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Almost 1 in 2 Aussie teens living with a chronic disease or developmental condition
Research also uncovers overlap with ultra-processed foods, sugary drinks, mental health, screen time, smoking and alcohol
New research published today shows that almost half (45.6%) of Australian teens are living with chronic diseases or developmental conditions like attention deficient hyperactivity disorder (ADHD) or autism (ASD). The study has linked the conditions to unhealthy lifestyles, diets and poor mental health, prompting calls for further research and government action.
The study, published today in the Australian and New Zealand Journal of Public Health, involved a survey of over 5,000 Australian adolescents.
It is the first study of its kind in Australia to examine six unhealthy behaviours and mental health, while examining their overlap with common and emerging health conditions in teens such as irritable bowel syndrome (IBS), asthma, eczema, chronic fatigue, hay fever, food allergies, type 1 / type 2 diabetes, ADHD and ASD.
Lead author Dr Bridie Osman from the Matilda Centre for Research in Mental Health and Substance Use at the University of Sydney, says that the issue of chronic disease and developmental conditions in teenagers is often overlooked as a serious public health concern.
“Alarmingly this study shows that one in two Australian teenagers are living with a chronic disease or developmental condition,” Dr Osman said.
“These conditions can have a profound impact. They can hinder a teenager’s ability to attend school or sports and can have social and developmental implications. Some of these chronic health conditions can also cause ongoing damage to the immune system and contribute to more severe diseases in later life1,2,3.
“This finding is a wake-up call that we need to do more to prioritise the health of young people,” she said.
Researchers found that the most common chronic diseases in teenagers were hay fever (23%) and asthma (15%), whilst the most common developmental condition was ADHD, affecting 9% of participants.
The study found that, overall, teenagers who were female consumed more ultra-processed foods, sugar sweetened beverages, alcohol, spent more time on screens or had a mental health condition were more likely to have at least one chronic disease or developmental condition.
But that doesn’t mean males aren’t at risk. It was teenage males who had disproportionally higher risk of having disease when they had a mental health condition, when compared with females who had the same mental health conditions.
Dr Osman pointed out that whilst the study could not demonstrate that diseases and conditions were caused by unhealthy lifestyles, there was a clear link that is important and requires further investigation.
“When looking at each of the diseases and conditions individually, we found that consuming more ultra-processed food, alcohol and smoking tobacco and having poorer mental health was linked to every one of the 10 different diseases and conditions we measured.
“While previous research has proven the cause of some of these relationships, we need to do more long-term research to get a clearer understanding of the causes behind all these common and emerging diseases and development conditions in teenagers so we can prevent them. In the meantime, we need to ensure a whole-of-lifestyle approach when preventing and treating these diseases.
“What we do know is that all teenagers’ immune health will benefit from healthy diets, exercise, sleep, reducing screen time and good mental health.”
Adjunct Professor Terry Slevin, CEO, Public Health Association of Australia said that this was a significant study with important findings, particularly when it comes to warnings around the increasing deterioration of young people’s diets.
“This large study offers a warning of the health impacts of unhealthy diets. Intake of ultra-processed foods amongst teens is at an all-time high and obesity has recently overtaken tobacco as Australia’s biggest cause of preventable disease.
“We need to do more to help all Australians, particularly teenagers, choose the right foods to set them up with good physical and mental health. That’s why we are calling on the next Federal Government to take comprehensive action on diet and obesity. We need to stop children from being bombarded with unhealthy food advertising, mandate health star ratings on packaged foods, and increase awareness of the benefits of a good healthy diet.”
Expert Reaction
These comments have been collated by the Science Media Centre to provide a variety of expert perspectives on this issue. Feel free to use these quotes in your stories. Views expressed are the personal opinions of the experts named. They do not represent the views of the SMC or any other organisation unless specifically stated.
Dr Muhammad Aziz Rahman is Head of Public Health and Research Adviser from the Institute of Health and Wellbeing at Federation University
It’s an important study, and the findings are interesting. Lifestyle factors contributed significantly to the non-communicable diseases among adolescents investigated in this study. Females having a higher burden of risks was particularly interesting and warrants further investigation. Similarly, the significant burden of mental health issues at this young age needs to be considered, and school-based mental health education and availability of support needs to be considered.
The association of smoking and alcohol with such non-communicable diseases has been known for many years, focusing on both the demand side by providing cessation support and the supply side by specifically addressing accessibility is required. Health awareness campaigns along with prevention efforts, should be strengthened at the institutional settings.
Bearing in mind the limitations of this study, as mentioned by the authors, inability to assess the temporality of associations due to the cross-sectional nature of the study design, these snapshots of findings provide reasonable evidence to take action.
Dr Bridie Osman is a Postdoctoral Research Associate at The University of Sydney and lead author of the paper
In this study, we found that almost half of Australian teenagers are living with a noncommunicable disease or developmental condition. Teenagers who had either asthma, eczema, chronic fatigue, hay fever, food allergies, IBS, type 2 diabetes, type 1 diabetes, ADHD or autism were consuming higher amounts of ultra-processed food, alcohol and tobacco, spending more time on screens and had higher rates of mental health conditions.
This is the first study of its kind to examine these common and emerging diseases and conditions and their associations with important health behaviours and mental health in adolescents, showcasing the significant public health challenges that young people are currently facing. These diseases and conditions can have considerable impacts on adolescents' lifestyles including socially, developmentally and mentally i.e. school absenteeism, reduced physical abilities for sports/activities and increased isolation, posing strong justification for society to stop overlooking these conditions because some may be perceived as 'mild', 'manageable' or 'common’.
The significance of these findings are further evident by the large sample size (5,014 teens), spanning three Australian states. This new understanding of these inter-relationships signifies the need for a whole lifestyle approach to help with future prevention and treatment attempts, specifically targeting consuming more nourishing food, reducing screen time, improving mental health and reduced alcohol and tobacco intake.
Professor Brian Oliver leads the Respiratory Molecular Pathogenesis Group at the University of Technology Sydney and the Woolcock Institute.
This is an important cross sectional study which reports on associations between diet, other lifestyle behaviours and mental health and the presence and prevalence of noncommunicable diseases and developmental conditions. It is very important that these associations are not interpreted as causation.
If we use asthma as an example, we know that genetics and the in-utero environment (especially maternal smoking during pregnancy) are important risk factors for the development of asthma. However, when we consider how severe a disease is, for example, how severe asthma is, this study has replicated the findings of other studies in that smoking and poor dietary choices are likely to make asthma worse.
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