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Abstract：
Our knowledge of associations between specific types of food and mental health problems in preschool children, an important developmental period, remains scarce. Using a large sample size and a brief measure, we aimed to examine associations between food groups and mental health problems in preschoolers.
A descriptive cross-sectional study was conducted among 19,548 preschoolers in nine counties in China using a two-stage cluster sampling method. Information on food frequencies, physical activity, sedentary behavior, and sleep conditions was collected by a parent-reported questionnaire. Mental health status was assessed by a parent-reported Strength and Difficulty Questionnaire (SDQ). Height and weight were measured, and BMI was calculated. Relationships between specific types of food groups and mental health status were examined using multivariable regression modeling.
Of the present study sample, 47.45% of children were girls. Boys had higher scores relating to total difficulties, conduct problems, hyperactivity, and peer problems than girls but lower scores in emotional symptoms and prosocial behavior. Children with more types of food categories tended to get lower SDQ total scores even after adjusting for confounding variables (p < 0.0001). The subscale scores of SDQ varied depending on the types and numbers of food consumed. Notably, boys\' mental health problems were more likely to be associated with their consumed food type. Processed meat frequency intake among boys and girls was positively related to prosocial behavior (Girls: pickled food: p = 0.003, fried food: p < 0.0001, barbecued food: p = 0.006, smoked food: p = 0.005; Boys: pickled food: p = 0.3, fried food: p < 0.0001, barbecued food: p = 0.006, smoked food: p = 0.005) and negatively associated with the SDQ total and the other subscale scores (Girls: pickled food: p ≤ 0.02, fried food: p ≤ 0.005 except for emotions (p = 0.1), barbecued food: p ≤ 0.047, smoked food: p ≤ 0.04 (except for emotions (p = 0.06) and conduct behaviors (p = 0.2)); Boys: pickled food: p < 0.01 except for hyperactivity (p = 0.5), fried food: p ≤ 0.005 except for emotions (p = 0.1), barbecued food: p ≤ 0.007 except for hyperactivity (p = 0.8), smoked food: p ≤ 0.001 except for hyperactivity (p = 0.1) and peer problem (p = 0.08)). Adequate intake frequency of confectionery (2-4 times/week) was beneficial to their emotions, conduct, and total difficulties and was also beneficial for peer and prosocial behavior for boys (Girls: emotions: p = 0.02, conduct: p = 0.02, hyperactivity: p = 0.4, peer: p = 0.06, total difficulties: p = 0.01, prosocial behavior: p = 0.1; Boys: emotions: p = 0.009, conduct: p = 0.0009, hyperactivity: p = 0.7, peer: p = 0.02: total difficulties: p = 0.003, prosocial behavior: p = 0.0002).
Diverse food categories and adequate frequency of confectionery were found to be beneficial for children\'s mental health, with the exception of processed meat. These findings provide novel information and supportive data for children\'s dietary guidelines and the improvement of mental health.
A descriptive cross-sectional study was conducted among 19,548 preschoolers in nine counties in China using a two-stage cluster sampling method. Information on food frequencies, physical activity, sedentary behavior, and sleep conditions was collected by a parent-reported questionnaire. Mental health status was assessed by a parent-reported Strength and Difficulty Questionnaire (SDQ). Height and weight were measured, and BMI was calculated. Relationships between specific types of food groups and mental health status were examined using multivariable regression modeling.
Of the present study sample, 47.45% of children were girls. Boys had higher scores relating to total difficulties, conduct problems, hyperactivity, and peer problems than girls but lower scores in emotional symptoms and prosocial behavior. Children with more types of food categories tended to get lower SDQ total scores even after adjusting for confounding variables (p < 0.0001). The subscale scores of SDQ varied depending on the types and numbers of food consumed. Notably, boys\' mental health problems were more likely to be associated with their consumed food type. Processed meat frequency intake among boys and girls was positively related to prosocial behavior (Girls: pickled food: p = 0.003, fried food: p < 0.0001, barbecued food: p = 0.006, smoked food: p = 0.005; Boys: pickled food: p = 0.3, fried food: p < 0.0001, barbecued food: p = 0.006, smoked food: p = 0.005) and negatively associated with the SDQ total and the other subscale scores (Girls: pickled food: p ≤ 0.02, fried food: p ≤ 0.005 except for emotions (p = 0.1), barbecued food: p ≤ 0.047, smoked food: p ≤ 0.04 (except for emotions (p = 0.06) and conduct behaviors (p = 0.2)); Boys: pickled food: p < 0.01 except for hyperactivity (p = 0.5), fried food: p ≤ 0.005 except for emotions (p = 0.1), barbecued food: p ≤ 0.007 except for hyperactivity (p = 0.8), smoked food: p ≤ 0.001 except for hyperactivity (p = 0.1) and peer problem (p = 0.08)). Adequate intake frequency of confectionery (2-4 times/week) was beneficial to their emotions, conduct, and total difficulties and was also beneficial for peer and prosocial behavior for boys (Girls: emotions: p = 0.02, conduct: p = 0.02, hyperactivity: p = 0.4, peer: p = 0.06, total difficulties: p = 0.01, prosocial behavior: p = 0.1; Boys: emotions: p = 0.009, conduct: p = 0.0009, hyperactivity: p = 0.7, peer: p = 0.02: total difficulties: p = 0.003, prosocial behavior: p = 0.0002).
Diverse food categories and adequate frequency of confectionery were found to be beneficial for children\'s mental health, with the exception of processed meat. These findings provide novel information and supportive data for children\'s dietary guidelines and the improvement of mental health.
摘要：
我们对学龄前儿童特定类型食物与心理健康问题之间关联的知识，一个重要的发展时期，仍然稀缺。使用大样本量和简短的测量，我们的目的是研究食物群体与学龄前儿童心理健康问题之间的关联。
使用两阶段整群抽样方法，对中国9个县的19,548名学龄前儿童进行了描述性横断面研究。关于食物频率的信息，身体活动,久坐的行为，睡眠状况由家长报告的问卷收集。通过父母报告的力量和困难问卷（SDQ）评估心理健康状况。测量身高和体重，计算BMI。使用多变量回归模型检查了特定类型的食物与心理健康状况之间的关系。
在本研究样本中，47.45%的儿童是女孩。男孩在总困难方面得分较高，行为问题,多动症,和同伴问题比女孩低，但在情感症状和亲社会行为方面得分较低。具有更多食物类型的儿童倾向于获得更低的SDQ总分，即使在调整混杂变量后也是如此（p<0.0001）。SDQ的子量表得分根据所消耗食物的类型和数量而变化。值得注意的是,男孩的心理健康问题更可能与他们食用的食物类型有关。男孩和女孩的加工肉类摄入频率与亲社会行为呈正相关（女孩：腌制食品：p=0.003，油炸食品：p<0.0001，烧烤食品：p=0.006，熏制食品：p=0.005；男孩：腌制食品：p=0.3，油炸食品：p<0.0001，烧烤食品：p=0.006，熏制食品：p=0.005），与Q值0.02呈负相关（油炸食品，其他p=0.1烧烤食品：p≤0.047，熏制食品：p≤0.04（除情绪（p=0.06）和行为行为（p=0.2））；男孩：腌制食品：p<0.01，除多动（p=0.5），油炸食品：除情绪外，p≤0.005（p=0.1），烧烤食物：p≤0.007，多动症除外（p=0.8），烟熏食品：除了多动症（p=0.1）和同伴问题（p=0.08）外，p≤0.001）。充足的糖果摄入频率（2-4次/周）有利于他们的情绪，行为,和总困难，也有利于男孩的同伴和亲社会行为（女孩：情绪：p=0.02，行为：p=0.02，多动：p=0.4，同伴：p=0.06，总困难：p=0.01，亲社会行为：p=0.1;男孩：情绪：p=0.009，行为：p=0.0009，多动：p=0.7，同伴：p=0.02：总困难：p=0.003，亲社会行为：
不同的食物种类和适当的糖果频率被发现有利于儿童的心理健康，除了加工肉。这些发现为儿童的饮食指南和心理健康的改善提供了新的信息和支持数据。
使用两阶段整群抽样方法，对中国9个县的19,548名学龄前儿童进行了描述性横断面研究。关于食物频率的信息，身体活动,久坐的行为，睡眠状况由家长报告的问卷收集。通过父母报告的力量和困难问卷（SDQ）评估心理健康状况。测量身高和体重，计算BMI。使用多变量回归模型检查了特定类型的食物与心理健康状况之间的关系。
在本研究样本中，47.45%的儿童是女孩。男孩在总困难方面得分较高，行为问题,多动症,和同伴问题比女孩低，但在情感症状和亲社会行为方面得分较低。具有更多食物类型的儿童倾向于获得更低的SDQ总分，即使在调整混杂变量后也是如此（p<0.0001）。SDQ的子量表得分根据所消耗食物的类型和数量而变化。值得注意的是,男孩的心理健康问题更可能与他们食用的食物类型有关。男孩和女孩的加工肉类摄入频率与亲社会行为呈正相关（女孩：腌制食品：p=0.003，油炸食品：p<0.0001，烧烤食品：p=0.006，熏制食品：p=0.005；男孩：腌制食品：p=0.3，油炸食品：p<0.0001，烧烤食品：p=0.006，熏制食品：p=0.005），与Q值0.02呈负相关（油炸食品，其他p=0.1烧烤食品：p≤0.047，熏制食品：p≤0.04（除情绪（p=0.06）和行为行为（p=0.2））；男孩：腌制食品：p<0.01，除多动（p=0.5），油炸食品：除情绪外，p≤0.005（p=0.1），烧烤食物：p≤0.007，多动症除外（p=0.8），烟熏食品：除了多动症（p=0.1）和同伴问题（p=0.08）外，p≤0.001）。充足的糖果摄入频率（2-4次/周）有利于他们的情绪，行为,和总困难，也有利于男孩的同伴和亲社会行为（女孩：情绪：p=0.02，行为：p=0.02，多动：p=0.4，同伴：p=0.06，总困难：p=0.01，亲社会行为：p=0.1;男孩：情绪：p=0.009，行为：p=0.0009，多动：p=0.7，同伴：p=0.02：总困难：p=0.003，亲社会行为：
不同的食物种类和适当的糖果频率被发现有利于儿童的心理健康，除了加工肉。这些发现为儿童的饮食指南和心理健康的改善提供了新的信息和支持数据。
