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Spending more than 3 hours a day sedentary worsens teens’ mental health

Adolescents who spend more than three hours a day engaged in sedentary behaviors – including playing video games, reading for leisure or spending a lot of time distracted by screens – have a higher risk of facing psychological distress in the future.

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Adolescents who spend more than three hours a day engaged in sedentary behaviors – including playing video games, reading for leisure or spending a lot of time distracted by screens – have a higher risk of facing psychological distress in the future, according to a study published in the Journal of Adolescent Health.

On the other hand, moderate screen exposure (between 60 and 119 minutes per day) invested in educational activities, such as doing homework or attending classes, was considered a “protective” factor associated with less psychological distress.

Sedentary behavior among adolescents has become a growing problem worldwide, with significant implications for the physical and mental health of the population in this age group. Several studies have shown that a lack of physical activity, especially when combined with excessive use of electronic devices, contributes to an increase in problems such as obesity and cardiovascular disease.

In addition, a growing body of research shows that the effects of a sedentary lifestyle are not limited to the physical body, but can also affect mental health, increasing feelings of anxiety and depression, for example.

The study, conducted at the Institute of Psychiatry, Psychology and Neuroscience at King’s College London in the United Kingdom, analyzed information from 3,675 adolescents who were part of the Millennium Cohort Study, a project that follows children born between 2000 and 2002 and maintains a large database.

The analysis included information on sedentary behavior collected at two points in time: when the adolescents were 14 years old and then at the age of 17. In the first phase, the participants completed a diary in which they recorded the different activities they performed every ten minutes. These activities were categorized into broader contexts: general physical activity, time spent sleeping, recreational screen time, non-screen recreational time, and educational sedentary behavior.

At age 17, the same participants reported their psychological distress using a six-question questionnaire about their feelings, using a tool known as the Kessler Scale. The questions included “how often in the past 30 days” did the participant feel nervous, hopeless, restless, depressed, anxious, and worthless. Analysis of the scores, based on the scale, indicated whether or not they were in psychological distress.

According to André de Oliveira Werneck, author of the article and doctoral student at the Center for Epidemiological Research in Nutrition and Health at the School of Public Health of the University of São Paulo (FSP-USP) in Brazil, the fact that the research was based on responses to sedentary behavior recorded in a diary is one of the differences that make the results so relevant.

Werneck explains that there are several ways to measure sedentary behavior. One of them, which is more objective, uses an accelerometer (a type of device that measures how much a person moves), but it cannot distinguish between different sedentary activities, which are very broad.

“Sedentary behavior includes a variety of activities, such as using a computer, watching television, reading, listening to music, or attending class. Most research focuses on analyzing total sitting time, but we can have positive sedentary activities, such as attending class and doing homework, for example. And there are activities that are not beneficial, such as spending too much time on the Internet or playing video games,” he explains.

A second method of measuring sedentary behavior is subjective, in which people answer a questionnaire about how much time they spend sedentary, watching TV, playing video games, working, or studying in a typical week. Nevertheless, it depends on the participant’s memory.

“Having a record of all the activities of these adolescents, formalized in a diary, provides a much more faithful result and has a more reliable accuracy of the different time periods. It’s not common to use this type of tool, precisely because it’s difficult to implement,” says the doctoral student, who carried out the study as part of a research internship funded by FAPESP.

Impact of reading

To analyze the data, the researchers adjusted for several covariates, including gender, parental education, net family income, parental psychological distress, body mass index, physical activity, total sedentary time and depressive symptoms.

After cross-checking the information, they found that the adolescents spent an average of four hours a day in educational sedentary behavior (school, homework) and about three hours a day in screen and non-screen sedentary behavior. Those who spent more than 180 minutes a day on screens for leisure were associated with greater psychological distress at age 17.

Similarly – and surprisingly – the researchers found that those who spent more than three hours a day reading for leisure (especially boys) also reported more psychological distress. According to the study, while previous research has shown that reading is associated with better mental health outcomes and other healthy behaviors, this new research suggests that excessive reading may be harmful in some cases.

One of the hypotheses to explain this finding, says Werneck, is that adolescents who spend many hours reading are “displacing” time that could be spent on activities with face-to-face or outdoor social interactions, which are protective, leading to greater isolation. In addition, it is possible that some of the reading is done on screen devices (cell phones, computers or tablets), which is also harmful – there are studies in adults that link screen reading to poorer sleep because of exposure to blue light.

“This is an unexpected finding in the study, but it’s important to emphasize that very few adolescents spend a lot of time reading for leisure. Our main finding, given the general context, is that more leisure screen time [video games] was associated with worse psychological distress, while more time in educational activities was associated with less distress,” he says.

Professor Brendon Stubbs, who supervised the study, told Agência FAPESP by email that the study revealed several worrying patterns. “We found that adolescents who spent more than three hours a day on screen-based leisure activities showed significantly greater psychological distress three years later. Video games were particularly influential, with each additional hour associated with a 3% increase in psychological distress.”

According to Stubbs, the results suggest a clear dose-response relationship between excessive recreational screen time and future mental health outcomes. “Importantly, this relationship was context-dependent, meaning that educational screen time did not show the same negative effects, highlighting that the problem is not screen use per se, but how and why screens are used.”

How to minimize the impact

Based on the findings, the researchers suggest interventions that could help minimize the negative psychological effects:

  • Set clear limits on screen time: Implement guidelines that limit recreational screen time to less than three hours per day, as the study results show that this is when the risks increase significantly;
  • Focus on context: Encourage more educational and structured screen activities rather than passive recreational screen time. The study found that educational screen time had no negative effects;
  • Balance activities: Promote alternative leisure activities with social interaction components, as isolated screen time can contribute to psychological distress;
  • Gender-specific approaches: Consider personalized interventions, as work has found gender differences in effects (e.g., girls were more associated with screen use for Internet browsing, boys for video games);
  • Educational support: Since moderate amounts of homework and class time have been associated with less psychological distress, ensure adequate academic engagement;
  • Manage and optimize screen time instead of eliminating it altogether.

Werneck emphasizes that sedentary behavior is very complex, and for adolescents, each activity and context needs to be evaluated separately. “We need to focus on interventions that not only reduce sedentary behavior but also reduce it in some specific and very long activities that are more associated with psychological distress,” he concludes.

NewsMakers

A Woman leader’s journey to health, empowerment

As a woman who believes in the power of preventive care, Rebecca Bustamante shares her story of health challenges and triumphs—all fueled by her trust in Fullerton’s executive health screening facility.

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Rebecca Bustamante, CEO of Asia CEO Events, has always been a force to be reckoned with among key industries and businesses in the Philippines. As an inspirational keynote speaker and organizer of the largest business forums and summits in the country, she has paved the way for empowering professionals to take charge of their careers and create their path to success. 

She is, indeed, one of the best examples of what it truly means to be an empowered woman—one who helps others achieve success while fueling and creating change. But beyond her professional triumphs, Bustamante knows that true empowerment starts with taking charge of one’s health, and for her, partnering with Fullerton Health has been a crucial part of that journey. 

With the intention of taking control of her health, she turned to Fullerton Health, a leading vertically integrated healthcare platform in Asia with a proven track record of providing enterprise healthcare solutions.

As a woman who believes in the power of preventive care, she shares her story of health challenges and triumphs—all fueled by her trust in Fullerton’s executive health screening facility. 

A Wake-Up Call to Prioritize Health

Bustamante’s journey to prioritizing wellness began with a moment that changed everything. In 2005, at just 38 years old, she was diagnosed with a brain tumor and only given six months to live. The news was devastating. 

“I was paralyzed, I couldn’t function,” she recalls. “It was the biggest turning point of my life.” 

Against all odds, Bustamante survived. But the experience left a lasting impact, reshaping her entire perspective on health. She realized that no matter how successful one becomes, it all means nothing if one’s health is compromised.

That wake-up call made her more intentional about wellness, sparking a lifelong commitment to proactive healthcare and preventive measures. Since then, taking care of her health has been at the forefront of her priorities. She knew that while she had achieved great success, maintaining her well-being was just as important as building her career. 

Discovering Fullerton Health

In her search for a healthcare provider that aligned with her commitment to long-term wellness, she was introduced to Fullerton Health by her colleague and friend, Carmie De Leon, who happens to be Radlink Philippines’ Country General Manager and EHS Lead. Fullerton’s executive health screening offered a seamless, thorough, and personalized approach—something Bustamante knew was essential in maintaining her well-being. 

“Upon learning about it, my husband and I were excited to experience Fullerton Health because we wanted to see if we were really looking after ourselves properly,” Bustamante explains.

She added that her first executive check-up exceeded all expectations. 

“It’s truly a five-star experience,” Rebecca shares. “We didn’t have to wait for the whole day just to get our results because Fullerton Health is efficient and personalized. In just three hours, we completed a full-body assessment. It felt like a business-class health experience.” 

Taking Charge of Her Health with Fullerton

Through Fullerton’s comprehensive executive check-up, Bustamante, along with her husband, gained valuable insights into her health—all consolidated into one detailed report and thoroughly explained by Fullerton Health’s doctors. These results served as a guide for her wellness journey, helping her make necessary lifestyle adjustments. 

“Fullerton doesn’t just give you test results—they guide you on what to improve and maintain,” Bustamante says. “It’s not just about diagnosing problems but about taking control of your health before issues arise.” 

She also emphasized the convenience and efficiency of Fullerton’s services, which allowed her to focus on making meaningful lifestyle changes while balancing the demands of being a CEO and a mother. She shared how her experience with Fullerton Health made her realize the importance of treasuring time with family. 

“If you love your family, you owe it to them to stay healthy. You don’t want to be a burden. Instead, you want to be present for your children and grandchildren,” she emphasizes. 

When asked what advice she would give to others looking to take charge of their health, she states: “Don’t wait for a wake-up call. Your health is your greatest investment.

Fullerton Health has given me clarity, confidence, and control over my well-being—and that’s priceless.” 

A Commitment to a Healthier Future

Through Fullerton Health, Bustamante proves that true success begins with taking care of yourself. Her story is a testament to how prioritizing health can lead to a fuller, more empowered life. 

More than just an executive check-up, her experience with Fullerton Health reinforced her belief that preventive care is the best care. Now, she eagerly anticipates her annual check-ups, seeing them not as a task, but as an essential step in her journey to a healthier, more empowered life.

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High dietary fish intake may slow disability progression in MS

The anti-inflammatory and neuroprotective properties of the nutrients found in fish may be key, underscoring the potential importance of diet in managing MS.

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A high dietary intake of lean and oily fish may slow the progression of disability in people with multiple sclerosis (MS), suggests a comparative population based study, published online in the Journal of Neurology Neurosurgery & Psychiatry.

The anti-inflammatory and neuroprotective properties of the nutrients found in fish may be key, say the researchers, who add that their findings underscore the potential importance of diet in managing the disease.

Emerging evidence indicates that diet may have a role in the development of inflammatory diseases, including MS, explain the researchers. 

While previously published research has linked fish consumption with lower levels of disability among those with MS, few studies have looked at whether it might slow or lessen the progression of disability, they point out. 

To explore this further, they drew on 2719 newly diagnosed participants (average age 38) in The Epidemiologic Investigation of Multiple Sclerosis (EIMS) study, a Swedish nationwide population based case-control study, all of whom were recruited between April 2005 and June 2015.

On entry to EIMS, all participants provided information on environmental exposures and lifestyle habits, including their consumption of lean and oily fish, which was categorised as: never or seldom; 1 to 3 times a month; and weekly, and scored from 2 to 6, depending on whether they ate lean or oily fish, or both. 

Their disease progression, measured using the Expanded Disability Status Scale (EDSS), was tracked for up to 15 years through the Swedish MS Registry.

Confirmed disability worsening was defined as an increase in the EDSS score of at least 1 point from baseline, sustained between two further check-ups, at least 6 months apart.

The highest fish consumption at diagnosis was associated with a 44% lower risk of confirmed disability worsening as well as a 45% lower risk of progressing to EDSS 3 and and a 43% lower risk of progressing to EDSS 4 compared with those who ate none or very little.

And the more lean and oily fish that was consumed, the lower was the risk of confirmed disability worsening and progression to EDSS 3 and 4, trends analysis indicated.

In 2021, 1719 participants completed an online follow-up questionnaire which assessed changes in fish intake over time. Some 412 (24%) had altered their fish consumption: 288 had increased it; 124 had decreased it. 

Those who increased their score from 2–3 to a score of 5–6 within 5 years after diagnosis (133) had a 20% lower risk of confirmed disability worsening, compared with those who continued to eat little or no fish (400). 

Only 16 participants increased their fish consumption from a baseline score of 2 to a score of 5–6, but they had a 59% lower risk of confirmed disability worsening, compared with those who remained at the lowest level of consumption (101).

The findings held true even when the potentially influential factors of physical activity, weight (BMI), smoking, alcohol intake, and sun exposure were accounted for. They also remained similar when further adjustment was made for vitamin D level.

This is an observational study, and as such, no firm conclusions can be drawn about cause and effect. And further research to validate the findings and investigate the underlying biological mechanisms is required, say the researchers.

But they suggest: “While omega-3 fatty acids, predominantly found in oily fish, may contribute to reduced disability progression, the beneficial effects observed from lean fish consumption suggest that other factors may also play a significant role. One such factor is taurine, an amino acid found in significant amounts in fish and seafood.”  

They explain: “Taurine is the most abundant free amino acid in the brain and, although there are endogenous mechanisms for its production, an exogenous supply is necessary to meet physiological needs.”  

They add: “Taurine has diverse cellular functions, including cytoprotective actions through antioxidative and anti-inflammatory effects, making it a potential therapeutic agent for neurological disorders.” 

And they conclude: “The results underscore the potential role of diet, particularly fish consumption, as a modifiable factor that could complement existing therapeutic strategies for MS.” 

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NewsMakers

Myth busted: Healthy habits take longer than 21 days to set in

Planning and intending to complete a new behaviour can also help solidify a new habit, so make sure you continue to make time to include your new healthy habits into your everyday activities. This could be as easy as laying out your gym clothes the night before a morning walk or having a healthy lunch ready to go in the fridge.

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We’re nearly two months into 2025, but if you’re struggling to hold onto your New Year’s resolution, stay strong, as University of South Australia research shows that forming a healthy habit can take longer than you expect.

In the first systematic review of its kind, UniSA researchers found that new habits can begin forming within about two months (median of 59–66 days) but can take up to 335 days to establish.

It’s an important finding that could inform health interventions to promote healthy behaviours and prevent chronic disease.

In Australia, chronic disease contributes to a large portion of the disease burden. Many conditions, including type 2 diabetes, heart disease, lung diseases and stroke, can be prevented by changing unhealthy habits or lifestyle factors. 

University of South Australia researcher, Dr Ben Singh, says that contrary to popular belief, healthy habits take far longer than three weeks to lock down.

“Adopting healthy habits is essential for long-term well-being but forming these habits – and breaking unhealthy ones – can be challenging,” Dr Singh says.

“At the beginning of the year, many of us are setting goals and making plans for the months ahead –things like being more active, cutting back on sugar, or making healthier food choices – but while common wisdom suggests that it takes just 21 days to form such habits, these claims are not evidence-based.

“In our research, we’ve found that habit formation starts within around two months, but there is significant variability, with formation times ranging from four days to nearly a year.

“So, it’s important for people who are hoping to make healthier habits not to give up at that mythical three-week mark.”

The study of more than 2600 participants also found that certain factors can influence successful habit formation.

“When trying to establish a new healthy habit, success can be influenced by a range of things including how frequently we undertake the new activity, the timing of the practice, and whether we enjoy it or not,” Dr Singh says.

“If you add a new practice to your morning routine, the data shows that you’re more likely to achieve it. You’re also more likely to stick to a new habit if you enjoy it.

“Planning and intending to complete a new behaviour can also help solidify a new habit, so make sure you continue to make time to include your new healthy habits into your everyday activities. This could be as easy as laying out your gym clothes the night before a morning walk or having a healthy lunch ready to go in the fridge.

“Tailoring habit-building strategies into our day and making plans on how we can achieve them, will put you in a position for success.”

While more research is needed, researchers say that these findings can guide public health initiatives and personalised programs that support sustained and healthy behaviour change.

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