TY  - JOUR
AU  - Li, Huilun
AU  - Lu, Zhaohui
AU  - Zhang, Erliang
AU  - Zhang, Jie
AU  - Cui, Shuheng
AU  - Takahashi, Masaki
AU  - Xiang, Mi
PY  - 2024
DA  - 2024/10/23
TI  - Meal Timing and Depression Among Chinese Children and Adolescents: Cross-Sectional Study
JO  - JMIR Public Health Surveill
SP  - e54275
VL  - 10
KW  - mental health
KW  - meal timing
KW  - chrononutrition
KW  - depression
KW  - mhealth
KW  - meal time
KW  - children
KW  - adolescent
KW  - cross-sectional study
KW  - China
KW  - schedule of meal
KW  - metabolic disorder
KW  - correlation
KW  - survey
KW  - breakfast skipping
KW  - food intake
KW  - daily eating
KW  - analysis
KW  - logistic regression
AB  - Background: Depression in children and adolescents is a rising concern in China. Dietary behavior is a critical determinant of mental health. Meal timing, or the schedule of meal consumption, has been related to several metabolic disorders. However, the effect of meal timing on mental health is scarce, particularly in children and adolescents who are in a critical period of physical and psychological development. Objective: This research examined the relationship between meal timing and depression in children and adolescents in China. Methods: Children and adolescents from grades 1 to 9 were recruited from 16 districts in Shanghai, China, from January 3 to January 21, 2020. Ten schools attended the study. A survey was distributed to the students and their parents to collect demographic and health-related information. Depression was measured by the Children’s Depression Inventory-Short Form. Breakfast consumption was analyzed as a binary outcome. Participants were defined as breakfast consumers if they never skipped breakfast during the week. They were otherwise defined as breakfast skippers if they skipped breakfast at least once per week. A similar categorization was applied to analyze food intake proximal to bed. Daily eating windows were calculated using the last food intake time frame—the first food intake time frame. Participants were classified into eating window groups of less than 10 hours, 10-12 hours, and more than 12 hours. A logistic regression model was used to compute the odds ratio (OR) and 95% CI. Results: A total of 6874 participants were included in the analysis. Participants who skipped breakfast were associated with a 2.70 times higher occurrence of depression (OR 2.70, 95% CI 2.24‐3.26; P<.001). The prevalence of depression was 1.28 times higher in participants who ate before bed than in those who never ate before bed (OR 1.28, 95% CI 1.08‐1.50; P<.001). The occurrence of depression was 1.37 times higher if the eating time window was shorter than 10 hours (OR 1.37, 95% CI 1.08‐1.73; P=.009) and 1.23 times higher if the eating time window was longer than 12 hours (OR 1.23, 95% CI 1.01‐1.50; P=.004). The lowest occurrence of depression was observed at 11.5 hours. Subgroup analysis showed that such relationships remained significant in adolescents aged 10 years or older. In children, only skipping breakfast was associated with a higher odds of depression (OR 2.77, 95% CI 1.94‐3.96; P<.001). Conclusions: Breakfast skipping and eating before bed significantly increase the occurrence of depression. The optimal daily eating window to lower the occurrence of depression is 11.5 hours in children and adolescents. Daily eating windows longer than 12 hours or shorter than 10 hours are associated with an elevated occurrence of depression. Current findings advocate evidence-based dietary strategies to prevent and treat depression in children and adolescents. 
SN  - 2369-2960
UR  - https://publichealth.jmir.org/2024/1/e54275
UR  - https://doi.org/10.2196/54275
DO  - 10.2196/54275
ID  - info:doi/10.2196/54275
ER  -