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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.

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Cannabidiol therapy could reduce symptoms in autistic children and teenagers

The use of cannabidiol (CBD) cannabis extract can lead to meaningful benefits and improve the behaviour of children and adolescents with autism spectrum disorder.

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New research presented at the 2025 European Congress of Psychiatry reveals that the use of cannabidiol (CBD) cannabis extract can lead to meaningful benefits and improve the behaviour of children and adolescents with autism spectrum disorder (ASD). ASD affects approximately 1 in 100 children around the world and symptoms can include difficulty interpreting language, difficulty expressing emotions, and repetitive behaviour and routines.1,2 

The meta-analysis included randomised, placebo-controlled trials on the efficacy or safety of CBD cannabis extracts in children and adolescents with ASD. Three studies were used in total with 276 participants with a mean age of 10.5, ranging in age from 5 to 21. The dosage of CBD cannabis extract started at 1 mg/kg per day and was titrated up to 10 mg/kg.  

Key findings from the study include: 

  • CBD cannabis extract use shows moderate improvements in social responsiveness and small yet notable reductions in disruptive behaviours.
  • CBD cannabis extract significantly enhanced social responsiveness and reduced disruptive behaviour.
  • The use of CBD cannabis extract has a favourable safety profile as it did not increase adverse events compared to placebo  
  • There were no significant differences between adverse events in CBD cannabis extract versus placebo  

Lara Cappelletti Beneti Branco, Lead Investigator, São Camilo University Center, University of São Paulo, said: “The global population prevalence of ASD diagnosis amongst children and adolescents is growing, but many treatment pathways are not effective. It is promising to see the effect of CBD cannabis extract on the study participants. However, there still needs to be considerable focus on further research with larger trials to clarify its efficacy and safety in managing ASD.” 

Professor Geert Dom, EPA President, said: “ASD can be extremely frustrating for all involved; parents of children and adolescents with the disorder, the treating clinicians and of course the children and adolescents themselves. A large part of this frustration is down to finding a viable treatment option that works to reduce symptoms. It is with delight that we see the results of this meta-analysis and we hope to see further research into this so we can move towards a solution to the unmet need within this community”.  

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Relaxation techniques may help lower high blood pressure — at least in the short term

Most relaxation techniques seemed to lower both systolic and diastolic blood pressure for people with high blood pressure after 3 or fewer months. The most commonly included interventions were breath control (13 studies), yoga/tai chi (11), biofeedback (8), progressive muscle relaxation (7), and music (7).

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Relaxation techniques may help lower high blood pressure—at least in the short term—but the longer term effects are unclear, finds a pooled data analysis of the existing research published in the open access journal BMJ Medicine.

And the risk of bias in the existing body of research means that further, more rigorously designed and longer studies are needed to confirm whether these techniques have a constructive role in the treatment of high blood pressure, conclude the researchers.

High blood pressure affects around a third of 30-79 year olds and is one of the leading attributable causes of deaths in both men and women, note the researchers. While drugs are available to treat the condition, adherence to them is poor, generating interest in alternative approaches, such as relaxation techniques, to reduce one of the major risk factors for high blood pressure—high stress levels. But it’s far from clear which of these methods, which can include breath control, mindfulness, yoga, Tai Chi, and biofeedback, among others, might be most effective.

To build on the evidence base, the researchers scoured research databases for studies, published in English up to February 2024 that looked at the potential impact of relaxation techniques on high blood pressure (140/90 mm Hg and above) and elevated blood pressure (120/80 mm Hg and above). They included 182 studies, 166 of which looked at high blood pressure, and 16 of which looked at elevated blood pressure (pre-hypertension).

Where possible, the researchers deployed network meta analysis, a statistical technique used to simultaneously compare the effects of several different ‘treatments’.

The pooled results of 54 studies showed that most relaxation techniques seemed to lower both systolic and diastolic blood pressure for people with high blood pressure after 3 or fewer months. The most commonly included interventions were breath control (13 studies), yoga/tai chi (11), biofeedback (8), progressive muscle relaxation (7), and music (7).

Compared with no intervention, breath control achieved a reduction of 6.65 mm Hg in systolic blood pressure (the first and higher number in a blood pressure reading), meditation a drop of 7.71 mm Hg, meditative movement, such as tai chi and yoga, a drop of 9.58 mm Hg, and mindfulness a drop of 9.90 mm Hg.

Music was also associated with a fall of 6.61 mm Hg, progressive muscle relaxation with a fall of 7.46 mm Hg, and psychotherapy with a reduction of 9.83 mm Hg. Combined techniques were associated with a drop of 6.78 mm Hg in blood pressure. 

There was no statistical evidence of effectiveness for any technique after 3 to 12 months and the certainty of the evidence was very low. The most commonly included techniques at this timepoint were biofeedback (7 studies), yoga/tai chi (4), and progressive muscle relaxation (4).

Very few studies included long term follow up of 12 months or more, and of the 3 included in the network analysis, the results showed that compared with no treatment autogenic (self directed) training might lower both systolic and diastolic blood pressure, but the certainty of the evidence was low. 

There was no statistical evidence of effectiveness for other treatments assessed at this time point, including biofeedback, progressive muscle relaxation, and techniques involving a combined approach.

Limited data were available for elevated blood pressure: only two studies compared relaxation techniques with no treatment/usual care and the effects on systolic blood pressure were small. 

The researchers note that the descriptions of relaxation interventions were sometimes incomplete or sparse, there were few data on costs and cost effectiveness, and most of the included studies didn’t report information on the risk of cardiovascular disease/events/deaths. 

But they suggest: “The results of our systematic review and network meta-analysis indicate that relaxation or stress management techniques might result in meaningful reductions in blood pressure at up to three months of follow-up.” 

But they caution: “Uncertainty exists about this effect, however, because of the risk of bias in the primary studies, the potential for publication bias in this area, and imprecision in the effect estimates, meaning that the observed changes in blood pressure might be too small to affect cardiovascular or cerebrovascular outcomes.” 

And they add: “Hypertension is a chronic condition, likely to require long term drug treatments or behavioural changes. As such, interventions that are used for a brief period, or provide only short term benefits, are unlikely to be clinically useful. 

“Too few studies exist, however, to assess whether the beneficial effects of relaxation are maintained when the techniques are practised for longer than three months. Future studies must clearly report whether participants were still using relaxation methods at the time of the outcome assessment, with details on adherence to the relaxation schedule. These factors might strongly influence the effectiveness of the different relaxation and stress management techniques.” 

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Poor oral health linked with body pain and migraines in women

Findings highlight the importance of good oral health to potentially mitigate pain and improve overall wellbeing, prompting further exploration into the role of oral microbiota in chronic unexplained pain conditions. This includes fibromyalgia, a condition experienced by 67 percent of the study participants.

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New research from the University of Sydney has revealed poor oral health is significantly associated with higher instances of migraines, abdominal and body pain in women. 

Published in Frontiers in Pain Research, the world-first study identified specific oral microbes correlated with certain pain conditions, suggesting a potential relationship between the oral microbiome and the nervous system.   

The findings highlight the importance of good oral health to potentially mitigate pain and improve overall wellbeing, prompting further exploration into the role of oral microbiota in chronic unexplained pain conditions. This includes fibromyalgia, a condition experienced by 67 percent of the study participants. 

“This is the first study to investigate oral health, oral microbiota and pain commonly experienced in women with fibromyalgia, with our study showing a clear and significant association between poor oral health and pain,” said lead investigator Associate Professor Joanna Harnett from the Faculty of Medicine and Health. 

“Our findings are particularly important to fibromyalgia which, despite being a common rheumatological condition, is often underrecognised,” said first author and PhD candidate in the Faculty of Medicine and HealthSharon Erdrich.  

“Fibromyalgia is a chronic condition characterised by widespread musculoskeletal pain, and headaches including headaches, as well as fatigue, sleep disturbances, and cognitive problems.” 

The research examined associations between self-reported oral health, the oral microbiome, and various pain presentations in a group of New Zealand women with and without fibromyalgia.   

Oral health was assessed using the WHO oral health questionnaire and evaluated against body pain, headaches, migraines, and abdominal pain using validated instruments, including the Short-form 36 (which measures quality of life), the International Headache Society headache survey and the functional bowel disorder severity index. Strong associations were evident between oral health scores and pain and each of these were associated with specific microbes found in the mouth, which were assessed using advanced genomic technology.   

Participants with the poorest oral health were more likely to suffer from higher pain scores: 60 percent were more likely to experience moderate to severe body pain, and 49 percent were more likely to experience migraine headaches. Lower oral health was a statistically significant predictor of frequent and chronic migraine. 

Four oral microbial species from the Dialister, Fusobacterium, Parvimonas and Solobacterium genera were significantly associated with pain after age, BMI and added dietary sugars were considered.   

A weak but significant inverse correlation with diet quality and oral health was also found, though the researchers note this has yet to be investigated in detail. 

The Australian Dental Association recommends regular oral hygiene appointments and dental health checks, in addition to twice daily teeth brushing and flossing. 

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