How much do friends influence teens’ mental health? What a new study can (and can’t) tell us


During adolescence, young people become especially sensitive to peer influence – more so than any other time in life.

So, how does this affect their mental health?

A new study from Finland, released today, analysed data from more than 600,000 young people born between 1985 and 2000 (meaning both millennials and early Gen Zs).

It found that people whose peers had been diagnosed with a mental health condition – such as anxiety or depression – were more likely to develop a mental health condition themselves.

The researchers say these findings support the idea of “social transmission” of mental health conditions. But we need to be careful: this doesn’t mean these conditions are “contagious” in the same way as an infectious disease.

Many other factors, including genetic predisposition, also play a role in teen mental health. The data also can’t tell us if the “peers” are actually friends. Let’s take a look.

Mental health conditions on the rise

Around the world, depression and anxiety are increasing among young people. In Australia, recent data shows rates of anxiety in young people have increased from 13% to 28% over the past 15 years, while suicide attempts have doubled.

Despite greater awareness and expanded mental health services, young people are experiencing more severe and complex mental health challenges than ever before.

We know both friends and family play an important role in mental health. Family factors – including genetics – and environmental influences – such as peer relationships – each uniquely shape the development of mental health conditions.

What the study did and what it found

The new Finnish study explored the relationship between young people’s mental health and that of their peers. It aimed to find out whether having a peer with a diagnosed mental health condition, or a peer with a family history of one, increases your own likelihood of a diagnosis.

The researchers did this by analysing nationwide data in Finland, including health records and school enrolments.

The study made some interesting key findings:

  1. if you had a peer with a diagnosed mental health condition or a peer with diagnoses in their family – for example, anxiety – you were more likely to be diagnosed with this same condition

  2. the effect was stronger among peers who attended the same school, rather than lived in the same area – particularly in later adolescence.

The authors conclude that the findings support the idea of “transmission” of mental health risk in adolescence.

But there are some important caveats

It’s important to note that terms like “transmission” or “contagion” are not used in the same way as for infectious diseases. You cannot “catch” a mental health condition.

Instead, these terms describe how emotions, behaviours and social norms can spread between peers over time and influence mental health. For example, if there is increased awareness of mental health and reduced stigma within a group of peers, people in that group may be more comfortable seeking help (although the study didn’t test this).

Importantly, peer relationships and genetic risk are part of a complex mix of factors that shape adolescent mental health.

Because this study defined peers by school year or location, findings likely reflect shared school and community influences. In other words, these “peers” were likely exposed to similar environmental conditions, ranging from school cultures and educational approaches to neighbourhood features such as green space.

What the study couldn’t measure

The size of this study is a key strength. However, because this is achieved by using “register data” such as health records, there are some constraints:

  • the data can’t tell you if people actually knew each other or were friends. So the study defined “peer networks” according to school (for example, those in the same grade and born in the same year) or where they lived (for example, people in the same postcode born in the same year)

  • “genetic risk” was inferred from family diagnoses, rather than DNA, and there may be various reasons someone with a mental health condition doesn’t get a diagnosis

  • the study couldn’t account for all the factors known to increase or lower someone’s risk of having a mental health condition. For example, it included someone’s sex, age and their parents’ income and education level. But it didn’t consider other factors known to play a role in adolescent mental health, such as their gender identity, ethnicity and what their school is like, as well as lifestyle behaviours, such as whether they smoke, drink alcohol or get regular exercise

  • the study also found that if someone’s peer had a family history of a mental health condition, such as a substance use disorder, they had a higher chance of receiving the same diagnosis. But because the data only looks at diagnosis, it can’t capture other factors which might better explain the link – such as shared factors in families’ social environments.

Where to next?

This study shows both peers and their family risk are linked to adolescent mental health, but it cannot explain how these effects occur.

To understand how mental health conditions “spread” within peer networks, we still need research that disentangles the effects of peer selection (choosing similar friends) from peer influence (how friends shape each other).

But the importance of school environments is clear. School-based mental health programs which harness the influential role of peers are key. In Australia, a program called Mind your Mate, has already shown promise in lowering depression risk in teens through education about mental health and how to support peers.

Together, these findings point beyond individuals to the wider environments young people are part of. Ultimately, improving adolescent mental health means investing in the people and places around them, such as the schools and communities where peer relationships take shape.


Thank you to Professor Cath Chapman for her role in developing this article.

If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14. Aboriginal and Torres Strait Islander people can also call 13YARN on 13 92 76.The Conversation

Scarlett Smout, Research Fellow, The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney; Louise Birrell, Researcher, The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, and Tim Slade, Professor, The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Is dark chocolate healthier than milk chocolate? 2 dietitians explain

 
Lauren Ball, The University of Queensland and Emily Burch, Southern Cross University

Easter chocolate is all over supermarket shelves. Some people reach straight for milk chocolate eggs while others pause at the darker varieties, assuming they’re healthier.

Dark chocolate has gained a reputation as the “better” choice because it usually contains more cocoa and less sugar than milk chocolate.

But is dark chocolate actually healthier?

Let’s see how the evidence stacks up.

How do they compare?

All chocolate begins with the cocoa (or cacao) bean. Cocoa beans are the seeds of the Theobroma cacao tree, a tropical plant native to Central and South America.

Processing the bean gives you cocoa solids (the bitter part) and cocoa butter (the fat part that gives chocolate its smooth texture).

Chocolate is made from cocoa solids, cocoa butter and sugar. Milk chocolate also contains milk powder or condensed milk.

Dark chocolate typically contains a much higher proportion of cocoa solids, usually 50–90%.

Milk chocolate generally contains 20–30% cocoa solids, with the remaining bulk made up of milk ingredients and sugar.

How about nutritional benefits?

Because dark chocolate contains more cocoa solids than milk chocolate, it naturally provides slightly higher amounts of certain minerals.

This table shows the differences between milk chocolate (30% cocoa) and dark chocolate (more than 60% cocoa) per 20-gram serve. That’s about one row of a Lindt chocolate block.

As you can see, dark chocolate provides more minerals such as magnesium, iron and zinc. It also contains noticeably more caffeine (but far less than in a typical cup of coffee, which would contain about 100mg).

Milk chocolate offers significantly more calcium due to its milk solids, but it generally contains more added sugar.

Cocoa is naturally rich in plant compounds called polyphenols. These act as antioxidants in the body, helping to protect the body’s cells from damage.

Because dark chocolate contains more cocoa, it naturally contains higher levels of these compounds. In fact, dark chocolate contains roughly five times more flavanols (a type of polyphenol) than milk chocolate.

Compared to other foods often praised for their antioxidant content, cocoa contains around 17 times more catechins (another type of polyphenol) per serving than black tea. It also contains around three times more than red wine.

Does dark chocolate improve your health?

Research into cocoa and dark chocolate has produced some interesting findings, particularly about heart health.

Cocoa flavanols appear to help blood vessels relax and support better blood flow. Some clinical trials have reported small reductions in blood pressure and improvements in measures of blood vessel function after consuming cocoa products.

There is also broader evidence suggesting diets rich in flavanols may be linked with a lower risk of cardiovascular disease overall.

However, these findings come with important caveats.

Many of these trials use cocoa extracts containing high levels of flavanols. Others contain specially formulated chocolate rather than the typical chocolate bars or Easter eggs you’d find in supermarkets. The doses tested are also often far larger and far more concentrated than what people normally consume.

A large umbrella review (a review of reviews) involving more than one million participants did find links between eating chocolate and lower risks of cardiovascular disease, stroke and diabetes.

But the overall quality of evidence was rated as weak or very low, largely because many of the studies were observational. Observational studies can identify patterns, but they cannot prove chocolate itself caused those benefits.

The bottom line is that cocoa does contain beneficial plant compounds but the chocolate most of us enjoy is not a health supplement.

But I thought dark chocolate has less sugar?

Choosing dark chocolate doesn’t automatically make it the healthier option, especially where sugar is concerned. Some dark chocolate contains surprisingly high amounts.

Depending on the cocoa percentage and recipe, some dark chocolate products contain 40–50% sugar.

So a 150g dark chocolate Easter bunny containing 50% sugar, for example, can contain about 19 teaspoons of added sugar.

This applies to Easter eggs too. Some dark chocolate Easter eggs sold in supermarkets still list sugar as one of their first and main ingredients, ahead of cocoa butter. This means sugar makes up a significant chunk of what you’re eating.

So it’s always worth flipping the packet over and checking the ingredients list and nutritional panel to be sure.

What to choose this Easter?

Dark chocolate has a nutritional advantage over milk chocolate. But how much depends on the cocoa percentage and how it’s been made.

As a general rule, aim for 70% cocoa or more, and flip the packet over before you buy. In a higher-quality dark chocolate, cocoa should appear first in the ingredients list – not sugar.

A higher-quality dark chocolate might have its ingredients listed in this order: cocoa mass, cocoa powder, cocoa butter, sugar, vanilla.

A lower-quality dark chocolate might look like this: sugar, cocoa mass, cocoa butter, emulsifiers, flavour, milk solids.

If sugar is listed first, it’s the largest ingredient by weight.

Beyond that, choose chocolate you actually enjoy and watch your portion size. Remember that your overall diet matters far more than a few Easter eggs.

The real health benefit of Easter chocolate? The enjoyment of sharing it.The Conversation

Lauren Ball, Professor of Community Health and Wellbeing, The University of Queensland and Emily Burch, Accredited Practising Dietitian and Lecturer, Southern Cross University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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