Diet, Sleep, and Physical Activity in Children and Adolescents With Depression: An Umbrella Review of Systematic...

Health behaviors (diet, physical activity [PA], and sleep) have been identified as potential targets for improving symptoms of adolescent depression, yet no comprehensive review has evaluated the collective evidence. This umbrella review aimed to synthesize current systematic review evidence on the effects of diet, sleep, and PA on depression in children and adolescents. Searches were conducted across eight databases. Included reviews focused on diet, sleep, and/or PA in individuals under 19 years. The primary study overlap was assessed using the corrected covered area. Out of 14,938 records screened, 49 systematic reviews were included, comprising 485 unique studies and 1.9 million participants (mean age = 14.3 years; 55.5% female) across 48 countries. Greater sleep disruption and unhealthier diets were associated with greater depression symptoms (g = 0.55 and 0.14, respectively), while longer sleep duration, healthier diet, and increased PA (g = -0.40, -0.16, and -0.16, respectively) were associated with fewer depression symptoms. Similar trends were observed in intervention reviews for PA (g = -0.54), though results for diet interventions were inconsistent (g = -0.20). Increased PA and better sleep are consistently associated with fewer depression symptoms in adolescents, whereas diet findings show more variability. These results clarify where evidence is strongest and where further research is needed.