Prevalence of Unhealthy Lifestyle Behaviours in Children and Adolescents with Mental Disorders

Prevalence of Unhealthy Lifestyle Behaviours in Children and Adolescents with Mental Disorders | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Prevalence of Unhealthy Lifestyle Behaviours in Children and Adolescents with Mental Disorders Emilie Maria Antonia van Tetering, Malindi van der Mheen, Helen Klip, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6562159/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 30 Aug, 2025 Read the published version in Child Psychiatry & Human Development → Version 1 posted 7 You are reading this latest preprint version Abstract Unhealthy lifestyle behaviours, such as sleep problems, low physical activity, poor diet, and excessive screen time, are common among children and adolescents. Lifestyle has a significant impact on children’s physical and mental health. This study examined the prevalence of unhealthy lifestyle habits in children and adolescents in psychiatric care, and how they vary by age, gender, and diagnosis. Parent-reported data on sleep, physical activity, diet (i.e., vegetables and fruit), and screen time from 4,633 children and adolescents (ages 0-18 years) referred for specialized psychiatric care were used. Parents reported high levels of unhealthy lifestyle habits among children with mental disorders. Adolescents (13-18 years) exhibited the unhealthiest lifestyles, with more sleep problems, less physical activity, more screen time and less fruit intake. Reported lifestyle habits were worse for girls than boys, with girls exhibited less physical activity, more sleeping problems, more screen time and less fruit intake. Children and adolescents with depression and anxiety disorders reported the least physical activity, most screen time and the least fruit and vegetable intake. Children and adolescents with trauma and stressor related disorders had the most sleep problems. To conclude, parents report high amounts of unhealthy lifestyle habits in their children with mental disorders. These unhealthy lifestyle habits appeared to be highly prevalent in this group of children compared to those in the normative population. Given the high prevalence of unhealthy lifestyle in this clinical population of children, it is crucial to place greater emphasis on improving lifestyle interventions within psychiatric care. Lifestyle Child Adolescent Mental disorders Psychiatry Introduction Unhealthy lifestyle behaviours are common among children and adolescents, and profoundly impact children’s health. In particular, insufficient physical activity, poor dietary habits, sleep problems, and excessive screen time play major roles in these behaviours (Alosaimi et al., 2023; Carson et al., 2017; Chaput et al., 2017; Kumar & Kelly, 2017; Poitras et al., 2017). In The Netherlands, less than half of the individuals aged four years and older meet the national physical activity guidelines. Specifically, 56.8% of children aged 4 to 12 years engage in at least one hour of moderate-to-vigorous physical activity per day, while only 33.4% of adolescents aged 13 to 18 years meet this recommendation (CBS, 2023b). Additionally, a significant proportion of children in the Netherlands have inadequate fruit intake, with only 38.2% consuming sufficient amounts (CBS, 2017). Furthermore, studies from Europe and the United States of America have found that the majority of children and adolescents failed to eat the recommended amount of fruit and vegetables (Diethelm et al., 2012; Krebs-Smith et al., 2010). Besides unhealthy diet and lack of physical activity, sleep problems are also highly prevalent among children. Sixteen percent of Dutch children aged 12 to 16 years suffer from sleep problems, with higher prevalence rates (22.7%) observed in adolescents (18-20 years) (CBS, 2023a). Also, worldwide, many children and adolescents suffer from sleep problems (Owens & Mindell, 2011). The prevalence of sleep difficulties is estimated to range from 20% to 30% among children aged 1 to 12 years (Owens & Mindell, 2011) and from 16% to 23% among adolescents (Gradisar et al., 2011; Moore & Meltzer, 2008; Roberts et al., 2008). Insufficient physical activity and suboptimal dietary habits are examples of unhealthy lifestyle behaviours that can elevate the risk of chronic diseases including cardiovascular disease, cancer, and diabetes (Gotay, 2005; Jayedi et al., 2020; Livingstone et al., 2021; Lloyd-Jones et al., 2010; Lopez, 2006; Whatnall et al., 2016). Although these chronic diseases may not manifest until adulthood, the behaviours that increase the risk of these diseases, often develop in childhood and adolescence (Forrest & Riley, 2004), which highlights the importance of targeting prevention in youth. Unhealthy lifestyle behaviours are even more prevalent among children with mental disorders , such as autism spectrum disorder (ASD), Attention Deficit/Hyperactivity Disorder (ADHD), depression, and anxiety disorders, compared to their peers in the general population (Cortese et al., 2016; Kamal Nor et al., 2019; Sutaria et al., 2019). Notably, obesity is frequently observed in children diagnosed with ASD (i.e. 21.9% - 23.05%) and ADHD (i.e. the pooled prevalence of obesity was increased by 40% in children with ADHD, compared to children without ADHD) (Cortese et al., 2016; Healy et al., 2019; Kamal Nor et al., 2019). Furthermore, a review of children with ASD revealed higher incidences of sedentary behaviour, unhealthy dietary habits, and sleep disturbances compared to their peers in the general population (Curtin et al., 2014). In a recently published study, focusing on children with mental health issues, it was found that a majority exhibited somatic symptoms related to unhealthy lifestyle patterns, characterized by overweight and obesity, problems associated with food intake, and sleep problems (Muskens et al., 2023). While lifestyle behaviours in children and adolescents with mental health problems still appear to be under-researched, existing studies clearly highlight the importance of early detection and intervention (Kong et al., 2023; Muskens et al. 2023). An illustrative example is a recently published randomized controlled trial (RCT) that investigated the impact of a healthy diet on ADHD symptoms and reported a reduction in symptoms among children adhering to a healthy diet (Huberts-Bosch et al., 2023). Also, in another study improvements in sleep quality following a lifestyle intervention among children with ADHD were observed (Hong et al., 2021). Recent findings show a growing awareness of the relationship between lifestyle factors and mental disorders (Caamaño-Navarrete et al., 2024; Firth et al., 2019; Lianov & Johnson, 2010; Yang et al., 2017). For instance, an umbrella review, primarily focused on adults, demonstrated that some lifestyle behaviours, such as low levels of physical activity, sleep disturbances, adverse dietary patterns, and tobacco smoking, are associated with an increased risk of mental disorders (Firth et al., 2020). Overall, there is consensus that lifestyle factors are contributors to mental health issues in children and adolescents, and vice versa; more unhealthy lifestyle habits are seen in children and adolescents with mental disorders (Cortese et al., 2016; Kamal Nor et al., 2019; Sutaria et al., 2019). Nevertheless, data on the prevalence of lifestyle behaviours across diagnostic groups in children with mental disorders are currently lacking. Hence, the primary objective of this study was to gain more insight into the prevalence of lifestyle behaviours among children with diverse mental disorders. It is expected that the prevalence of lifestyle problems is higher among children and adolescents with mental disorders than among their peers without such conditions. In this exploratory study, we aimed to assess differences in lifestyle behaviours between age groups, sexes, and diagnostic diagnoses in children with mental disorders. Methods Design, procedures and participants Data were obtained from two academic Dutch child and adolescent psychiatry centers (Karakter and Levvel). These two centers are part of the DREAMS consortium (www.dreams-study.nl), covering the eastern and western regions of the Netherlands, and provide inpatient and outpatient care for children and adolescents with various mental disorders (van der Mheen et al., 2024). Data were extracted from the electronic health records of all children ( N = 4,633; data from Karakter n = 3,784; data from Levvel n = 849) aged 0-18 years ( M = 9.83, SD = 4.58) at the time of admission between April 2021 and September 2023. To examine possible differences between age groups on the various lifestyle habits, the data were stratified in three age cohorts. Given clear differences in sleep needs and eating patterns (Boesveldt et al., 2018; Kocevska et al., 2021; Yee et al., 2017), we divided the sample into the following age cohorts: 0-3 years, 4-12 years, and 13-18 years. The data for this study were collected in the course of clinical practice and obtained retrospectively, and as a result, this study was not subject to the Dutch Medical Research Involving Human Subjects Act. This was confirmed by the Medical Ethics Committee of Amsterdam UMC (reference code: 2023.0921). Both patients and their legal caregivers were informed that the data collected during regular care could be used in scientific research. They were given the option to opt out of having their data used for research purposes at any time with the assurance that this decision would have no impact on their treatment. Before their initial appointment at Karakter or Levvel, parents were asked to complete a digital intake questionnaire developed by DREAMS. This questionnaire assessed a range of variables, including demographic information such as the country of birth of the child and both parents as well as the parents' educational levels. Additionally, the intake questionnaire included inquiries related to lifestyle behaviours such as sleep habits, screen time, consumption of fruits and vegetables, and levels of physical activity. Measures Sleep Measurements on sleep behaviour were operationalised with a composite of several questions from the intake questionnaire. The following four criteria of insomnia were used to define sleep behaviour: (1) difficulties initiating sleep ("How often does it take more than 30 minutes for your child to fall asleep? Think of the past four weeks"), (2) difficulties maintaining sleep ("How often does your child wake up more than three times a night or lie awake for more than 20 minutes a night? Think of the past four weeks”), (3) early morning awakenings ("How often does your child wake up before 6 AM? Think of the past four weeks"), and (4) daytime fatigue ("How often does your child suffer from tiredness during the daytime? Think of the past four weeks"). Responses were provided on a 5-point Likert scale ranging from 1 = ( almost) never to 5 = always . To assess the prevalence of sleep difficulties, we computed the proportion of individuals experiencing specific sleep-related challenges. Sleep problems were dichotomized, with a score of 4 (often) and 5 (always) indicating the presence of a sleep problem, a score of three or lower indicated the absence of a sleep problem. Physical activity The amount of physical activity was measured with the item “How many days a week, on average, does your child get at least 60 minutes of moderate to strenuous physical activity or play?”. Responses were given on a 8-point Likert scale ranging from 0 = Zero days a week to 7 = Seven days a week. Fruit and vegetable intake The frequency of fruit intake by the child was assessed with the item: "How many days a week does your child eat fruit?" The frequency of vegetable intake was examined similarly with the item: "How many days a week does your child eat vegetables?" Responses for both questions were given on a 5-point Likert scale, ranging from 0 = Never/hardly ever to 4 = every day . Screen time The amount of screen time was assessed using two items: “How many hours a day does your child sit in front of a screen on weekdays?” (1), and “How many hours a day does your child sit in front of a screen at weekends?”(2). Both items were open-ended. An upper limit of 12 h was imposed to ensure realistic assessment. DSM-classification of psychiatric disorders The classifications of psychiatric disorders were retrieved from the electronic health records. Mental health professionals (child and adolescent psychiatrists and certified psychologists) classified psychiatric disorders during the course of clinical practice according to the DSM-5 criteria (American Psychiatric Association, 2013), adhering to standard diagnostic procedures. In this study, we used the primary DSM-5 classification in our analyses, because this classification addresses the mental disorders that are the primary focus of clinical attention (van der Mheen et al., 2024). The DSM-5 diagnostic classes used were: ADHD, ASS, trauma and stressor related disorders (i.e., reactive attachment disorder, disinhibited social contact disorder, posttraumatic stress disorder, acute stress disorder, adjustment disorders, other specified trauma or stressor-related disorder, unspecified trauma or stressor-related disorder), depressive disorders (i.e., disruptive mood dysregulation disorder, depressive disorder, dysthymia, premenstrual mood disorder, depressive mood disorder due to a substance/medication, depressive mood disorder due to a general medical condition, other specified depressive mood disorder, unspecified depressive mood disorder), and anxiety disorders (i.e., separation anxiety disorder, selective mutism, specific phobia, social anxiety disorder, panic disorder, agoraphobia, generalized anxiety disorder, anxiety due to a substance/medication, anxiety disorder due to a general medical condition, other specified anxiety disorder, and unspecified anxiety disorder). Depressive disorders and anxiety disorders were taken together in the category ‘depressive and anxiety disorders’, since both are characterized by internalizing problems. The reason for selecting only these DSM-classifications is twofold: first, they have the highest prevalence within this sample, and second, there is substantial evidence in the literature supporting the association between these mental disorders and lifestyle problems in children and adolescents. Statistical analysis Data were analysed using SPSS 29 for Windows (SPSS IBM). For all lifestyle habits, the analyses were conducted across three distinct age cohorts (i.e. 0-3 years, 4-12 years, and 13-18 years), sex (i.e., boys or girls) and DSM-diagnoses (i.e., ADHD, Autism, Trauma and stressor-related disorders, mood and anxiety disorders). Before testing, assumptions of normality were checked. The variables of sleep behaviour and screen time use were normally distributed, while the variables of fruit and vegetable intake and physical activity did not follow a normal distribution. In case of normal distribution, independent samples t-tests were used to examine the differences in means between boys and girls for sleep behaviour and screen time use. For physical activity and fruit and vegetable intake, a Mann-Whitney U test was performed because the assumption of normality was not met. A one-way ANOVA was conducted to examine the differences in means between the three age groups and between four DSM-diagnoses for sleep behaviour and screen time use. Additionally, the Kruskal-Wallis test was used for physical activity and fruit and vegetable intake due to the violated assumption of normality. Since the variables had more than five response categories, all outcome measures were treated as continuous variables. Finally, a Bonferroni correction was applied to adjust the p-values for each analysis. Results Descriptive statistics The characteristics of the study population are presented in Table 1. The intake questionnaire was completed by caregivers of 4,979 children (2,743 boys, 2,219 girls, and 17 children with unspecified sex). The sample consisted of 346 duplicates, which occurred because the intake questionnaire was completed at multiple time points or by multiple informants (e.g., fathers and mothers). The decision was made to retain the questionnaire with the most recent completion date ( n = 117 removals). Subsequently, duplicates involving multiple informants were removed ( n = 229 removals), prioritizing the responses from the biological mother. After removing duplicates, N = 4,633 children and adolescents were included in the study (2,553 boys, 2,064 girls, and 15 with unspecified sex). Table 1. Characteristics of the study population (N = 4,633). M (SD) Age in years 9.83 (4.58) N (%) Age 0-3 years 459 9.9 4-12 years 2553 55.1 13-18 years 1620 35.0 Missing data 1 .0 Gender Boys 2553 55.1 Girls 2064 44.5 Non-binary 15 0.3 Missing data 1 .0 Primary DSM-5 diagnostic classifications ASD 1,41 30.4 ADHD 685 14.8 Depressive/anxiety disorders 441 9.5 Trauma and stressor related-disorders 242 5.2 Other a 856 18.5 Missing data 999 21.6 Socio Economic Status (SES) b Low SES 870 18.8 Middle SES 1509 32.6 High SES 2243 48.4 Missing data 11 .20 Child Mother Father N % N % N % Country of birth Western 4263 92.0 3981 85.9 3537 76.3 Non-Western 90 1.9 355 7.7 335 7.2 Missing data 280 6.0 297 6.4 761 16.4 Education level Practical c 681 14.7 740 16.0 Practical-theoretical d 1798 38.8 1517 32.7 Theoretical e 1871 40.4 1559 33.6 Missing data 283 6.1 817 17.6 Note: a Other DSM-5 diagnostic classifications: Mild intellectual disability, Neurodevelopmental disorders, Schizophrenia spectrum and other psychotic disorders, Obsessive-compulsive and related disorders, Somatic symptom and related disorders, Feeding and eating disorders, Toilet training disorders, Sleep-wake disorders, Gender dysphoria, Disruptive, impulse-control, and conduct disorders, Substance-related and addictive disorders, Neurocognitive disorders, Personality disorders, Other mental disorders and Child and adolescent disorders b The socio economic status (SES) of parents was based on their postal codes using reference data obtained from the Central Bureau of Statistics in the Netherlands. Reference SES scores were calculated by CBS using multiple correspondence analysis, with inputs including national wealth decile, household educational level, and recent employment history. The total SES-WOA score for each household is the sum of the corresponding factors, while the postal code area's score represents the average of all household SES-WOA scores within that area. c Practical includes: No education, Primary school, Pre-vocational secondary education. d Practical-theoretical includes: Secondary vocational education, Higher general secondary education, Pre-university. e Theoretical includes: University of applied sciences and University Table 2a, 2b, 2c and 2d present a description of lifestyle behaviours in the total sample. The majority of children experienced at least one sleep-related problem, with 44.9% (N = 2,080) reporting difficulties initiating sleep and 37.9% (N = 1,755) experiencing daytime fatigue. Only 14.0% (N = 647) engaged in the recommended 60 minutes of daily physical activity. Regarding screen time on weekdays, 35.6% (N = 1,651) had 0-2 hours per day, while 13.2% (N = 612) exceeded 6 hours daily. On weekends, 35.8% (N = 1,659) had 3-5 hours of screen time, and 25.4% (N = 1,175) had over 6 hours. Daily fruit consumption was reported by 50.7% (N = 2,350) of children, whereas only 38.6% (N = 1,787) consumed vegetables daily. Table 2a. Sleep items for the total study population (N = 4,633). (almost) never Seldom Sometimes Often Always Missing data n % n % n % n % n % n % Difficulties maintaining sleep 1795 38.7 833 18.0 731 15.8 546 11.8 197 4.3 531 11.5 Early morning awakenings 2225 48.0 859 18.5 749 16.2 432 9.3 128 2.8 240 5.2 Daytime fatigue 656 14.2 733 15.8 1339 28.9 1229 26.5 526 11.4 150 3.2 Difficulties initiating sleep 607 13.1 588 12.7 974 21.0 1144 24.7 936 20.2 384 8.3 Table 2b. How many days per week does your child average at least 60 minutes of moderate to vigorous physical activity or play? (N = 4,633). 0 days a week 1 day a week 2 days a week 3 days a week 4 days a week 5 days a week 6 days a week 7 days a week Missing data n % n % n % n % n % n % n % n % n % Physical activity 617 13.3 501 10.8 583 12.6 625 13.5 390 8.4 539 11.6 276 6.0 647 14.0 455 9.8 Table 2c. How many hours a day does your child spend time in front of a screen on a week day/weekend day? (N = 4,633). 0-2 hours a day 3-5 hours a day 6+ hours a day Missing data n % n % n % n % Week day 1651 35.6 1342 29.0 612 13.2 1028 22.2 Weekend day 964 20.8 1659 35.8 1175 25.4 835 18.0 Table 2d. How many days per week does your child eats fruit/vegetables? (N = 4,633). Almost never 1-2 days a week 3-4 days a week 5-6 days a week Everyday Missing data n % n % n % n % n % n % Fruit 380 8.2 349 7.5 546 11.8 851 18.4 2350 50.7 157 3.4 Vegetable 301 6.5 267 5.8 675 14.6 1460 31.5 1787 38.6 143 3.1 Lifestyle behaviours across age groups Significant differences across the three age groups were observed for all four lifestyle behaviours: sleep, physical activity, screen time (on both weekdays and weekends), and nutrition intake (i.e., fruit and vegetable consumption) (Table 3). Post-hoc tests were performed to examine which age group did differ significantly from each other. For sleep problems, the Tukey post-hoc test indicated that all three groups differed significantly from each other ( p < .001), although effect sizes were small ( ή 2 = .05). Similarly, for physical activity, post-hoc comparisons showed that each age groups differed significantly from the other (p <.001), again with small effect sizes ( r = .26). Screen time use was analysed separately for weekends and weekdays. On weekdays, the Tukey post-hoc test revealed significant differences between the 0-3 years and 13-18 years groups ( p < .001), as well as between the 4-12 years and 13-18 years groups ( p < .001). A large effect size was observed ( ή 2 = .29). For weekend scree time, all three age groups differed significantly from each other ( p < .001), also, with a large effect size ( ή 2 = .29). Post-hoc tests for nutrition intake showed that, for fruit consumption, significant differences existed between the age group 0-3 years and 13-18 years ( p < .001) and between age group 4-12 years and 13-18 years ( p < .001). These differences corresponded to a medium effect sizes ( r = .34). In addition, for vegetable intake, the post-hoc tests showed a significant difference between age group 0-3 years and 4-12 years ( p < .001), and between age group 0-3 years and 13-18 years ( p < .001). However, these effect sizes were small ( r = .08). Table 3. Lifestyle behaviours across age groups. 0-3 years 4-12 years 13-18 years Test statistic 7 P-value Effect size n = 459 n = 2,553 n = 1,620 M SE M SE M SE Sleep a 1.63 .04 1.47 .02 1.87 .02 F (2, 4303) = 100.69 <.001 1 ή 2 = .05 Physical activity (days per week ) b 4.35 .14 3.72 .05 2.52 .05 H (2, 4177) = 302.37 <.001 2 r = .26 Screen use (hours a day) c 2.16 .08 2.26 .03 4.91 .07 F (2, 3942) = 810.01 <.001 3 ή 2 = .29 Week day 2.54 .08 3.40 .04 6.30 .08 F (2, 3955) = 809.38 <.001 4 ή 2 = .29 Weekend day 3.27 .06 3.32 .02 2.36 .04 H (2, 4475) = 520.49 <.001 5 r = .34 Nutrition intake (days per week) d 2.54 .07 2.95 .02 3.01 .03 H (2, 4489) = 31.35 <.001 6 r = .08 Fruit 1.63 .04 1.47 .02 1.87 .02 F (2, 4303) = 100.69 <.001 1 ή 2 = .05 Vegetables Note: M = Mean; SE = Standard Error; ή 2 = Eta squared * ; r = effect size Kruskal-Wallis rank-biserial correlation * , Test statistic is defined as F (ANOVA) or H = Kruskal-Wallis H test * Interpretation effect sizes: ή 2 : 0.01 = small effect, 0.06 = medium effect, 0.14 = large effect, r : 0.1 = small effect, 0.3 = medium effect, 0.5 = large effect. a Score 0 = never, 1 = rarely, 2 = sometimes, 3 = often, 4 = always b How many days per week does your child average at least 60 minutes of moderate to vigorous physical activity or play? Answer options go from 0 till 7 days. c How many hours a day does your child spend time in front of a screen on a week day/weekend day? Answer options go to a maximum of 12 hours. d How many days per week does your child eats fruit/vegetables? 1 Tucky post-hoc test showed that all three groups significantly differ from each other (p<.001). 2 Post-hoc tests showed that all three groups significantly differ from each other (p<.001). 3 Tuckey post-hoc tests showed a significant difference between age group 0-3 years and 13-18 years (p<.001) and a significant difference between age group 4-12 years and 13-18 years (p<.001). 4 Tuckey post-hoc tests showed that all three age groups significantly differ from each other (p<.001). 5 Post-hoc tests showed a significant difference between age group 0-3 years and 13-18 years (p<.001) and a significant difference between age group 4-12 years and 13-18 years (p<.001). 6 Post-hoc tests showed a significant difference between age group 0-3 years and 4-12 years (p<.001) and a significant difference between age group 0-3 years and 13-18 years (p<.001). 7 Significant values have been adjusted by the Bonferonni correction for multiple tests. Lifestyle behaviours by sex The differences between lifestyle behaviours between boys and girls are presented in Table 4. The data for children with unspecified sex were excluded due to the small sample size of this group ( N = 15, 0.3%). Significant sex differences were observed across all four lifestyle behaviours: sleep, physical activity, screen time use (on both weekdays and weekends), and nutrition intake (i.e., fruit and vegetable consumption) (Table 4). The largest effect size was found for screen time use during weekdays, with girls reporting significantly more screen time than boys ( d = -.39), although this still falls within the small effect range. Table 4 . Lifestyle behaviours by sex. Boys Girls Test statistic 5 P-value Effect size N = 1,410 N = 685 M SE M SE Sleep 1 1.50 .82 1.76 .87 t(3893) = -9.89 <.001 d = -.31 Physical activity (days per week ) 2 3.62 .05 3.03 .05 U = 1842903 <.001 r = -.12 Screen use (hours a day) 3 2.77 .45 3.65 .06 t(3370) = -11.79 <.001 d = -.39 Week day 3.92 .05 4.83 .07 t(3603) = -10.61 <.001 d = -.34 Weekend day 3.06 .03 2.91 .03 U = 4259430 <.001 r = -.06 Nutrition intake (days per week) 4 2.85 .03 3.03 .03 U = 2297491 <.001 r = -.06 Fruit 1.50 .82 1.76 .87 t(3893) = -9.89 <.001 d = -.31 Vegetables Note: M = Mean; SD = Standard Deviation; t = t-test; U = Mann-Whitney U; d = Cohen’s d * ; r = effect size Rank-biserial correlation of Mann-Whitney U * . *Interpretation effects sizes: d: 0.2 = small effect, 0.5 = medium effect, 0.8 = large effect, r: 0.1 = small effect, 0.3 = medium effect, 0.5 = large effect. 1 Sleep behaviour was defined as a difficulty when a score of ‘often’ or ‘always’ was given. 2 How many days per week does your child average at least 60 minutes of moderate to vigorous physical activity or play? 3 How many hours a day does your child spend time in front of a screen on a week day/weekend day? 4 How many days per week does your child eats fruit/vegetables? 5 Significant values have been adjusted by the Bonferonni correction for multiple tests. The differences between lifestyle behaviours across DSM-5 diagnostic classes are presented in Table 5. The analysis included the most frequently occurring diagnostic groups in the sample, namely: ADHD, autism, depressive and anxiety disorders and trauma and stressor-related disorders. For almost all lifestyle habits (sleep, physical activity, screen time use (i.e. during weekends and during week days) and nutrition intake (i.e. fruit)), there was a significant difference between the four DSM-5 diagnostic classes (Table 5). However, no significant difference was found between DSM-diagnoses on vegetable intake. Sleep problems showed significantly variation across groups ( p < .001), with post-hoc tests indicating that most diagnostic classes differed significantly from one another. Notable differences were observed between ASD and ADHD ( p < .001), ADHD and depressive and anxiety disorders ( p = .016), ADHD and trauma ( p < .001), ASD and trauma ( p = .043) and between trauma and depressive and anxiety disorders ( p = .048). Despite these differences, the effect size was small ( ή 2 = .01). Physical activity also differed significantly across diagnostic classes ( p < .001). Post-hoc tests revealed significant differences between ASD and depressive and anxiety disorders ( p =.011), ADHD and depressive and anxiety disorders ( p <.001), ADHD and trauma ( p = .024), and ASD and ADHD ( p <.001). No significant difference was found between trauma and ASD. The effect was interpreted as small ( r = .11). In terms of screen time, significant differences were observed both for weekdays and weekends. Post-hoc tests on weekdays showed significant difference between ASD and ADHD ( p < .001), ASD and depressive and anxiety disorders ( p < .001), ADHD and depressive and anxiety disorders ( p < .001), and ADHD and Trauma ( p < .001). However, again small effect sizes were found ( ή 2 = .02). A significant difference was also found in screen time use during weekend days; with significant differences observed between ASD and ADHD ( p = .002), ASD and depressive and anxiety disorders ( p = .023), ADHD and depressive and anxiety disorders ( p < .001), ADHD and Trauma ( p = .013). However, the effect size was small ( ή 2 = .01). Regarding nutrition, significant differences were found for fruit intake ( p < .001, r = .08), especially between ADHD and depressive/anxiety disorders ( p < .001), and between ASD and ADHD ( p = .037). However, no significant post-hoc differences remained for vegetable intake after adjusting for multiple comparisons. Table 5. Primary DSM-5 diagnostic classes. ASD ADHD Depressive and anxiety disorders Trauma e Test statistic 7 P-value Effect size N = 1,410 N = 685 N = 441 N = 242 M SE M SE M SE M SE Sleep a 1.69 .02 1.51 .03 1.68 .05 1.86 .06 F (3, 2583) = 11.09 <.001 1 ή 2 = .01 Physical activity (days per week ) b 3.27 .07 3.79 .09 2.83 .11 3.26 .16 H (3, 2507) = 42.62 <.001 2 r = .11 Screen use (hours a day) c Week day 3.29 .07 2.74 .08 3.89 .15 3.50 .18 F (3, 2364) = 18.36 <.001 3 ή 2 = .02 Weekend day 4.50 .08 3.98 .10 4.98 .16 4.68 .21 F (3, 2359) = 10.24 <.001 4 ή 2 = .01 Nutrition intake (days per week) d Fruit 2.93 .04 3.15 .05 2.76 .07 2.89 .09 H (3, 2696) = 19.34 <.001 5 r = .08 Vegetables 2.82 .03 3.05 .04 2.98 .05 3.05 .07 H (3, 2705) = 9.82 .020 6 r = .06 Note: Autism Spectrum Disorders = ASD; Attention Deficit Hyperactivity Disorder; ADHD; M = Mean; SD = Standard Error; ή 2 = Eta squared * ; r = effect size Kruskal-Wallis rank-biserial correlation * ; Test statistic is defined as F (ANOVA) or H = Kruskal-Wallis H test. Significant values have been adjusted by the Bonferonni correction for multiple tests. * Interpretation effect sizes: ή 2 : 0.01 = small effect, 0.06 = medium effect, 0.14 = large effect, r : 0.1 = small effect, 0.3 = medium effect, 0.5 = large effect. a Sleep behaviour was defined as a difficulty when a score of ‘often’ or ‘always’ was given. b How many days per week does your child average at least 60 minutes of moderate to vigorous physical activity or play? c How many hours a day does your child spend time in front of a screen on a week day/weekend day? d How many days per week does your child eats fruit/vegetables? e Trauma stands for trauma and stressor related disorders 1 Tukey post-hoc tests showed significant difference between ASD and ADHD (p <.001), ADHD and Depressive and anxiety disorders (p =.016), ADHD and Trauma (p <.001), ASD and Trauma (p = .043) and between Trauma and Depressive and anxiety disorders (p = .048). 2 Post-hoc tests showed significant difference between ASD and Depressive and anxiety disorders (p =.011), ADHD and Depressive and anxiety disorders (p <.001), ADHD and trauma (p = .024), and ASD and ADHD (p <.001). 3 Tukey post-hoc tests showed significant difference between ASD and ADHD (p <.001), ASD and Depressive and anxiety disorders (p <.001), ADHD and Depressive and anxiety disorders (p <.001), and ADHD and Trauma (p <.001). 4 Tukey post-hoc tests showed significant difference between ASD and ADHD (p =.002), ASD and Depressive and anxiety disorders (p =.023), ADHD and Depressive and anxiety disorders (p <.001), ADHD and Trauma (p =.013). 5 Post-hoc tests showed significant differences between ADHD and Depressive and anxiety disorders (p <.001) and between ASD and ADHD (p =.037). 6 Post-hoc tests showed no significant differences between the DSM-classifications after adjusting for multiple tests. 7 Significant values have been adjusted by the Bonferonni correction for multiple tests. Discussion The primary aim of this study was to examine the prevalence of lifestyle habits in children and adolescents referred to specialized mental health care. Overall, our findings underscore a concerningly high rate of unhealthy lifestyle habits in this clinical population, highlighting the urgent need for targeted interventions and preventive strategies. Nearly half of the children and adolescents had difficulties initiating sleep (44.9%), closely followed by daytime fatigue (37.9%). Only 14.0% met the recommended levels of physical activity ( Beweegrichtlijnen , 2025). Daily fruit and vegetable intake was reported by 50.7% and 38.6% respectively. Regarding screentime, 13.2% exceeded 6 hours on weekdays, while 35.6% used a screen 1-2 hours a day, which meets the guidelines in the Netherlands (Jeugdinstituut, 2025). During weekend days, screentime was higher, with 35.8% using screens 3-5 hours a day and 25.4% more than 6 hours. Compared to normative populations, sleep problems seem to be more common in our sample. A recent meta-analysis examining similar self-reported and parent-reported sleep behaviours identified prevalence rates ranging from 4% to 28% among children and adolescents in a normative population (Kocevska et al., 2021). Similarly, the amount of physical activity in our clinical population seems to be less than the amount of activity reported in the Dutch general population, which is 56.8% for school-age children and 33.4% for adolescents (CBS, 2023b). In terms of nutrition intake, 52.5% of children ate fruit daily, but only 39.8% consumed vegetables daily, which is lower than recommended frequencies. In general, Dutch children consume insufficient amounts of vegetables and fruit (Voedselconsumptiepeiling, 2021). On average, they eat 100 grams of vegetables daily, while the recommended intake is 100 to 200 grams. Additionally, vegetables are consumed an average of 6 times a week, whereas daily consumption is advised. Similar trends are seen internationally, with fewer than of children and adolescents meeting the daily fruit and vegetable intake recommendations (Guenther et al., 2006; Peltzer & Pengpid, 2010; Shi et al., 2005). Our results align with these trends, as only 38.2% of Dutch children consumed sufficient amount of fruit and 39.8% sufficient vegetables (CBS, 2017). Finally, while limited literature exists on screen time use in normative populations, some Dutch studies report an average of 1-2 hours for children (Jeugdinstituut, 2023), and around 6 hours for adolescents (Instituut, 2025), consistent with our findings. As an exploratory analysis, differences in lifestyle behaviours across age groups, genders, and diagnostic categories were studied. Adolescents (13-18 years old) exhibited the unhealthiest habits, while the youngest children (0-3 years) showed the healthiest habits. However, it is important to note that the majority of the adolescents in our sample were girls (65%), which suggests that the unhealthy lifestyle of adolescents may be partially explained by the influence of gender. This is supported by the finding that girls in our sample exhibited more unhealthy lifestyle habits compared to boys. Among DSM diagnostic classes, parents of children and adolescents with depression and/or anxiety reported the least physical activity, most screen time, and lowest fruit and vegetable intake. However, the highest amount of sleep problems was reported among the children and adolescents with trauma and stressor-related disorders. Our findings on adolescents’ unhealthy lifestyle seems to be in line with previous research. High amounts of sleep problems among adolescents were also found in previous studies (Huang et al., 2010; Meltzer & Mindell, 2006; Ohida et al., 2004; Sivertsen et al., 2014). This higher prevalence of sleep problems among adolescents may be attributed to pubertal development, as it is well established that the biological clock shifts during this period (Carskadon et al., 1997). This shift delays the circadian rhythm, resulting in a later onset of sleepiness and a naturally later wake-up time for adolescents (Carskadon et al., 1997; van Tetering et al., 2024). Our findings on adolescents’ low levels of physical activity and high amounts of screen time are also consistent with previous research in the general population (van Sluijs et al., 2021). As to gender, girls had a more unhealthy lifestyle than boys. Which is in line with previous research were more sleep problems were found in girls in the general population than in boys (Estes et al., 2023; Lewien et al., 2021; van Tetering et al., 2024). Additionally, for physical activity the present study aligns with previous research in the general population, indicating that boys engage in more moderate to vigorous physical activity than girls (Kjellenberg et al., 2021; Sanz-Martín et al., 2022; Zhang et al., 2020). Lastly, when comparing diagnostic categories, the most unhealthy behaviours were observed among children and adolescents with depression and/or anxiety. The low amount of physical activity reported among depression/anxiety is in line with previous research among adolescents were an association was found between depressive symptoms and a decrease in physical activity (Kandola et al., 2020). Additionally, previous studies have identified an association between screen time and depression, suggesting that a high level of screen time usage, and thereby a high degree of sedentary behaviour, is prevalent within this group (Stiglic & Viner, 2019; Tang et al., 2021; Wang et al., 2019). Furthermore, a study among adolescents found an association between a high amount of screen time (i.e. 4 or more hours) and both anxiety disorders and depression (Kim et al., 2020). This is in line with, cross-sectional evidence showing a strong association between screen time use and depression symptoms in female adolescents (Twenge & Farley, 2021). Moreover, the small amount of fruit and vegetable intake in children with depression and/or anxiety disorders was also found in previous research. International research focussing on adolescents (12-15 years) has shown that an inadequate amount of fruit and vegetable intake was associated with a higher risk of depressive symptoms. More specifically, fruit intake was significantly associated with a reduced risk of both depressive and anxiety symptoms, whereas vegetable intake was linked to a lower risk of depressive symptoms but not anxiety symptoms (Liu et al., 2020). Mechanisms such as oxidative stress and micronutrient imbalances have been suggested to underlie these associations (Kaur & Kapoor, 2001; Khanzode et al., 2003; Kim et al., 2008; Ng et al., 2008). Moreover, the highest amount of sleep problems were reported in children with PTSD. Children with trauma-related disorders, particularly PTSD, reported the highest prevalence of sleep problems, consistent with sleep disturbances being a core feature of PTSD (American Psychiatric Association, 2013; Giannakopoulos & Kolaitis, 2021). Several mechanisms may explain the higher prevalence of unhealthy behaviours in our clinical sample. For example, children with ADHD exhibit a stronger preference for engaging in activities later in the day (“evening preference”) compared to their peers without ADHD, contributing to sleep problems (Durmuş et al., 2017). Those with ASD may experience melatonin dysregulation, leading to difficulties in regulating biological rhythms and with a later chronotype (Kantermann et al., 2015; Melke et al., 2008). These factors may contribute to the high prevalence of difficulties in initiating sleep observed in our sample. Reduced physical activity may relate to a high amount of screen time, but also to motor difficulties in children with ASD (Pan, 2008; Pan et al., 2011; Stanish et al., 2015), behavioural challenges in those with ADHD and therefore less engagement in physical activities (Mercurio et al., 2021; Tandon et al., 2019), or motivational issues in youth with depression (Parfitt & Eston, 2005; Wiles et al., 2012). Regarding unhealthy dietary patterns, such as selective eating in ASD, because of the sensory hypersensitivity to smell, taste, and texture, and impulsive behaviours in ADHD may explain the low intake of fruit and vegetables (Cortese et al., 2016; Del-Ponte et al., 2019; Demir & Özcan, 2022; Loewen et al., 2020; Mian et al., 2019; Nimbley et al., 2022; Ríos-Hernández et al., 2017; Salvat et al., 2022; Shareghfarid et al., 2020; Strimas et al., 2008). Regarding screen time, difficulties in executive functioning (i.e. limited self-regulation, impulsivity, response inhibition problems) and emotion regulation may contribute to excessive use, particularly among children with ASD and ADHD (Bioulac et al., 2008; Kelly et al., 2021; Kuenzel et al., 2024; Mazurek et al., 2012; Mostert-Kerckhoffs et al., 2015). A major strength of this study is the inclusion of a large and diverse sample of children and adolescents with mental disorders from various regions across the Netherlands, allowing for greater generalizability of the results. Unlike previous studies that have focused on specific subgroups, our study includes all children entering specialized mental health care, without exclusion criteria, ensuring a more comprehensive perspective. Additionally, in this study, we examined four distinct areas of lifestyle, offering a broad overview of lifestyle factors that may impact the population under study. By exploring various subgroups including gender, age, and DSM classification, we were able to gain valuable insights into how these factors might interact with lifestyle behaviours. Lastly, while much of the existing research has primarily focused on adults, our study specifically targets children and adolescents, an often underrepresented group in literature. Limitations should also be considered when interpreting the results of this study. First, the intake questionnaire used to assess the different lifestyle habits is not a validated instrument with norm scores, which limits our abilities to compare results with the general population. This prevented a direct comparison between the clinical and normative groups, making it more challenging to determine whether the observed lifestyle habits differ from those in the general population. Second, all data was parent-reported. Parents may have less insight into the various lifestyle behaviours of their children, which may cause self-administered questionnaires to differ from parent-reported questionnaires (Koning et al., 2018). Furthermore, the dietary data collected only focused on the frequency of food intake, without assessing the quantities consumed, which restricts the ability to draw comprehensive conclusions regarding the participants’ nutritional intake. Additionally, the study examined only primary DSM classifications, without accounting for comorbidities, which may limit the generalizability of the findings. The cross-sectional design of the study limits our ability to establish causal relationships between variables. Lastly, the severity of psychiatric problems experienced by participants could not be taken into account which may affect the interpretation of the findings in relation to the depth of the issues being investigated. Future research should include validated lifestyle instruments and incorporate normative comparison groups. Longitudinal designs would help clarify causal relationships between lifestyle and mental health. Self-report methods, particularly for adolescents, may improve data accuracy. Furthermore, more detailed assessment of diet, including portion size and variety, is essential for a deeper understanding of nutrition-related mental health risks. Finally, it would be valuable for future studies on lifestyle behaviours to incorporate substance use (including nicotine, vaping, alcohol, and drugs), due to its substantial influence on adolescents’ mental and physical well-being. To conclude, parents report high amounts of unhealthy lifestyle habits in their children with mental disorders. The unhealthiest habits were observed in older children, girls, and those with depression and/or anxiety. These findings underscore the need for routine screening and targeted interventions focusing on sleep, nutrition, physical activity, and screen time within psychiatric care for children and adolescents. Declarations Funding This study is funded by ZonMw (Project number: 555003205). The funder had no role in the design of the study, in the collection, analyses, or interpretation of data, in the writing of the manuscript, or in the decision to publish results. Any views expressed are those of the authors and not necessarily those of the funder. Data availability and preprint The original data supporting the conclusions of this article are available from the corresponding author upon reasonable request, conform the journal’s guidelines. Competing interests The authors declare no financial or non-financial conflict of interest. References Alosaimi, N., Sherar, L. B., Griffiths, P., & Pearson, N. (2023). Clustering of diet, physical activity and sedentary behaviour and related physical and mental health outcomes: a systematic review. BMC public health , 23 (1), 1572. https://doi.org/10.1186/s12889-023-16372-6 American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Beweegrichtlijnen . (2025). Kenniscentrum sport & bewegen. https://www.kenniscentrumsportenbewegen.nl/beweegrichtlijnen/ Bioulac, S., Arfi, L., & Bouvard, M. P. (2008). Attention deficit/hyperactivity disorder and video games: A comparative study of hyperactive and control children. European Psychiatry , 23 (2), 134-141. Boesveldt, S., Bobowski, N., McCrickerd, K., Maître, I., Sulmont-Rossé, C., & Forde, C. G. (2018). The changing role of the senses in food choice and food intake across the lifespan. Food Quality and Preference , 68 , 80-89. https://doi.org/https://doi.org/10.1016/j.foodqual.2018.02.004 Caamaño-Navarrete, F., Saavedra-Vallejos, E., Guzmán-Guzmán, I. P., Arriagada-Hernández, C., Fuentes-Vilugrón, G., Jara-Tomckowiack, L., Lagos-Hernández, R., Fuentes-Merino, P., Alvarez, C., & Delgado-Floody, P. (2024). Unhealthy Lifestyle Contributes to Negative Mental Health and Poor Quality of Life in Young University Students. Healthcare , 12 (22), 2213. https://www.mdpi.com/2227-9032/12/22/2213 Carskadon, M. A., Acebo, C., Richardson, G. S., Tate, B. A., & Seifer, R. (1997). An approach to studying circadian rhythms of adolescent humans. Journal of biological rhythms , 12 (3), 278-289. Carson, V., Lee, E.-Y., Hewitt, L., Jennings, C., Hunter, S., Kuzik, N., Stearns, J. A., Unrau, S. P., Poitras, V. J., & Gray, C. (2017). Systematic review of the relationships between physical activity and health indicators in the early years (0-4 years). BMC public health , 17 (5), 33-63. CBS. (2017). Gezondheidsenquête: Kinderen eten te weinig fruit, groente en vis . CBS. https://www.cbs.nl/nl-nl/nieuws/2017/46/kinderen-eten-te-weinig-fruit-groente-en-vis CBS. (2023a). Gezondheid en zorggebruik; persoonskenmerken (slaapproblemen) . CBS. Retrieved 9 juni from https://opendata.cbs.nl/statline/#/CBS/nl/dataset/85454NED/table?dl=8ED08 CBS. (2023b). Leefstijl; persoonskenmerken . CBS. https://opendata.cbs.nl/statline/#/CBS/nl/dataset/85457NED/table?dl=8ED0C&ts=1691580771758 Chaput, J.-P., Gray, C. E., Poitras, V. J., Carson, V., Gruber, R., Birken, C. S., MacLean, J. E., Aubert, S., Sampson, M., & Tremblay, M. S. (2017). Systematic review of the relationships between sleep duration and health indicators in the early years (0–4 years). BMC public health , 17 , 91-107. Cortese, S., Moreira-Maia, C. R., St. Fleur, D., Morcillo-Peñalver, C., Rohde, L. A., & Faraone, S. V. (2016). Association between ADHD and obesity: a systematic review and meta-analysis. American Journal of Psychiatry , 173 (1), 34-43. Curtin, C., Jojic, M., & Bandini, L. G. (2014). Obesity in children with autism spectrum disorders. Harvard review of psychiatry , 22 (2), 93. Del-Ponte, B., Quinte, G. C., Cruz, S., Grellert, M., & Santos, I. S. (2019). Dietary patterns and attention deficit/hyperactivity disorder (ADHD): a systematic review and meta-analysis. Journal of Affective Disorders , 252 , 160-173. Demir, A. Ç., & Özcan, Ö. (2022). The nutritional behavior of children with autism spectrum disorder, parental feeding styles, and anthropometric measurements. Nordic Journal of Psychiatry , 76 (1), 64-70. https://doi.org/10.1080/08039488.2021.1934109 Diethelm, K., Jankovic, N., Moreno, L. A., Huybrechts, I., De Henauw, S., De Vriendt, T., González-Gross, M., Leclercq, C., Gottrand, F., Gilbert, C. C., Dallongeville, J., Cuenca-Garcia, M., Manios, Y., Kafatos, A., Plada, M., & Kersting, M. (2012). Food intake of European adolescents in the light of different food-based dietary guidelines: results of the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Study. Public Health Nutrition , 15 (3), 386-398. https://doi.org/10.1017/S1368980011001935 Durmuş, F. B., Arman, A. R., & Ayaz, A. B. (2017). Chronotype and its relationship with sleep disorders in children with attention deficit hyperactivity disorder. Chronobiology International , 34 (7), 886-894. Estes, A., Munson, J., St. John, T., Finlayson, R., Pandey, J., Gottlieb, B., Herrington, J., & Schultz, R. T. (2023). Sleep problems in autism: Sex differences in the school‐age population. Autism Research , 16 (1), 164-173. Firth, J., Siddiqi, N., Koyanagi, A., Siskind, D., Rosenbaum, S., Galletly, C., Allan, S., Caneo, C., Carney, R., Carvalho, A. F., Chatterton, M. L., Correll, C. U., Curtis, J., Gaughran, F., Heald, A., Hoare, E., Jackson, S. E., Kisely, S., Lovell, K.,…Stubbs, B. (2019). The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness. The Lancet Psychiatry , 6 (8), 675-712. https://doi.org/10.1016/S2215-0366(19)30132-4 Firth, J., Solmi, M., Wootton, R. E., Vancampfort, D., Schuch, F. B., Hoare, E., Gilbody, S., Torous, J., Teasdale, S. B., & Jackson, S. E. (2020). A meta‐review of “lifestyle psychiatry”: the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders. World Psychiatry , 19 (3), 360-380. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7491615/pdf/WPS-19-360.pdf Forrest, C. B., & Riley, A. W. (2004). Childhood origins of adult health: a basis for life-course health policy. Health Affairs , 23 (5), 155-164. Giannakopoulos, G., & Kolaitis, G. (2021). Sleep problems in children and adolescents following traumatic life events. World J Psychiatry , 11 (2), 27-34. https://doi.org/10.5498/wjp.v11.i2.27 Gotay, C. C. (2005). Behavior and cancer prevention. Journal of Clinical Oncology , 23 (2), 301-310. Gradisar, M., Gardner, G., & Dohnt, H. (2011). Recent worldwide sleep patterns and problems during adolescence: a review and meta-analysis of age, region, and sleep. Sleep medicine , 12 (2), 110-118. Guenther, P. M., Dodd, K. W., Reedy, J., & Krebs-Smith, S. M. (2006). Most Americans eat much less than recommended amounts of fruits and vegetables. Journal of the American Dietetic Association , 106 (9), 1371-1379. Healy, S., Aigner, C. J., & Haegele, J. A. (2019). Prevalence of overweight and obesity among US youth with autism spectrum disorder. Autism , 23 (4), 1046-1050. Hong, G. C., Conduit, R., Wong, J., Di Benedetto, M., & Lee, E. (2021). Diet, physical Activity, and screen time to sleep better: Multiple mediation analysis of lifestyle factors in school-aged children with and without attention deficit hyperactivity disorder. Journal of attention disorders , 25 (13), 1847-1858. Huang, Y.-S., Wang, C.-H., & Guilleminault, C. (2010). An epidemiologic study of sleep problems among adolescents in North Taiwan. Sleep medicine , 11 (10), 1035-1042. https://doi.org/https://doi.org/10.1016/j.sleep.2010.04.009 Huberts-Bosch, A., Bierens, M., Ly, V., van der Velde, J., de Boer, H., van Beek, G., Appelman, D., Visser, S., Bos, L. H., & Reijmers, L. (2023). Short-term effects of an elimination diet and healthy diet in children with attention-deficit/hyperactivity disorder: a randomized-controlled trial. European Child & Adolescent Psychiatry , 1-14. Instituut, T. (2025). Hoeveel tijd brengen jongeren door achter een scherm? Wat is het sociale mediagebruik van kinderen? Alle feiten en cijfers over schermgebruik op een rij. . https://www.trimbos.nl/kennis/digitale-media-gokken/expertisecentrum-digitalisering-en-welzijn/feiten-en-cijfers-digitale-media/schermgebruik/?utm Jayedi, A., Soltani, S., Abdolshahi, A., & Shab-Bidar, S. (2020). Healthy and unhealthy dietary patterns and the risk of chronic disease: an umbrella review of meta-analyses of prospective cohort studies. British Journal of Nutrition , 124 (11), 1133-1144. https://doi.org/10.1017/S0007114520002330 Jeugdinstituut, N. (2023). Cijfers over mediagebruik . https://www.nji.nl/cijfers/mediagebruik?utm Jeugdinstituut, N. (2025). Wat is een goede schermtijd voor mijn kind? https://www.nji.nl/mediaopvoeding/wat-is-een-goede-schermtijd-voor-mijn-kind Kamal Nor, N., Ghozali, A. H., & Ismail, J. (2019). Prevalence of overweight and obesity among children and adolescents with autism spectrum disorder and associated risk factors. Frontiers in pediatrics , 7 , 38. Kandola, A., Lewis, G., Osborn, D. P. J., Stubbs, B., & Hayes, J. F. (2020). Depressive symptoms and objectively measured physical activity and sedentary behaviour throughout adolescence: a prospective cohort study. The Lancet Psychiatry , 7 (3), 262-271. https://doi.org/10.1016/S2215-0366(20)30034-1 Kantermann, T., Sung, H., & Burgess, H. J. (2015). Comparing the Morningness-Eveningness Questionnaire and Munich ChronoType Questionnaire to the dim light melatonin onset. Journal of biological rhythms , 30 (5), 449-453. Kaur, C., & Kapoor, H. C. (2001). Antioxidants in fruits and vegetables–the millennium’s health. International journal of food science & technology , 36 (7), 703-725. Kelly, S. E., Schmitt, L. M., Sweeney, J. A., & Mosconi, M. W. (2021). Reduced proactive control processes associated with behavioral response inhibition deficits in autism spectrum disorder. Autism Research , 14 (2), 389-399. Khanzode, S. D., Dakhale, G. N., Khanzode, S. S., Saoji, A., & Palasodkar, R. (2003). Oxidative damage and major depression: the potential antioxidant action of selective serotonin re-uptake inhibitors. Redox report , 8 (6), 365-370. Kim, J.-M., Stewart, R., Kim, S.-W., Yang, S.-J., Shin, I.-S., & Yoon, J.-S. (2008). Predictive value of folate, vitamin B12 and homocysteine levels in late-life depression. The British Journal of Psychiatry , 192 (4), 268-274. Kim, S., Favotto, L., Halladay, J., Wang, L., Boyle, M. H., & Georgiades, K. (2020). Differential associations between passive and active forms of screen time and adolescent mood and anxiety disorders. Social psychiatry and psychiatric epidemiology , 55 , 1469-1478. Kjellenberg, K., Ekblom, Ö., Stålman, C., Helgadóttir, B., & Nyberg, G. (2021). Associations between physical activity patterns, screen time and cardiovascular fitness levels in Swedish adolescents. Children , 8 (11), 998. Kocevska, D., Lysen, T. S., Dotinga, A., Koopman-Verhoeff, M. E., Luijk, M. P. C. M., Antypa, N., Biermasz, N. R., Blokstra, A., Brug, J., Burk, W. J., Comijs, H. C., Corpeleijn, E., Dashti, H. S., de Bruin, E. J., de Graaf, R., Derks, I. P. M., Dewald-Kaufmann, J. F., Elders, P. J. M., Gemke, R. J. B. J.,…Tiemeier, H. (2021). Sleep characteristics across the lifespan in 1.1 million people from the Netherlands, United Kingdom and United States: a systematic review and meta-analysis. Nature Human Behaviour , 5 (1), 113-122. https://doi.org/10.1038/s41562-020-00965-x Kong, C., Chen, A., Ludyga, S., Herold, F., Healy, S., Zhao, M., Taylor, A., Müller, N. G., Kramer, A. F., & Chen, S. (2023). Associations between meeting 24-hour movement guidelines and quality of life among children and adolescents with autism spectrum disorder. Journal of sport and Health Science , 12 (1), 73-86. Koning, M., de Jong, A., de Jong, E., Visscher, T. L. S., Seidell, J. C., & Renders, C. M. (2018). Agreement between parent and child report of physical activity, sedentary and dietary behaviours in 9-12-year-old children and associations with children’s weight status. BMC Psychology , 6 (1), 14. https://doi.org/10.1186/s40359-018-0227-2 Krebs-Smith, S. M., Guenther, P. M., Subar, A. F., Kirkpatrick, S. I., & Dodd, K. W. (2010). Americans Do Not Meet Federal Dietary Recommendations1. The Journal of Nutrition , 140 (10), 1832-1838. https://doi.org/https://doi.org/10.3945/jn.110.124826 Kuenzel, E., Hennessy, A., Choi, E. J., Nichols, E. S., & Duerden, E. G. (2024). Response inhibition in neurodiverse children and the association with excessive screen time use. Kumar, S., & Kelly, A. S. (2017). Review of Childhood Obesity: From Epidemiology, Etiology, and Comorbidities to Clinical Assessment and Treatment. Mayo Clin Proc , 92 (2), 251-265. https://doi.org/10.1016/j.mayocp.2016.09.017 Lewien, C., Genuneit, J., Meigen, C., Kiess, W., & Poulain, T. (2021). Sleep-related difficulties in healthy children and adolescents. BMC pediatrics , 21 , 1-11. Lianov, L., & Johnson, M. (2010). Physician competencies for prescribing lifestyle medicine. JAMA , 304 (2), 202-203. Liu, M.-w., Chen, Q.-t., Towne, S. D., Zhang, J., Yu, H.-j., Tang, R., Gasevic, D., Wang, P.-g., & He, Q.-q. (2020). Fruit and vegetable intake in relation to depressive and anxiety symptoms among adolescents in 25 low- and middle-income countries. Journal of Affective Disorders , 261 , 172-180. https://doi.org/https://doi.org/10.1016/j.jad.2019.10.007 Livingstone, K. M., Abbott, G., Ward, J., & Bowe, S. J. (2021). Unhealthy Lifestyle, Genetics and Risk of Cardiovascular Disease and Mortality in 76,958 Individuals from the UK Biobank Cohort Study. Nutrients , 13 (12), 4283. https://www.mdpi.com/2072-6643/13/12/4283 Lloyd-Jones, D. M., Hong, Y., Labarthe, D., Mozaffarian, D., Appel, L. J., Van Horn, L., Greenlund, K., Daniels, S., Nichol, G., & Tomaselli, G. F. (2010). Defining and setting national goals for cardiovascular health promotion and disease reduction: the American Heart Association’s strategic Impact Goal through 2020 and beyond. Circulation , 121 (4), 586-613. Loewen, O. K., Maximova, K., Ekwaru, J. P., Asbridge, M., Ohinmaa, A., & Veugelers, P. J. (2020). " Adherence to lifestyle recommendations and ADHD: A population-based study of children aged 10-11 years": Erratum. Lopez, A. D. (2006). Global burden of disease and risk factors. Mazurek, M. O., Shattuck, P. T., Wagner, M., & Cooper, B. P. (2012). Prevalence and correlates of screen-based media use among youths with autism spectrum disorders. Journal of autism and developmental disorders , 42 (8), 1757-1767. Melke, J., Goubran Botros, H., Chaste, P., Betancur, C., Nygren, G., Anckarsäter, H., Rastam, M., Ståhlberg, O., Gillberg, I. C., & Delorme, R. (2008). Abnormal melatonin synthesis in autism spectrum disorders. Molecular psychiatry , 13 (1), 90-98. Meltzer, L. J., & Mindell, J. A. (2006). Sleep and Sleep Disorders in Children and Adolescents. Psychiatric Clinics , 29 (4), 1059-1076. https://doi.org/10.1016/j.psc.2006.08.004 Mercurio, L. Y., Amanullah, S., Gill, N., & Gjelsvik, A. (2021). Children With ADHD Engage in Less Physical Activity. Journal of attention disorders , 25 (8), 1187-1195. https://doi.org/10.1177/1087054719887789 Mian, A., Jansen, P. W., Nguyen, A. N., Bowling, A., Renders, C. M., & Voortman, T. (2019). Children's attention-deficit/hyperactivity disorder symptoms predict lower diet quality but not vice versa: results from bidirectional analyses in a population-based cohort. The Journal of Nutrition , 149 (4), 642-648. Moore, M., & Meltzer, L. J. (2008). The sleepy adolescent: causes and consequences of sleepiness in teens. Paediatric respiratory reviews , 9 (2), 114-121. Mostert-Kerckhoffs, M. A., Staal, W. G., Houben, R. H., & de Jonge, M. V. (2015). Stop and change: Inhibition and flexibility skills are related to repetitive behavior in children and young adults with autism spectrum disorders. Journal of autism and developmental disorders , 45 , 3148-3158. Muskens, J. B., Ester, W. A., Klip, H., van Dongen-Boomsma, M., & Staal, W. G. (2023). Novel insights into somatic comorbidities in children and adolescents across psychiatric diagnoses: an explorative study. Ng, F., Berk, M., Dean, O., & Bush, A. I. (2008). Oxidative stress in psychiatric disorders: evidence base and therapeutic implications. International Journal of Neuropsychopharmacology , 11 (6), 851-876. Nimbley, E., Golds, L., Sharpe, H., Gillespie‐Smith, K., & Duffy, F. (2022). Sensory processing and eating behaviours in autism: A systematic review. European Eating Disorders Review , 30 (5), 538-559. Ohida, T., Osaki, Y., Doi, Y., Tanihata, T., Minowa, M., Suzuki, K., Wada, K., Suzuki, K., & Kaneita, Y. (2004). An Epidemiologic Study of Self-Reported Sleep Problems among Japanese Adolescents. Sleep , 27 (5), 978-985. https://doi.org/10.1093/sleep/27.5.978 Owens, J. A., & Mindell, J. A. (2011). Pediatric insomnia. Pediatric Clinics , 58 (3), 555-569. Pan, C.-Y. (2008). Objectively measured physical activity between children with autism spectrum disorders and children without disabilities during inclusive recess settings in Taiwan. Journal of autism and developmental disorders , 38 , 1292-1301. Pan, C.-Y., Tsai, C.-L., & Hsieh, K.-W. (2011). Physical activity correlates for children with autism spectrum disorders in middle school physical education. Research quarterly for exercise and sport , 82 (3), 491-498. Parfitt, G., & Eston, R. G. (2005). The relationship between children's habitual activity level and psychological well‐being. Acta Paediatrica , 94 (12), 1791-1797. Peltzer, K., & Pengpid, S. (2010). Fruits and vegetables consumption and associated factors among in-school adolescents in seven African countries. International journal of public health , 55 , 669-678. Poitras, V. J., Gray, C. E., Janssen, X., Aubert, S., Carson, V., Faulkner, G., Goldfield, G. S., Reilly, J. J., Sampson, M., & Tremblay, M. S. (2017). Systematic review of the relationships between sedentary behaviour and health indicators in the early years (0–4 years). BMC public health , 17 , 65-89. Ríos-Hernández, A., Alda, J. A., Farran-Codina, A., Ferreira-García, E., & Izquierdo-Pulido, M. (2017). The Mediterranean diet and ADHD in children and adolescents. Pediatrics , 139 (2). Roberts, R. E., Ramsay Roberts, C., & Chan, W. (2008). Persistence and change in symptoms of insomnia among adolescents. Sleep , 31 (2), 177-184. Salvat, H., Mohammadi, M. N., Molavi, P., Mostafavi, S. A., Rostami, R., & Salehinejad, M. A. (2022). Nutrient intake, dietary patterns, and anthropometric variables of children with ADHD in comparison to healthy controls: a case-control study. BMC pediatrics , 22 (1), 70. Sanz-Martín, D., Ubago-Jiménez, J. L., Ruiz-Tendero, G., Zurita-Ortega, F., Melguizo-Ibáñez, E., & Puertas-Molero, P. (2022). The relationships between physical activity, screen time and sleep time according to the adolescents’ sex and the day of the week. Healthcare, Shareghfarid, E., Sangsefidi, Z. S., Salehi-Abargouei, A., & Hosseinzadeh, M. (2020). Empirically derived dietary patterns and food groups intake in relation with Attention Deficit/Hyperactivity Disorder (ADHD): A systematic review and meta-analysis. Clinical nutrition ESPEN , 36 , 28-35. Shi, Z., Lien, N., Kumar, B. N., & Holmboe-Ottesen, G. (2005). Socio-demographic differences in food habits and preferences of school adolescents in Jiangsu Province, China. European Journal of Clinical Nutrition , 59 (12), 1439-1448. Sivertsen, B., Harvey, A. G., Lundervold, A. J., & Hysing, M. (2014). Sleep problems and depression in adolescence: results from a large population-based study of Norwegian adolescents aged 16–18 years. European Child & Adolescent Psychiatry , 23 (8), 681-689. https://doi.org/10.1007/s00787-013-0502-y Stanish, H., Curtin, C., Must, A., Phillips, S., Maslin, M., & Bandini, L. (2015). Enjoyment, barriers, and beliefs about physical activity in adolescents with and without autism spectrum disorder. Adapted physical activity quarterly , 32 (4), 302-317. Stiglic, N., & Viner, R. M. (2019). Effects of screentime on the health and well-being of children and adolescents: a systematic review of reviews. BMJ open , 9 (1), e023191. Strimas, R., Davis, C., Patte, K., Curtis, C., Reid, C., & McCool, C. (2008). Symptoms of attention-deficit/hyperactivity disorder, overeating, and body mass index in men. Eating behaviors , 9 (4), 516-518. Sutaria, S., Devakumar, D., Yasuda, S. S., Das, S., & Saxena, S. (2019). Is obesity associated with depression in children? Systematic review and meta-analysis. Archives of disease in childhood , 104 (1), 64-74. Tandon, P. S., Sasser, T., Gonzalez, E. S., Whitlock, K. B., Christakis, D. A., & Stein, M. A. (2019). Physical activity, screen time, and sleep in children with ADHD. Journal of Physical Activity and Health , 16 (6), 416-422. Tang, S., Werner-Seidler, A., Torok, M., Mackinnon, A. J., & Christensen, H. (2021). The relationship between screen time and mental health in young people: A systematic review of longitudinal studies. Clinical psychology review , 86 , 102021. https://doi.org/https://doi.org/10.1016/j.cpr.2021.102021 Twenge, J. M., & Farley, E. (2021). Not all screen time is created equal: associations with mental health vary by activity and gender. Social psychiatry and psychiatric epidemiology , 56 (2), 207-217. https://doi.org/10.1007/s00127-020-01906-9 van der Mheen, M., Zijlmans, J., van der Doelen, D. M., Klip, H., van der Lans, R. M., Ruisch, I. H., de Vries, Y. A., Tieskens, J. M., Wildschut, M., Buitelaar, J. K., Hoekstra, P. J., Lindauer, R. J. L., Popma, A., Vermeiren, R., Broek, E. M., Dekkers, T. J., Dietrich, A., Hein, I. M., Luman, M.,…Polderman, T. J. C. (2024). Patterns of Mental Disorders in a Large Child Psychiatric Sample (N = 65,363): A DREAMS Study. JAACAP Open . https://doi.org/https://doi.org/10.1016/j.jaacop.2024.06.007 van Sluijs, E. M. F., Ekelund, U., Crochemore-Silva, I., Guthold, R., Ha, A., Lubans, D., Oyeyemi, A. L., Ding, D., & Katzmarzyk, P. T. (2021). Physical activity behaviours in adolescence: current evidence and opportunities for intervention. The lancet , 398 (10298), 429-442. https://doi.org/https://doi.org/10.1016/S0140-6736(21)01259-9 van Tetering, E. M., Mies, G. W., Klip, H., Pillen, S., Muskens, J. B., Polderman, T. J., van der Mheen, M., Staal, W. G., & Pieters, S. (2024). The relationship between sleep difficulties and externalizing and internalizing problems in children and adolescents with mental illness. Journal of Sleep research , e14398. Voedselconsumptiepeiling. (2021). Nederlandse voedingsmiddelen consumptie . https://www.wateetnederland.nl/resultaten/voedingsmiddelen Wang, X., Li, Y., & Fan, H. (2019). The associations between screen time-based sedentary behavior and depression: a systematic review and meta-analysis [Article]. BMC public health , 19 (1), Article 1524. https://doi.org/10.1186/s12889-019-7904-9 Whatnall, M. C., Collins, C. E., Callister, R., & Hutchesson, M. J. (2016). Associations between Unhealthy Diet and Lifestyle Behaviours and Increased Cardiovascular Disease Risk in Young Overweight and Obese Women. Healthcare , 4 (3), 57. https://www.mdpi.com/2227-9032/4/3/57 Wiles, N. J., Haase, A. M., Lawlor, D. A., Ness, A., & Lewis, G. (2012). Physical activity and depression in adolescents: cross-sectional findings from the ALSPAC cohort. Social psychiatry and psychiatric epidemiology , 47 , 1023-1033. Yang, H., Gao, J., Wang, T., Yang, L., Liu, Y., Shen, Y., Gong, J., Dai, W., Zhou, J., Gu, J., Pan, Z., & Zhu, S. (2017). Association between adverse mental health and an unhealthy lifestyle in rural-to-urban migrant workers in Shanghai. Journal of the Formosan Medical Association , 116 (2), 90-98. https://doi.org/https://doi.org/10.1016/j.jfma.2016.03.004 Yee, A. Z. H., Lwin, M. O., & Ho, S. S. (2017). The influence of parental practices on child promotive and preventive food consumption behaviors: a systematic review and meta-analysis. International Journal of Behavioral Nutrition and Physical Activity , 14 (1), 47. https://doi.org/10.1186/s12966-017-0501-3 Zhang, Z., Li, H., Slapsinskaite, A., Zhang, T., Zhang, L., & Gui, C. (2020). Accelerometer-measured physical activity and sedentary behavior in Chinese children and adolescents: a systematic review and meta-analysis. Public Health , 186 , 71-77. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 30 Aug, 2025 Read the published version in Child Psychiatry & Human Development → Version 1 posted Editorial decision: Revision requested 09 Jun, 2025 Reviews received at journal 17 May, 2025 Reviewers agreed at journal 14 May, 2025 Reviewers invited by journal 14 May, 2025 Editor assigned by journal 11 May, 2025 Submission checks completed at journal 30 Apr, 2025 First submitted to journal 30 Apr, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6562159","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":457215268,"identity":"e9a1fa44-c42d-4263-83a9-7a19d46529b9","order_by":0,"name":"Emilie Maria Antonia van Tetering","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABEUlEQVRIie2PsUrDQBzG/yEQl4Pb5I4geYULHRwazatcCFyXLm4ZRBICyVKcr1h8jE4OVwKZ8gZddImrRYSAQm3qUuRaMgreb/qG78fHB2Aw/G2sFCDhu+AMaXMgP0qzV/o0SOmHigEKBuS/33TBHXar4uXjUXiXZT153jyBh8+VVqEpGrmSC0Lvo3J0sZz6i0asMtmCP3/gWoUph7uIV4Q1VuHSZWJJmGQ5UsDZWq+Eyok/Ed+ScK8sklDi1yz/OqEwsOvdiiIMWQXdpNNIErHK4YRCKrseIxFT2a9ALWJJ2mg+U+ToF1xm+RoF1xjPzlra3cZXEgv21qnAw65eAfswo4N5ff03VjesZzAYDP+MbwHRWZhXjv+8AAAAAElFTkSuQmCC","orcid":"","institution":"Radboud University Nijmegen Medical Centre","correspondingAuthor":true,"prefix":"","firstName":"Emilie","middleName":"Maria Antonia van","lastName":"Tetering","suffix":""},{"id":457215269,"identity":"965a0aab-e763-4c7f-b62c-173a82073606","order_by":1,"name":"Malindi van der Mheen","email":"","orcid":"","institution":"Levvel","correspondingAuthor":false,"prefix":"","firstName":"Malindi","middleName":"van der","lastName":"Mheen","suffix":""},{"id":457215270,"identity":"b9667f5e-dbcc-45ac-b451-1ae68c11112b","order_by":2,"name":"Helen Klip","email":"","orcid":"","institution":"Karakter","correspondingAuthor":false,"prefix":"","firstName":"Helen","middleName":"","lastName":"Klip","suffix":""},{"id":457215271,"identity":"5c8a722c-3283-4271-8a9d-b3e35217bb5b","order_by":3,"name":"Jet Muskens","email":"","orcid":"","institution":"Radboud University Nijmegen Medical Centre","correspondingAuthor":false,"prefix":"","firstName":"Jet","middleName":"","lastName":"Muskens","suffix":""},{"id":457215272,"identity":"7fce8610-d662-424a-af09-d61886ac4748","order_by":4,"name":"Tinca J. C. Polderman","email":"","orcid":"","institution":"Levvel","correspondingAuthor":false,"prefix":"","firstName":"Tinca","middleName":"J. C.","lastName":"Polderman","suffix":""},{"id":457215273,"identity":"3ebfefd6-8eca-47b9-a98c-4bafc597fc2a","order_by":5,"name":"Ramon J. L. Lindauer","email":"","orcid":"","institution":"Levvel","correspondingAuthor":false,"prefix":"","firstName":"Ramon","middleName":"J. L.","lastName":"Lindauer","suffix":""},{"id":457215274,"identity":"dad25f89-297b-4712-8cdb-266597d2c645","order_by":6,"name":"Wouter G. Staal","email":"","orcid":"","institution":"Karakter","correspondingAuthor":false,"prefix":"","firstName":"Wouter","middleName":"G.","lastName":"Staal","suffix":""}],"badges":[],"createdAt":"2025-04-30 07:23:15","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6562159/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6562159/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1007/s10578-025-01877-5","type":"published","date":"2025-08-30T15:57:20+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":90344951,"identity":"ea0dbbc5-5f41-43be-a127-ae88ddf94e13","added_by":"auto","created_at":"2025-09-01 16:08:16","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1192874,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6562159/v1/8147104b-6564-40b4-9481-a0a8e8b5eadb.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Prevalence of Unhealthy Lifestyle Behaviours in Children and Adolescents with Mental Disorders","fulltext":[{"header":"Introduction","content":"\u003cp\u003eUnhealthy lifestyle behaviours are common among children and adolescents, and profoundly impact children\u0026rsquo;s health. In particular, insufficient physical activity, poor dietary habits, sleep problems, and excessive screen time play major roles in these behaviours (Alosaimi et al., 2023; Carson et al., 2017; Chaput et al., 2017; Kumar \u0026amp; Kelly, 2017; Poitras et al., 2017). In The Netherlands, less than half of the individuals aged four years and older meet the national physical activity guidelines. Specifically, 56.8% of children aged 4 to 12 years engage in at least one hour of moderate-to-vigorous physical activity per day, while only 33.4% of adolescents aged 13 to 18 years meet this recommendation (CBS, 2023b). Additionally, a significant proportion of children in the Netherlands have inadequate fruit intake, with only 38.2% consuming sufficient amounts (CBS, 2017). Furthermore, studies from Europe and the United States of America have found that the majority of children and adolescents failed to eat the recommended amount of fruit and vegetables (Diethelm et al., 2012; Krebs-Smith et al., 2010).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eBesides unhealthy diet and lack of physical activity, sleep problems are also highly prevalent among children. Sixteen percent of Dutch children aged 12 to 16 years suffer from sleep problems, with higher prevalence rates (22.7%) observed in adolescents (18-20 years) (CBS, 2023a). Also, worldwide, many children and adolescents suffer from sleep problems (Owens \u0026amp; Mindell, 2011). The prevalence of sleep difficulties is estimated to range from 20% to 30% among children aged 1 to 12 years (Owens \u0026amp; Mindell, 2011) and from 16% to 23% among adolescents (Gradisar et al., 2011; Moore \u0026amp; Meltzer, 2008; Roberts et al., 2008).\u003c/p\u003e\n\u003cp\u003eInsufficient physical activity and suboptimal dietary habits are examples of unhealthy lifestyle behaviours that can elevate the risk of chronic diseases including cardiovascular disease, cancer, and diabetes (Gotay, 2005; Jayedi et al., 2020; Livingstone et al., 2021; Lloyd-Jones et al., 2010; Lopez, 2006; Whatnall et al., 2016). Although these chronic diseases may not manifest until adulthood, the behaviours that increase the risk of these diseases, often develop in childhood and adolescence (Forrest \u0026amp; Riley, 2004), which highlights the importance of targeting prevention in youth.\u003c/p\u003e\n\u003cp\u003eUnhealthy lifestyle behaviours are even more prevalent among children with mental disorders , such as autism spectrum disorder (ASD), Attention Deficit/Hyperactivity Disorder (ADHD), depression, and anxiety disorders, compared to their peers in the general population (Cortese et al., 2016; Kamal Nor et al., 2019; Sutaria et al., 2019). Notably, obesity is frequently observed in children diagnosed with ASD (i.e. 21.9% - 23.05%) and ADHD (i.e. the pooled prevalence of obesity was increased by 40% in children with ADHD, compared to children without ADHD) (Cortese et al., 2016; Healy et al., 2019; Kamal Nor et al., 2019). Furthermore, a review of children with ASD revealed higher incidences of sedentary behaviour, unhealthy dietary habits, and sleep disturbances compared to their peers in the general population (Curtin et al., 2014). In a recently published study, focusing on children with mental health issues, it was found that a majority exhibited somatic symptoms related to unhealthy lifestyle patterns, characterized by overweight and obesity, problems associated with food intake, and sleep problems (Muskens et al., 2023). While lifestyle behaviours in children and adolescents with mental health problems still appear to be under-researched, existing studies clearly highlight the importance of early detection and intervention (Kong et al., 2023; Muskens et al. 2023). An illustrative example is a recently published randomized controlled trial (RCT) that investigated the impact of a healthy diet on ADHD symptoms and reported a reduction in symptoms among children adhering to a healthy diet (Huberts-Bosch et al., 2023). Also, in another study improvements in sleep quality following a lifestyle intervention among children with ADHD were observed (Hong et al., 2021).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eRecent findings show a growing awareness of the relationship between lifestyle factors and mental disorders (Caama\u0026ntilde;o-Navarrete et al., 2024; Firth et al., 2019; Lianov \u0026amp; Johnson, 2010; Yang et al., 2017). For instance, an umbrella review, primarily focused on adults, demonstrated that some lifestyle behaviours, such as low levels of physical activity, sleep disturbances, adverse dietary patterns, and tobacco smoking, are associated with an increased risk of mental disorders (Firth et al., 2020).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOverall, there is consensus that lifestyle factors are contributors to mental health issues in children and adolescents, and vice versa; more unhealthy lifestyle habits are seen in children and adolescents with mental disorders (Cortese et al., 2016; Kamal Nor et al., 2019; Sutaria et al., 2019). Nevertheless, data on the prevalence of lifestyle behaviours across diagnostic groups in children with mental disorders are currently lacking. Hence, the primary objective of this study was to gain more insight into the prevalence of lifestyle behaviours among children with diverse mental disorders. It is expected that the prevalence of lifestyle problems is higher among children and adolescents with mental disorders than among their peers without such conditions. In this exploratory study, we aimed to assess differences in lifestyle behaviours between age groups, sexes, and diagnostic diagnoses in children with mental disorders.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cem\u003eDesign, procedures and participants\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eData were obtained from two academic Dutch child and adolescent psychiatry centers (Karakter \u0026nbsp;and Levvel). These two centers are part of the DREAMS consortium (www.dreams-study.nl), covering the eastern and western regions of the Netherlands, and provide inpatient and outpatient care for children and adolescents with various mental disorders (van der Mheen et al., 2024). Data were extracted from the electronic health records of all children (\u003cem\u003eN\u0026nbsp;\u003c/em\u003e= 4,633; data from Karakter \u003cem\u003en\u0026nbsp;\u003c/em\u003e= 3,784; data from Levvel \u003cem\u003en\u0026nbsp;\u003c/em\u003e= 849) aged 0-18 years (\u003cem\u003eM\u0026nbsp;\u003c/em\u003e= 9.83,\u003cem\u003e\u0026nbsp;SD\u0026nbsp;\u003c/em\u003e= 4.58) at the time of admission between April 2021 and September 2023. To examine possible differences between age groups on the various lifestyle habits, the data were stratified in three age cohorts. Given clear differences in sleep needs and eating patterns (Boesveldt et al., 2018; Kocevska et al., 2021; Yee et al., 2017), we divided the sample into the following age cohorts: 0-3 years, 4-12 years, and 13-18 years.\u003c/p\u003e\n\u003cp\u003eThe data for this study were collected in the course of clinical practice and obtained retrospectively, and as a result, this study was not subject to the Dutch Medical Research Involving Human Subjects Act. This was confirmed by the Medical Ethics Committee of Amsterdam UMC (reference code: 2023.0921). Both patients and their legal caregivers were informed that the data collected during regular care could be used in scientific research.\u003cem\u003e\u0026nbsp;\u003c/em\u003eThey were given the option to opt out of having their data used for research purposes at any time with the assurance that this decision would have no impact on their treatment.\u003c/p\u003e\n\u003cp\u003eBefore their initial appointment at Karakter or Levvel, parents were asked to complete a digital intake questionnaire developed by DREAMS. This questionnaire assessed a range of variables, including demographic information such as the country of birth of the child and both parents as well as the parents\u0026apos; educational levels. Additionally, the intake questionnaire included inquiries related to lifestyle behaviours such as sleep habits, screen time, consumption of fruits and vegetables, and levels of physical activity.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eMeasures\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eSleep\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eMeasurements on sleep behaviour were operationalised with a composite of several questions from the intake questionnaire. The following four criteria of insomnia were used to define sleep behaviour: (1) difficulties initiating sleep (\u0026quot;How often does it take more than 30 minutes for your child to fall asleep? Think of the past four weeks\u0026quot;), (2) difficulties maintaining sleep (\u0026quot;How often does your child wake up more than three times a night or lie awake for more than 20 minutes a night? Think of the past four weeks\u0026rdquo;), (3) early morning awakenings (\u0026quot;How often does your child wake up before 6 AM? Think of the past four weeks\u0026quot;), and (4) daytime fatigue (\u0026quot;How often does your child suffer from tiredness during the daytime? Think of the past four weeks\u0026quot;). Responses were provided on a 5-point Likert scale ranging from 1 = \u003cem\u003e(\u003c/em\u003e\u003cem\u003ealmost) never\u003c/em\u003e to 5 = \u003cem\u003ealways\u003c/em\u003e. To assess the prevalence of sleep difficulties, we computed the proportion of individuals experiencing specific sleep-related challenges. Sleep problems were dichotomized, with a score of 4 (often) and 5 (always) indicating the presence of a sleep problem, a score of three or lower indicated the absence of a sleep problem.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003ePhysical activity\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe amount of physical activity was measured with the item \u0026ldquo;How many days a week, on average, does your child get at least 60 minutes of moderate to strenuous physical activity or play?\u0026rdquo;. Responses were given on a 8-point Likert scale ranging from 0 = \u003cem\u003eZero days a week\u003c/em\u003e to 7 = \u003cem\u003eSeven days a week.\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eFruit and vegetable intake\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe frequency of fruit intake by the child was assessed with the item: \u0026quot;How many days a week does your child eat fruit?\u0026quot; The frequency of vegetable intake was examined similarly with the item: \u0026quot;How many days a week does your child eat vegetables?\u0026quot; Responses for both questions were given on a 5-point Likert scale, ranging from 0 = \u003cem\u003eNever/hardly ever\u003c/em\u003e to 4 = \u003cem\u003eevery day\u003c/em\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eScreen time\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe amount of screen time was assessed using two items: \u0026ldquo;How many hours a day does your child sit in front of a screen on weekdays?\u0026rdquo; (1), and \u0026ldquo;How many hours a day does your child sit in front of a screen at weekends?\u0026rdquo;(2). Both items were open-ended. An upper limit of 12 h was imposed to ensure realistic assessment. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eDSM-classification of psychiatric disorders\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe classifications of psychiatric disorders were retrieved from the electronic health records. Mental health professionals (child and adolescent psychiatrists and certified psychologists) classified psychiatric disorders during the course of clinical practice according to the DSM-5 criteria (American Psychiatric Association, 2013), adhering to standard diagnostic procedures.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;In this study, we used the primary DSM-5 classification in our analyses, because this classification addresses the mental disorders that are the primary focus of clinical attention (van der Mheen et al., 2024). The DSM-5 diagnostic classes used were: ADHD, ASS, trauma and stressor related disorders (i.e., reactive attachment disorder, disinhibited social contact disorder, posttraumatic stress disorder, acute stress disorder, adjustment disorders, other specified trauma or stressor-related disorder, unspecified trauma or stressor-related disorder), depressive disorders (i.e., disruptive mood dysregulation disorder, depressive disorder, dysthymia, premenstrual mood disorder, depressive mood disorder due to a substance/medication, depressive mood disorder due to a general medical condition, other specified depressive mood disorder, unspecified depressive mood disorder), and anxiety disorders (i.e., separation anxiety disorder, selective mutism, specific phobia, social anxiety disorder, panic disorder, agoraphobia, generalized anxiety disorder, anxiety due to a substance/medication, anxiety disorder due to a general medical condition, other specified anxiety disorder, and unspecified anxiety disorder). Depressive disorders and anxiety disorders were taken together in the category \u0026lsquo;depressive and anxiety disorders\u0026rsquo;, since both are characterized by internalizing problems. The reason for selecting only these DSM-classifications is twofold: first, they have the highest prevalence within this sample, and second, there is substantial evidence in the literature supporting the association between these mental disorders and lifestyle problems in children and adolescents.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eStatistical analysis\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eData were analysed using SPSS 29 for Windows (SPSS IBM). For all lifestyle habits, the analyses were conducted across three distinct age cohorts (i.e. 0-3 \u0026nbsp;years, 4-12 years, and 13-18 years), sex (i.e., boys or girls) and DSM-diagnoses (i.e., ADHD, Autism, Trauma and stressor-related disorders, mood and anxiety disorders). Before testing, assumptions of normality were checked. The variables of sleep behaviour and screen time use were normally distributed, while the variables of fruit and vegetable intake and physical activity did not follow a normal distribution. In case of normal distribution, independent samples t-tests were used to examine the differences in means between boys and girls for sleep behaviour and screen time use. For physical activity and fruit and vegetable intake, a Mann-Whitney U test was performed because the assumption of normality was not met. A one-way ANOVA was conducted to examine the differences in means between the three age groups and between four DSM-diagnoses for sleep behaviour and screen time use. Additionally, the Kruskal-Wallis test was used for physical activity and fruit and vegetable intake due to the violated assumption of normality. Since the variables had more than five response categories, all outcome measures were treated as continuous variables. Finally, a Bonferroni correction was applied to adjust the p-values for each analysis. \u0026nbsp;\u0026nbsp;\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eDescriptive statistics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe characteristics of the study population are presented in Table 1. The intake questionnaire was completed by caregivers of 4,979 children (2,743 boys, 2,219 girls, and 17 children with unspecified sex). The sample consisted of 346 duplicates, which occurred because the intake questionnaire was completed at multiple time points or by multiple informants (e.g., fathers and mothers). The decision was made to retain the questionnaire with the most recent completion date (\u003cem\u003en\u003c/em\u003e = 117 removals). Subsequently, duplicates involving multiple informants were removed (\u003cem\u003en\u0026nbsp;\u003c/em\u003e= 229 removals), prioritizing the responses from the biological mother. After removing duplicates, \u003cem\u003eN\u003c/em\u003e = 4,633 children and adolescents were included in the study (2,553 boys, 2,064 girls, and 15 with unspecified sex).\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"105%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"9\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 1.\u0026nbsp;\u003c/strong\u003e\u003cem\u003eCharacteristics of the study population (N = 4,633).\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003eM\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003e(SD)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003eAge in years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e9.83\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e(4.58)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003eN\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003e(%)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003eAge\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;0-3 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e459\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e9.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;4-12 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e2553\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e55.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;13-18 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e1620\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e35.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Missing data\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Boys\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e2553\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e55.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Girls\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e2064\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e44.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Non-binary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Missing data\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003ePrimary DSM-5 diagnostic classifications\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;ASD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e1,41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e30.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;ADHD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e685\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e14.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Depressive/anxiety disorders\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e441\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e9.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Trauma and stressor related-disorders\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e242\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e5.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Other\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e856\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e18.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Missing data\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e999\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e21.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003eSocio Economic Status (SES)\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Low SES\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e870\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e18.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Middle SES\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e1509\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e32.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;High SES\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e2243\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e48.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Missing data\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 15px;\"\u003e\n \u003cp\u003eChild\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 16px;\"\u003e\n \u003cp\u003eMother\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 15px;\"\u003e\n \u003cp\u003eFather\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003eN\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003e%\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cem\u003eN\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003e%\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003eN\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003e%\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003eCountry of birth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Western\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e4263\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e92.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e3981\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e85.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e3537\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e76.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Non-Western\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e1.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e355\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e7.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e335\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e7.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Missing data\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e280\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e6.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e297\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e6.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e761\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e16.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003eEducation level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Practical\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e681\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e14.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e740\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e16.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Practical-theoretical\u003csup\u003ed\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e1798\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e38.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e1517\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e32.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Theoretical\u003csup\u003ee\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e1871\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e40.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e1559\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e33.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Missing data\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e283\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e6.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e817\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e17.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"9\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cem\u003eNote:\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003csup\u003ea\u003c/sup\u003eOther DSM-5 diagnostic\u0026nbsp;classifications: Mild intellectual disability, Neurodevelopmental disorders, Schizophrenia spectrum and other psychotic disorders, Obsessive-compulsive and related disorders, Somatic symptom and related disorders, Feeding and eating disorders, Toilet training disorders, Sleep-wake disorders, Gender dysphoria, Disruptive, impulse-control, and conduct disorders, Substance-related and addictive disorders, Neurocognitive disorders, Personality disorders, Other mental disorders and Child and adolescent disorders\u003c/p\u003e\n \u003cp\u003e\u003csup\u003eb\u003c/sup\u003eThe socio economic status (SES) of parents was based on their postal codes using reference data obtained from the Central Bureau of Statistics in the Netherlands. Reference SES scores were calculated by CBS using multiple correspondence analysis, with inputs including national wealth decile, household educational level, and recent employment history. The total SES-WOA score for each household is the sum of the corresponding factors, while the postal code area\u0026apos;s score represents the average of all household SES-WOA scores within that area.\u003c/p\u003e\n \u003cp\u003e\u003csup\u003ec\u003c/sup\u003ePractical includes: No education, Primary school, Pre-vocational secondary education.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003csup\u003ed\u003c/sup\u003ePractical-theoretical includes: Secondary vocational education, Higher general secondary education, Pre-university.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003csup\u003ee\u003c/sup\u003eTheoretical includes: University of applied sciences and University\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 2a, 2b, 2c and 2d present a description of lifestyle behaviours in the total sample. The majority of children experienced at least one sleep-related problem, with 44.9% (N = 2,080) reporting difficulties initiating sleep and 37.9% (N = 1,755) experiencing daytime fatigue. Only 14.0% (N = 647) engaged in the recommended 60 minutes of daily physical activity. Regarding screen time on weekdays, 35.6% (N = 1,651) had 0-2 hours per day, while 13.2% (N = 612) exceeded 6 hours daily. On weekends, 35.8% (N = 1,659) had 3-5 hours of screen time, and 25.4% (N = 1,175) had over 6 hours. Daily fruit consumption was reported by 50.7% (N = 2,350) of children, whereas only 38.6% (N = 1,787) consumed vegetables daily.\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"13\" valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 2a.\u0026nbsp;\u003c/strong\u003e\u003cem\u003eSleep items for the total study population (N = 4,633).\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 28px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 11px;\"\u003e\n \u003cp\u003e(almost) never\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 11px;\"\u003e\n \u003cp\u003eSeldom\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 11px;\"\u003e\n \u003cp\u003eSometimes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 11px;\"\u003e\n \u003cp\u003eOften\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 11px;\"\u003e\n \u003cp\u003eAlways\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 12px;\"\u003e\n \u003cp\u003eMissing data\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 28px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e\u003cem\u003e%\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e\u003cem\u003e%\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e\u003cem\u003e%\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e\u003cem\u003e%\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e\u003cem\u003e%\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u003cem\u003e%\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003eDifficulties maintaining sleep\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e1795\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e38.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e833\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e18.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e731\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e15.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e546\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e11.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e197\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e4.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e531\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e11.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003eEarly morning awakenings\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e2225\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e48.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e859\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e18.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e749\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e16.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e432\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e9.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e128\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e2.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e240\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e5.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003eDaytime fatigue\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e656\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e14.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e733\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e15.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e1339\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e28.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e1229\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e26.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e526\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e11.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e150\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e3.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003eDifficulties initiating sleep\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e607\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e13.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e588\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e12.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e974\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e21.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e1144\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e24.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e936\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e20.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e384\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e8.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"676\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"19\" valign=\"bottom\" style=\"width: 676px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 2b.\u0026nbsp;\u003c/strong\u003e\u003cem\u003eHow many days per week does your child average at least 60 minutes of moderate to vigorous physical activity or play? (N = 4,633).\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"bottom\" style=\"width: 98px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 64px;\"\u003e\n \u003cp\u003e0 days a week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 64px;\"\u003e\n \u003cp\u003e1 day a week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 64px;\"\u003e\n \u003cp\u003e2 days a week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 64px;\"\u003e\n \u003cp\u003e3 days a week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 64px;\"\u003e\n \u003cp\u003e4 days a week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 64px;\"\u003e\n \u003cp\u003e5 days a week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 64px;\"\u003e\n \u003cp\u003e6 days a week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 64px;\"\u003e\n \u003cp\u003e7 days a week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 64px;\"\u003e\n \u003cp\u003eMissing data\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 30px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cem\u003e%\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 30px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cem\u003e%\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 30px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cem\u003e%\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 30px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cem\u003e%\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 30px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cem\u003e%\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 30px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cem\u003e%\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 30px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cem\u003e%\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 30px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cem\u003e%\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 30px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cem\u003e%\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 98px;\"\u003e\n \u003cp\u003ePhysical activity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 30px;\"\u003e\n \u003cp\u003e617\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e13.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 30px;\"\u003e\n \u003cp\u003e501\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e10.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 30px;\"\u003e\n \u003cp\u003e583\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e12.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 30px;\"\u003e\n \u003cp\u003e625\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e13.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 30px;\"\u003e\n \u003cp\u003e390\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e8.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 30px;\"\u003e\n \u003cp\u003e539\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e11.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 30px;\"\u003e\n \u003cp\u003e276\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e6.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 30px;\"\u003e\n \u003cp\u003e647\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e14.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 30px;\"\u003e\n \u003cp\u003e455\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e9.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"9\" valign=\"bottom\" style=\"width: 474px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 2c.\u0026nbsp;\u003c/strong\u003e\u003cem\u003eHow many hours a day does your child spend time in front of a screen on a week day/weekend day? (N = 4,633).\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 99px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e0-2 hours a day\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e3-5 hours a day\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 94px;\"\u003e\n \u003cp\u003e6+ hours a day\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 85px;\"\u003e\n \u003cp\u003eMissing data\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 99px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cem\u003e%\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cem\u003e%\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e\u003cem\u003e%\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cem\u003e%\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003eWeek day\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e1651\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e35.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e1342\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e29.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e612\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e13.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e1028\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e22.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003eWeekend day\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e964\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e20.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e1659\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e35.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e1175\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e25.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e835\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e18.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"13\" valign=\"bottom\" style=\"width: 517px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eTable 2d.\u0026nbsp;\u003c/strong\u003e\u003cem\u003eHow many days per week does your child eats fruit/vegetables? (N = 4,633).\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003eAlmost never\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003e1-2 days a week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003e3-4 days a week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003e5-6 days\u003c/p\u003e\n \u003cp\u003ea week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003eEveryday\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003eMissing data\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cem\u003e%\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cem\u003e%\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cem\u003e%\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cem\u003e%\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cem\u003e%\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cem\u003e%\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eFruit\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e380\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e8.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e349\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e7.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e546\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e11.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e851\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e18.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2350\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e50.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e157\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e3.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eVegetable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e301\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e6.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e267\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e5.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e675\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e14.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1460\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e31.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1787\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e38.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e143\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e3.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLifestyle behaviours across age groups\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSignificant differences across the three age groups were observed for all four lifestyle behaviours: sleep, physical activity, screen time (on both weekdays and weekends), and nutrition intake (i.e., fruit and vegetable consumption) (Table 3). Post-hoc tests were performed to examine which age group did differ significantly from each other. For sleep problems, the Tukey post-hoc test indicated that all three groups differed significantly from each other (\u003cem\u003ep\u003c/em\u003e \u0026lt; .001), although effect sizes were small (\u003cem\u003eή\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e = .05). Similarly, for physical activity, post-hoc comparisons showed that each age groups differed significantly from the other (p \u0026lt;.001), again with small effect sizes (\u003cem\u003er =\u0026nbsp;\u003c/em\u003e.26). Screen time use was analysed separately for weekends and weekdays. On weekdays, the Tukey post-hoc test revealed significant differences between the 0-3 years and 13-18 years groups (\u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026lt; .001), as well as between the 4-12 years and 13-18 years groups (\u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026lt; .001). A large effect size was observed (\u003cem\u003eή\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e = .29). For weekend scree time, all three age groups differed significantly from each other (\u003cem\u003ep\u003c/em\u003e \u0026lt; .001), also, with a large effect size (\u003cem\u003eή\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e = .29). Post-hoc tests for nutrition intake showed that, for fruit consumption, significant differences existed between the age group 0-3 years and 13-18 years (\u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026lt; .001) and between age group 4-12 years and 13-18 years (\u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026lt; .001). These differences corresponded to a medium effect sizes (\u003cem\u003er =\u0026nbsp;\u003c/em\u003e.34). In addition, for vegetable intake, the post-hoc tests showed a significant difference between age group 0-3 years and 4-12 years (\u003cem\u003ep\u003c/em\u003e \u0026lt; .001), and between age group 0-3 years and 13-18 years (\u003cem\u003ep\u003c/em\u003e \u0026lt; .001). However, these effect sizes were small (\u003cem\u003er =\u0026nbsp;\u003c/em\u003e.08).\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"620\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"14\" style=\"width: 620px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 3.\u0026nbsp;\u003c/strong\u003e\u003cem\u003eLifestyle behaviours across age groups.\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 65px;\"\u003e\n \u003cp\u003e0-3 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.0968%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 10.6451%;\"\u003e\n \u003cp\u003e4-12 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 76px;\"\u003e\n \u003cp\u003e13-18 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"bottom\" style=\"width: 128px;\"\u003e\n \u003cp\u003eTest statistic\u003csup\u003e7\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"bottom\" style=\"width: 45px;\"\u003e\n \u003cp\u003eP-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003eEffect size\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e = 459\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.0968%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 10.6451%;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e = 2,553\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e = 1,620\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003eM\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003eSE\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.0968%;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.3226%;\"\u003e\n \u003cp\u003e\u003cem\u003eM\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003eSE\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cem\u003eM\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cem\u003eSE\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.0968%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.3226%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 42px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 128px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003eSleep\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e1.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2.0968%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.3226%;\"\u003e\n \u003cp\u003e1.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e1.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u003cem\u003eF\u003c/em\u003e(2, 4303) = 100.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u0026lt;.001\u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cem\u003eή\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e = .05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2.0968%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.3226%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003ePhysical activity (days per week )\u003csup\u003e\u0026nbsp;b\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e4.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2.0968%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.3226%;\"\u003e\n \u003cp\u003e3.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e2.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u003cem\u003eH\u003c/em\u003e(2, 4177) = 302.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u0026lt;.001\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cem\u003er =\u0026nbsp;\u003c/em\u003e.26\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2.0968%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.3226%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003eScreen use (hours a day)\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e2.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2.0968%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.3226%;\"\u003e\n \u003cp\u003e2.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e4.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u003cem\u003eF\u003c/em\u003e(2, 3942) = 810.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u0026lt;.001\u003csup\u003e3\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cem\u003eή\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e = .29\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp; \u0026nbsp;Week day\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e2.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2.0968%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.3226%;\"\u003e\n \u003cp\u003e3.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e6.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u003cem\u003eF\u003c/em\u003e(2, 3955) = 809.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u0026lt;.001\u003csup\u003e4\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cem\u003eή\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e = .29\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp; \u0026nbsp;Weekend day\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2.0968%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.3226%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e3.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2.0968%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.3226%;\"\u003e\n \u003cp\u003e3.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e2.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u003cem\u003eH\u003c/em\u003e (2, 4475) = 520.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u0026lt;.001\u003csup\u003e5\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cem\u003er =\u0026nbsp;\u003c/em\u003e.34\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003eNutrition intake (days per week)\u003csup\u003ed\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e2.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2.0968%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.3226%;\"\u003e\n \u003cp\u003e2.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e3.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u003cem\u003eH\u003c/em\u003e (2, 4489) = 31.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u0026lt;.001\u003csup\u003e6\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cem\u003er =\u0026nbsp;\u003c/em\u003e.08\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp; \u0026nbsp;Fruit\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e1.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2.0968%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.3226%;\"\u003e\n \u003cp\u003e1.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e1.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u003cem\u003eF\u003c/em\u003e(2, 4303) = 100.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u0026lt;.001\u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cem\u003eή\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e = .05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp; \u0026nbsp;Vegetables\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2.0968%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.3226%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 128px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.0968%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.3226%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 42px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 128px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"14\" valign=\"top\" style=\"width: 620px;\"\u003e\n \u003cp\u003e\u003cem\u003eNote: M\u003c/em\u003e = Mean; \u003cem\u003eSE\u003c/em\u003e = Standard Error; \u003cem\u003eή\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e\u003cem\u003e\u003csup\u003e\u0026nbsp;\u003c/sup\u003e\u003c/em\u003e\u003cem\u003e=\u0026nbsp;\u003c/em\u003eEta squared\u003csup\u003e*\u003c/sup\u003e\u003cem\u003e; r =\u0026nbsp;\u003c/em\u003eeffect size\u003cem\u003e\u0026nbsp;\u003c/em\u003eKruskal-Wallis rank-biserial correlation\u003csup\u003e*\u003c/sup\u003e\u003cem\u003e,\u0026nbsp;\u003c/em\u003eTest statistic is defined as \u003cem\u003eF\u003c/em\u003e (ANOVA) or \u003cem\u003eH\u003c/em\u003e = Kruskal-Wallis H test\u003c/p\u003e\n \u003cp\u003e\u003csup\u003e*\u003c/sup\u003eInterpretation effect sizes: \u003cem\u003eή\u003csup\u003e2\u003c/sup\u003e:\u0026nbsp;\u003c/em\u003e0.01 = small effect, 0.06 = medium effect, 0.14 = large effect, \u003cem\u003er\u003c/em\u003e: 0.1 = small effect, 0.3 = medium effect, 0.5 = large effect. \u003cem\u003e\u0026nbsp;\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003csup\u003ea\u0026nbsp;\u003c/sup\u003eScore 0 = never, 1 = rarely, 2 = sometimes, 3 = often, 4 = always\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003csup\u003eb\u0026nbsp;\u003c/sup\u003eHow many days per week does your child average at least 60 minutes of moderate to vigorous physical activity or play? Answer options go from 0 till 7 days.\u003c/p\u003e\n \u003cp\u003e\u003csup\u003ec\u0026nbsp;\u003c/sup\u003eHow many hours a day does your child spend time in front of a screen on a week day/weekend day? Answer options go to a maximum of 12 hours.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003csup\u003ed\u0026nbsp;\u003c/sup\u003eHow many days per week does your child eats fruit/vegetables?\u003c/p\u003e\n \u003cp\u003e\u003csup\u003e1\u003c/sup\u003eTucky post-hoc test showed that all three groups significantly differ from each other (p\u0026lt;.001).\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003csup\u003e2\u003c/sup\u003ePost-hoc tests showed that all three groups significantly differ from each other (p\u0026lt;.001).\u003c/p\u003e\n \u003cp\u003e\u003csup\u003e3\u003c/sup\u003eTuckey post-hoc tests showed a significant difference between age group 0-3 years and 13-18 years (p\u0026lt;.001) and a significant difference between age group 4-12 years and 13-18 years (p\u0026lt;.001).\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003csup\u003e4\u003c/sup\u003eTuckey post-hoc tests showed that all three age groups significantly differ from each other (p\u0026lt;.001).\u003c/p\u003e\n \u003cp\u003e\u003csup\u003e5\u003c/sup\u003ePost-hoc tests showed a significant difference between age group 0-3 years and 13-18 years (p\u0026lt;.001) and a significant difference between age group 4-12 years and 13-18 years (p\u0026lt;.001).\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003csup\u003e6\u003c/sup\u003ePost-hoc tests showed a significant difference between age group 0-3 years and 4-12 years (p\u0026lt;.001) and a significant difference between age group 0-3 years and 13-18 years (p\u0026lt;.001).\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003csup\u003e7\u003c/sup\u003eSignificant values have been adjusted by the Bonferonni correction for multiple tests. \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eLifestyle behaviours by sex\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe differences between lifestyle behaviours between boys and girls are presented in Table 4. The data for children with unspecified sex were excluded due to the small sample size of this group (\u003cem\u003eN =\u0026nbsp;\u003c/em\u003e15, 0.3%). Significant sex differences were observed across all four lifestyle behaviours: sleep, physical activity, screen time use (on both weekdays and weekends), and nutrition intake (i.e., fruit and vegetable consumption) (Table 4). The largest effect size was found for screen time use during weekdays, with girls reporting significantly more screen time than boys (\u003cem\u003ed\u0026nbsp;\u003c/em\u003e= -.39), although this still falls within the small effect range.\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"586\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"11\" style=\"width: 586px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eTable 4\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003e.\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cem\u003eLifestyle behaviours by sex.\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 203px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cem\u003eBoys\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cem\u003eGirls\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"bottom\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cem\u003eTest statistic\u003csup\u003e5\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"bottom\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003eP-value\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cem\u003eEffect size\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 203px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cem\u003eN = 1,410\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cem\u003eN = 685\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 203px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003eM\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003eSE\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003eM\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003eSE\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 203px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 203px;\"\u003e\n \u003cp\u003e\u003cem\u003eSleep\u003csup\u003e1\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003e1.50\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003e.82\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003e1.76\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003e.87\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cem\u003et(3893) = -9.89\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026lt;.001\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cem\u003ed = -.31\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 203px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 203px;\"\u003e\n \u003cp\u003e\u003cem\u003ePhysical activity (days per week )\u003csup\u003e\u0026nbsp;2\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003e3.62\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003e.05\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003e3.03\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003e.05\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cem\u003eU = 1842903\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026lt;.001\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cem\u003er = -.12\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 203px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 203px;\"\u003e\n \u003cp\u003e\u003cem\u003eScreen use (hours a day)\u003csup\u003e3\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003e2.77\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003e.45\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003e3.65\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003e.06\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cem\u003et(3370) = -11.79\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026lt;.001\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cem\u003ed = -.39\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 203px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp; \u0026nbsp;Week day\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003e3.92\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003e.05\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003e4.83\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003e.07\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cem\u003et(3603) = -10.61\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026lt;.001\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cem\u003ed = -.34\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 203px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp; \u0026nbsp;Weekend day\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 203px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003e3.06\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003e.03\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003e2.91\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003e.03\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cem\u003eU = 4259430\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026lt;.001\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cem\u003er = -.06\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 203px;\"\u003e\n \u003cp\u003e\u003cem\u003eNutrition intake (days per week)\u003csup\u003e4\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003e2.85\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003e.03\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003e3.03\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003e.03\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cem\u003eU = 2297491\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026lt;.001\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cem\u003er = -.06\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 203px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp; \u0026nbsp;Fruit\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003e1.50\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003e.82\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003e1.76\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003e.87\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cem\u003et(3893) = -9.89\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026lt;.001\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cem\u003ed = -.31\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 203px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp; \u0026nbsp;Vegetables\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 203px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"11\" style=\"width: 586px;\"\u003e\n \u003cp\u003e\u003cem\u003eNote: M = Mean; SD = Standard Deviation; t = t-test; U = Mann-Whitney U; d = Cohen\u0026rsquo;s d\u003csup\u003e*\u003c/sup\u003e; r = effect size \u003cstrong\u003eRank-biserial correlation of Mann-Whitney U\u003csup\u003e*\u003c/sup\u003e.\u003c/strong\u003e\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e*Interpretation effects sizes: d: 0.2 = small effect, 0.5 = medium effect, 0.8 = large effect, r: 0.1 = small effect, 0.3 = medium effect, 0.5 = large effect.\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u003csup\u003e1\u0026nbsp;\u003c/sup\u003e\u003c/em\u003e\u003cem\u003eSleep behaviour was defined as a difficulty when a score of \u0026lsquo;often\u0026rsquo; or \u0026lsquo;always\u0026rsquo; was given.\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e\u003c/em\u003e\u003cem\u003eHow many days per week does your child average at least 60 minutes of moderate to vigorous physical activity or play?\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u003csup\u003e3\u0026nbsp;\u003c/sup\u003e\u003c/em\u003e\u003cem\u003eHow many hours a day does your child spend time in front of a screen on a week day/weekend day?\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u003csup\u003e4\u0026nbsp;\u003c/sup\u003e\u003c/em\u003e\u003cem\u003eHow many days per week does your child eats fruit/vegetables?\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u003csup\u003e5\u003c/sup\u003e\u003c/em\u003e\u003cem\u003eSignificant values have been adjusted by the Bonferonni correction for multiple tests.\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eThe differences between lifestyle behaviours across DSM-5 diagnostic classes are presented in Table 5. The analysis included the most frequently occurring diagnostic groups in the sample, namely: ADHD, autism, depressive and anxiety disorders and trauma and stressor-related disorders. For almost all lifestyle habits (sleep, physical activity, screen time use (i.e. during weekends and during week days) and nutrition intake (i.e. fruit)), there was a significant difference between the four DSM-5 diagnostic classes (Table 5). However, no significant difference was found between DSM-diagnoses on vegetable intake.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSleep problems showed significantly variation across groups (\u003cem\u003ep\u003c/em\u003e \u0026lt; .001), with post-hoc tests indicating that most diagnostic classes differed significantly from one another. Notable differences were observed between ASD and ADHD (\u003cem\u003ep\u003c/em\u003e \u0026lt; .001), ADHD and depressive and anxiety disorders (\u003cem\u003ep\u003c/em\u003e = .016), ADHD and trauma (\u003cem\u003ep\u003c/em\u003e \u0026lt; .001), ASD and trauma (\u003cem\u003ep\u003c/em\u003e = .043) and between trauma and depressive and anxiety disorders (\u003cem\u003ep\u0026nbsp;\u003c/em\u003e= .048). Despite these differences, the effect size was small (\u003cem\u003eή\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e = .01).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003ePhysical activity\u0026nbsp;also differed significantly across diagnostic classes (\u003cem\u003ep\u003c/em\u003e \u0026lt; .001). Post-hoc tests revealed significant differences between ASD and depressive and anxiety disorders (\u003cem\u003ep\u003c/em\u003e =.011), ADHD and depressive and anxiety disorders (\u003cem\u003ep\u003c/em\u003e \u0026lt;.001), ADHD and trauma (\u003cem\u003ep\u003c/em\u003e = .024), and ASD and ADHD (\u003cem\u003ep\u003c/em\u003e \u0026lt;.001). No significant difference was found between trauma and ASD. The effect was interpreted as small (\u003cem\u003er =\u0026nbsp;\u003c/em\u003e.11).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn terms of screen time, significant differences were observed both for weekdays and weekends. Post-hoc tests on weekdays showed significant difference between ASD and ADHD (\u003cem\u003ep\u003c/em\u003e \u0026lt; .001), ASD and depressive and anxiety disorders (\u003cem\u003ep\u003c/em\u003e \u0026lt; .001), ADHD and depressive and anxiety disorders (\u003cem\u003ep\u003c/em\u003e \u0026lt; .001), and ADHD and Trauma (\u003cem\u003ep\u003c/em\u003e \u0026lt; .001). However, again small effect sizes were found (\u003cem\u003eή\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e = .02). A significant difference was also found in screen time use during weekend days; with significant differences observed between ASD and ADHD (\u003cem\u003ep\u003c/em\u003e = .002), ASD and depressive and anxiety disorders (\u003cem\u003ep\u003c/em\u003e = .023), ADHD and depressive and anxiety disorders (\u003cem\u003ep\u003c/em\u003e \u0026lt; .001), ADHD and Trauma (\u003cem\u003ep\u003c/em\u003e = .013). However, the effect size was small (\u003cem\u003eή\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e = .01).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eRegarding nutrition, significant differences were found for fruit intake (\u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026lt; .001, \u003cem\u003er\u0026nbsp;\u003c/em\u003e= .08), especially between ADHD and depressive/anxiety disorders (\u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026lt; .001), and between ASD and ADHD (\u003cem\u003ep\u0026nbsp;\u003c/em\u003e= .037). However, no significant post-hoc differences remained for vegetable intake after adjusting for multiple comparisons.\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"643\" class=\"fr-table-selection-hover\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"16\" style=\"width: 643px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 5.\u0026nbsp;\u003c/strong\u003e\u003cem\u003ePrimary DSM-5 diagnostic classes.\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 65px;\"\u003e\n \u003cp\u003eASD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 66px;\"\u003e\n \u003cp\u003eADHD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 69px;\"\u003e\n \u003cp\u003eDepressive and anxiety disorders\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 66px;\"\u003e\n \u003cp\u003eTrauma\u003csup\u003ee\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"bottom\" style=\"width: 117px;\"\u003e\n \u003cp\u003eTest statistic\u003csup\u003e7\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"bottom\" style=\"width: 45px;\"\u003e\n \u003cp\u003eP-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"bottom\" style=\"width: 62px;\"\u003e\n \u003cp\u003eEffect size\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 110px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cem\u003eN\u003c/em\u003e = 1,410\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cem\u003eN\u003c/em\u003e = 685\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cem\u003eN\u003c/em\u003e = 441\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cem\u003eN\u003c/em\u003e = 242\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 110px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003eM\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003eSE\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003eM\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003eSE\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cem\u003eM\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e\u003cem\u003eSE\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cem\u003eM\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cem\u003eSE\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 110px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 110px;\"\u003e\n \u003cp\u003eSleep\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e1.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e1.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e1.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e1.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cem\u003eF\u003c/em\u003e(3, 2583) = 11.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e\u0026lt;.001\u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e\u003cem\u003eή\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e = .01\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 110px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 110px;\"\u003e\n \u003cp\u003ePhysical activity (days per week )\u003csup\u003e\u0026nbsp;b\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e3.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e3.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e2.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e3.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cem\u003eH\u003c/em\u003e (3, 2507) = 42.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e\u0026lt;.001\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e\u003cem\u003er =\u0026nbsp;\u003c/em\u003e.11\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 110px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 110px;\"\u003e\n \u003cp\u003eScreen use (hours a day)\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp; \u0026nbsp;Week day\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e3.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e2.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e3.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e3.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cem\u003eF\u003c/em\u003e(3, 2364) = 18.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e\u0026lt;.001\u003csup\u003e3\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e\u003cem\u003eή\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e = .02\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp; \u0026nbsp;Weekend day\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e4.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e3.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e4.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e4.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cem\u003eF\u003c/em\u003e(3, 2359) = 10.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e\u0026lt;.001\u003csup\u003e4\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e\u003cem\u003eή\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e = .01\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 110px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 110px;\"\u003e\n \u003cp\u003eNutrition intake (days per week)\u003csup\u003ed\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp; \u0026nbsp;Fruit\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e2.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e3.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e2.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e2.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cem\u003eH\u003c/em\u003e (3, 2696) = 19.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e\u0026lt;.001\u003csup\u003e5\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e\u003cem\u003er =\u0026nbsp;\u003c/em\u003e.08\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp; \u0026nbsp;Vegetables\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e2.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e3.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e2.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e3.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cem\u003eH\u003c/em\u003e (3, 2705) = 9.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e.020\u003csup\u003e6\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e\u003cem\u003er =\u0026nbsp;\u003c/em\u003e.06\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"16\" style=\"width: 643px;\"\u003e\n \u003cp\u003e\u003cem\u003eNote:\u0026nbsp;\u003c/em\u003eAutism Spectrum Disorders = ASD; Attention Deficit Hyperactivity Disorder; ADHD; \u003cem\u003eM\u003c/em\u003e = Mean; \u003cem\u003eSD\u003c/em\u003e = Standard Error; \u003cem\u003eή\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e\u003cem\u003e\u003csup\u003e\u0026nbsp;\u003c/sup\u003e\u003c/em\u003e\u003cem\u003e=\u0026nbsp;\u003c/em\u003eEta squared\u003csup\u003e*\u003c/sup\u003e;\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003cem\u003e\u0026nbsp;r =\u0026nbsp;\u003c/em\u003eeffect size\u003cem\u003e\u0026nbsp;\u003c/em\u003eKruskal-Wallis rank-biserial correlation\u003csup\u003e*\u003c/sup\u003e; Test statistic is defined as \u003cem\u003eF\u003c/em\u003e (ANOVA) or \u003cem\u003eH\u003c/em\u003e = Kruskal-Wallis H test.\u003c/p\u003e\n \u003cp\u003eSignificant values have been adjusted by the Bonferonni correction for multiple tests. \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003csup\u003e*\u003c/sup\u003eInterpretation effect sizes: \u003cem\u003eή\u003csup\u003e2\u003c/sup\u003e:\u0026nbsp;\u003c/em\u003e0.01 = small effect, 0.06 = medium effect, 0.14 = large effect, \u003cem\u003er\u003c/em\u003e: 0.1 = small effect, 0.3 = medium effect, 0.5 = large effect. \u003cem\u003e\u0026nbsp;\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003csup\u003ea\u0026nbsp;\u003c/sup\u003eSleep behaviour was defined as a difficulty when a score of \u0026lsquo;often\u0026rsquo; or \u0026lsquo;always\u0026rsquo; was given.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003csup\u003eb\u0026nbsp;\u003c/sup\u003eHow many days per week does your child average at least 60 minutes of moderate to vigorous physical activity or play?\u003c/p\u003e\n \u003cp\u003e\u003csup\u003ec\u0026nbsp;\u003c/sup\u003eHow many hours a day does your child spend time in front of a screen on a week day/weekend day?\u003c/p\u003e\n \u003cp\u003e\u003csup\u003ed\u0026nbsp;\u003c/sup\u003eHow many days per week does your child eats fruit/vegetables?\u003c/p\u003e\n \u003cp\u003e\u003csup\u003ee\u003c/sup\u003eTrauma stands for trauma and stressor related disorders \u003csup\u003e\u0026nbsp;\u003c/sup\u003e\u003c/p\u003e\n \u003cp\u003e\u003csup\u003e1\u003c/sup\u003eTukey post-hoc tests showed significant difference between ASD and ADHD (p \u0026lt;.001), ADHD and Depressive and anxiety disorders (p =.016), ADHD and Trauma (p \u0026lt;.001), ASD and Trauma (p = .043) and between Trauma and Depressive and anxiety disorders (p = .048).\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003csup\u003e2\u003c/sup\u003ePost-hoc tests showed significant difference between ASD and Depressive and anxiety disorders (p =.011), ADHD and Depressive and anxiety disorders (p \u0026lt;.001), ADHD and trauma (p = .024), and ASD and ADHD (p \u0026lt;.001).\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003csup\u003e3\u003c/sup\u003eTukey post-hoc tests showed significant difference between ASD and ADHD (p \u0026lt;.001), ASD and Depressive and anxiety disorders (p \u0026lt;.001), ADHD and Depressive and anxiety disorders (p \u0026lt;.001), and ADHD and Trauma (p \u0026lt;.001).\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003csup\u003e4\u003c/sup\u003eTukey post-hoc tests showed significant difference between ASD and ADHD (p =.002), ASD and Depressive and anxiety disorders (p =.023), ADHD and Depressive and anxiety disorders (p \u0026lt;.001), ADHD and Trauma (p =.013).\u003c/p\u003e\n \u003cp\u003e\u003csup\u003e5\u003c/sup\u003ePost-hoc tests showed significant differences between ADHD and Depressive and anxiety disorders (p \u0026lt;.001) and between ASD and ADHD (p =.037).\u003c/p\u003e\n \u003cp\u003e\u003csup\u003e6\u003c/sup\u003ePost-hoc tests showed no significant differences between the DSM-classifications after adjusting for multiple tests.\u003c/p\u003e\n \u003cp\u003e\u003csup\u003e7\u003c/sup\u003eSignificant values have been adjusted by the Bonferonni correction for multiple tests. \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe primary aim of this study was to examine the prevalence of lifestyle habits in children and adolescents referred to specialized mental health care. Overall, our findings underscore a concerningly high rate of unhealthy lifestyle habits in this clinical population, highlighting the urgent need for targeted interventions and preventive strategies. Nearly half of the children and adolescents had difficulties initiating sleep (44.9%), closely followed by daytime fatigue (37.9%). Only 14.0% met the recommended levels of physical activity (\u003cem\u003eBeweegrichtlijnen\u003c/em\u003e, 2025). Daily fruit and vegetable intake was reported by 50.7% and 38.6% respectively. Regarding screentime, 13.2% exceeded 6 hours on weekdays, while 35.6% used a screen 1-2 hours a day, which meets the guidelines in the Netherlands (Jeugdinstituut, 2025). During weekend days, screentime was higher, with 35.8% using screens 3-5 hours a day and 25.4% more than 6 hours.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eCompared to normative populations, sleep problems seem to be more common in our sample. A recent meta-analysis examining similar self-reported and parent-reported sleep behaviours identified prevalence rates ranging from 4% to 28% among children and adolescents in a normative population (Kocevska et al., 2021). Similarly, the amount of physical activity in our clinical population seems to be less than the amount of activity reported in the Dutch general population, which is 56.8% for school-age children and 33.4% for adolescents (CBS, 2023b). In terms of nutrition intake, 52.5% of children ate fruit daily, but only 39.8% consumed vegetables daily, which is lower than recommended frequencies. In general, Dutch children consume insufficient amounts of vegetables and fruit (Voedselconsumptiepeiling, 2021). On average, they eat 100 grams of vegetables daily, while the recommended intake is 100 to 200 grams. Additionally, vegetables are consumed an average of 6 times a week, whereas daily consumption is advised. Similar trends are seen internationally, with fewer than of children and adolescents meeting the daily fruit and vegetable intake recommendations (Guenther et al., 2006; Peltzer \u0026amp; Pengpid, 2010; Shi et al., 2005). Our results align with these trends, as only 38.2% of Dutch children consumed sufficient amount of fruit and 39.8% sufficient vegetables (CBS, 2017). Finally, while limited literature exists on screen time use in normative populations, some Dutch studies report an average of 1-2 hours for children (Jeugdinstituut, 2023), and around 6 hours for adolescents (Instituut, 2025), consistent with our findings. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAs an exploratory analysis, differences in lifestyle behaviours across age groups, genders, and diagnostic categories were studied. Adolescents (13-18 years old) exhibited the unhealthiest habits, while the youngest children (0-3 years) showed the healthiest habits. However, it is important to note that the majority of the adolescents in our sample were girls (65%), which suggests that the unhealthy lifestyle of adolescents may be partially explained by the influence of gender. This is supported by the finding that girls in our sample exhibited more unhealthy lifestyle habits compared to boys. Among DSM diagnostic classes, parents of children and adolescents with depression and/or anxiety reported the least physical activity, most screen time, and lowest fruit and vegetable intake. However, the highest amount of sleep problems was reported among the children and adolescents with trauma and stressor-related disorders.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOur findings on adolescents\u0026rsquo; unhealthy lifestyle seems to be in line with previous research. High amounts of sleep problems among adolescents were also found in previous studies (Huang et al., 2010; Meltzer \u0026amp; Mindell, 2006; Ohida et al., 2004; Sivertsen et al., 2014). This higher prevalence of sleep problems among adolescents may be attributed to pubertal development, as it is well established that the biological clock shifts during this period (Carskadon et al., 1997). This shift delays the circadian rhythm, resulting in a later onset of sleepiness and a naturally later wake-up time for adolescents (Carskadon et al., 1997; van Tetering et al., 2024). Our findings on adolescents\u0026rsquo; low levels of physical activity and high amounts of screen time are also consistent with previous research in the general population (van Sluijs et al., 2021).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAs to gender, girls had a more unhealthy lifestyle than boys. Which is in line with previous research were more sleep problems were found in girls in the general population than in boys (Estes et al., 2023; Lewien et al., 2021; van Tetering et al., 2024). Additionally, for physical activity the present study aligns with previous research in the general population, indicating that boys engage in more moderate to vigorous physical activity than girls (Kjellenberg et al., 2021; Sanz-Mart\u0026iacute;n et al., 2022; Zhang et al., 2020). \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eLastly, when comparing diagnostic categories, the most unhealthy behaviours were observed among children and adolescents with depression and/or anxiety. The low amount of physical activity reported among depression/anxiety is in line with previous research among adolescents were an association was found between depressive symptoms and a decrease in physical activity (Kandola et al., 2020). Additionally, previous studies have identified an association between screen time and depression, suggesting that a high level of screen time usage, and thereby a high degree of sedentary behaviour, is prevalent within this group (Stiglic \u0026amp; Viner, 2019; Tang et al., 2021; Wang et al., 2019). Furthermore, a study among adolescents found an association between a high amount of screen time (i.e. 4 or more hours) and both anxiety disorders and depression (Kim et al., 2020). This is in line with, cross-sectional evidence showing a strong association between screen time use and depression symptoms in female adolescents (Twenge \u0026amp; Farley, 2021). Moreover, the small amount of fruit and vegetable intake in children with depression and/or anxiety disorders was also found in previous research. International research focussing on adolescents (12-15 years) has shown that an inadequate amount of fruit and vegetable intake was associated with a higher risk of depressive symptoms. More specifically, fruit intake was significantly associated with a reduced risk of both depressive and anxiety symptoms, whereas vegetable intake was linked to a lower risk of depressive symptoms but not anxiety symptoms (Liu et al., 2020). Mechanisms such as oxidative stress and micronutrient imbalances have been suggested to underlie these associations (Kaur \u0026amp; Kapoor, 2001; Khanzode et al., 2003; Kim et al., 2008; Ng et al., 2008). Moreover, the highest amount of sleep problems were reported in children with PTSD. Children with trauma-related disorders, particularly PTSD, reported the highest prevalence of sleep problems, consistent with sleep disturbances being a core feature of PTSD (American Psychiatric Association, 2013; Giannakopoulos \u0026amp; Kolaitis, 2021). \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSeveral mechanisms may explain the higher prevalence of unhealthy behaviours in our clinical sample. For example, children with ADHD exhibit a stronger preference for engaging in activities later in the day (\u0026ldquo;evening preference\u0026rdquo;) compared to their peers without ADHD, contributing to sleep problems (Durmuş et al., 2017). Those with ASD may experience melatonin dysregulation, leading to difficulties in regulating biological rhythms and with a later chronotype (Kantermann et al., 2015; Melke et al., 2008). These factors may contribute to the high prevalence of difficulties in initiating sleep observed in our sample. Reduced physical activity may relate to a high amount of screen time, but also to motor difficulties in children with ASD (Pan, 2008; Pan et al., 2011; Stanish et al., 2015), behavioural challenges in those with ADHD and therefore less engagement in physical activities (Mercurio et al., 2021; Tandon et al., 2019), or motivational issues in youth with depression (Parfitt \u0026amp; Eston, 2005; Wiles et al., 2012). Regarding unhealthy dietary patterns, such as selective eating in ASD, because of the sensory hypersensitivity to smell, taste, and texture, and impulsive behaviours in ADHD may explain the low intake of fruit and vegetables (Cortese et al., 2016; Del-Ponte et al., 2019; Demir \u0026amp; \u0026Ouml;zcan, 2022; Loewen et al., 2020; Mian et al., 2019; Nimbley et al., 2022; R\u0026iacute;os-Hern\u0026aacute;ndez et al., 2017; Salvat et al., 2022; Shareghfarid et al., 2020; Strimas et al., 2008). Regarding screen time, difficulties in executive functioning (i.e. limited self-regulation, impulsivity, response inhibition problems) and emotion regulation may contribute to excessive use, particularly among children with ASD and ADHD (Bioulac et al., 2008; Kelly et al., 2021; Kuenzel et al., 2024; Mazurek et al., 2012; Mostert-Kerckhoffs et al., 2015).\u003c/p\u003e\n\u003cp\u003eA major strength of this study is the inclusion of a large and diverse sample of children and adolescents with mental disorders from various regions across the Netherlands, allowing for greater generalizability of the results. Unlike previous studies that have focused on specific subgroups, our study includes all children entering specialized mental health care, without exclusion criteria, ensuring a more comprehensive perspective. Additionally, in this study, we examined four distinct areas of lifestyle, offering a broad overview of lifestyle factors that may impact the population under study. By exploring various subgroups including gender, age, and DSM classification, we were able to gain valuable insights into how these factors might interact with lifestyle behaviours. Lastly, while much of the existing research has primarily focused on adults, our study specifically targets children and adolescents, an often underrepresented group in literature. Limitations should also be considered when interpreting the results of this study. First, the intake questionnaire used to assess the different lifestyle habits is not a validated instrument with norm scores, which limits our abilities to compare results with the general population. This prevented a direct comparison between the clinical and normative groups, making it more challenging to determine whether the observed lifestyle habits differ from those in the general population. Second, all data was parent-reported. Parents may have less insight into the various lifestyle behaviours of their children, which may cause self-administered questionnaires to differ from parent-reported questionnaires (Koning et al., 2018). Furthermore, the dietary data collected only focused on the frequency of food intake, without assessing the quantities consumed, which restricts the ability to draw comprehensive conclusions regarding the participants\u0026rsquo; nutritional intake. Additionally, the study examined only primary DSM classifications, without accounting for comorbidities, which may limit the generalizability of the findings. The cross-sectional design of the study limits our ability to establish causal relationships between variables. Lastly, the severity of psychiatric problems experienced by participants could not be taken into account which may affect the interpretation of the findings in relation to the depth of the issues being investigated.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFuture research should include validated lifestyle instruments and incorporate normative comparison groups. Longitudinal designs would help clarify causal relationships between lifestyle and mental health. Self-report methods, particularly for adolescents, may improve data accuracy. Furthermore, more detailed assessment of diet, including portion size and variety, is essential for a deeper understanding of nutrition-related mental health risks. Finally, it would be valuable for future studies on lifestyle behaviours to incorporate substance use (including nicotine, vaping, alcohol, and drugs), due to its substantial influence on adolescents\u0026rsquo; mental and physical well-being.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTo conclude, parents report high amounts of unhealthy lifestyle habits in their children with mental disorders. The unhealthiest habits were observed in older children, girls, and those with depression and/or anxiety. These findings underscore the need for routine screening and targeted interventions focusing on sleep, nutrition, physical activity, and screen time within psychiatric care for children and adolescents.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study is funded by ZonMw (Project number: 555003205). The funder had no role in the design of the study, in the collection, analyses, or interpretation of data, in the writing of the manuscript, or in the decision to publish results. Any views expressed are those of the authors and not necessarily those of the funder.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability and preprint\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe original data supporting the conclusions of this article are available from the corresponding author upon reasonable request, conform the journal\u0026rsquo;s guidelines.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no financial or non-financial conflict of interest.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAlosaimi, N., Sherar, L. B., Griffiths, P., \u0026amp; Pearson, N. (2023). Clustering of diet, physical activity and sedentary behaviour and related physical and mental health outcomes: a systematic review. \u003cem\u003eBMC public health\u003c/em\u003e,\u003cem\u003e 23\u003c/em\u003e(1), 1572. https://doi.org/10.1186/s12889-023-16372-6 \u003c/li\u003e\n\u003cli\u003eAmerican Psychiatric Association. (2013). \u003cem\u003eDiagnostic and Statistical Manual of Mental Disorders\u003c/em\u003e (5th ed.). \u003c/li\u003e\n\u003cli\u003e\u003cem\u003eBeweegrichtlijnen\u003c/em\u003e. (2025). Kenniscentrum sport \u0026amp; bewegen. https://www.kenniscentrumsportenbewegen.nl/beweegrichtlijnen/\u003c/li\u003e\n\u003cli\u003eBioulac, S., Arfi, L., \u0026amp; Bouvard, M. P. (2008). Attention deficit/hyperactivity disorder and video games: A comparative study of hyperactive and control children. \u003cem\u003eEuropean Psychiatry\u003c/em\u003e,\u003cem\u003e 23\u003c/em\u003e(2), 134-141. \u003c/li\u003e\n\u003cli\u003eBoesveldt, S., Bobowski, N., McCrickerd, K., Ma\u0026icirc;tre, I., Sulmont-Ross\u0026eacute;, C., \u0026amp; Forde, C. G. (2018). The changing role of the senses in food choice and food intake across the lifespan. \u003cem\u003eFood Quality and Preference\u003c/em\u003e,\u003cem\u003e 68\u003c/em\u003e, 80-89. https://doi.org/https://doi.org/10.1016/j.foodqual.2018.02.004 \u003c/li\u003e\n\u003cli\u003eCaama\u0026ntilde;o-Navarrete, F., Saavedra-Vallejos, E., Guzm\u0026aacute;n-Guzm\u0026aacute;n, I. P., Arriagada-Hern\u0026aacute;ndez, C., Fuentes-Vilugr\u0026oacute;n, G., Jara-Tomckowiack, L., Lagos-Hern\u0026aacute;ndez, R., Fuentes-Merino, P., Alvarez, C., \u0026amp; Delgado-Floody, P. (2024). Unhealthy Lifestyle Contributes to Negative Mental Health and Poor Quality of Life in Young University Students. \u003cem\u003eHealthcare\u003c/em\u003e,\u003cem\u003e 12\u003c/em\u003e(22), 2213. https://www.mdpi.com/2227-9032/12/22/2213 \u003c/li\u003e\n\u003cli\u003eCarskadon, M. A., Acebo, C., Richardson, G. S., Tate, B. A., \u0026amp; Seifer, R. (1997). An approach to studying circadian rhythms of adolescent humans. \u003cem\u003eJournal of biological rhythms\u003c/em\u003e,\u003cem\u003e 12\u003c/em\u003e(3), 278-289. \u003c/li\u003e\n\u003cli\u003eCarson, V., Lee, E.-Y., Hewitt, L., Jennings, C., Hunter, S., Kuzik, N., Stearns, J. A., Unrau, S. P., Poitras, V. J., \u0026amp; Gray, C. (2017). Systematic review of the relationships between physical activity and health indicators in the early years (0-4 years). \u003cem\u003eBMC public health\u003c/em\u003e,\u003cem\u003e 17\u003c/em\u003e(5), 33-63. \u003c/li\u003e\n\u003cli\u003eCBS. (2017). \u003cem\u003eGezondheidsenqu\u0026ecirc;te: Kinderen eten te weinig fruit, groente en vis\u003c/em\u003e. CBS. https://www.cbs.nl/nl-nl/nieuws/2017/46/kinderen-eten-te-weinig-fruit-groente-en-vis\u003c/li\u003e\n\u003cli\u003eCBS. (2023a). \u003cem\u003eGezondheid en zorggebruik; persoonskenmerken (slaapproblemen)\u003c/em\u003e. CBS. Retrieved 9 juni from https://opendata.cbs.nl/statline/#/CBS/nl/dataset/85454NED/table?dl=8ED08\u003c/li\u003e\n\u003cli\u003eCBS. (2023b). \u003cem\u003eLeefstijl; persoonskenmerken\u003c/em\u003e. CBS. https://opendata.cbs.nl/statline/#/CBS/nl/dataset/85457NED/table?dl=8ED0C\u0026amp;ts=1691580771758\u003c/li\u003e\n\u003cli\u003eChaput, J.-P., Gray, C. E., Poitras, V. J., Carson, V., Gruber, R., Birken, C. S., MacLean, J. E., Aubert, S., Sampson, M., \u0026amp; Tremblay, M. S. (2017). Systematic review of the relationships between sleep duration and health indicators in the early years (0\u0026ndash;4 years). \u003cem\u003eBMC public health\u003c/em\u003e,\u003cem\u003e 17\u003c/em\u003e, 91-107. \u003c/li\u003e\n\u003cli\u003eCortese, S., Moreira-Maia, C. R., St. Fleur, D., Morcillo-Pe\u0026ntilde;alver, C., Rohde, L. A., \u0026amp; Faraone, S. V. (2016). Association between ADHD and obesity: a systematic review and meta-analysis. \u003cem\u003eAmerican Journal of Psychiatry\u003c/em\u003e,\u003cem\u003e 173\u003c/em\u003e(1), 34-43. \u003c/li\u003e\n\u003cli\u003eCurtin, C., Jojic, M., \u0026amp; Bandini, L. G. (2014). Obesity in children with autism spectrum disorders. \u003cem\u003eHarvard review of psychiatry\u003c/em\u003e,\u003cem\u003e 22\u003c/em\u003e(2), 93. \u003c/li\u003e\n\u003cli\u003eDel-Ponte, B., Quinte, G. C., Cruz, S., Grellert, M., \u0026amp; Santos, I. S. (2019). Dietary patterns and attention deficit/hyperactivity disorder (ADHD): a systematic review and meta-analysis. \u003cem\u003eJournal of Affective Disorders\u003c/em\u003e,\u003cem\u003e 252\u003c/em\u003e, 160-173. \u003c/li\u003e\n\u003cli\u003eDemir, A. \u0026Ccedil;., \u0026amp; \u0026Ouml;zcan, \u0026Ouml;. (2022). The nutritional behavior of children with autism spectrum disorder, parental feeding styles, and anthropometric measurements. \u003cem\u003eNordic Journal of Psychiatry\u003c/em\u003e,\u003cem\u003e 76\u003c/em\u003e(1), 64-70. https://doi.org/10.1080/08039488.2021.1934109 \u003c/li\u003e\n\u003cli\u003eDiethelm, K., Jankovic, N., Moreno, L. A., Huybrechts, I., De Henauw, S., De Vriendt, T., Gonz\u0026aacute;lez-Gross, M., Leclercq, C., Gottrand, F., Gilbert, C. C., Dallongeville, J., Cuenca-Garcia, M., Manios, Y., Kafatos, A., Plada, M., \u0026amp; Kersting, M. (2012). Food intake of European adolescents in the light of different food-based dietary guidelines: results of the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Study. \u003cem\u003ePublic Health Nutrition\u003c/em\u003e,\u003cem\u003e 15\u003c/em\u003e(3), 386-398. https://doi.org/10.1017/S1368980011001935 \u003c/li\u003e\n\u003cli\u003eDurmuş, F. B., Arman, A. R., \u0026amp; Ayaz, A. B. (2017). Chronotype and its relationship with sleep disorders in children with attention deficit hyperactivity disorder. \u003cem\u003eChronobiology International\u003c/em\u003e,\u003cem\u003e 34\u003c/em\u003e(7), 886-894. \u003c/li\u003e\n\u003cli\u003eEstes, A., Munson, J., St. John, T., Finlayson, R., Pandey, J., Gottlieb, B., Herrington, J., \u0026amp; Schultz, R. T. (2023). Sleep problems in autism: Sex differences in the school‐age population. \u003cem\u003eAutism Research\u003c/em\u003e,\u003cem\u003e 16\u003c/em\u003e(1), 164-173. \u003c/li\u003e\n\u003cli\u003eFirth, J., Siddiqi, N., Koyanagi, A., Siskind, D., Rosenbaum, S., Galletly, C., Allan, S., Caneo, C., Carney, R., Carvalho, A. F., Chatterton, M. L., Correll, C. U., Curtis, J., Gaughran, F., Heald, A., Hoare, E., Jackson, S. E., Kisely, S., Lovell, K.,\u0026hellip;Stubbs, B. (2019). The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness. \u003cem\u003eThe Lancet Psychiatry\u003c/em\u003e,\u003cem\u003e 6\u003c/em\u003e(8), 675-712. https://doi.org/10.1016/S2215-0366(19)30132-4 \u003c/li\u003e\n\u003cli\u003eFirth, J., Solmi, M., Wootton, R. E., Vancampfort, D., Schuch, F. B., Hoare, E., Gilbody, S., Torous, J., Teasdale, S. B., \u0026amp; Jackson, S. E. (2020). A meta‐review of \u0026ldquo;lifestyle psychiatry\u0026rdquo;: the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders. \u003cem\u003eWorld Psychiatry\u003c/em\u003e,\u003cem\u003e 19\u003c/em\u003e(3), 360-380. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7491615/pdf/WPS-19-360.pdf \u003c/li\u003e\n\u003cli\u003eForrest, C. B., \u0026amp; Riley, A. W. (2004). Childhood origins of adult health: a basis for life-course health policy. \u003cem\u003eHealth Affairs\u003c/em\u003e,\u003cem\u003e 23\u003c/em\u003e(5), 155-164. \u003c/li\u003e\n\u003cli\u003eGiannakopoulos, G., \u0026amp; Kolaitis, G. (2021). Sleep problems in children and adolescents following traumatic life events. \u003cem\u003eWorld J Psychiatry\u003c/em\u003e,\u003cem\u003e 11\u003c/em\u003e(2), 27-34. https://doi.org/10.5498/wjp.v11.i2.27 \u003c/li\u003e\n\u003cli\u003eGotay, C. C. (2005). Behavior and cancer prevention. \u003cem\u003eJournal of Clinical Oncology\u003c/em\u003e,\u003cem\u003e 23\u003c/em\u003e(2), 301-310. \u003c/li\u003e\n\u003cli\u003eGradisar, M., Gardner, G., \u0026amp; Dohnt, H. (2011). Recent worldwide sleep patterns and problems during adolescence: a review and meta-analysis of age, region, and sleep. \u003cem\u003eSleep medicine\u003c/em\u003e,\u003cem\u003e 12\u003c/em\u003e(2), 110-118. \u003c/li\u003e\n\u003cli\u003eGuenther, P. M., Dodd, K. W., Reedy, J., \u0026amp; Krebs-Smith, S. M. (2006). Most Americans eat much less than recommended amounts of fruits and vegetables. \u003cem\u003eJournal of the American Dietetic Association\u003c/em\u003e,\u003cem\u003e 106\u003c/em\u003e(9), 1371-1379. \u003c/li\u003e\n\u003cli\u003eHealy, S., Aigner, C. J., \u0026amp; Haegele, J. A. (2019). Prevalence of overweight and obesity among US youth with autism spectrum disorder. \u003cem\u003eAutism\u003c/em\u003e,\u003cem\u003e 23\u003c/em\u003e(4), 1046-1050. \u003c/li\u003e\n\u003cli\u003eHong, G. C., Conduit, R., Wong, J., Di Benedetto, M., \u0026amp; Lee, E. (2021). Diet, physical Activity, and screen time to sleep better: Multiple mediation analysis of lifestyle factors in school-aged children with and without attention deficit hyperactivity disorder. \u003cem\u003eJournal of attention disorders\u003c/em\u003e,\u003cem\u003e 25\u003c/em\u003e(13), 1847-1858. \u003c/li\u003e\n\u003cli\u003eHuang, Y.-S., Wang, C.-H., \u0026amp; Guilleminault, C. (2010). An epidemiologic study of sleep problems among adolescents in North Taiwan. \u003cem\u003eSleep medicine\u003c/em\u003e,\u003cem\u003e 11\u003c/em\u003e(10), 1035-1042. https://doi.org/https://doi.org/10.1016/j.sleep.2010.04.009 \u003c/li\u003e\n\u003cli\u003eHuberts-Bosch, A., Bierens, M., Ly, V., van der Velde, J., de Boer, H., van Beek, G., Appelman, D., Visser, S., Bos, L. H., \u0026amp; Reijmers, L. (2023). Short-term effects of an elimination diet and healthy diet in children with attention-deficit/hyperactivity disorder: a randomized-controlled trial. \u003cem\u003eEuropean Child \u0026amp; Adolescent Psychiatry\u003c/em\u003e, 1-14. \u003c/li\u003e\n\u003cli\u003eInstituut, T. (2025). \u003cem\u003eHoeveel tijd brengen jongeren door achter een scherm? Wat is het sociale mediagebruik van kinderen? Alle feiten en cijfers over schermgebruik op een rij. \u003c/em\u003e. https://www.trimbos.nl/kennis/digitale-media-gokken/expertisecentrum-digitalisering-en-welzijn/feiten-en-cijfers-digitale-media/schermgebruik/?utm\u003c/li\u003e\n\u003cli\u003eJayedi, A., Soltani, S., Abdolshahi, A., \u0026amp; Shab-Bidar, S. (2020). Healthy and unhealthy dietary patterns and the risk of chronic disease: an umbrella review of meta-analyses of prospective cohort studies. \u003cem\u003eBritish Journal of Nutrition\u003c/em\u003e,\u003cem\u003e 124\u003c/em\u003e(11), 1133-1144. https://doi.org/10.1017/S0007114520002330 \u003c/li\u003e\n\u003cli\u003eJeugdinstituut, N. (2023). \u003cem\u003eCijfers over mediagebruik\u003c/em\u003e. https://www.nji.nl/cijfers/mediagebruik?utm\u003c/li\u003e\n\u003cli\u003eJeugdinstituut, N. (2025). \u003cem\u003eWat is een goede schermtijd voor mijn kind?\u003c/em\u003e https://www.nji.nl/mediaopvoeding/wat-is-een-goede-schermtijd-voor-mijn-kind\u003c/li\u003e\n\u003cli\u003eKamal Nor, N., Ghozali, A. H., \u0026amp; Ismail, J. (2019). Prevalence of overweight and obesity among children and adolescents with autism spectrum disorder and associated risk factors. \u003cem\u003eFrontiers in pediatrics\u003c/em\u003e,\u003cem\u003e 7\u003c/em\u003e, 38. \u003c/li\u003e\n\u003cli\u003eKandola, A., Lewis, G., Osborn, D. P. J., Stubbs, B., \u0026amp; Hayes, J. F. (2020). Depressive symptoms and objectively measured physical activity and sedentary behaviour throughout adolescence: a prospective cohort study. \u003cem\u003eThe Lancet Psychiatry\u003c/em\u003e,\u003cem\u003e 7\u003c/em\u003e(3), 262-271. https://doi.org/10.1016/S2215-0366(20)30034-1 \u003c/li\u003e\n\u003cli\u003eKantermann, T., Sung, H., \u0026amp; Burgess, H. J. (2015). Comparing the Morningness-Eveningness Questionnaire and Munich ChronoType Questionnaire to the dim light melatonin onset. \u003cem\u003eJournal of biological rhythms\u003c/em\u003e,\u003cem\u003e 30\u003c/em\u003e(5), 449-453. \u003c/li\u003e\n\u003cli\u003eKaur, C., \u0026amp; Kapoor, H. C. (2001). Antioxidants in fruits and vegetables\u0026ndash;the millennium\u0026rsquo;s health. \u003cem\u003eInternational journal of food science \u0026amp; technology\u003c/em\u003e,\u003cem\u003e 36\u003c/em\u003e(7), 703-725. \u003c/li\u003e\n\u003cli\u003eKelly, S. E., Schmitt, L. M., Sweeney, J. A., \u0026amp; Mosconi, M. W. (2021). Reduced proactive control processes associated with behavioral response inhibition deficits in autism spectrum disorder. \u003cem\u003eAutism Research\u003c/em\u003e,\u003cem\u003e 14\u003c/em\u003e(2), 389-399. \u003c/li\u003e\n\u003cli\u003eKhanzode, S. D., Dakhale, G. N., Khanzode, S. S., Saoji, A., \u0026amp; Palasodkar, R. (2003). Oxidative damage and major depression: the potential antioxidant action of selective serotonin re-uptake inhibitors. \u003cem\u003eRedox report\u003c/em\u003e,\u003cem\u003e 8\u003c/em\u003e(6), 365-370. \u003c/li\u003e\n\u003cli\u003eKim, J.-M., Stewart, R., Kim, S.-W., Yang, S.-J., Shin, I.-S., \u0026amp; Yoon, J.-S. (2008). Predictive value of folate, vitamin B12 and homocysteine levels in late-life depression. \u003cem\u003eThe British Journal of Psychiatry\u003c/em\u003e,\u003cem\u003e 192\u003c/em\u003e(4), 268-274. \u003c/li\u003e\n\u003cli\u003eKim, S., Favotto, L., Halladay, J., Wang, L., Boyle, M. H., \u0026amp; Georgiades, K. (2020). Differential associations between passive and active forms of screen time and adolescent mood and anxiety disorders. \u003cem\u003eSocial psychiatry and psychiatric epidemiology\u003c/em\u003e,\u003cem\u003e 55\u003c/em\u003e, 1469-1478. \u003c/li\u003e\n\u003cli\u003eKjellenberg, K., Ekblom, \u0026Ouml;., St\u0026aring;lman, C., Helgad\u0026oacute;ttir, B., \u0026amp; Nyberg, G. (2021). Associations between physical activity patterns, screen time and cardiovascular fitness levels in Swedish adolescents. \u003cem\u003eChildren\u003c/em\u003e,\u003cem\u003e 8\u003c/em\u003e(11), 998. \u003c/li\u003e\n\u003cli\u003eKocevska, D., Lysen, T. S., Dotinga, A., Koopman-Verhoeff, M. E., Luijk, M. P. C. M., Antypa, N., Biermasz, N. R., Blokstra, A., Brug, J., Burk, W. J., Comijs, H. C., Corpeleijn, E., Dashti, H. S., de Bruin, E. J., de Graaf, R., Derks, I. P. M., Dewald-Kaufmann, J. F., Elders, P. J. M., Gemke, R. J. B. J.,\u0026hellip;Tiemeier, H. (2021). Sleep characteristics across the lifespan in 1.1\u0026thinsp;million people from the Netherlands, United Kingdom and United States: a systematic review and meta-analysis. \u003cem\u003eNature Human Behaviour\u003c/em\u003e,\u003cem\u003e 5\u003c/em\u003e(1), 113-122. https://doi.org/10.1038/s41562-020-00965-x \u003c/li\u003e\n\u003cli\u003eKong, C., Chen, A., Ludyga, S., Herold, F., Healy, S., Zhao, M., Taylor, A., M\u0026uuml;ller, N. G., Kramer, A. F., \u0026amp; Chen, S. (2023). Associations between meeting 24-hour movement guidelines and quality of life among children and adolescents with autism spectrum disorder. \u003cem\u003eJournal of sport and Health Science\u003c/em\u003e,\u003cem\u003e 12\u003c/em\u003e(1), 73-86. \u003c/li\u003e\n\u003cli\u003eKoning, M., de Jong, A., de Jong, E., Visscher, T. L. S., Seidell, J. C., \u0026amp; Renders, C. M. (2018). Agreement between parent and child report of physical activity, sedentary and dietary behaviours in 9-12-year-old children and associations with children\u0026rsquo;s weight status. \u003cem\u003eBMC Psychology\u003c/em\u003e,\u003cem\u003e 6\u003c/em\u003e(1), 14. https://doi.org/10.1186/s40359-018-0227-2 \u003c/li\u003e\n\u003cli\u003eKrebs-Smith, S. M., Guenther, P. M., Subar, A. F., Kirkpatrick, S. I., \u0026amp; Dodd, K. W. (2010). Americans Do Not Meet Federal Dietary Recommendations1. \u003cem\u003eThe Journal of Nutrition\u003c/em\u003e,\u003cem\u003e 140\u003c/em\u003e(10), 1832-1838. https://doi.org/https://doi.org/10.3945/jn.110.124826 \u003c/li\u003e\n\u003cli\u003eKuenzel, E., Hennessy, A., Choi, E. J., Nichols, E. S., \u0026amp; Duerden, E. G. (2024). Response inhibition in neurodiverse children and the association with excessive screen time use. \u003c/li\u003e\n\u003cli\u003eKumar, S., \u0026amp; Kelly, A. S. (2017). Review of Childhood Obesity: From Epidemiology, Etiology, and Comorbidities to Clinical Assessment and Treatment. \u003cem\u003eMayo Clin Proc\u003c/em\u003e,\u003cem\u003e 92\u003c/em\u003e(2), 251-265. https://doi.org/10.1016/j.mayocp.2016.09.017 \u003c/li\u003e\n\u003cli\u003eLewien, C., Genuneit, J., Meigen, C., Kiess, W., \u0026amp; Poulain, T. (2021). Sleep-related difficulties in healthy children and adolescents. \u003cem\u003eBMC pediatrics\u003c/em\u003e,\u003cem\u003e 21\u003c/em\u003e, 1-11. \u003c/li\u003e\n\u003cli\u003eLianov, L., \u0026amp; Johnson, M. (2010). Physician competencies for prescribing lifestyle medicine. \u003cem\u003eJAMA\u003c/em\u003e,\u003cem\u003e 304\u003c/em\u003e(2), 202-203. \u003c/li\u003e\n\u003cli\u003eLiu, M.-w., Chen, Q.-t., Towne, S. D., Zhang, J., Yu, H.-j., Tang, R., Gasevic, D., Wang, P.-g., \u0026amp; He, Q.-q. (2020). Fruit and vegetable intake in relation to depressive and anxiety symptoms among adolescents in 25 low- and middle-income countries. \u003cem\u003eJournal of Affective Disorders\u003c/em\u003e,\u003cem\u003e 261\u003c/em\u003e, 172-180. https://doi.org/https://doi.org/10.1016/j.jad.2019.10.007 \u003c/li\u003e\n\u003cli\u003eLivingstone, K. M., Abbott, G., Ward, J., \u0026amp; Bowe, S. J. (2021). Unhealthy Lifestyle, Genetics and Risk of Cardiovascular Disease and Mortality in 76,958 Individuals from the UK Biobank Cohort Study. \u003cem\u003eNutrients\u003c/em\u003e,\u003cem\u003e 13\u003c/em\u003e(12), 4283. https://www.mdpi.com/2072-6643/13/12/4283 \u003c/li\u003e\n\u003cli\u003eLloyd-Jones, D. M., Hong, Y., Labarthe, D., Mozaffarian, D., Appel, L. J., Van Horn, L., Greenlund, K., Daniels, S., Nichol, G., \u0026amp; Tomaselli, G. F. (2010). Defining and setting national goals for cardiovascular health promotion and disease reduction: the American Heart Association\u0026rsquo;s strategic Impact Goal through 2020 and beyond. \u003cem\u003eCirculation\u003c/em\u003e,\u003cem\u003e 121\u003c/em\u003e(4), 586-613. \u003c/li\u003e\n\u003cli\u003eLoewen, O. K., Maximova, K., Ekwaru, J. P., Asbridge, M., Ohinmaa, A., \u0026amp; Veugelers, P. J. (2020). \u0026quot; Adherence to lifestyle recommendations and ADHD: A population-based study of children aged 10-11 years\u0026quot;: Erratum. \u003c/li\u003e\n\u003cli\u003eLopez, A. D. (2006). Global burden of disease and risk factors. \u003c/li\u003e\n\u003cli\u003eMazurek, M. O., Shattuck, P. T., Wagner, M., \u0026amp; Cooper, B. P. (2012). Prevalence and correlates of screen-based media use among youths with autism spectrum disorders. \u003cem\u003eJournal of autism and developmental disorders\u003c/em\u003e,\u003cem\u003e 42\u003c/em\u003e(8), 1757-1767. \u003c/li\u003e\n\u003cli\u003eMelke, J., Goubran Botros, H., Chaste, P., Betancur, C., Nygren, G., Anckars\u0026auml;ter, H., Rastam, M., St\u0026aring;hlberg, O., Gillberg, I. C., \u0026amp; Delorme, R. (2008). Abnormal melatonin synthesis in autism spectrum disorders. \u003cem\u003eMolecular psychiatry\u003c/em\u003e,\u003cem\u003e 13\u003c/em\u003e(1), 90-98. \u003c/li\u003e\n\u003cli\u003eMeltzer, L. J., \u0026amp; Mindell, J. A. (2006). Sleep and Sleep Disorders in Children and Adolescents. \u003cem\u003ePsychiatric Clinics\u003c/em\u003e,\u003cem\u003e 29\u003c/em\u003e(4), 1059-1076. https://doi.org/10.1016/j.psc.2006.08.004 \u003c/li\u003e\n\u003cli\u003eMercurio, L. Y., Amanullah, S., Gill, N., \u0026amp; Gjelsvik, A. (2021). Children With ADHD Engage in Less Physical Activity. \u003cem\u003eJournal of attention disorders\u003c/em\u003e,\u003cem\u003e 25\u003c/em\u003e(8), 1187-1195. https://doi.org/10.1177/1087054719887789 \u003c/li\u003e\n\u003cli\u003eMian, A., Jansen, P. W., Nguyen, A. N., Bowling, A., Renders, C. M., \u0026amp; Voortman, T. (2019). Children\u0026apos;s attention-deficit/hyperactivity disorder symptoms predict lower diet quality but not vice versa: results from bidirectional analyses in a population-based cohort. \u003cem\u003eThe Journal of Nutrition\u003c/em\u003e,\u003cem\u003e 149\u003c/em\u003e(4), 642-648. \u003c/li\u003e\n\u003cli\u003eMoore, M., \u0026amp; Meltzer, L. J. (2008). The sleepy adolescent: causes and consequences of sleepiness in teens. \u003cem\u003ePaediatric respiratory reviews\u003c/em\u003e,\u003cem\u003e 9\u003c/em\u003e(2), 114-121. \u003c/li\u003e\n\u003cli\u003eMostert-Kerckhoffs, M. A., Staal, W. G., Houben, R. H., \u0026amp; de Jonge, M. V. (2015). Stop and change: Inhibition and flexibility skills are related to repetitive behavior in children and young adults with autism spectrum disorders. \u003cem\u003eJournal of autism and developmental disorders\u003c/em\u003e,\u003cem\u003e 45\u003c/em\u003e, 3148-3158. \u003c/li\u003e\n\u003cli\u003eMuskens, J. B., Ester, W. A., Klip, H., van Dongen-Boomsma, M., \u0026amp; Staal, W. G. (2023). Novel insights into somatic comorbidities in children and adolescents across psychiatric diagnoses: an explorative study. \u003c/li\u003e\n\u003cli\u003eNg, F., Berk, M., Dean, O., \u0026amp; Bush, A. I. (2008). Oxidative stress in psychiatric disorders: evidence base and therapeutic implications. \u003cem\u003eInternational Journal of Neuropsychopharmacology\u003c/em\u003e,\u003cem\u003e 11\u003c/em\u003e(6), 851-876. \u003c/li\u003e\n\u003cli\u003eNimbley, E., Golds, L., Sharpe, H., Gillespie‐Smith, K., \u0026amp; Duffy, F. (2022). Sensory processing and eating behaviours in autism: A systematic review. \u003cem\u003eEuropean Eating Disorders Review\u003c/em\u003e,\u003cem\u003e 30\u003c/em\u003e(5), 538-559. \u003c/li\u003e\n\u003cli\u003eOhida, T., Osaki, Y., Doi, Y., Tanihata, T., Minowa, M., Suzuki, K., Wada, K., Suzuki, K., \u0026amp; Kaneita, Y. (2004). An Epidemiologic Study of Self-Reported Sleep Problems among Japanese Adolescents. \u003cem\u003eSleep\u003c/em\u003e,\u003cem\u003e 27\u003c/em\u003e(5), 978-985. https://doi.org/10.1093/sleep/27.5.978 \u003c/li\u003e\n\u003cli\u003eOwens, J. A., \u0026amp; Mindell, J. A. (2011). Pediatric insomnia. \u003cem\u003ePediatric Clinics\u003c/em\u003e,\u003cem\u003e 58\u003c/em\u003e(3), 555-569. \u003c/li\u003e\n\u003cli\u003ePan, C.-Y. (2008). Objectively measured physical activity between children with autism spectrum disorders and children without disabilities during inclusive recess settings in Taiwan. \u003cem\u003eJournal of autism and developmental disorders\u003c/em\u003e,\u003cem\u003e 38\u003c/em\u003e, 1292-1301. \u003c/li\u003e\n\u003cli\u003ePan, C.-Y., Tsai, C.-L., \u0026amp; Hsieh, K.-W. (2011). Physical activity correlates for children with autism spectrum disorders in middle school physical education. \u003cem\u003eResearch quarterly for exercise and sport\u003c/em\u003e,\u003cem\u003e 82\u003c/em\u003e(3), 491-498. \u003c/li\u003e\n\u003cli\u003eParfitt, G., \u0026amp; Eston, R. G. (2005). The relationship between children\u0026apos;s habitual activity level and psychological well‐being. \u003cem\u003eActa Paediatrica\u003c/em\u003e,\u003cem\u003e 94\u003c/em\u003e(12), 1791-1797. \u003c/li\u003e\n\u003cli\u003ePeltzer, K., \u0026amp; Pengpid, S. (2010). Fruits and vegetables consumption and associated factors among in-school adolescents in seven African countries. \u003cem\u003eInternational journal of public health\u003c/em\u003e,\u003cem\u003e 55\u003c/em\u003e, 669-678. \u003c/li\u003e\n\u003cli\u003ePoitras, V. J., Gray, C. E., Janssen, X., Aubert, S., Carson, V., Faulkner, G., Goldfield, G. S., Reilly, J. J., Sampson, M., \u0026amp; Tremblay, M. S. (2017). Systematic review of the relationships between sedentary behaviour and health indicators in the early years (0\u0026ndash;4 years). \u003cem\u003eBMC public health\u003c/em\u003e,\u003cem\u003e 17\u003c/em\u003e, 65-89. \u003c/li\u003e\n\u003cli\u003eR\u0026iacute;os-Hern\u0026aacute;ndez, A., Alda, J. A., Farran-Codina, A., Ferreira-Garc\u0026iacute;a, E., \u0026amp; Izquierdo-Pulido, M. (2017). The Mediterranean diet and ADHD in children and adolescents. \u003cem\u003ePediatrics\u003c/em\u003e,\u003cem\u003e 139\u003c/em\u003e(2). \u003c/li\u003e\n\u003cli\u003eRoberts, R. E., Ramsay Roberts, C., \u0026amp; Chan, W. (2008). Persistence and change in symptoms of insomnia among adolescents. \u003cem\u003eSleep\u003c/em\u003e,\u003cem\u003e 31\u003c/em\u003e(2), 177-184. \u003c/li\u003e\n\u003cli\u003eSalvat, H., Mohammadi, M. N., Molavi, P., Mostafavi, S. A., Rostami, R., \u0026amp; Salehinejad, M. A. (2022). Nutrient intake, dietary patterns, and anthropometric variables of children with ADHD in comparison to healthy controls: a case-control study. \u003cem\u003eBMC pediatrics\u003c/em\u003e,\u003cem\u003e 22\u003c/em\u003e(1), 70. \u003c/li\u003e\n\u003cli\u003eSanz-Mart\u0026iacute;n, D., Ubago-Jim\u0026eacute;nez, J. L., Ruiz-Tendero, G., Zurita-Ortega, F., Melguizo-Ib\u0026aacute;\u0026ntilde;ez, E., \u0026amp; Puertas-Molero, P. (2022). The relationships between physical activity, screen time and sleep time according to the adolescents\u0026rsquo; sex and the day of the week. Healthcare, \u003c/li\u003e\n\u003cli\u003eShareghfarid, E., Sangsefidi, Z. S., Salehi-Abargouei, A., \u0026amp; Hosseinzadeh, M. (2020). Empirically derived dietary patterns and food groups intake in relation with Attention Deficit/Hyperactivity Disorder (ADHD): A systematic review and meta-analysis. \u003cem\u003eClinical nutrition ESPEN\u003c/em\u003e,\u003cem\u003e 36\u003c/em\u003e, 28-35. \u003c/li\u003e\n\u003cli\u003eShi, Z., Lien, N., Kumar, B. N., \u0026amp; Holmboe-Ottesen, G. (2005). Socio-demographic differences in food habits and preferences of school adolescents in Jiangsu Province, China. \u003cem\u003eEuropean Journal of Clinical Nutrition\u003c/em\u003e,\u003cem\u003e 59\u003c/em\u003e(12), 1439-1448. \u003c/li\u003e\n\u003cli\u003eSivertsen, B., Harvey, A. G., Lundervold, A. J., \u0026amp; Hysing, M. (2014). Sleep problems and depression in adolescence: results from a large population-based study of Norwegian adolescents aged 16\u0026ndash;18 years. \u003cem\u003eEuropean Child \u0026amp; Adolescent Psychiatry\u003c/em\u003e,\u003cem\u003e 23\u003c/em\u003e(8), 681-689. https://doi.org/10.1007/s00787-013-0502-y \u003c/li\u003e\n\u003cli\u003eStanish, H., Curtin, C., Must, A., Phillips, S., Maslin, M., \u0026amp; Bandini, L. (2015). Enjoyment, barriers, and beliefs about physical activity in adolescents with and without autism spectrum disorder. \u003cem\u003eAdapted physical activity quarterly\u003c/em\u003e,\u003cem\u003e 32\u003c/em\u003e(4), 302-317. \u003c/li\u003e\n\u003cli\u003eStiglic, N., \u0026amp; Viner, R. M. (2019). Effects of screentime on the health and well-being of children and adolescents: a systematic review of reviews. \u003cem\u003eBMJ open\u003c/em\u003e,\u003cem\u003e 9\u003c/em\u003e(1), e023191. \u003c/li\u003e\n\u003cli\u003eStrimas, R., Davis, C., Patte, K., Curtis, C., Reid, C., \u0026amp; McCool, C. (2008). Symptoms of attention-deficit/hyperactivity disorder, overeating, and body mass index in men. \u003cem\u003eEating behaviors\u003c/em\u003e,\u003cem\u003e 9\u003c/em\u003e(4), 516-518. \u003c/li\u003e\n\u003cli\u003eSutaria, S., Devakumar, D., Yasuda, S. S., Das, S., \u0026amp; Saxena, S. (2019). Is obesity associated with depression in children? Systematic review and meta-analysis. \u003cem\u003eArchives of disease in childhood\u003c/em\u003e,\u003cem\u003e 104\u003c/em\u003e(1), 64-74. \u003c/li\u003e\n\u003cli\u003eTandon, P. S., Sasser, T., Gonzalez, E. S., Whitlock, K. B., Christakis, D. A., \u0026amp; Stein, M. A. (2019). Physical activity, screen time, and sleep in children with ADHD. \u003cem\u003eJournal of Physical Activity and Health\u003c/em\u003e,\u003cem\u003e 16\u003c/em\u003e(6), 416-422. \u003c/li\u003e\n\u003cli\u003eTang, S., Werner-Seidler, A., Torok, M., Mackinnon, A. J., \u0026amp; Christensen, H. (2021). The relationship between screen time and mental health in young people: A systematic review of longitudinal studies. \u003cem\u003eClinical psychology review\u003c/em\u003e,\u003cem\u003e 86\u003c/em\u003e, 102021. https://doi.org/https://doi.org/10.1016/j.cpr.2021.102021 \u003c/li\u003e\n\u003cli\u003eTwenge, J. M., \u0026amp; Farley, E. (2021). Not all screen time is created equal: associations with mental health vary by activity and gender. \u003cem\u003eSocial psychiatry and psychiatric epidemiology\u003c/em\u003e,\u003cem\u003e 56\u003c/em\u003e(2), 207-217. https://doi.org/10.1007/s00127-020-01906-9 \u003c/li\u003e\n\u003cli\u003evan der Mheen, M., Zijlmans, J., van der Doelen, D. M., Klip, H., van der Lans, R. M., Ruisch, I. H., de Vries, Y. A., Tieskens, J. M., Wildschut, M., Buitelaar, J. K., Hoekstra, P. J., Lindauer, R. J. L., Popma, A., Vermeiren, R., Broek, E. M., Dekkers, T. J., Dietrich, A., Hein, I. M., Luman, M.,\u0026hellip;Polderman, T. J. C. (2024). Patterns of Mental Disorders in a Large Child Psychiatric Sample (N = 65,363): A DREAMS Study. \u003cem\u003eJAACAP Open\u003c/em\u003e. https://doi.org/https://doi.org/10.1016/j.jaacop.2024.06.007 \u003c/li\u003e\n\u003cli\u003evan Sluijs, E. M. F., Ekelund, U., Crochemore-Silva, I., Guthold, R., Ha, A., Lubans, D., Oyeyemi, A. L., Ding, D., \u0026amp; Katzmarzyk, P. T. (2021). Physical activity behaviours in adolescence: current evidence and opportunities for intervention. \u003cem\u003eThe lancet\u003c/em\u003e,\u003cem\u003e 398\u003c/em\u003e(10298), 429-442. https://doi.org/https://doi.org/10.1016/S0140-6736(21)01259-9 \u003c/li\u003e\n\u003cli\u003evan Tetering, E. M., Mies, G. W., Klip, H., Pillen, S., Muskens, J. B., Polderman, T. J., van der Mheen, M., Staal, W. G., \u0026amp; Pieters, S. (2024). The relationship between sleep difficulties and externalizing and internalizing problems in children and adolescents with mental illness. \u003cem\u003eJournal of Sleep research\u003c/em\u003e, e14398. \u003c/li\u003e\n\u003cli\u003eVoedselconsumptiepeiling. (2021). \u003cem\u003eNederlandse voedingsmiddelen consumptie\u003c/em\u003e. https://www.wateetnederland.nl/resultaten/voedingsmiddelen\u003c/li\u003e\n\u003cli\u003eWang, X., Li, Y., \u0026amp; Fan, H. (2019). The associations between screen time-based sedentary behavior and depression: a systematic review and meta-analysis [Article]. \u003cem\u003eBMC public health\u003c/em\u003e,\u003cem\u003e 19\u003c/em\u003e(1), Article 1524. https://doi.org/10.1186/s12889-019-7904-9 \u003c/li\u003e\n\u003cli\u003eWhatnall, M. C., Collins, C. E., Callister, R., \u0026amp; Hutchesson, M. J. (2016). Associations between Unhealthy Diet and Lifestyle Behaviours and Increased Cardiovascular Disease Risk in Young Overweight and Obese Women. \u003cem\u003eHealthcare\u003c/em\u003e,\u003cem\u003e 4\u003c/em\u003e(3), 57. https://www.mdpi.com/2227-9032/4/3/57 \u003c/li\u003e\n\u003cli\u003eWiles, N. J., Haase, A. M., Lawlor, D. A., Ness, A., \u0026amp; Lewis, G. (2012). Physical activity and depression in adolescents: cross-sectional findings from the ALSPAC cohort. \u003cem\u003eSocial psychiatry and psychiatric epidemiology\u003c/em\u003e,\u003cem\u003e 47\u003c/em\u003e, 1023-1033. \u003c/li\u003e\n\u003cli\u003eYang, H., Gao, J., Wang, T., Yang, L., Liu, Y., Shen, Y., Gong, J., Dai, W., Zhou, J., Gu, J., Pan, Z., \u0026amp; Zhu, S. (2017). Association between adverse mental health and an unhealthy lifestyle in rural-to-urban migrant workers in Shanghai. \u003cem\u003eJournal of the Formosan Medical Association\u003c/em\u003e,\u003cem\u003e 116\u003c/em\u003e(2), 90-98. https://doi.org/https://doi.org/10.1016/j.jfma.2016.03.004 \u003c/li\u003e\n\u003cli\u003eYee, A. Z. H., Lwin, M. O., \u0026amp; Ho, S. S. (2017). The influence of parental practices on child promotive and preventive food consumption behaviors: a systematic review and meta-analysis. \u003cem\u003eInternational Journal of Behavioral Nutrition and Physical Activity\u003c/em\u003e,\u003cem\u003e 14\u003c/em\u003e(1), 47. https://doi.org/10.1186/s12966-017-0501-3 \u003c/li\u003e\n\u003cli\u003eZhang, Z., Li, H., Slapsinskaite, A., Zhang, T., Zhang, L., \u0026amp; Gui, C. (2020). Accelerometer-measured physical activity and sedentary behavior in Chinese children and adolescents: a systematic review and meta-analysis. \u003cem\u003ePublic Health\u003c/em\u003e,\u003cem\u003e 186\u003c/em\u003e, 71-77. \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"child-psychiatry-and-human-development","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"chud","sideBox":"Learn more about [Child Psychiatry \u0026 Human Development](http://link.springer.com/journal/10578)","snPcode":"10578","submissionUrl":"https://submission.nature.com/new-submission/10578/3","title":"Child Psychiatry \u0026 Human Development","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"Lifestyle, Child, Adolescent, Mental disorders, Psychiatry","lastPublishedDoi":"10.21203/rs.3.rs-6562159/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6562159/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eUnhealthy lifestyle behaviours, such as sleep problems, low physical activity, poor diet, and excessive screen time, are common among children and adolescents. Lifestyle has a significant impact on children’s physical and mental health. This study examined the prevalence of unhealthy lifestyle habits in children and adolescents in psychiatric care, and how they vary by age, gender, and diagnosis. Parent-reported data on sleep, physical activity, diet (i.e., vegetables and fruit), and screen time from 4,633 children and adolescents (ages 0-18 years) referred for specialized psychiatric care were used. Parents reported high levels of unhealthy lifestyle habits among children with mental disorders. Adolescents (13-18 years) exhibited the unhealthiest lifestyles, with more sleep problems, less physical activity, more screen time and less fruit intake. Reported lifestyle habits were worse for girls than boys, with girls exhibited less physical activity, more sleeping problems, more screen time and less fruit intake. Children and adolescents with depression and anxiety disorders reported the least physical activity, most screen time and the least fruit and vegetable intake. Children and adolescents with trauma and stressor related disorders had the most sleep problems.\u003c/p\u003e\n\u003cp\u003eTo conclude, parents report high amounts of unhealthy lifestyle habits in their children with mental disorders. These unhealthy lifestyle habits appeared to be highly prevalent in this group of children compared to those in the normative population. Given the high prevalence of unhealthy lifestyle in this clinical population of children, it is crucial to place greater emphasis on improving lifestyle interventions within psychiatric care.\u003c/p\u003e","manuscriptTitle":"Prevalence of Unhealthy Lifestyle Behaviours in Children and Adolescents with Mental Disorders","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-16 14:13:22","doi":"10.21203/rs.3.rs-6562159/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-06-10T00:05:09+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-05-17T10:13:46+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"127368855136448079054234828237225018442","date":"2025-05-14T18:35:06+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-05-14T13:12:07+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-05-12T02:26:51+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-04-30T08:42:06+00:00","index":"","fulltext":""},{"type":"submitted","content":"Child Psychiatry \u0026 Human Development","date":"2025-04-30T07:12:07+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"child-psychiatry-and-human-development","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"chud","sideBox":"Learn more about [Child Psychiatry \u0026 Human Development](http://link.springer.com/journal/10578)","snPcode":"10578","submissionUrl":"https://submission.nature.com/new-submission/10578/3","title":"Child Psychiatry \u0026 Human Development","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"0d6a8fbe-e2c2-43d6-ad48-e0405ff06011","owner":[],"postedDate":"May 16th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-09-01T16:04:09+00:00","versionOfRecord":{"articleIdentity":"rs-6562159","link":"https://doi.org/10.1007/s10578-025-01877-5","journal":{"identity":"child-psychiatry-and-human-development","isVorOnly":false,"title":"Child Psychiatry \u0026 Human Development"},"publishedOn":"2025-08-30 15:57:20","publishedOnDateReadable":"August 30th, 2025"},"versionCreatedAt":"2025-05-16 14:13:22","video":"","vorDoi":"10.1007/s10578-025-01877-5","vorDoiUrl":"https://doi.org/10.1007/s10578-025-01877-5","workflowStages":[]},"version":"v1","identity":"rs-6562159","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6562159","identity":"rs-6562159","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}