra V, Vandoni M, Pellino VC, Cena H. Special attention to diet and physical activity in children and adolescents with obesity during the coronavirus disease-2019 pandemic. Frontiers in Pediatrics. 2020 Jun 26; 8:407.
31. Fegert JM, Vitiello B, Plener PL, Clemens V. Challenges and burden of the Coronavirus 2019 (COVID-19) pandemic for child and adolescent mental health: a narrative review to highlight clinical and research needs in the acute phase and the long return to normality. Child and adolescent psychiatry and mental health. 2020 Dec; 14:1-1.







How to Cite

The Role of Life Style Behaviors on Depressive Symptoms in Children during the COVID-19 Pandemic. (2021). International Journal of Health Studies, 8(1), 1-5.