Young-HUNT Study Research Articles

Exploring the Link Between Physical Activity, Sports Participation, and Loneliness in Adolescents Before and Into the COVID-19 Pandemic: The HUNT Study, Norway

Background: The COVID-19 pandemic’s effects on adolescents’ physical activity, sports involvement, and feelings of loneliness remain inadequately understood. This study aimed to explore the shifts in leisure-time physical activity, sports participation, and loneliness among adolescents before and during the pandemic, positing that the pandemic has led to decreased physical activity and sports engagement, as well as heightened loneliness, where more active adolescents experience lower loneliness levels. This study included a prior four-year follow-up cohort from the same region two decades earlier to explore the existence of typical longitudinal aging effects in a cohort not affected by the pandemic. Methods: Prospective and longitudinal data from two cohorts of the Young-HUNT Study two decades apart involving adolescents aged 13–19 years were utilized. The controls were as follows: Cohort 1 from the Young-HUNT1 (YH1) Survey included 2399 adolescents with follow-up in the Young-HUNT2 (YH2) Survey four years later. Cohort 2 included the Young-HUNT4 (YH4) Survey (2017–2019) of 8066 adolescents, with a subset of 1565 participants followed up in the Young-HUNT COVID Survey (YHC) (2021) after exposure to the COVID-19 pandemic and associated restrictions. Changes over time were assessed using McNemar’s tests and dependent sample T-tests, while multinomial logistic regression modeled within-individual changes in loneliness, adjusting for age, gender, and other factors. Results: The findings revealed a significant decline in physical activity and sports participation in both cohorts from early to late adolescence. Additionally, there was a considerable increase in reported loneliness, more after exposure to the pandemic and especially among girls, but without any difference in historical initial levels (between cohorts). Inactive adolescents faced a greater risk of increased loneliness, while those participating in sports had a lower risk of loneliness. Physically inactive boys had a higher risk of loneliness compared with physically active boys at both time points in Cohort 2, which was higher than in the control Cohort 1. There was no historical difference between initial assessments. Conclusion: Adolescents experienced a significant decrease in physical activity and sports participation, along with increased loneliness, from early to late adolescence. Given the protective benefits of physical activity against loneliness and the negative longitudinal trends observed, public health initiatives should focus on increasing physical activity and reducing sports drop-out rates among adolescents to combat rising loneliness.

Correction: Aasan et al. The Relative Importance of Family, School, and Leisure Activities for the Mental Wellbeing of Adolescents: The Young-HUNT Study in Norway. Societies 2023, 13, 93

In the original publication [...]

Cohort Profile Update: The Young-HUNT Study, Norway.

Cohort Profile Update: The Young-HUNT Study, Norway.

Loneliness in the Norwegian adolescent population: prevalence trends and relations to mental and self-rated health

BackgroundLoneliness has become a significant public health problem and should be addressed with more research over a broader period. This study investigates the variations in the prevalence of loneliness among a nationally representative study population of Norwegian adolescents over the last three decades and whether age, gender, self-rated health, and mental distress are associated with these changes.MethodsAdolescents aged 13–19 years completed the structured and validated questionnaires from the three waves of the Young-HUNT Study: 1995–1997, 2006–2008, and 2017–2019. Loneliness was measured with one item asking, ‘Are you lonely?’. Hopkins Symptom Checklist-5 was used to measure mental distress (cut-off ≥ 2). Self-rated health was assessed by a single question ‘How is your health at the moment?’ Measures were provided by self-report. Descriptive analyses were stratified by age, gender, self-rated health, and mental distress. Linear-by-Linear association test across survey years was performed to test time trends of loneliness. Logistic regression was used to analyze the cross-sectional associations of self-rated health and mental distress with loneliness, adjusting for sociodemographic factors in all three waves of Young-HUNT.ResultsLoneliness prevalence doubled from 5.9% in 1995/97 to 10.2% in 2017/19 in the total population sample. The highest loneliness prevalence and an increase from 8.9% in 1995/97 to 16.7% in 2017/19 was observed in girls of 16–19 years. Among mentally distressed adolescents, loneliness increased from 22.3% in 1995/97 to 32.8% in 2006/08 and lowered to 27% in 2017/19. Increasing loneliness prevalence was seen in those with poor self-rated health, i.e., 14.6% in 1995-97 and 26.6% in 2017-19. Mental distress and poor self-rated health were associated with higher odds of loneliness in each wave (p < 0.001).ConclusionThe results highlight the increasing burden of loneliness in the Norwegian adolescent population, especially girls. Those with mental distress and poor self-rated health have a higher risk of experiencing loneliness. Thus, health-promoting upbringing environments for children and adolescents that support mutual affinity, social support, integration, and belongingness in adolescents’ daily arenas are essential.

Trends in social inequality and how mental wellbeing vary and covary among Norwegian adolescents and their families: the Young-HUNT Study.

The study had two aims: first, to investigate trends in socioeconomic inequalities in psychological distress and loneliness among Norwegian adolescents, and second, to study variation and covariation of psychological distress and loneliness within adolescents and between siblings within families. Multivariate mixed models were used to investigate trends in socioeconomic inequality in psychological distress and loneliness using three separate cohorts of Norwegian adolescents from the Young-HUNT study conducted in 1995-1997 (Young-HUNT1, n = 8980), 2006-2008 (Young-HUNT3, n = 8199) and 2017-2019 (Young-HUNT4, n = 8066). Register data on parental education level was used as a marker of socioeconomic position (SEP), and a unique family number was used to identify adolescents belonging to the same family. A three-level multivariate mixed model was created, consisting of the outcomes at level 1, adolescents at level 2 and families at level 3. No statistically significant difference in scores on loneliness and psychological distress was observed between low and high parental education level in Young-HUNT1, whereas in Young-HUNT4, low parental education level was associated with a higher score on both psychological distress (β = 0.09; 95% confidence interval (CI), 0.03-0.14) and loneliness (β = 0.12; 95% CI 0.07-0.17). Analyses of covariation between psychological distress and loneliness showed that they were correlated within adolescents and strongly correlated within families across all timepoints. Increasing socioeconomic inequalities in psychological distress and loneliness among Norwegian adolescents is worrisome. Further, the family seems to be an important arena for potential prevention of psychological distress and loneliness among adolescents, regardless of parental education level.

The Relative Importance of Family, School, and Leisure Activities for the Mental Wellbeing of Adolescents: The Young-HUNT Study in Norway

It is well-known that the social environment in which children and adolescents live and grow has an impact on their mental wellbeing, though the relative importance of different social contexts may vary. In the present study, we used data from the Young-HUNT4 survey in Norway (n = 8066, age range 13 to 19 years). Linear regression models were used to investigate the relative importance of family cohesion, school climate, and number of leisure activities on psychological distress, loneliness, and life dissatisfaction among Norwegian adolescents by investigating whether the strength of association varied across social contexts for the three outcomes. Additionally, analyses were stratified by parental education to investigate whether the relative importance of family, school, and leisure activities differed between adolescents from families with low and high parental education. We found that family cohesion showed the strongest association with all three outcomes, followed by the school climate and number of leisure activities. These associations did not vary significantly between low and high parental education. Understanding the relative importance of social contexts may be essential in developing effective public health policies and interventions in preventing mental ill health and promoting mental wellbeing in children and adolescents.

Exposure to traumatic events and use of over-the-counter analgesics in adolescents: cross-sectional findings from the Young-HUNT study

ObjectiveFrequent and increasing use of over-the-counter analgesics (OTCA) among adolescents is a public health concern. Prior research indicates that adolescents exposed to traumatic events may be at increased risk of...

Physical Activity and Depression/Anxiety Symptoms in Adolescents – the Young-HUNT Study

Children and adolescents who report mental health problems, such as depression and anxiety, has increased steadily in recent years. At the same time there is also a reduction in physical activity level among children and adolescents. The present study aimed to explore the association of physical activity and participation in sport activity with depression and anxiety symptoms stratified by sex and age group. Cohort data was obtained from the Trøndelag Health Study (Young-HUNT4). The analyses were based on cross-sectional data on 7,347 participants. Multinominal logistic regression models were used to estimate the association between physical activity and participation in sport activity with depressive/anxiety symptoms. The analyses showed that depression and anxiety symptoms increased with age and that girls were at an increased risk of developing depressive/anxiety symptoms than boys. For physical activity, the analyses suggested that inactive adolescents had a higher possibility of experiencing anxiety and depression symptoms than active adolescents. This applied for both girls (OR = 1.51, <em>p</em> &lt; 0.001) and boys (OR = 1.29, <em>p</em> = 0.037). For sport activity, adolescents with a low activity level had a higher probability of experiencing symptoms of anxiety and depression than adolescents with high activity level. This also applied to both girls (OR = 1.75, <em>p</em> &lt; 0.001) and boys (OR) = 1,55, <em>p</em> = 0.007). The study indicates that adolescents who are regularly physically active in sport activities have a lower possibility of experiencing symptoms of depression and anxiety than those who are physically less active.

Mental health problems in adolescence, first births, and union formation: Evidence from the Young HUNT Study.

While a large literature documents how mental health problems in adolescence have long-term consequences for adult socioeconomic outcomes, less is known about the relation with family-formation behavior. In this paper, we use data from a population based Norwegian health survey (the Young-HUNT study) linked to administrative registry data (N = 8,113) to examine the long-term consequences of symptoms of internalizing and externalizing problems, the two most common forms of mental health problems, on family-formation outcomes: the likelihood of a first birth, the union status of a first birth, and entering first marriage. For men, externalizing problems are associated with earlier parenthood, especially becoming a father without having a coresidential relationship with the child's mother. Internalizing problems, on the other hand, are associated with lower first-birth rates and the association grows progressively stronger with age. We also find that the associations are more pronounced among men with low childhood socioeconomic status. In contrast, women's family-formation appears for the most part unrelated to their mental health.

Physical activity and sport participation among adolescents: associations with mental health in different age groups. Results from the Young-HUNT study: a cross-sectional survey

ObjectivesKnowledge of how physical activity (PA) and sport participation are related to mental health throughout adolescence is scarce. Our objective was to describe PA levels and sport participation in a...

Adolescent Mental Health Problems, Behaviour Penalties, and Distributional Variation in Educational Achievement

Abstract Prior research shows that mental health problems are linked to worse student achievements in school, but few studies address whether the consequences of such problems vary by student achievement level and the role of teachers’ grading practices in these processes. In this study, I examine the relationship between mental health problems and grade achievement at the end of compulsory education using a population-based Norwegian health survey, the Young-HUNT study, matched with administrative data. The results show a robust negative influence of attention problems and conduct problems on average grade achievement, and a positive role of internalizing problems, in fixed-effects models controlling for unobserved characteristics of school context. Further, conduct problems are more strongly related with student achievement in the lower end of the grade distribution, indicating that low-achieving students are disproportionally affected by mental health problems. I also compare grades assigned by classroom teachers with anonymously graded exams, and find that part of the negative association between externalizing problems and achievement reflect a ‘behavioural penalty’ due to teacher-bias in grading practices.

The Impact of Diet During Adolescence on the Neonatal Health of Offspring: Evidence on the Importance of Preconception Diet. The HUNT Study

Background: Emerging evidence suggests that parents' nutritional status before and at the time of conception influences the lifelong physical and mental health of their child. Yet little is known about the relationship between diet in adolescence and the health of the next generation at birth. This study examined data from Norwegian cohorts to assess the relationship between dietary patterns in adolescence and neonatal outcomes. Methods: Data from adolescents who participated in the Nord-TrA¸ndelag Health Study (Young-HUNT) were merged with birth data for their offspring through the Medical Birth Registry of Norway (MBRN). Young-HUNT1 collected data from 8980 adolescents between 1995 and 1997. Linear regression was used to assess associations between adolescents' diet and later neonatal outcomes of their offspring adjusting for socio-demographic factors. Analyses were run separately for mother-offspring and father-offspring dyads. Analyses were also replicated with data from the Young-HUNT3 cohort (dietary data collected from 2006-08) and combined with Young-HUNT1 for pooled analyses. Findings: Young-HUNT1 included 2947 mother-offspring and 2140 father-offspring dyads, in Young-HUNT3 this was 850 and 391 respectively. In Young-HUNT1 there was evidence of associations between dietary choices, meal patterns and neonatal outcomes, these were similar in the pooled analyses but were attenuated to the point of non-significance in the smaller Young-HUNT3 cohort. Overall, energy-dense food products (e.g., crisps, sweets) were associated with a small detrimental impact on some neonatal outcomes whereas healthier food choices appeared protective (e.g., whole grain bread, daily breakfast and lunch). Interpretation: Our study suggests that if there are causal links between consumption of healthy and unhealthy food and meal patterns in adolescence with neonatal outcomes for offspring some years later. The effects seen are small and will require even larger studies with more state-of-the-art dietary assessment to estimate these robustly. Funding Statement: University of Agder funded this specific study and Co-author CK Hanson is funded by NIMHD of the National Institutes of Health under award number 1P50MD010431-01. Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: The Young-HUNT study adhered to the Helsinki Declaration and was approved by the Norwegian Data Inspectorate, the Regional and National Committees for Medical and Health Research Ethics in Norway and the Norwegian Directorate of Health. Additional consent for this specific study was provided by the Central Regional Committee for Medical and Health Research Ethics in Norway (Reference: 2017/1220/REK midt).

Suicidal ideation amongst adolescent suffering from disordered eating: The Young-HUNT study

IntroductionSuicide takes a great toll on both individuals and societies. Successful preventive measures would require a careful understanding of the scope of suicidal ideation as well as its associated factors. Amongst mental disorders, anorexia nervosa has the highest mortality rate due to suicide.Objective and aimsStudying the prevalence of suicidal ideation and its associated factors in adolescents (13–19 years old) affected by disordered eating (DE).MethodsLogistic regression was employed to study associations between suicidal ideation and age, gender and disordered eating in adolescents from a population-based prospective study, The Young-HUNT 3 cohort, 2006-8. DE cases were defined using the self-reported questionnaire (Eating Attitude Test-7) and then grouped into two subscales, poor appetite/under-eating and uncontrolled appetite/overeating.ResultsA total of 3933(boys 49% and 51% girls) were included. In total, 177 poor appetite/under-eating and 365 uncontrolled appetite/overeating cases were identified. Prevalence of suicidal ideation was 24.5% in total sample with girls being more affected (27.1%). Prevalence of suicidal ideation amongst poor appetite/under-eating case group and uncontrolled appetite/overeating cases was respectively 43.5 and 39.2%. The odds-ratio of suicidal ideation amongst poor appetite/under-eating cases compared to control group was 2.56 (95% CI, 1.85 to 3.42, P-value &lt; 0.001) whilst the odds-ratio of suicidal ideation amongst uncontrolled appetite/overeating cases compared to control group was 2.19 (95% CI, 1.75 to 2.74, P-value &lt; 0.001). Results remained significant after adjusting for anxiety and depression symptoms.ConclusionFocus on high risk groups such as DE seems important in taking suicide preventive measures.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Adolescent mental health and earnings inequalities in adulthood: evidence from the Young-HUNT Study

BackgroundPrevious studies have shown that adolescent mental health problems are associated with lower employment probabilities and risk of unemployment. The evidence on how earnings are affected is much weaker, and...

Sport participation and physical activity level in relation to musculoskeletal pain in a population-based sample of adolescents: The Young-HUNT Study

Abstract Aims Studies have shown conflicting results regarding associations between physical activity (PA) and musculoskeletal pain among adolescents, and few have evaluated the impact of sport participation. Therefore, the aims of this study were to examine the associations between sport participation and persistent weekly pain by body region in a population-based sample of adolescents. Methods In this cross-sectional study, data from the adolescent part of the Nord-Trøndelag Health Study (Young-HUNT3) were used. Participants were asked how often during the last 3 months they had experienced pain in the neck-and-shoulders (NSP), low back (LBP) or lower extremities (LEP). The impact of sport participation and PA level on pain was evaluated using logistic regression analyses, stratified by gender, and adjusted for age, socioeconomic status and psychological distress. Results In total, 3765 boys and 3831 girls were included, mean age 15.8 years (SD 1.7). NSP was most prevalent (17%). Adolescents who participated in endurance sports had lower odds of NSP and LBP compared to non-participants. Participation in technical sports was associated with increased odds of LBP, and participation in team sports with increased odds of LEP, vs. no participation in the respective sports. Participation in strength sports and risk sports, vs. no participation, was related to higher levels of pain in all regions. Compared to a low PA level, a moderate PA level reduced the odds of NSP and LBP, whereas a high PA level increased the odds of LEP. Conclusion This study identified sports potentially protective, as well as sports associated with higher odds of NSP, LBP and LEP in a large population-based sample, and has increased the understanding of participation in sports as potential determinants of musculoskeletal pain among adolescents. Our findings highlight that types of sport adolescents participate in should be considered by healthcare professionals when evaluating their musculoskeletal pain.

The Role of Internalizing and Externalizing Problems in Adolescence for Adult Educational Attainment: Evidence from Sibling Comparisons using Data from the Young HUNT Study

The Role of Internalizing and Externalizing Problems in Adolescence for Adult Educational Attainment: Evidence from Sibling Comparisons using Data from the Young HUNT Study

The effect of physical activity on mental health among adolescents with and without self-reported visual impairment: The Young-HUNT Study, Norway

The purpose was to study the effect of physical activity (PA) on mental health according to self-reported vision categories among adolescents. The study was conducted in Nord-Trøndelag, Norway, during the period 1995–1997, with a follow-up 4 years later. Self-reported measurements were used to assess PA and vision at baseline, and mental health problems and well-being at follow-up. The main linear regression analyses included 1417 adolescents between the age of 12 and 17 years, of which 46 had reported visual impairment. Among those reporting no impairment, conducting &lt;1 day per week of PA was significantly associated with having lower levels of well-being at follow-up compared to those conducting ⩾1 day of PA. Among those reporting visual impairment, the mental health benefits of conducting weekly PA compared with conducting non-weekly PA were observed only among those who were more emotionally unstable or introvert at baseline. In conclusion, further longitudinal studies are warranted to examine whether the mental health responses of PA may be dependent on the adolescent’s vision status.

Cultural activity participation and associations with self-perceived health, life-satisfaction and mental health: the Young HUNT Study, Norway

BackgroundLeisure time activities and culture participation may have health effects and be important in pulic health promotion. More knowledge on how cultural activity participation may influence self-perceived health, life-satisfaction, self-esteem and mental health is needed.MethodsThis article use data from the general population-based Norwegian HUNT Study, using the cross-sectional Young-HUNT3 (2006–08) Survey including 8200 adolescents. Data on cultural activity participation, self-perceived health, life-satisfaction, self-esteem, anxiety and depression were collected by self-reported questionnaires.ResultsBoth attending meetings or training in an organisation or club, and attending sports events were positively associated with each of the health parameters good self-percieved health, good life-satisfaction, good self-esteem, and low anxiety and depression symptoms. We found differences according to gender and age (13–15 years versus 16–19 years old) for several culture activities, where girls aged 16–19 years seemed to benefit most from being culturally active. The extent of participation seemed to matter. Those who had frequent participation in cultural activities reported better health outcomes compared to inactive adolecents.ConclusionsThe results from this study indicate that participation in cultural activities may be positively associated with health, life-satisfaction and self-esteem in adolescents and thus important in public health promotion. Possible sex and age differences should be taken into account.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-1873-4) contains supplementary material, which is available to authorized users.

The relationship of anxiety, depression and behavioral problems with recurrent headache in late adolescence – a Young-HUNT follow-up study.

BackgroundThe comorbidity of headache and psychiatric symptoms is a well-recognized clinical phenomenon, but there are only limited data regarding the temporal relationship between headache and symptoms of anxiety and depression as well as behavioral problems in adolescents. This study investigates the relationship of anxiety and depressive symptoms and behavioral problems at baseline with recurrent headache at follow-up four years later.MethodsWithin the Nord-Trøndelag Health Study (HUNT), including repeated population-based studies conducted in Norway, 2399 adolescents in junior high schools aged 12–16 years (77% of the invited) participated in Young-HUNT1 (1995–1997) and again at follow-up four years later, in Young-HUNT2 (2000–2001). The same comprehensive questionnaire that included assessment of symptoms of anxiety and depression and behavioral problems, i.e. conduct and attention difficulties was completed in both studies. In addition 1665 of the participants were interviewed about their headache complaints in Young-HUNT2.ResultsIn adjusted multivariate analyses we found that higher scores of anxiety and depressive symptoms at baseline were associated with recurrent headache at follow-up four years later (OR: 1.6, 95% CI: 1.2-2.1, p = 0.001), evident for migraine (OR: 1.8, 95% CI: 1.2-2.7, p = 0.008) and non-classifiable headache (OR: 1.7, 95% CI: 1.0-2.8, p = 0.034), but not statistically significant for tension-type headache (OR: 1.4, 95% CI: 1.0-1.9, p = 0.053). Higher scores of anxiety and depressive symptoms at baseline were significantly associated with more frequent headache at follow-up (monthly vs. no recurrent headache OR: 1.8, 95% CI: 1.3-2.5, p = 0.001, weekly or daily vs. no recurrent headache OR: 1.9, 95% CI: 1.2-2.9, p = 0.005). Among adolescents without recurrent headache at baseline, higher scores for symptoms of anxiety and depression were associated with new onset migraine four years later (OR: 2.6, 95% CI: 1.1-4.8, p = 0.036). Higher scores of attention problems at baseline were associated with non-classifiable headache at follow-up (OR: 2.0, 95% CI: 1.3-3.4, p = 0.017).ConclusionsResults from the present study showed that symptoms of anxiety and depression in early adolescence were associated with recurrent headache four years later. Recognizing anxiety and depressive symptoms should be considered part of the clinical assessment in young headache patients, as early identification of these associated factors may lead to improved headache management.

General, but not abdominal, overweight increases odds of asthma among Norwegian adolescents: the Young-HUNT study.

The aim of this analysis was to examine the association between asthma and general and abdominal weight status, defined by age- and sex-specific cut-offs for body mass index (BMI) and waist circumference (WC) in adolescents. Participants aged 12-19 years in the Young-HUNT (YH) Study (YH1 1995-1997: n = 8222; YH3 2006-2008: n = 7403) completed self-administered questionnaires in school as part of a series of cross-sectional, population-based studies conducted in Nord-Trøndelag, Norway. Weight, height and WC were measured. Adjusted odds ratios (ORs) and 95% Confidence Intervals (CI) for asthma, defined by self-reported physician diagnosis, were calculated. Potential effect modifiers evaluated included sex and pubertal development status (PDS). Asthma was reported by 11.8% of the adolescents in YH1 and 17.0% in YH3. Asthma odds significantly increased for adolescents with general (OR = 1.33; 95%CI: 1.13, 1.56), but not abdominal, overweight and increased for adolescents with general (OR = 1.34; 95%CI: 1.02, 1.75) or abdominal obesity (OR = 1.36; 95%CI: 1.16, 1.60). Underweight had no association with asthma regardless of weight assessment type, and PDS did not meaningfully influence the associations between asthma and weight. Overweight and obesity both increased the odds of asthma in 12-19 year-old Norwegians. WC did not add further information to that already provided by BMI to improve our understanding of the association between asthma and weight.