Latinx kids who experienced depression, anxiety, or other mental health issues in middle school had a greater chance of developing sleep problems, as well as unhealthy weight gain and sedentary behavior, in high school, according to a study published in the Journal of Adolescent Health.

The research, led by a team at George Washington University, suggests that unhealthy behaviors linked to mental health issues may start early in life and trigger obesity, high blood pressure, diabetes, and other serious health problems.

“Our study suggests signs of depression or anxiety in Latinx kids can set up a cycle that leads to weight gain, an unhealthy diet, and inactivity by the high school years,” Kathleen M. Roche, PhD, a professor of prevention and community health at the GW Milken Institute School of Public Health, says in a release. “If such problems are not addressed early on they can set the stage for adult diseases like heart disease and stroke.”

Latinx high school students are 50% more likely to be obese compared to white youth and are at much higher risk of developing diabetes, according to the US Department of Health and Human Services. And researchers know that mental health issues can trigger many unhealthy behaviors such as overeating high-fat comfort food and a sedentary lifestyle.

Roche and her colleagues studied data from 547 Latinx middle school students in suburban Atlanta. The majority of students in the sample were US citizens. The students were, on average, age 13 at the time of the first survey and 17 at the time of the most recent survey.

Researchers asked the students questions about their diet, sleep patterns, and physical activity. They also had youth report on their mental health symptoms such as depression and anxiety.

They found that even after adjusting for confounding factors, kids who had more depression, anxiety, and other internalizing mental health symptoms were more likely to report more sleep problems, to be sedentary, to have an unhealthy diet, and to be overweight or obese just four years later. These are all risk factors that can lead to cardiovascular disease in young adulthood.

The findings represent a reminder that teens, even those in middle school, can suffer from mental health issues that continue into the high school years and may also set in motion health problems, according to the researchers in a release.

Additionally, the findings indicate a need for increased health and social services that can help ease the mental distress faced by Latinx teens. Roche says in the release that parents, teachers, and health professionals should be alert to symptoms of mental health problems and arrange for treatment that can keep teens healthy.

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