Perceived stress, depression and food consumption frequency in the college students of China seven cities

A Structural Equation Modelling Approach to Examine the Mediating Effect of Stress on Diet in Culturally Diverse Women of Childbearing Age

Background: Stress has been shown to be associated with poor nutrition among young women. However, studies around the topic have major limitations in their methodologies and the role of confounding factors within this association remains unclear in the literature. Objective: To investigate the associations between stress and dietary quality/patterns in a culturally diverse population of childbearing-aged women. Methods: A secondary analysis of data from two studies conducted in UK and Lebanon was performed using Structural Equation Modelling (SEM) to explore the role of country context, socio-economic status, and physical variables. Participants were healthy women of childbearing age (n = 493). Variables measured were dietary intake, stress, physical activity, sociodemographic variables, and Body Mass Index. These were included in the SEM analysis to examine the mediating effect of stress. Results: The results showed that, among all variables, only country had a significant effect on dietary quality and patterns through the mediatory effect of stress. Participants from Lebanon were found to have higher stress levels compared to participants from the UK, and this contributed to a lower adherence to a Mediterranean diet. Conclusions: This study shows that for women of childbearing age, having a good diet quality/pattern is dependent on stress levels and country context.

Association of Fast-Food Intake with Depressive and Anxiety Symptoms among Young Adults: A Pilot Study

Background: High intake of fast food has been linked to increased risks of both depressive and anxiety disorders. However, associations between individual fast-food items and depressive/anxiety disorders are rarely examined. Method: Using cross-sectional survey the association between common fast-food items and depressive/anxiety symptoms among 142 young Hong Kong adults aged 18-27 years old was examined. A qualitative food frequency questionnaire was employed to measure the intake frequency of 22 common fast-food items found in Hong Kong. Occurrence of significant depressive and anxiety symptoms was measured by the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), respectively. Primary measures were multivariate-adjusted odds ratios for occurrence of depressive and anxiety symptoms compared with the low intake frequency group for common fast-food items. Results: Our observations suggest that frequent intake of high-fat, -sugar, and -sodium fast-foods increased depressive symptoms, while frequent high-fat fast-food intake was associated with anxiety symptoms. However, frequent intake of sugar-free beverages reduced the risk of depressive symptoms. Conclusions: Habitual intake of certain fast foods were related to depressive/anxiety symptoms in young adults.

Association between junk food consumption and mental health problems in adults: a systematic review and meta-analysis

BACKGROUND

Anxiety and depression can seriously undermine mental health and quality of life globally. The consumption of junk foods, including ultra-processed foods, fast foods, unhealthy snacks, and sugar-sweetened beverages, has been linked to mental health. The aim of this study is to use the published literature to evaluate how junk food consumption may be associated with mental health disorders in adults.

METHODS

A systematic search was conducted up to July 2023 across international databases including PubMed/Medline, ISI Web of Science, Scopus, Cochrane, Google Scholar, and EMBASE. Data extraction and quality assessment were performed by two independent reviewers. Heterogeneity across studies was assessed using the I2 statistic and chi-square-based Q-test. A random/fixed effect meta-analysis was conducted to pool odds ratios (ORs) and hazard ratios (HRs).

RESULTS

Of the 1745 retrieved articles, 17 studies with 159,885 participants were suitable for inclusion in the systematic review and meta-analysis (seven longitudinal, nine cross-sectional and one case-control studies). Quantitative synthesis based on cross-sectional studies showed that junk food consumption increases the odds of having stress and depression (OR = 1.15, 95% CI: 1.06 to 1.23). Moreover, pooling results of cohort studies showed that junk food consumption is associated with a 16% increment in the odds of developing mental health problems (OR = 1.16, 95% CI: 1.07 to 1.24).

CONCLUSION

Meta-analysis revealed that consumption of junk foods was associated with an increased hazard of developing depression. Increased consumption of junk food has heightened the odds of depression and psychological stress being experienced in adult populations.

Cross-sectional and longitudinal associations between self-esteem and BMI depends on baseline BMI category in a population-based study

BACKGROUND

Some studies have reported associations between self-esteem and weight status, but longitudinal data on adults remain scarce. The aim of this population-based study was to analyze the cross-sectional and longitudinal association between self-esteem and body mass index (BMI) and to investigate whether baseline BMI has an impact on this association.

METHODS

In 2016, 29,735 participants aged ≥ 18 years in the NutriNet-Santé cohort completed the Rosenberg Self-Esteem Scale. BMI was self-reported yearly over a 4-year period. Association between self-esteem and BMI was assessed using mixed models and logistic regressions. Analyses were stratified by BMI (categorical) at baseline and adjusted on sociodemographic and lifestyle characteristics.

RESULTS

At baseline, higher self-esteem was associated with higher BMI in normal weight individuals(p = 0.32), and with lower BMI in obese class II and III individuals (p = 0.13). In addition, higher baseline self-esteem was associated with BMI increase over time in normal weight individuals (p = 0.15). Among normal weight individuals, those with higher self-esteem were less likely to show a decrease in their BMI (p = 0.005), while no association was observed with BMI increase (p = 0.81).

DISCUSSION

Our findings suggest that the association between self-esteem and BMI depends on the initial category of BMI, with a negligible effect of self-esteem.

Association between Western Dietary Patterns, Typical Food Groups, and Behavioral Health Disorders: An Updated Systematic Review and Meta-Analysis of Observational Studies

Western dietary patterns (WDP) and typical food groups may play a major role in the risk of behavioral health disorders. Nevertheless, the relationships between WDP, common food categories, and mental health disorders lack consistency and remain incompletely understood in relation to potential mechanisms. Therefore, the objective of the present study was conducted to synthesize available evidence linking WDP and typical food groups to these outcomes. Web of Science, PubMed, EMBASE, and MEDLINE were searched up to August 2023. Random effect meta-analyses were performed to obtain pooled odds ratio and the relative risk for the prevalence of outcomes and the incidence of outcomes, respectively. A total of 54 articles were included. WDP was associated with increased risk of both depression (1.19; 95% CI: 1.06-1.32) and depressive symptoms (1.20; 95% CI: 1.08-1.34). Except for high-fat dairy products, food groups are associated with an increased risk of anxiety, depression, and depressive symptoms. This review presents evidence to further understand the relationship between WDP, typical food groups, and the incidence of behavioral health disorders, and more randomized controlled trials and cohort studies are urgently required to confirm these findings and elucidate potential mechanisms.

Effects of a group-based music imagery program on promoting coping resources among undergraduate students: a pilot randomized controlled trial

Background

Music is well-known for its stress-reducing effects. Little is known about the potential effect of music interventions in fostering internal coping resources for stress management among undergraduate students in Hong Kong.

Objectives

This pilot study aimed to examine the efficacy of the Group-based Focus Music Imagery Program (GFMI) in promoting a stress-is-enhancing mindset, sense of coherence, and self-compassion among undergraduate students.

Methods

We used a two-arm parallel randomized controlled trial (RCT). The experimental arm received 6 weeks of GFMI with measures taken at two time points after completing baseline assessments (Weeks 6, 10). The control arm received 6 weeks of an active control program and completed the outcome measures at time points similar to the GFMI group. Data were collected using the Chinese versions of the Sense of Coherence Scale (C-SOC-13), the Self-Compassion Scale-Short Form (C-SCS-SF), the Stress Mindset Measure (C-SMM), the Perceived Stress Scale (C-PSS-10), and the Generalized Anxiety Disorder scale (C-GAD-7).

Results

Sixty-four participants were randomly assigned to either the experimental group (n = 32) or the control group (n = 32) between July 2021 and September 2022. The experimental group exhibited a retention rate of 71.9% at T1 (23 out of 32 participants), which slightly decreased to 65.6% (21 out of 32) at T2. The control group displayed a retention rate of 75% (24 out of 32) at T1, which dropped to 43.8% (14 out of 32) at T2. The GEE analyses showed insignificant differences between groups at any time point in C-SOC-13, C-SCS-SF, and C-SMM. Instead, the control group had a higher reduction in stress scores (C-PSS-10) at T1, and anxiety (C-GAD-7) at T2 than the experimental group.

Conclusion

The pilot trial provided valuable information in examining the feasibility of the trial design and intervention. Future studies with larger samples are needed to validate if GFMI can reliably promote coping resources to manage stress and anxiety in undergraduate students.

Trial registration number

https://www.researchregistry.com/, researchregistry8209.

Association between periodontitis and depression severity - A cross-sectional study of the older population in Hamburg

The aim of the current study is to investigate the association between periodontitis (exposure variable) and depression severity (outcome variable) in an older German population. We evaluated data from 6,209 participants (median age 62 years) of the Hamburg City Health Study (HCHS). The HCHS is a prospective cohort study and is registered at ClinicalTrial.gov (NCT03934957). Depression severity were assessed with the 9-item Patient Health Questionnaire (PHQ-9). Periodontal examination included probing depth, gingival recession, plaque index, and bleeding on probing. Descriptive analyses were stratified by periodontitis severity. Multiple linear regression models were adjusted for age, sex, diabetes, education, smoking, and antidepressant medication. Linear regression analyses revealed a significant association between log-transformed depression severity and periodontitis when including the interaction term for periodontitis * age, even after adjusting for age, sex, diabetes, education, smoking and antidepressant medication. We identified a significant association between severe periodontitis and elevated depression severity, which interacts with age. Additionally, we performed a linear regression model for biomarker analyses, which revealed significant associations between depression severity and severe periodontitis with log-transformed inflammatory biomarkers interleukin 6 (IL-6) and high-sensitivity C-reactive protein (hsCRP). In order to identify new therapeutic strategies for patients with depression and periodontal disease, future prospective studies are needed to assess the physiological and psychosocial mechanisms behind this relationship and the causal directionality.

Barriers to consumption of fruits and vegetables and strategies to overcome them in low- and middle-income countries: a narrative review

This review provides an overview of the barriers to the consumption of fruits and vegetables (FVs) as well as strategies to improve the intake of FVs in low- and middle-income countries (LMICs). The importance of the consumption of FVs and its role in disease prevention are discussed briefly. Trends in the consumption of FVs in LMICs are also summarised. The WHO recommends that every individual should consume at least five servings or 400 grams of FVs per day. Epidemiological and clinical investigations have demonstrated that FVs contain numerous bioactive compounds with health-protecting activities. Despite their health benefits, the intake of FVs in LMICs remains low. Major barriers identified were socio-demographic factors, environmental conditions, individual and cultural factors, and macrosystem influences. These barriers may be lowered at the household, school, community, and national level through multi-component interventions including behaviour change communication (BCC) initiatives, nutrition education (NE), gardening initiatives, farm to institution programs (FIPs), food baskets, cash transfers, nutrition-agriculture policy and program linkages, and food-market environment-based strategies. This review has research implications due to the positive outcomes of strategies that lower such barriers and boost consumption of FVs in LMICs.

Correlates of depressive mood among graduate-level allied health students: An exploratory study examining trait energy and fatigue

Objective: The objective of this study was to identify factors associated with the occurrence and severity of depressive mood states among graduate-level allied health students. Participants: Students (N = 77) completed this study. Methods: Participants completed a series of self-reported surveys measuring moods, lifestyle behaviors, trait mental and physical energy and fatigue, and objective assessments of Trail-Making Test Part-B, and muscle oxygen consumption. Multiple backwards linear regression models were fitted to identify factors associated with depressive mood states. Results: When accounting for all subjects, increased severity of depressive mood states was associated with worse sleep quality (SQ), increased sitting time (ST), and trait physical fatigue (TPF). When examining subjects reporting depressive mood states, increased severity of depressive mood states was associated with worse SQ, increased ST, decreased mental workload on non-school days, and trait physical energy (TPE). Conclusion: Adjustments in lifestyle factors such as sleep, mental workload, and ST, may ameliorate depressive mood states.

Efficacy of low carbohydrate and ketogenic diets in treating mood and anxiety disorders: systematic review and implications for clinical practice

BACKGROUND

There is mounting interest in the potential efficacy of low carbohydrate and very low carbohydrate ketogenic diets in various neurological and psychiatric disorders.

AIMS

To conduct a systematic review and narrative synthesis of low carbohydrate and ketogenic diets (LC/KD) in adults with mood and anxiety disorders.

METHOD

MEDLINE, Embase, PsycINFO and Cochrane databases were systematically searched for articles from inception to 6 September 2022. Studies that included adults with any mood or anxiety disorder treated with a low carbohydrate or ketogenic intervention, reporting effects on mood or anxiety symptoms were eligible for inclusion. PROSPERO registration CRD42019116367.

RESULTS

The search yielded 1377 articles, of which 48 were assessed for full-text eligibility. Twelve heterogeneous studies (stated as ketogenic interventions, albeit with incomplete carbohydrate reporting and measurements of ketosis; diet duration: 2 weeks to 3 years; n = 389; age range 19 to 75 years) were included in the final analysis. This included nine case reports, two cohort studies and one observational study. Data quality was variable, with no high-quality evidence identified. Efficacy, adverse effects and discontinuation rates were not systematically reported. There was some evidence for efficacy of ketogenic diets in those with bipolar disorder, schizoaffective disorder and possibly unipolar depression/anxiety. Relapse after discontinuation of the diet was reported in some individuals.

CONCLUSIONS

Although there is no high-quality evidence of LC/KD efficacy in mood or anxiety disorders, several uncontrolled studies suggest possible beneficial effects. Robust studies are now needed to demonstrate efficacy, to identify clinical groups who may benefit and whether a ketogenic diet (beyond low carbohydrate) is required and to characterise adverse effects and the risk of relapse after diet discontinuation.

Meal Skipping and Shorter Meal Intervals Are Associated with Increased Risk of All-Cause and Cardiovascular Disease Mortality among US Adults

BACKGROUND

Previous dietary studies and current dietary guidelines have mainly focused on dietary intake and food patterns. Little is known about the association between eating behaviors such as meal frequency, skipping and intervals, and mortality.

OBJECTIVE

The objective was to examine the associations of meal frequency, skipping, and intervals with all-cause and cardiovascular disease (CVD) mortality.

DESIGN

This was a prospective study.

PARTICIPANTS/SETTING

A total of 24,011 adults (aged ≥40 years) who participated in the National Health and Nutrition Examination Survey 1999-2014 were included in this study. Eating behaviors were assessed using 24-hour recall. Death and underlying causes of death were ascertained by linkage to death records through December 31, 2015.

MAIN OUTCOME MEASURES

The outcomes were all-cause and CVD mortality.

STATISTICAL ANALYSES PERFORMED

Multivariable Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) of all-cause and CVD mortality.

RESULTS

During 185,398 person-years of follow-up period, 4,175 deaths occurred, including 878 cardiovascular deaths. Most participants ate three meals per day. Compared with participants eating three meals per day, the multivariable-adjusted HRs for participants eating one meal per day were 1.30 (95% CI 1.03 to 1.64) for all-cause mortality, and 1.83 (95% CI 1.26 to 2.65) for CVD mortality. Participants who skipped breakfast have multivariable-adjusted HRs 1.40 (95% CI 1.09 to 1.78) for CVD mortality compared with those who did not. The multivariable-adjusted HRs for all-cause mortality were 1.12 (95% CI 1.01 to 1.24) for skipping lunch and 1.16 (95% CI 1.02 to 1.32) for skipping dinner compared with those who did not. Among participants eating three meals per day, the multivariable-adjusted HR for participants with an average interval of ≤4.5 hours in two adjacent meals was 1.17 (95% CI 1.04 to 1.32) for all-cause mortality, comparing with those having a meal interval of 4.6 to 5.5 hours.

CONCLUSIONS

In this large, prospective study of US adults aged 40 years or older, eating one meal per day was associated with an increased risk of all-cause and CVD mortality. Skipping breakfast was associated with increased risk of CVD mortality, whereas skipping lunch or dinner was associated with increased risk of all-cause mortality. Among participant with three meals per day, a meal interval of ≤4.5 hours in two adjacent meals was associated with higher all-cause mortality.

Study of Different Personalised Dietary Plans on Eating Behaviour, Body Image and Mood in Young Female Professional Handball Players: A Randomised Controlled Trial

Low energy availability may precede or be caused by cognitive disturbances in professional athletes. Related psychological problems include disordered eating patterns, body shape preoccupation, depression or anxiety. The objective of this research was to evaluate the effects of different personalised dietary plans on psychological factors in young professional female handball players with low energy availability. This 12-week randomised clinical trial involved 21 female players aged 22 ± 4 years, 172.0 ± 5.4 cm and 68.4 ± 6.7 kg divided into three groups (FD: free diet; MD: Mediterranean diet; HAD: high antioxidant diet). Eating behaviour (Eating Attitude Test, EAT-26: diet, bulimia and oral control subscales), body image (Body Shape Questionnaire, BSQ) and mood state (Profile of Mode State, POMS: tension, vigour, anger, depression, fatigue) were assessed. All participants showed low energy availability (<30 kcal/lean mass per day). The different plans showed no significant differences between them but significant differences over time within groups for the variables: body image, Tension, Vigour and Depression (p < 0.05). Eating behaviour improved slightly but did not show statistically significant changes. Following an adequate nutritional planning for athletes seems to improve the mood and body perception of young female handball players. A longer intervention period is required to assess the differences between diets and improvement of other parameters.

A systematic review of the association of diet quality with the mental health of university students: implications in health education practice

University students are at risk of experiencing mental health problems during the transition from home to university. This transition can also adversely affect their diet quality. This review aims to examine bidirectional associations from observational studies regarding the influence of diet quality on the mental health of university students, and vice versa. The databases PubMed, CINAHL, EMBASE, PsycINFO, The Cochrane Library and Web of Science were searched using relevant search terms. The searches were last updated on 15 July 2022. Majority of studies (36 out of 45) found that good diet quality of students was associated with better mental health in terms of depression, anxiety, stress and overall general mental well-being. Moreover, majority of studies (19 out of 23) found that stress and anxiety of students were associated with poorer diet quality. The effect sizes observed were generally small-moderate. Healthy diets of students have been associated with better mental health in terms of depression, anxiety, stress or other mental health issues. Stress experienced by university students has been associated with unhealthy diets. There are implications for health education research, as interventions to improve diet quality at the university level could reduce mental health issues; additionally, interventions to support students under stress may lead to healthier dietary habits when living on campuses. Randomized controlled trials and intervention studies are needed to further investigate these implications.

Diet self-management: A qualitative study of college students' experiences and perspectives

Background

Overweight and obesity among college students have become an emergent public health concern, which may be effectively prevented by diet self-management (DSM). The purpose of this explorative study was to explore college students' experiences and perspectives on diet self-management (DSM), as well as its influencing factors.

Method

Thirty-three college students were recruited from different universities in China. A qualitative method was used to conduct semi-structured interviews with audio recording to explore their DSM experience and factors that influence DSM. Data were analyzed using thematic analysis to develop themes related to DSM.

Result

In the perception of what "good DSM" means, three themes and ten subthemes were identified: characteristics of good DSM (including 5 subthemes: regularity, balanced diet, no picky eating, good eating habits, and scientificity), method of good DSM (including three subthemes: self-control, adjusting, and making plans), and content of good DSM (including two subthemes: nutrition management and safety management). The influencing factors of DSM can be categorized into four levels of themes and 34 subthemes: individual, family, school, and social levels.

Conclusion

The results of this qualitative research highlighted the complexity and multi-dimension of DSM and its influencing factors. Our findings may help to inform diverse and needs-based intervention approaches to improve DSM and promote healthy diet among college students so as to prevent overweight and obesity.

Effects of the COVID-19 Pandemic on Health Behaviors of Higher Education Students in Ghana: A Cross-Sectional Study

Stressful events can significantly impact health behaviors of tertiary students in various ways. Many studies reported adverse alterations in health behaviors during the COVID-19 pandemic. However, there is limited knowledge about students from sub-Saharan African countries. Therefore, this study aimed to assess effects of the COVID-19 pandemic on the health behaviors of Ghanaian tertiary students, with an emphasis on the association between sleep and other health behaviors. A cross-sectional study with eligible tertiary students from the Kwame Nkrumah University of Science and Technology in Ghana (n = 129) was conducted. An online survey assessed quality and duration of sleep, financial stress, dietary risk, alcohol misuse, and physical exercise using validated tools. Health behaviors did not differ by gender. The COVID-19 pandemic negatively affected health behaviors for many students including dietary intake (20.2%), sleep quality (20.2%) and duration (81.4%), alcohol consumption (3.1%), exercise frequency (4.1%), and exercise intensity (38%). Shorter sleep duration was linked with greater alcohol misuse scores (p < 0.05). A majority of the students (56%) had increased financial stress during the pandemic. This study contributes important insights into the effects that stressful events such as a pandemic have on the health of higher education students in sub-Saharan Africa.

Mealtime Behavior and Depressive Symptoms in Late-Life Marriage

This study examined whether one spouse's mealtime behaviors were associated with their own and their partner's depressive symptoms among older, married couples. We examined gender differences in these associations and tested marital satisfaction as a mediator of these associations. 101 couples self-reported mealtime behavior (number of meals, snacks, fast-food meals, and meals eaten alone), depressive symptoms, and marital satisfaction. Results of the Actor Partner Interdependence Model revealed a statistically significant actor effect of number of fast-food meals on depressive symptoms and a significant partner effect of number of fast-food meals and number of meals eaten alone on depressive symptoms. There were gender differences. Husbands' marital satisfaction mediated the effect of meals eaten alone on depressive symptoms. Wife's marital satisfaction mediated the effect of the husband's meals eaten alone, and wife's number of fast-food meals on the wife's depressive symptoms. Findings have implications for dyadic interventions to improve depressive symptoms.

Frequency of fruit consumption and savoury snacking predict psychological health; selective mediation via cognitive failures

While there is growing interest in the link between diet and psychological health, there is a surprising lack of studies investigating the precise associations between nutrient-rich foods (such as fruit and vegetables) versus nutrient-poor foods (such as energy-dense savoury and sweet snacks), and psychological health. Similarly, the psychological processes underpinning the relationship between dietary intake and psychological health remain unclear. Hence, the present study aimed to explore the relationship between dietary consumption and psychological health, with cognitive processes as a theoretical mediator. This cross-sectional online study included 428 healthy adults (53% female; mean age= 39.7, SD= 13.0), with participants completing a range of validated questionnaires measuring dietary habits and psychological health. Stepwise multiple regression revealed that more frequent consumption of fruit was associated with reduced symptoms of depression (β = -.109, p = 0.025) and greater positive psychological wellbeing (β = .187, p < 0.001). Conversely, more frequent savoury snacking was associated with increased anxiety (β = .127, p = 0.005). Further, mediation analyses revealed that more frequent consumption of savoury snacks was associated with increased symptoms of depression, stress, anxiety, and reduced psychological wellbeing, via an increase in cognitive failures (ps < 0.001). These results provide new insights on the independent associations between certain types of food and psychological health, and the psychological mechanisms that may mediate these. Further work is now required to establish causality and determine whether these may represent modifiable dietary targets that can directly (and indirectly) influence our psychological health.

Food Consumption Frequency, Perceived Stress, and Depressive Symptoms Among Female University Students in Dubai, United Arab Emirates

Background

This study assessed whether perceived stress and depressive symptoms were associated with the frequency of consumption of specific food groups among female university students.

Methods

A cross-sectional study was conducted among female university students using a simple random sampling method. The response rate was 97%, with a total number of 385 participants. The associations between stress levels and most/least-consumed food groups, and between depressive symptoms levels and most/least-consumed food groups were assessed. The questionnaire included a 12-item self-administered food frequency questionnaire, Cohen's Perceived Stress Scale, and the Beck Depression Inventory-II. The study was approved by the University Ethical Committee prior to the data collection. One-way Analysis of Variance (ANOVA) and an independent-sample t-test were performed to test the equality of population means across the categories of each independent variable depending on the number of categories of the independent variable.

Results

Overall, this group of female university students fell under the mild mood disturbance category (depressive symptoms) (BDI-II) and had moderate perceived stress (PSS). Perceived stress was associated with more frequent consumption of salad/raw vegetables and cooked vegetables and less frequent consumption of cake/cookies and meat/sausage products (p &lt; 0.05). Additionally, depressive symptoms were associated with less frequent consumption of fresh fruits and increased consumption of fast food/canned food and soft drinks (p &lt; 0.05).

Conclusions

The data showed that stress and depression were associated with different dietary preferences, which is consistent with the distinctions between stress and depression in human behavior. Specifically, the results revealed associations between soft drinks consumption and higher depressive symptoms and between frequent consumption of salad/raw vegetables and cooked vegetables and higher perceived stress among this group of female university students.

Distinct Roles of Distress and Coping Capacity in the Effects of Psychological Stress on Energy Intake and Percentage of Energy from Macronutrients

The aim of this study was to explore the association of perceived stress on energy intake and percentage of energy from macronutrients. We examined cross-sectional data from the China Health and Nutrition Survey among Chinese adults. Perceived stress scale was used to assess psychological stress, and confirmatory factor analysis was used to calculate the two latent variable scores: distress factor and coping factor of perceived stress. Combined two-level random effect model and structural equation modeling were used to explore the association between distress, coping, and energy intake. The study involved 6865 adults with an average age of 46.9 years. The intake of energy was 2047.9 ± 666.6 kcal/d, 51.1% from carbohydrate and 35.2% from fat. Neither distress nor coping capacity had an association with energy intake. The coping factor score was positively associated with the sum of percentage of energy intake from carbohydrate and fat (%C&F) in females (β = 0.149, p = 0.015) but not in males. Compared to the lowest tertile, %C&F of females with a coping factor score in the medium and top tertiles were 0.44 and 0.81 significantly higher, respectively (pmedium = 0.0013, ptop < 0.0001). Psychological stress was positively associated with %C&F in females. It was insufficient capacity to cope with stress that led to unhealthy eating behavior.

Association between positive psychological traits and changes in dietary behaviour related to first COVID-19 lockdown: A general population-based study

Background

The spread of the coronavirus disease (COVID-19) led many countries to implement lockdown measures, which resulted in changes in dietary behaviours that could persist over the long term and have associated health consequences. Psychological traits may impact these changes given their known association with dietary behaviours. We aimed to investigate in a population-based study, whether positive psychological traits were associated with changes of snacking behaviour and food consumption observed during the first COVID-19 lockdown period.

Design

In 2016, levels of optimism, resilience, self-esteem, satisfaction with life, mindfulness and mastery were assessed in 33,766 adults of the French NutriNet-Santé cohort. Snacking and food group consumption were assessed in April–May 2020. Association between psychological traits and changes (no change, increase, decrease) in snacking and food group consumption were assessed using logistic regressions. Multiple correspondence analysis followed by ascending hierarchical classification were used to derive clusters of dietary behaviours. Covariance analyses were used to compare mean scores of psychological traits between clusters. Analyses were adjusted for sociodemographic and lifestyle characteristics, anxiety and depressive symptomatology.

Results

Participants with higher levels of optimism, resilience, self-esteem, satisfaction with life, mindfulness or mastery were less likely to change their snacking behaviour and food group consumption of various food groups. Individuals with lower levels were more likely to make changes, with either unhealthy (e.g., less fruits and vegetables, more processed meat) or healthy (e.g., more pasta/rice (whole-grain)) changes. Overall, individuals showed higher levels of positive psychological traits in the “no change” cluster, followed by the “healthy” and the “unhealthy” cluster (all P < 0.05).

Conclusions

Individuals with higher levels of optimism, resilience, self-esteem, satisfaction with life, mindfulness or mastery were less impacted by the lockdown in terms of dietary behaviours.

Poor Dietary Quality and Patterns Are Associated with Higher Perceived Stress among Women of Reproductive Age in the UK

The aim of this study was to investigate the association between stress and diet quality/patterns among women of reproductive age in UK. In total, 244 reproductive aged women participated in an online survey consisting of the European Prospective into Cancer and Nutrition food frequency questionnaire in addition to stress, depression, physical-activity, adiposity, and socioeconomic questions. An a-priori diet quality index was derived by assessing the adherence to Alternate Mediterranean Diet (aMD). A-posteriori dietary-patterns (DPs) were explored through factor analysis. Regression models were used to assess the predictors of the DPs. Participants mainly had medium (n = 113) aMD adherence. Higher stress levels were reported by participants with low aMD adherence. Participants with high aMD adherence were of normal BMI. Factor analysis revealed three DPs: fats and oils, sugars, snacks, alcoholic-beverages, red/processed meat, and cereals (DP-1), fish and seafood, eggs, milk and milk-products (DP-2), and fruits, vegetables, nuts and seeds (DP-3). Regression models showed that DP-1 was positively associated with stress (p = 0.005) and negatively with age (p = 0.004) and smoking (p = 0.005). DP-2 was negatively associated with maternal educational-level (p = 0.01) while DP-3 was negatively associated with stress (p < 0.001), BMI (p = 0.001), and white ethnicity (p = 0.01). Stress was negatively associated with healthy diet quality/patterns among reproductive aged women.

Digital Consumers in the Foodservices Market

The dynamic development of e-commerce in the foodservice market has been observed in recent years (especially during the COVID-19 pandemic), both in Poland and in other countries. The purpose of the study was to determine the characteristics of e-foodservice customers, identify their motivations for ordering food online and the nutritional consequences of such actions, as well as recognize the influence of consumers’ s-commerce activity on their foodservice market behavior. The study was carried out using the CAWI method on a sample of 1018 adult Poles. With the use of cluster analysis, three consumer segments were distinguished: frequent e-commerce users (221), moderate users (400), and sporadic users (397). The results indicate that frequent users of e-commerce in the foodservice market are slightly more often young and educated men who work full-time, have a higher than average income, and live in a large or medium city. In their own opinions, frequent users are the most concerned about proper nutrition, but despite such declarations, their nutritional quality is inferior to other groups. Compared to other segments, they are the most socially active and show the greatest commitment to s-commerce activity, which influences their purchasing intentions and behaviors.

Gender Differences in Healthy and Unhealthy Food Consumption and Its Relationship with Depression in Young Adulthood

This study explores the relationship between the consumption of healthy and unhealthy foods and depression among young adults and the moderating effect of gender on these relationships. The National Longitudinal Survey of Youth 1979 for Children and Young Adults (NLSY79 CY) was used. A total of 2983 young adults were selected for the final sample. Logistic Regression Analysis and Ordinary Linear Regression were conducted to examine the research questions. Young men were overall more likely than young women to engage in negative eating habits. The consumption of healthy foods, which included fruits and vegetables, had a significant inverse relationship with depression. An interaction effect was found, indicating that gender moderated the relationship between fruit consumption and depression among young adults. Young males need to be taught more about the importance of good eating habits. Eating more fruits and vegetables (healthy foods) is more important than avoiding fast food or soft drinks (unhealthy foods) for young adults' mental health. The gender differences in the effect of fruit consumption implies that increased fruit consumption may be critical to reduce young females' depression.

Mediterranean diet adherence amongst adolescents in North Lebanon: the role of skipping meals, meals with the family, physical activity and physical well-being

The Mediterranean diet (MD) is a model of a healthy diet and healthy lifestyle. Adherence to the MD has been correlated with a reduction in many metabolic disorders including cancers. The factors associated with adolescents' adherence to the MD in North Lebanon using the KIDMED index have never been explored. Therefore, we thought to examine these factors amongst a sample of them. A cross-sectional survey was conducted in the city of Tripoli, North Lebanon. A total of 798 adolescents aged 11-18 years were randomly selected to participate in this study. All participants completed a questionnaire assessing adherence to the MD (KIDMED index), physical activity (physical activity questionnaires for older children and adolescents), health-related quality of life (KIDSCREEN-27 index) and sociodemographic characteristics (age, sex, grade level and parents' educational status). Anthropometric measurements, including weight, height and waist circumference, were also collected. Adherence to the MD was good amongst only 13·3 % of the adolescents. The prevalence rate of overweight and obesity was elevated, affecting 36·9 % of the students. Lower adherence to the MD was significantly correlated with skipping meals (P = 0·001). Meanwhile, adolescents who were engaged in a high level of physical activity, those who consumed more meals with their families and those who benefited from better physical well-being had a better diet quality (P < 0·001). Nutrition intervention programmes, as well as public health policies, would be of interest in order to improve diet quality amongst Lebanese adolescents.

Depression and association with diet diversity score among adolescent (14-19) students of Jimma town high school, Jimma, southwest Ethiopia

Purpose

Dietary patterns are important for the physical and psychological development of adolescents. The purpose of this study is to determine magnitude and severity of depression and its relation with diet diversity score (DDS) among adolescent high school students.

Design/methodology/approach

A cross-sectional study was conducted among 546 adolescents selected from schools using multistage sampling technique. Dietary intakes were assessed using a 24-h dietary recall, and depression severity and prevalence were assessed by PHQ-9A. A structured questionnaire was used to collect data. Linear regression analysis was used, and unstandardized beta (ß) coefficients with 95% confidence intervals (CI) were computed to determine the association of depression and its severity with dietary diversity score.

Findings

In all, 546 questionnaires were filled completely and consistently making a response rate of 97.3%. The dietary diversity score in 97 (17.8%) of the adolescents were between 1 and 3 (low dietary diversity score) but 259 (47.4%) scored greater than 6 (high dietary diversity score). Chi-square test revealed that with a decrease in DDS from highest to lowest level, the percentage of moderate to severe and severe depression slightly increased (3.4%). In addition, the percentage of moderate to severe and severe depression who consumed meat, fish and milk and dairy products slightly increased (3% and 3.2%). Multivariate adjusted regression analysis demonstrated that dietary diversity score was found to be inversely associated with depression severity and prevalence.

Originality/value

It was found that linear association between diet diversity and depression severity, and prevalence after adjustment for relevant con-founders. The study provided epidemiological evidence of a robust association of dietary pattern with depression symptoms' severity and prevalence in adolescents.

Stress and eating behaviours in healthy adults: a systematic review and meta-analysis

Stress leads to detrimental health outcomes through direct biological and indirect behavioural changes. Stress can lead to disruption to normal eating behaviours, although the strength of these associations is unknown. This is the first meta-analysis to determine the strength of the stress-eating relationship in healthy adults and to explore the impact of potential moderators. Studies included had a clearly defined measure of stress (i.e., any noxious event or episode in one's environment with the exclusion of emotional distress) that was linked to non-disordered eating. Key terms were searched in Medline, PsycInfo and Ovid databases (23,104 studies identified). 54 studies (combined N = 119,820) were retained in the meta-analysis. A small, positive effect size was found for the stress-overall food intake relationship (Hedges' g = 0.114). Stress was associated with increased consumption of unhealthy foods (Hedges' g = 0.116) but decreased consumption of healthy foods (Hedges' g = -0.111). Only one significant moderator (restraint on stress-unhealthy eating) was identified. This meta-analysis identified the magnitude of the effect of stress on eating behaviour outcomes. Significant heterogeneity was observed that was not explained by the moderators examined. Further research on moderators of the stress-eating relationship is required and should distinguish effects for healthy versus unhealthy eating.

Associations between health behaviors and mental health in Australian nursing students

AIM

Nursing students experience high levels of stress, anxiety and depression. This study examined associations between health behaviors and stress, anxiety and depression in Australian nursing students.

DESIGN

this was a cross-sectional study.

METHODS

Participants completed an online survey providing demographic information and responses to the 21-item Depression Anxiety Stress Scale, Fagerström Test for Nicotine Dependence, short Food Frequency Questionnaire, Alcohol Use Disorders Identification Test, International Physical Activity Questionnaire and Workforce Sitting Questionnaire. Associations were evaluated using multivariate linear regression.

RESULTS

Mild to extremely severe stress (46.6%), anxiety (52.8%) and depression (42.2%) were prevalent. Intake of snack-foods was associated with higher depression (β = 8.66, p < 0.05) and stress (β = 3.92, p = 0.055) scores. More time spent sitting was associated with higher depression (β = 0.48, p < 0.001) and stress (β = 0.28, p < 0.05) scores. Skipping meals correlated with higher stress, anxiety and depression scores.

CONCLUSION

More support must be provided to nursing students to manage psychological distress and mental health during university study.

Dietary intake of persons with depressive and psychotic disorders in Singapore

INTRODUCTION

Nutritional psychiatry is an emerging field of study that investigates the role of diet and nutrition in mental health. Studies conducted in the general population have linked depressive symptoms with poor dietary patterns. The aim of this study was to characterise the dietary intake and analyse the dietary pattern using the Dietary Approach to Stop Hypertension (DASH) in a sample of psychiatric patients in a multiethnic Asian nation.

METHODS

Participants were recruited from an outpatient clinic and an inpatient unit at the Institute of Mental Health in Singapore. Self-reported dietary habits of a sample of psychiatric patients (N=380) were analysed using DASH. To examine the variables associated with DASH scores, a linear regression was conducted with the full sample and sociodemographic variables.

RESULTS

Persons with depressive disorders had a mean DASH score of 21.3 (±4.2), while persons with psychotic disorders had a mean DASH score of 21.2 (±4.9). Respondents who were older (B=1.94, 95% confidence interval [CI] 0.91-2.96, P<0.001), female (B=1.09, 95% CI 0.07-2.11, P=0.04) and economically inactive (B=1.98, 95% CI 0.006-3.96, P=0.049) were more likely to report a higher diet quality compared with their respective counterparts, while smokers (B= -1.39, 95% CI -2.45 to -0.34, P=0.009) tended to report a lower diet quality compared with their non-smoking counterparts.

CONCLUSION

Dietary patterns of persons with mental disorders were characterised. A host of sociodemographic factors, and not diagnosis of mental disorders, influenced the dietary quality of people with depressive and psychotic disorders. Clinicians treating psychiatric patients need to be aware of the nuanced reasons behind poor dietary choices and provide targeted psychoeducation to specific subgroups within the patient population.

Fruit and vegetable intake is inversely associated with perceived stress across the adult lifespan

BACKGROUND & AIMS

Poor nutritional habits are linked to higher perceived stress, but the relationship between fruit and vegetable (FV) intake and stress is uncertain. The primary aim of this cross-sectional study was to explore the relationship between FV intake and perceived stress in a population-based cohort of men and women aged ≥25 years from the Australian Diabetes, Obesity and Lifestyle (AusDiab) Study. A secondary aim was to investigate the relationship between serum carotenoids, biomarkers of FV intake, and perceived stress.

METHODS

In Australian men and women, dietary intake was assessed using a Food Frequency Questionnaire in 1999-2000 (n = 8689). Perceived stress was assessed using a validated Perceived Stress Questionnaire [PSQ index values ranging from 0 (lowest) to 1 (highest)]. Serum carotenoids were measured in a subset of participants (n = 1187) using high-performance liquid chromatography. Multivariable-adjusted linear and logistic regression were performed to investigate the associations between FV intake and perceived stress.

RESULTS

Mean age of participants was 47.4 (SD 14.1) years (49.8% females). Participants with the highest intakes of FV had 10% lower PSQ index values than those with the lowest intake [Q4: 0.27 ± 0.004 vs. Q1: 0.30 ± 0.004 (mean ± SE), p = 0.004]. Similar associations were found for fruits and vegetables, analysed separately. In subgroup analyses higher FV intake was associated with lower perceived stress in the middle-aged adults [≥45-<65 years (p = 0.004)], but not in the younger (<45 years) and older participants (≥65 years). Higher FV intake was also significantly associated with lower perceived stress in men (p = 0.009) and women (p = 0.012), separately. Serum carotenoid levels were inversely associated with perceived stress before, but not after adjusting for age and other confounding factors.

CONCLUSION

In Australian adults, higher FV intake was associated with lower perceived stress, particularly in the middle-aged adults. These findings support current recommendations that fruit and vegetables are essential for health and well-being.

Focus on disability-free life expectancy: implications for health-related quality of life

BACKGROUND

Since the end of the industrial revolution, advances in public health and clinical medicine have contributed to dramatic decreases in infant and childhood mortality, improvements in health-related quality of life (HRQoL), increases in overall life expectancy (LE), and rectangularization of survival curves.

OBJECTIVES

In this article, we focus on disability that has occurred with the overall lengthening of LE in many populations and the implications this has for decreased HRQoL.

METHODS

We utilize the concept of rectangularization of population survival to depict the rising prevalence of disability associated with increased LE, especially among racial and ethnic minorities and people of low socioeconomic status (SES) and relate this to HRQoL.

RESULTS

Disability-free life expectancy (DFLE) and healthy life expectancy (HLE) are defined in terms of HRQoL. Specific attention is focused on disability experienced by disparate populations around the globe. By focusing on disparities in DFLE, and the need to expand LE to include HLE as a central component of HRQoL, this work provides an important counterpoint to the attention that has been paid to LE disparities according to race, gender, ethnicity, education, and SES.

DISCUSSION

By calling attention to those factors that appear to be the most important drivers of the differences in quality and length of DFLE between different groups (i.e., the components of the social gradient, exposure to chronic stress, systemic inflammation, and the psychological and biological mechanisms associated with the gut-brain axis) and, by logical extension, HRQoL, we hope to promote research in this arena with the ultimate goal of improving DFLE, HLE, and overall HRQoL, especially in disparate populations around the globe.

Health Behaviors of Higher Education Students from 7 Countries: Poorer Sleep Quality during the COVID-19 Pandemic Predicts Higher Dietary Risk

Health behaviors of higher education students can be negatively influenced by stressful events. The global COVID-19 pandemic presents a unique opportunity to characterize and compare health behaviors across multiple countries and to examine how these behaviors are shaped by the pandemic experience. Undergraduate and graduate students enrolled in universities in China, Ireland, Malaysia, South Korea, Taiwan, the Netherlands and the United States (USA) were recruited into this cross-sectional study. Eligible students filled out an online survey comprised of validated tools for assessing sleep quality and duration, dietary risk, alcohol misuse and physical activity between late April and the end of May 2020. Health behaviors were fairly consistent across countries, and all countries reported poor sleep quality. However, during the survey period, the COVID-19 pandemic influenced the health behaviors of students in European countries and the USA more negatively than Asian countries, which could be attributed to the differences in pandemic time course and caseloads. Students who experienced a decline in sleep quality during the COVID-19 pandemic had higher dietary risk scores than students who did not experience a change in sleep quality (p = 0.001). Improved sleep quality was associated with less sitting time (p = 0.010). Addressing sleep issues among higher education students is a pressing concern, especially during stressful events. These results support the importance of making education and behavior-based sleep programming available for higher education students in order to benefit students' overall health.

Lifestyle-related behaviors and health-related quality of life among children and adolescents in China

PURPOSE

To investigate associations of five typical lifestyle-related behavioral risk factors (insufficient physical activity, prolonged screen viewing, deprived sleeping, consumption of fast food and sugar-sweetened beverage) with health-related quality of life (HRQoL) among school students in China.

METHODS

Students aged 9-17 years (grades 4-12) were randomly selected from primary and high schools in Nanjing, China, to participate in this cross-sectional study in 2018. The outcome variable, HRQoL, was assessed using the Child Health Utility 9D (CHU9D) instrument and scored from 0 (worst) to 1 (best). Physical activity (including screen viewing and sleeping) and dietary intake were measured using a validated Physical Activity Scale and Food Frequency Questionnaire, respectively. Lifestyle-related behaviors were categorized as sufficient/insufficient or no/yes, and their associations with HRQoL were assessed using mixed-effects linear regression models.

RESULTS

Overall, 4388 participants completed the questionnaire (response rate = 97.6%). Students with insufficient physical activity [mean difference (MD) = - 0.03; 95% confidence interval (CI) = - 0.04, - 0.01], prolonged screen time (MD = - 0.06; 95% CI = - 0.07, - 0.04), insufficient sleeping time (MD = - 0.04; 95% CI = - 0.07, - 0.02), consumption of sugar-sweetened beverage (MD = - 0.02; 95% CI = - 0.03, - 0.01) or fast food intake (MD = - 0.03; 95% CI = - 0.04, - 0.02) reported significantly lower HRQoL scores. When considered additively, each additional lifestyle-related risk factor was associated with an average decrease of 0.03 units (95% CI: - 0.03, - 0.02) CHU9D score.

CONCLUSIONS

For Chinese students, HRQoL was positively associated with physical activity and sleep duration, but negatively with screen time and consumption of sugar-sweetened beverage and fast food. Moreover, lifestyle-related behaviors may have an additive effect on HRQoL.

The Psychology of Food Cravings in Patients With First-Episode Psychosis

Objectives: Food cravings may cause weight gain in patients with schizophrenia. This study investigated psychological characteristics associated with food cravings in patients with first-episode psychosis. Methods: This study analyzed data from a clinical cohort of first-episode psychosis patients taking antipsychotics for 3 months or less. The strength of food cravings was measured using the General Food Cravings Questionnaire-Trait (G-FCQ-T). Psychological characteristics and psychiatric symptoms were investigated with the Positive and Negative Symptom Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), Social and Occupational Functioning Assessment Scale, Rosenberg Self-Esteem Scale (RSES), and Perceived Stress Scale (PSS). Clinical characteristics were compared according to significant weight gain (≥10% increase in body weight compared to baseline) over 3 months. Associations between the G-FCQ-T and other psychiatric scales were investigated. We conducted sex-stratified analyses. Results: In total, 182 patients (78 males and 104 females) with first-episode psychosis were enrolled in this study. In females, the G-FCQ-T total score at baseline was associated with baseline body weight and significant weight gain over 3 months. The PSS scales were significantly associated the G-FCQ-T total and all subscale scores in female participants. Scores on the RSES and CDSS were significantly associated with the G-FCQ-T total score and with the preoccupation and loss of control subscale scores. The PANSS negative and general subscales were significantly associated with the positive outcome expectancy and loss of control subscales of the G-FCQ-T, respectively. In males, the only significant association was between the loss of control subscale and RSES scores. Linear regression analysis showed significant associations of PSS scores with the total and all subscale scores of the G-FCQ-T despite the loss of significance for other variables. Conclusion: These results indicate that the food cravings in patients with first-episode psychosis, which were associated with weight gain, were influenced by perceived stress in females. To reduce food cravings in female patients with schizophrenia, interventions aimed at perceived stress should be considered.

Association of dietary acid-base load and psychological disorders among Iranian women: A cross-sectional study

Metabolic acidosis, which can be affected by dietary acid-base load, seems to be associated with psychological disorders through different pathways. Given limited evidence on dietary acid-base load, we aimed to examine the association of dietary acid-base load with psychological disorders in Iranian women. This cross-sectional study was performed on 447 female subjects (20-50 years old). Dietary intake was assessed using a valid food frequency questionnaire for Iran. Dietary acid-base load was calculated through different indices including potential renal acid load (PRAL), net endogenous acid production (NEAP), and dietary acid load (DAL). To assess psychological disorders, an Iranian validated version of depression, anxiety, and stress scale (DASS-21) was used. The mean value of PRAL, NEAP, and DAL were -8.87mEq/da, 37.94mEq/day, and 30.77mEq/day, respectively. Considering a wide range of confounding variables, compared with the first tertile, a significant positive association was observed between dietary acid-base load and depression (OR_PRAL: 3.63; 95 %CI:1.97, 6.71; P_trend = 0.0001) (OR_NEAP:3.42; 95 %CI: 1.87, 6.23; P_trend = 0.0001) (OR_DAL: 3.02; 95 %CI: 1.64, 5.58; P_trend = 0.0001). Women in the high dietary acid-base load category had higher anxiety (OR_PRAL: 3.31; 95 %CI: 1.81, 6.06; P_trend = 0.0001) (OR_NEAP:3.47; 95 %CI: 1.90, 6.33; P_trend = 0.0001) (OR_DAL: 3.25; 95 %CI: 1.76, 5.98; P_trend = 0.0001). Moreover, there was a strong positive relationship between dietary acid-base load and psychologicaldistress (OR_PRAL: 3.79; 95 %CI: 2.09, 6.90; P_trend = 0.0001) (OR_NEAP: 3.67; 95 %CI: 2.04, 6.58; P_trend = 0.0001) (OR_DAL: 3.00; 95 %CI: 1.66, 5.43; P_trend = 0.0001). Women with higher dietary acid-base load score had greater odds for depression, anxiety, and psychological distress compared to lower ones.

Higher Academic Stress Was Associated with Increased Risk of Overweight and Obesity among College Students in China

This study examined associations between academic stress and overweight and obesity, and moderation effects of gender, grade, and types of college on such associations. Data on academic stress, negative learning events, weight, and height were self-reported by 27,343 college students in China in 2018. About 23% and 91% of students perceived high academic stress and suffered from at least one negative learning event during the past six months, respectively, especially for females, undergraduates, and students major in humanities and social science subject groups. Perceived academic stress was associated with increased risk of overweight and obesity among all students (OR = 1.05, 95%CI: 1.00–1.10), male (OR = 1.09, 95%CI: 1.03–1.15), undergraduate (OR = 1.06, 95%CI: 1.00–1.11), and students from subordinate universities (OR = 1.13, 95%CI: 1.01–1.26). Negative learning events were associated with increased risk of overweight and obesity among all students (OR = 1.05, 95%CI: 1.01–1.09), undergraduates (OR = 1.05, 95%CI: 1.01–1.09), and students from local universities (OR = 1.07, 95%CI: 1.00–1.14). Interventions are needed to reduce the high academic stress of college students, considering the modifying effects of gender, grade, and college type. Such interventions may further contribute to the prevention of overweight and obesity among college students.

[Eating behavior and relationships with stress, anxiety, depression and insomnia in university students.]

Introduction

Introduction: there is growing evidence linking food consumption with psychological health of adult people. This association has not been well explored among university students. Objectives: the aims of this study were to analyze the diet quality in a university population, and to assess its association with prevalence of anxiety, stress, depression, and insomnia. Methods: cross-sectional study of a sample of 1055 university students. Three validated questionnaires were used: the Healthy Eating Index (HEI), the Depression Anxiety Stress Scales (DASS 21), and the Insomnia Severity Index. Results: The average HEI score was 68,57±12,17. Prevalence of unhealthy eating was 82,3%, higher in women (84,8% vs. 76,4%). Unhealthy eating was significantly associated with prevalence of anxiety, depression, and stress. Excessive intake of sweets and low of dairy products were associated with higher prevalence of psychological and sleep disturbances. Conclusions: unhealthy eating patterns are common in university population and are related to anxiety, stress, and depression. Educational interventions to reduce unhealthy food consumption in university students can also result in psychological health improvements and/or vice versa.

Predictors of health behaviours among Indian college students: an exploratory study

Purpose

The purpose of this study is to understand the association between health behaviours of diet, physical activity, smoking cigarettes, alcohol consumption, safe sex and sleep quality with demographic (e.g. age, gender) and psychological (i.e. stress, self-esteem and sense of coherence) factors in Indian residential college students.

Design/methodology/approach

Students studying for Bachelor of Technology at residential colleges in India were invited to complete an online questionnaire regarding their health behaviours, demographics and psychological variables. Each health behaviour was regressed onto demographic and psychological factors to determine which of them were associated with performing each behaviour.

Findings

There was no clear pattern of predictors for the health behaviours overall. Self-esteem was related to healthy diet, being single was related to adequate sleep, higher parental income was related to safer sex and being older was related to more alcohol use and safer sex.

Research limitations/implications

This study revealed that health education efforts may need to be designed for specific behaviours and correlates among Indian college students. Interventions regarding (1) healthy eating should target students with lower self-esteem, (2) sleep should target students in a relationship and (3) safer sex should target younger students and those from less affluent backgrounds.

Originality/value

This research is one of the first attempts to study the predictors of health behaviours among Indian college students. The study highlighted that psychological factors (e.g. self-esteem) and demographic factors (e.g. relationship status, parental income, age) affect different health behaviours. These findings can help health educators to design tailored interventions and aid in health education and promotion among Indian college students.

The relation between dietary intakes and psychological disorders in Iranian adults: a population-based study

BACKGROUND

Previous studies showed an association between dietary intakes and psychological disorders. This study aimed to assess the association between dietary intakes and psychiatric disorders in Iran.

METHODS

In this cross sectional research, the data on 9965 adults were extracted from enrollment phase of Yazd Health Study (YaHS); a population-based cohort study on Iranian adults which was conducted during 2014 to 2016. Data on socio-demographic characteristics, tobacco use, history of chronic disease, and dietary assessment were collected using a validated researcher-made questionnaire. Moreover, anthropometric measurement was conducted. Psychological and physical activity assessments were also performed by depression, anxiety and stress scale questionnaire (DASS 21 items) and the short form of the International Physical Activity Questionnaire (IPAQ) respectively. Finally, multiple logistic regression analysis was used to evaluate relation between dietary intakes and psychological disorders.

RESULTS

After adjusting for the confounders, egg (depression: OR = 0.72, 95% CI: 0.52-0.98; anxiety: OR = 0.72, CI: 0.55-0.94), fruits (depression: OR = 0.60, 95% CI: 0.43-0.82; anxiety: OR = 0.70, 95% CI: 0.53-0.91), milk (depression: OR = 0.72, CI: 0.58-0.89; anxiety: OR = 0.73, CI: 0.61-0.87), and yogurt (depression: OR = 0.67, CI: 0.47-0.97; anxiety: OR = 0.54, CI: 0.4-0.73) were found to have protective effects on depression and anxiety. Higher fish consumption was associated with greater depression odds (OR = 1.54, CI: 1.18-2.04). Vegetables' intake had an inverse relationship with anxiety (OR = 0.74, CI = 0.58-0.93) and stress (OR = 0.59, CI: 0.42-0.82). Fruits (OR = 0.6, CI: 0.43-0.85) and milk consumption (OR: 0.61, CI: 0.47-0.77) were found to have protective effects on stress.

CONCLUSIONS

Egg, fruits, milk, yogurt, and vegetables' consumption had an inverse relationship with psychiatric disorders; whereas, higher fish intake was associated with higher depression chance. Further prospective studies are needed to confirm these findings.

Specific Dietary (Poly)phenols Are Associated with Sleep Quality in a Cohort of Italian Adults

Background: Diet has been the major focus of attention as a leading risk factor for non-communicable diseases, including mental health disorders. A large body of literature supports the hypothesis that there is a bidirectional association between sleep and diet quality, possibly via the modulation of neuro-inflammation, adult neurogenesis and synaptic and neuronal plasticity. In the present study, the association between dietary total, subclasses of and individual (poly)phenols and sleep quality was explored in a cohort of Italian adults. Methods: The demographic and dietary characteristics of 1936 adults living in southern Italy were analyzed. Food frequency questionnaires (FFQs) were used to assess dietary intake. Data on the (poly)phenol content in foods were retrieved from the Phenol-Explorer database. The Pittsburg Sleep Quality Index was used to measure sleep quality. Multivariate logistic regression analyses were used to test the associations. Results: A significant inverse association between a higher dietary intake of lignans and inadequate sleep quality was found. Additionally, individuals with the highest quartile of hydroxycinnamic acid intake were less likely to have inadequate sleep quality. When individual compounds were taken into consideration, an association with sleep quality was observed for naringenin and apigenin among flavonoids, and for matairesinol among lignans. A secondary analysis was conducted, stratifying the population into normal weight and overweight/obese individuals. The findings in normal weight individuals showed a stronger association between certain classes of, subclasses of and individual compounds and sleep quality. Notably, nearly all individual compounds belonging to the lignan class were inversely associated with inadequate sleep quality. In the overweight/obese individuals, there were no associations between any dietary (poly)phenol class and sleep quality. Conclusions: The results of this study suggest that a higher dietary intake of certain (poly)phenols may be associated with better sleep quality among adult individuals.

Food Selection Under Stress Among Undergraduate Students in Riyadh, Saudi Arabia

Background

University students might experience numerous sources of stress in their daily lives. Previous research has found that stress affects food selection patterns, but the effect might vary by country and sex. No previous study conducted in Saudi Arabia has assessed the association between stress and dietary habits among university students. Thus, this study aimed to examine the association between perceived stress and food selection patterns among undergraduate students by sex at King Saud University (KSU).

Methods

A cross-sectional study of 400 students attending the College of Applied Medical Sciences in Riyadh, Saudi Arabia, was conducted. The self-administered questionnaire that was used consisted of three sections: sociodemographic, food frequency questionnaire, and Cohen's Perceived Stress Scale.

Results

Approximately (59.0%) of the participants reported suffering from some level of stress, with more females (64.5%) experiencing stress than males (54.0%). The univariate analysis showed that under stress, more females (68.0%) reported eating more than usual than males (49.0%), while the percentage of respondents that reported eating less than usual was higher for females (23.0%) than that for males (31.0%). The McNemar test indicated that under stress, there was an increased preference for salty flavors, which was not associated with sex. Significantly more females (82.0%) than males (64.5%) reported preferring sweets under stress. More males reported preferring bitter and savory flavors than females. Under stress, females preferred homemade food, while males preferred takeout foods. More females (68.0%) reported losing control and overeating than males (49.0%). A logistic regression showed that for female students, perceived stress was associated with frequent consumption of sweets, cake/cookies, snacks and beverages and less frequent consumption of fruits and vegetables. For males, the consumption of fast food and meat was significantly positively associated with perceived stress.

Conclusion

Perceived stress led to unhealthy changes in eating patterns in both sexes, as evidenced by reports of an increased preference for sweets, snacks and cake/cookies among females and an increased preference for fast food and meat among males. These results may be potentially important targets for interventions for stress-related food consumption.

A Scientometric Study on Depression among University Students in East Asia: Research and System Insufficiencies?

Given that mental health issues are acute in Asian countries, particularly Japan and Korea, and university students are more vulnerable to depression than the general population, this study aims to examine the landscapes of scientific research regarding depressive disorders among university students and evaluate the effectiveness of international collaboration and funding provision on the scientific impact in Korea, Japan, and China. Based on articles retrieved from the Web of Science database during the period 1992–2018, we found that the number of scientific publications, international collaborations, and allocated funds regarding depressive disorder among university students in China (97 articles, 43 international collaborations, and 52 funds provided, respectively) overwhelmingly surpassed the case of Korea (37 articles, 12 international collaborations, and 15 funds provided, respectively) and Japan (24 articles, 5 international collaborations, and 6 funds provided, respectively). The differences in collaboration patterns (p-value < 0.05) and the proportion of allocated funds (p-value < 0.05) among Korea, Japan, and China were also noted using Fisher’s exact test. Based on the Poisson regression analysis, China’s associations of scientific impact with international collaboration (β = −0.322, p-value < 0.01) and funding provision (β = −0.397, p-value < 0.01) are negative, while associations of the scientific impact and scientific quality with funding provision and international collaboration were statistically insignificant. These findings hint that Korea and Japan lacked scientific output, diversity in research targets, international collaboration, and funding provision, compared to China, but the quality of either China’s internationally collaborated or funded articles was contentious. As a result, policymakers in Korea and Japan are suggested to raise the importance of mental health problems in their future policy planning and resource distribution. Moreover, it would be advisable to establish a rigorous system of evaluation for the quality of internationally collaborated and funded studies in order to increase scientific impact and maintain public trust, especially in China.

Association between Physical Activity, Food Consumption and Depressive Symptoms Among Young Adults in Spain: Findings of a National Survey

Young adults have a significant prevalence of mental disorders, which could lead to dysfunctional quality of life. Records of 1,645 Spanish adolescents were examined and multiple logistic regressions were performed. Being a woman, being older and having a sedentary life were all associated with a higher psychological vulnerability, whereas a low frequency of fresh fruit and bread/cereals consumption, as well as regular intense physical activity, were considered protective against such susceptibility. Regular physical activity and a diet with a high consumption of fruit and cereals may help reduce depressive symptoms, but sociodemographic features are as much as important as lifestyle habits.

Dietary habits and psychological disorders in a large sample of Iranian adults: a population-based study

BACKGROUND

Since an association has been found between diet and psychological problems, this study aimed to evaluate the relationship between dietary habits and psychological problems among Iranian adults.

METHODS

Data on dietary habits and psychological problems among 9965 adults were provided from the recruitment phase of Yazd Health Study, a population-based cohort research on Iranian adults. The association between dietary habits and psychological problems was assessed by multiple logistic regression analysis.

RESULTS

After the adjustment for confounders, fast food and fried food consumptions were associated with increased depressive [odds ratio (OR) = 1.61, 95% confidence interval (CI) 1.18-2.20] and stress symptoms (OR = 2.47, 95% CI 1.46-4.18), respectively. Eating breakfast had a protective role on stress features (OR = 0.60, 95% CI 0.39-0.92), while snack intake was related to higher odds of depressive (OR = 1.36, 95% CI 1.01-1.84), anxiety (OR = 1.99, 95% CI 1.55-2.56) and stress symptoms (OR = 1.73, 95% CI 1.23-2.54). There was also an inverse association between sweetened drink consumption and depressive (OR = 0.76, 95% CI 0.59-0.96), anxiety (OR = 0.76, 95% CI 0.62-0.93), and stress features (OR = 0.73, 95% CI 0.55-0.97; OR = 0.63, 95% CI 0.48-0.82).

CONCLUSIONS

Even though an inverse relationship was found between sweetened drinks intake and psychological problems, snack consumption was associated with higher chances of them. Eating breakfast had a protective effect on stress symptoms, while fast food and fried food intakes were related to increased depressive and stress features chances, respectively.

Fruit and Vegetable Intake and Mental Health in Adults: A Systematic Review

The role of a properly balanced diet in the prevention and treatment of mental disorders has been suggested, while vegetables and fruits have a high content of nutrients that may be of importance in the case of depressive disorders. The aim of the study was to conduct a systematic review of the observational studies analyzing association between fruit and vegetable intake and mental health in adults. The search adhered to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and the review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42019138148). A search for peer-reviewed observational studies published until June 2019 was performed in PubMed and Web of Science databases, followed by an additional manual search for publications conducted via analyzing the references of the found studies. With respect to the intake of fruit and/or vegetable, studies that assessed the intake of fruits and/or vegetables, or their processed products (e.g., juices), as a measure expressed in grams or as the number of portions were included. Those studies that assessed the general dietary patterns were not included in the present analysis. With respect to mental health, studies that assessed all the aspects of mental health in both healthy participants and subjects with physical health problems were included, but those conducted in groups of patients with intellectual disabilities, dementia, and eating disorders were excluded. To assess bias, the Newcastle-Ottawa Scale (NOS) was applied. A total of 5911 studies were independently extracted by 2 researchers and verified if they met the inclusion criteria using a 2-stage procedure (based on the title, based on the abstract). After reviewing the full text, a total of 61 studies were selected. A narrative synthesis of the findings from the included studies was performed, which was structured around the type of outcome. The studies included mainly focused on depression and depressive symptoms, but also other characteristics ranging from general and mental well-being, quality of life, sleep quality, life satisfaction, flourishing, mood, self-efficacy, curiosity, creativity, optimism, self-esteem, stress, nervousness, or happiness, to anxiety, minor psychiatric disorders, distress, or attempted suicide, were analyzed. The most prominent results indicated that high total intake of fruits and vegetables, and some of their specific subgroups including berries, citrus, and green leafy vegetables, may promote higher levels of optimism and self-efficacy, as well as reduce the level of psychological distress, ambiguity, and cancer fatalism, and protect against depressive symptoms. However, it must be indicated that the studies included were conducted using various methodologies and in different populations, so their results were not always sufficiently comparable, which is a limitation. Taken together, it can be concluded that fruits and/or vegetables, and some of their specific subgroups, as well as processed fruits and vegetables, seems to have a positive influence on mental health, as stated in the vast majority of the included studies. Therefore, the general recommendation to consume at least 5 portions of fruit and vegetables a day may be beneficial also for mental health.

Negative Mood Is Associated with Diet and Dietary Antioxidants in University Students During the Menstrual Cycle: A Cross-Sectional Study from Guangzhou, China

Postpubescent females may have negative mood or premenstrual syndrome during the menstrual cycle; with the emotional and physical symptoms interfering with their quality of life. Little is known about the relationship of dietary behaviors and dietary antioxidant intake with negative mood or premenstrual syndrome in university students in China; so we explored the relationship between negative mood and dietary behavior in female university students during the three menstrual cycle phases. Random sampling was used to enroll 88 individuals from a university in Guangzhou; China in the study. Data were collected using self-administered questionnaires. Descriptive statistics and multiple logistic regression analyses were performed. During the menstrual phase, tea, black coffee and carbonated beverage intake was higher in the group with a high negative affect scale score than in the low score group (p < 0.05). Likewise; during the premenstrual phase, fresh fruit (banana and red Chinese dates) intake was higher in the group with a high negative affect scale score than in the low-score group (p < 0.05). The logistic regression analysis results showed that negative mood was positively associated with tea, coffee, and carbonated beverage intake during the menstrual phase (β = 0.21, p = 0.0453, odds ratio = 1.23), and negative mood was positively associated with banana and red Chinese dates intake during the premenstrual phase (β = 0.59, p = 0.0172, odds ratio = 1.81). Our results suggest that negative mood may be associated with diet and specific food in university postpubescent females.

Students' achievement motivation in Finnish and Chinese higher education and its relation to perceived teaching-learning environments

This cross-cultural study of Finnish and Chinese students set out to compare the levels of achievement motivation (AM) in order to investigate whether the differences in them might be explained by the different cultural response styles and whether these response styles could be controlled for with a method which includes response style variables as covariates in ANCOVA. This study also scrutinizes relationships between perceived teaching-learning environments (TLE) and AM within each cultural group. The survey sample consisted of 3,035 Finnish and 2,309 mainland Chinese university students. Finnish students were found to rate the level of AM markedly higher than do Chinese students. It was determined that the method applied for response style controlling is not suitable for cross-cultural studies, even though it is recommended for this use. A modification of the method, which is based on robust statistical tools, was found not to change this conclusion, but it can nevertheless be used to obtain useful information about the effects of response style differences. The results also show that similar relationships between AM and TLE could be identified in the data of both groups. However, for the Finnish group AM is related to perceived suitable workload, whereas for the Chinese group it is related to teacher encouragement.