Healthy Behaviors and Mental Health: A Review of Protective Factors in Adolescents
Keywords:
Mental health; adolescence; healthy behaviors; protective factors; lifestyle habits; systematic reviewAbstract
Introduction: Adolescence is a critical stage for establishing healthy behaviors that act as protective factors for mental health. This systematic review aimed to analyze the relationship between habits such as physical activity, a balanced diet, adequate sleep, social support, and psychoeducational interventions with psychological well-being in adolescents. Materials and methods: A search was conducted in the PubMed, Scopus, Web of Science, SciELO, Redalyc, and PsycINFO databases, following PRISMA guidelines, which allowed the selection of 30 studies published between 2013 and 2023. Results: The results show that regular physical activity is associated with a reduction in anxiety and depressive symptoms and improves emotional regulation. Adequate sleep hygiene acts as a modulator of stress and cognitive performance, while a balanced diet promotes executive functions. Perceived social and family support shows a robust inverse association with depressive symptoms, also enhancing adherence to other healthy habits. Discussion: Integrated psychoeducational interventions in schools, combining the promotion of healthy habits with emotional literacy, generate positive effects on self-esteem and resilience, especially when families are involved. Contextual factors such as a positive school climate and digital health literacy also emerge as relevant modulators. The synergistic and interdependent nature of these behaviors is highlighted, as is the need for intersectoral and culturally adapted approaches. Conclusions: Promoting multiple healthy behaviors, coordinated across school, family, and community settings, is an effective strategy for strengthening the mental health and overall well-being of adolescents.
References
Abraído-Lanza, A. F., Chao, M. T., & Flórez, K. R. (2005). Do healthy behaviors decline with greater acculturation? Implications for the Latino mortality paradox. Social Science & Medicine, 61(6), 1243–1255. https://doi.org/10.1016/j.socscimed.2005.01.016
Adams, J., Tyrrell, R., & White, M. (2011). Do television food advertisements portray advertised foods in a 'healthy' food context? British Journal of Nutrition, 105(6), 810–815. https://pubmed.ncbi.nlm.nih.gov/21078214/
Adrian, M., Charlesworth-Attie, S., Vander Stoep, A., McCauley, E., & Becker, L. (2014). Health promotion behaviors in adolescents: Prevalence and association with mental health status in a statewide sample. The Journal of Behavioral Health Services & Research, 41(2), 140–152. https://doi.org/10.1007/s11414-013-9370-y
Ahmadi, Z., Amini, L., & Haghani, H. (2020). Determining a health-promoting lifestyle among Afghan immigrant women in Iran. Journal of Primary Care & Community Health, 11, 2150132720954681. https://doi.org/10.1177/2150132720954681
Akter, M. S., Snoek, H. M., Rasheed, S., Maasen, K., Thilsted, S. H., Feskens, E. J. M., & Talsma, E. F. (2024). Diet quality and associations with motivation and ability to consume a healthy diet among adolescents from urban low-income households in Bangladesh. Appetite, 200, 107563. https://doi.org/10.1016/j.appet.2024.107563
Almeida, C., Novo, A., Canut, M. L., Ferré-Grau, C., & Sequeira, C. (2023). COVID-19—Evidence of the impact of literacy and salutogenic behaviours in positive mental health: A cross-sectional study. Behavioral Sciences, 13(10), 845. https://doi.org/10.3390/bs13100845
Andermo, S., Hellenius, M. L., Lidin, M., Hedby, U., Nordenfelt, A., & Nyberg, G. (2020). Effectiveness of a family intervention on health-related quality of life—a healthy generation, a controlled pilot trial. BMC Public Health, 20(1), Article 809. https://doi.org/10.1186/s12889-020-08895-z
Andres, E. B., Choi, E. P. H., Fung, A. W. C., Lau, K. W. C., Ng, N. H. T., Yeung, M., & Johnston, J. M. (2021). Comprehensive sexuality education in Hong Kong: Study protocol for process and outcome evaluation. BMC Public Health, 21(1), 197. https://doi.org/10.1186/s12889-021-10253-6
Ashida, S., Goodman, M., Pandya, C., Koehly, L. M., Lachance, C., Stafford, J., & Kaplingst, K. A. (2011). Age differences in genetic knowledge, health literacy and causal beliefs for health conditions. Public Health Genomics, 14(4–5), 307–316. https://doi.org/10.1159/000316234
Becker, S. P., Ramsay, H., & Byars, K. C. (2018). Predicting academic achievement and grade retention with attention-deficit/hyperactivity disorder symptom dimensions. Journal of Clinical Child & Adolescent Psychology, 47(3), 378–390. https://doi.org/10.1080/15374416.2016.1138408
Boniel-Nissim, M., Zhi, H., & Currie, C. (2015). Suicidal ideation and behaviors among adolescents: A multilevel analysis of the role of school climate and social support. The European Journal of Public Health, 25(1), 65–70. https://doi.org/10.1093/eurpub/cku084
Buckworth, J. (2017). Promoting self-efficacy for healthy behaviors. ACSM's Health & Fitness Journal, 21(5), 40–42. https://doi.org/10.1249/FIT.0000000000000317
Byrne, D. W., Rolando, L. A., Aliyu, M. H., McGown, P. W., Connor, L. R., Wang, S. C., & Yarbrough, M. I. (2016). Modifiable healthy lifestyle behaviors: 10-year health outcomes from a health promotion program. American Journal of Preventive Medicine, 51(6), 1027–1037. https://doi.org/10.1016/j.amepre.2016.09.012
Changizi, M., & Kaveh, M. H. (2017). Effectiveness of the mHealth technology in improvement of healthy behaviors in an elderly population—A systematic review. mHealth, 3, 51. https://doi.org/10.21037/mhealth.2017.08.06
Chauhan, A., Mahapatra, P., Kanungo, S., & Pati, S. (2025). Scoping review of knowledge, attitude and practices related to NCD risk factors among medical undergraduates, India. Journal of Health Management. https://doi.org/10.1177/09720634241279892
Etz, R. S., Cohen, D. J., Woolf, S. H., Holtrop, J. S., Donahue, K. E., Isaacson, N. F., Stange, K. C., Ferrer, R. L., & Olson, A. L. (2008). Bridging primary care practices and communities to promote healthy behaviors. American Journal of Preventive Medicine, 35(5 Suppl), S390–S397. https://doi.org/10.1016/j.amepre.2008.08.008
Ford, E. S., Bergmann, M. M., Boeing, H., Li, C., & Capewell, S. (2012). Healthy lifestyle behaviors and all-cause mortality among adults in the United States. Preventive Medicine, 55(1), 23–27. https://doi.org/10.1016/j.ypmed.2012.04.016
Hampson, S. E., Goldberg, L. R., Vogt, T. M., & Dubanoski, J. P. (2007). Mechanisms by which childhood personality traits influence adult health status: Educational attainment and healthy behaviors. Health Psychology, 26(1), 121–129. https://pubmed.ncbi.nlm.nih.gov/17209705/
Joseph, P. L., & Fleary, S. A. (2025). Designing health interventions to meet the needs and experiences of minoritized adolescents: #DoubleTap4Health. Health Education & Behavior, 52(2), 166–178. https://doi.org/10.1177/10901981241292313
Kelly, S. A., Melnyk, B. M., Jacobson, D. L., & O'Haver, J. A. (2011). Correlates among healthy lifestyle cognitive beliefs, healthy lifestyle choices, social support, and healthy behaviors in adolescents. Journal of Pediatric Health Care, 25(4), 216–223. https://doi.org/10.1016/j.pedhc.2010.03.002
Langford, R., Bonell, C., Jones, H. E., Pouliou, T., Murphy, S. M., Waters, E., Komro, K. A., Gibbs, L. F., Magnus, D., & Campbell, R. (2015). The WHO Health Promoting School framework for improving the health and well-being of students and their academic achievement. Cochrane Database of Systematic Reviews, (4), CD008958. https://doi.org/10.1002/14651858.CD008958.pub2
Lewallen, L. P. (2004). Healthy behaviors and sources of health information among low-income pregnant women. Public Health Nursing, 21(3), 200–206. https://pubmed.ncbi.nlm.nih.gov/15144364/
Maddaleno, M. (s.f.). Youth: Choices and change. Promoting healthy behaviors in adolescents. Academia.edu. https://www.academia.edu/61222252/Youth_Choices_and_Change_Promoting_Healthy_Behaviors_in_Adolescents
Mallick, A., & Sahoo, A. (2025). Unravelling the role of health-promoting and health-abusive lifestyle behaviours on health-related quality of life among the urban community-dwelling youths (19–25 years) in the Balasore district of Odisha, India. Discover Public Health, 22, 293. https://doi.org/10.1186/s12982-025-00698-0
Mousazadeh, Y., Sarbakhsh, P., Arbabisarjou, A., Tolouei, M., Mousavi, H., & Molaei, S. (2025). Association between health-promoting lifestyle and electronic health literacy among Iranian university students. BMC Medical Education, 25(1), Article 470. https://doi.org/10.1186/s12909-025-06823-6
Musavian, A. S., Pasha, A., Rahebi, S. M., Atrkar Roushan, Z., & Ghanbari, A. (2014). Health promoting behaviors among adolescents: A cross-sectional study. Nursing and Midwifery Studies, 3(1), e14560. https://doi.org/10.17795/nmsjournal14560
Myers, R. E. (2010). Promoting healthy behaviors: How do we get the message across? International Journal of Nursing Studies, 47(4), 500–512. https://pubmed.ncbi.nlm.nih.gov/20031126/
Nyaradi, A., Li, J., Hickling, S., Foster, J., & Oddy, W. H. (2015). The role of nutrition in children's neurocognitive development, from pregnancy through childhood. Frontiers in Human Neuroscience, 9, 586. https://doi.org/10.3389/fnhum.2015.00586
Redland, A. R., & Stuifbergen, A. K. (1993). Strategies for maintenance of health-promoting behaviors. Nursing Clinics of North America, 28(2), 427–442. https://pubmed.ncbi.nlm.nih.gov/8516183/
Rodriguez-Ayllon, M., Cadenas-Sanchez, C., Estevez-Lopez, F., Muñoz, N. E., Mora-Gonzalez, J., Migueles, J. H., Molina-García, P., Henriksson, H., Mena-Molina, A., Martínez-Vizcaíno, V., Catena, A., Löf, M., Erickson, K. I., Lubans, D. R., Ortega, F. B., & Esteban-Cornejo, I. (2019). Physical activity and mental health in children and adolescents: An updated review of reviews and an analysis of causality. Psychology of Sport and Exercise, 42, 146–155. https://doi.org/10.1016/j.psychsport.2019.01.005
Rueger, S. Y., Malecki, C. K., Pyun, Y., Aycock, C., & Coyle, S. (2016). A meta-analytic review of the association between perceived social support and depression in childhood and adolescence. Psychological Bulletin, 142(10), 1017–1067. https://doi.org/10.1037/bul0000058
Tabrizi, J. S., Doshmangir, L., Khoshmaram, N., Shakibazadeh, E., Abdolahi, H. M., & Khabiri, R. (2024). Key factors affecting health promoting behaviors among adolescents: A scoping review. BMC Health Services Research, 24(1), 58. https://doi.org/10.1186/s12913-023-10510-x
Valencia-Peris, A., Sanchis-Francés, L., & Chinchilla-Ramírez, C. (2025). The influence of health-promoting schools on the students' active and sedentary behaviour. Psychology, Society & Education, 17(1), 1–10. https://doi.org/10.21071/pse.v17i1.17384
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Diego Javier Mayorga Ortiz, Shirley Gabriela Abarca Obregón, Mishell Katherine Lata Sánchez, Marco Israel Claudio Chacón
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
This journal provides immediate open access to its content, based on the principle that offering the public free access to research helps a greater global exchange of knowledge. Each author is responsible for the content of each of their articles.
Universidad de Oriente 