Abstract
Introduction: The Covid-19 pandemic had a negative impact on mental health and lifestyle behaviors, including dietary habits. Negative psychological factors are known to adversely impact lifestyle behaviors, but the influence of positive psychological well-being on dietary intakes is relatively unknown. Hypothesis: We assessed the hypothesis that psychological factors related to both negative emotional states and positive psychological well-being would have an impact on dietary intakes among adults reporting poor sleep quality and at least moderate perceived stress during the Covid-19 pandemic. Methods: Thirty-one individuals (age 40.2±13.0 y, 81% women, 55% White, BMI 23.2±2.6 kg/m 2 ) were enrolled in a pilot study testing the efficacy of a well-being and sleep hygiene intervention to improve sleep, diet, and mental health. Questionnaires were administered at baseline to assess diet (single-day food recall), psychological well-being (Psychological Well-Being scales of autonomy, environmental mastery, personal growth, purpose in life, positive relations with others, and self-acceptance) and negative emotional states (Symptom Questionnaire scales of anxiety, depression, hostility, and somatization). Separate linear regression models were estimated for each psychological variable that was significantly correlated with diet at baseline, controlling for age, sex, and BMI. Results: Linear regression models showed that, at baseline, higher depression and hostility were associated with higher energy ( B = 77.6±20.3 ( SE ), p < 0.001 and B = 65.2±25.7, p = 0.01, respectively) and fat ( B = 4.6±1.5, p = 0.004 and B = 4.9±1.7, p = 0.008, respectively) intakes. Higher depression was also associated with higher intakes of protein ( B = 3.0±1.0, p = 0.006), carbohydrate ( B = 6.5±2.5, p = 0.01), sugar ( B = 3.9±1.1, p = 0.001), and sodium ( B = 130.7±36.6, p = 0.001). Higher positive relations was associated with lower carbohydrate ( B = -5.1±2.4, p = 0.04) and sugar ( B = -3.6±1.0, p = 0.001) intakes, and higher purpose in life was associated with lower sugar ( B = -3.3±1.2, p = 0.008), cholesterol ( B = -14.7±5.9, p = 0.01), and saturated fat ( B = -1.2±0.4, p = 0.008) intakes. When controlling for baseline levels of depression, hostility and purpose in life were no longer associated with dietary intakes, while positive relations remained associated with sugar intakes ( B = -2.3±1.2, p = 0.04). Conclusions: Under stressful circumstances, both negative emotional states and positive psychological well-being are associated with dietary intakes. Despite depression having the strongest overall impact on dietary intakes, positive relations with others independently affected sugar intakes. Personalized approaches focused on positive psychological well-being, along with distress reduction, should be considered in interventions aimed at promoting healthy dietary behaviors.
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