Screen time, alcohol & poor sleep for girls: how the pandemic impacts teens

Australian teens had overall improvements in sleep over the two years and some improvements in dietary choices during lockdown, however these were offset by increases in already concerning levels of screen time and worrying trends of alcohol use and poor sleep among girls.

Led by the University of Sydney and published in BMJ Open today, the study adds important new data to the growing chorus of concern around the long-term impacts of COVID-19 on young people. It also emphasises the importance of tailoring support and interventions to address specific concerns and groups – such as adolescent girls – who appear to be most impacted.

“We know these lifestyle risk behaviours are common among young people, but we also know they are key predictors of chronic diseases later in life, such as cancer, cardiovascular disease and mental disorders,” said lead author Dr Lauren Gardner, Research Fellow at the Matilda Centre for Research Excellence in Mental Health and Substance Use in the Faculty of Medicine and Health.

“It’s important that we understand how to best support young Australians moving forward, regardless of the course of the pandemic, and invest in prevention and health promotion activities.”

The research drew on self-reported longitudinal survey data from 983 Australian adolescents (average age 12.6 years at baseline) enrolled in the The Health4Life Study.

 It analysed data over a two-year period from before (2019) to during the COVID-19 pandemic (2021) – looking at the ‘Big 6’ health behaviours: diet, physical activity, recreational screen time, sleep and alcohol and tobacco use.

The researchers also examined if differences over time were associated with gender and lockdown status across three Australian states - New South Wales, Queensland and Western Australia.

• Compared to pre-pandemic levels, there were increases in the prevalence of excessive recreational screen time (86% to 94%), insufficient fruit intake (20% to 30%), and increased alcohol (2% to 10%) and tobacco use (1% to 4%)*.
• Overall, the prevalence of insufficient sleep decreased over the two-year period (by 26%), regardless of lockdown status.
• Being in lockdown was associated with improvements in sugar sweetened beverage consumption (39% lower than those not in lockdown) and discretionary food intake (27% lower than those not in lockdown).
• For females, there was an increase in the prevalence of insufficient sleep (24% higher than males) and alcohol use* (134% higher than males).
•  Although the prevalence of insufficient physical activity and insufficient vegetable intake did not change over time, nor were there differences based on lockdown status, these behaviours remain concerning, with 82% not achieving 60 minutes of moderate-to-vigorous physical activity per day and 84% not eating the recommended five serves of vegetables per day.

*The increase in alcohol and tobacco use over time was expected as the cohort aged and remained relatively low, however, the greater increase in alcohol use among females was unexpected.

“The Health4Life study gave us a unique opportunity to assess changes in key health behaviours in a large and geographically diverse sample. Due to Australia’s state-based public health restrictions, approximately one-third of the sample was subjected to the Greater Sydney stay-at-home orders at the second time point, allowing us to look at how different levels of restrictions impacted these behaviours,” said Dr Gardner.

Director of the Matilda Centre, Professor Maree Teesson said the new study reinforces other international research highlighting the varied impact of the COVD-19 pandemic across countries and within regions.

“The full extent of the impact of the pandemic on children and young people is being recognised internationally. This study is the first to examine those impacts on Australian teens,” said Professor Teesson.

“We need a COVID recovery plan – as proposed by Australia’s Mental Health Think Tank - that helps our young people get back on track for a healthier future.”

“Supporting young people to improve or maintain positive health behaviours is important.  Research such as this can help us start to understand the interplay between health behaviours and mental health to ensure we provide targeted interventions to those who need it the most.”

The Health4Life Study was funded by the Paul Ramsay Foundation and the Australian National Health and Medical Research Council via Fellowships (KC, APP1120641; MT, APP1078407; and NN, APP1166377) and via a Centre of Research Excellence in the Prevention and Early Intervention in Mental Illness and Substance Use (PREMISE; APP11349009). The authors have no potential conflicts of interest to declare.