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Are Preschoolers in the US Meeting Healthy Behavior Goals?
Are Preschoolers in the US Meeting Healthy Behavior Goals?

Medscape

time15 hours ago

  • Health
  • Medscape

Are Preschoolers in the US Meeting Healthy Behavior Goals?

TOPLINE: Only about 20% of preschoolers in the US followed five to six healthy habits, with clear differences by socioeconomic factors and geographic location. Children who lived in homes with enough food, had safe neighborhoods, had parents with excellent or very good mental health, and often ate meals with their families were more likely to have healthy behaviors. METHODOLOGY: Researchers analyzed data from the 2021 and 2022 National Survey of Children's Health to assess factors related to healthy behavior among children aged 3-5 years in the US. A total of 23,123 children were included in the analysis, with data collected through parent or caregiver reports. Six healthy behaviors were examined: daily consumption of fruits, daily consumption of vegetables, no sugary drinks, frequent outdoor play, limited screen time, and adequate sleep. Logistic regression modeling was used to assess relationships between healthy behaviors and various characteristics of the child, family, and community. TAKEAWAY: The prevalence of healthy behaviors among preschoolers varied, with 32.4% not consuming sugary drinks and 65.3% consuming fruit daily. Only 20.3% of preschoolers engaged in five to six healthy behaviors. Black non-Hispanic, Hispanic, and Asian non-Hispanic children were less likely to engage in five to six healthy behaviors than White non-Hispanic children (adjusted prevalence rate ratio [aPRR], 0.38, 0.57, and 0.64, respectively; P < .05 for all). Children aged 3 years were more likely to engage in five to six healthy behaviors than those aged 5 years. Engagement in five to six healthy behaviors was more likely among children with parents with excellent or very good mental health (aPRR, 1.30), those living in safe neighborhoods (aPRR, 1.17), those living in homes with enough food (aPRR, 1.35), and those who ate meals with their families 4 or more days a week (aPRR, 1.70; P < .05 for all). State-level variations were substantial, with Vermont having the highest adjusted prevalence of preschoolers engaging in five to six healthy behaviors (36.2%) and Mississippi, the lowest (8.3%). IN PRACTICE: 'Study findings underscore the importance of the family context and the challenges families experience in supporting children's engagement in HBs [healthy behaviors], with fewer than half of preschoolers having no sugary beverages, limited screen time, or eating vegetables daily,' wrote the authors of the study. 'There are opportunities to promote healthy living among children across multiple domains of influence, including direct counseling, screening, and referral to community resources to meet basic needs, and supporting family-focused policies and programs,' they added. SOURCE: The study was led by Julie F. Donney, PhD, of the Office of Epidemiology and Research at the Maternal and Child Health Bureau, Health Resources and Services Administration in Rockville, Maryland. It was published online on July 14, 2025, in the American Journal of Preventive Medicine. LIMITATIONS: The design of the study made it difficult to determine if healthy behaviors were caused by certain factors. The link between family or community factors and healthy behaviors may be affected by unmeasured variables such as parenting styles or seasonal changes. Different definitions of healthy behaviors were not examined. DISCLOSURES: This study did not receive any specific funding. The authors declared having no conflicts of interest. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

Talk Therapy for Young Depressed Children Shown Effective
Talk Therapy for Young Depressed Children Shown Effective

Medscape

time03-07-2025

  • Health
  • Medscape

Talk Therapy for Young Depressed Children Shown Effective

A novel psychotherapeutic intervention for depression in preschoolers was associated with reduced use of psychotropics and intensive mental health services in preadolescence, a new study has found. The study was published in Journal of the American Academy of Child & Adolescent Psychiatry. 'The need to identify depression at the earliest possible developmental point has been increasingly recognized as early onset of depressive symptoms has been associated with increased severity of mental health sequelae into adolescence including future suicidality,' the study's first author Mei Elansary, MD, and her colleagues wrote. Elansary is an attending developmental behavioral pediatrician at Boston University School of Medicine, Boston. 'Earlier identification is also of interest due to the possibility that earlier intervention may be more effective with more powerful treatment responses,' the authors continued. Depression can be a chronic and relapsing condition with high incidence of comorbidities and can affect children as young as 3 years, according to Joan Luby, MD, chair of psychiatry at Washington University Medicine in St. Louis, Missouri. Prevalence rates of preschool-onset major depressive disorder in the US between 1% and 2% have been reported, similar to rates in school-aged children. Parent-Child Interaction Therapy-Emotion Development (PCIT-ED) pairs therapists with parent-child dyads to help improve the child's emotional awareness and expression, while working with parents to help them reinforce their child's positive behaviors. The aim is to mitigate early signs of depression in the child. The intervention was developed and tested in a randomly controlled trial, by Luby, who is also one of the authors of this PCIT-ED study. Previously, meta-analyses have shown that for depression among youth aged 4-18 years, psychotherapeutic interventions have had only a moderate effect across randomized-controlled trials. Although Luby previously demonstrated high rates of remission upon completion of the 18-week study in her randomly controlled trial of a PCIT-ED intervention in children aged between 3 and 6 years, data regarding longer-term outcomes have been lacking. To fill that gap, Elansary and her colleagues followed 105 trial participants — children between the ages of 8 and 12 years — (4 years after the trial's treatment completion) to find those who'd remitted and any evidence of decreased use of mental health services and psychotropic prescriptions compared with participants who'd not had a response to the treatment. More than two thirds of the participants were men (68.6%). Diagnostic interviews of the children and their primary caregivers were conducted to assess the children for any symptoms of major depressive disorder, such as guilt, sadness, aggression, and sleep problems. The investigators also examined parenting strategies and whether caregivers had depression. Elansary et al found there was a high rate of remission at preadolescence (57.1%). Those in remission at preadolescence had significantly lower rates of lifetime use of alpha agonist, antidepressant, and atypical antipsychotic medication as well as decreased utilization of intensive mental health interventions. Whether a child exhibited externalizing symptoms post-intervention predicted relapse. These included symptoms of diagnoses such asattention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder. Luby credited the enduring effect of this intervention to its effect on parent-child interactions. 'After the treatment ends, the parent continues to interact with the child with greater sensitivity, and that becomes a draw to the child,' Luby said in a media advisory. 'The truth is there's nothing a child wants more than a validating, nurturing caregiver.' One expert lauded the findings, noting that early childhood depression has tended to be overlooked. 'As a society, we might have thought that these children are too young to be depressed, and we might explain it with adverse childhood events or caregiver depression, but the research seems to suggest that this is a distinct problem which is not fully explained by these things and with real downstream consequences. The opportunity to intervene early is essential,' Carl Bryce, MD, told Medscape Medical News . Bryce is the chair of family medicine at Midwestern University's Abrazo Central Campus in Phoenix, Arizona. The implications for clinical practice, according to Bryce, are that primary care physicians need to be able to distinguish depression in young children from typical age-appropriate development, and that qualified mental health providers skilled in the evaluation and treatment of this population will need to be available. 'Every child needs a personal physician with whom parents can discuss any concerns, even mood symptoms at a very young age,' Bryce said. 'And children need effective treatments based on high-quality evidence that we can advocate for and guide them toward. This study is another step toward that future.'

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