Abstract Body: Introduction

Prosociality involves behaving in a way that benefits others such as helping, cooperating, and volunteering. Prosocial behavior in adults is associated with better health and longevity, but it is unclear if health benefits begin to manifest in early life. This preregistered systematic review investigated the hypothesis that prosociality in children and adolescents is associated with healthier cardiometabolic outcomes across the life course.

Methods

In October 2023, we searched PubMed and PsycINFO databases for studies written in English with healthy individuals <18 years old, a childhood or adolescent assessment of prosocial behavior, and ≥1 cardiometabolic outcome (e.g., blood pressure, lipids, blood glucose, body mass index [BMI]). We identified 9,744 records, from which 168 duplicates were removed. Two researchers screened the titles and abstracts of 9,576 records, from which 163 full texts were reviewed. This resulted in ten studies included in the review. One researcher extracted data from each study and assessed the quality based on nine criteria (e.g., study design, validated assessments, accounting for confounders). Findings were synthesized in a narrative review.

Results

Included studies were comprised of up to 22,771 participants. Five were cross-sectional, four had longitudinal designs, and one was an experiment. The mean quality score for the included studies was 5.5 (SD = 0.97; possible range 1-9). Prosocial behavior was typically measured in mid-childhood or adolescence using the parent-reported prosocial subscale of the Strengths and Difficulties Questionnaire. Cardiometabolic outcomes were objectively assessed in all studies. BMI was the primary cardiometabolic outcome in nine of the ten studies, but most reported null associations between prosociality and BMI. Only four studies considered other outcomes. The most promising findings came from an intervention in which adolescents were randomly assigned to volunteer or be in a wait list control condition; adolescents who volunteered had lower post-intervention levels of inflammation, total cholesterol, and BMI.

Conclusions

Given the few studies evaluating prosocial behavior in youth and the nearly exclusive focus on BMI, we cannot draw firm conclusions as to whether greater prosociality in youth is related to better cardiometabolic health. More research on prosocial behavior in early life is warranted given its purported benefits for both the recipient and the giver.