Associations between indicators of diet quality and psychological distress, depression and anxiety in emerging adults: Results from a nationally representative observational sample

Abstract

BackgroundDepression, anxiety and their related symptoms are a leading cause of global disability and economic burden. Three quarters of all mental disorders occur by the age of 24 years making the identification of modifiable risk factors during these years imperative for prevention. This study examined associations between diet and psychological distress, depression and anxiety in a nationally representative sample of Australians during emerging adulthood. MethodsCross-sectional data (N= 1,340) from the 2017-18 Australian National Health Survey were analysed including fruit, vegetable and sugar sweetened beverage consumption. The primary outcome was psychological distress measured by the Kesler Psychological Distress Scale. Self-reported depression and anxiety were also assessed. Ordinal logistic regression analyses were fitted and adjusted for potential sociodemographic and lifestyle confounders. ResultsUnadjusted odds of high psychological distress were 45% greater among participants not meeting daily fruit intake guidelines (OR 1.45; 95% CI 1.17–1.81). Failure to meet fruit intake guidelines was associated with 66% and 48% increased odds for depression (OR 1.66; 95% CI 1.06–2.60) and anxiety (OR 1.48; 95% CI 1.02–2.15), respectively. Adjustment for lifestyle factors attenuated results across all outcomes. LimitationsThis study is limited by reliance on cross-sectional, self-reported data, limited statistical power for some exposures, and use of rudimentary diet proxies. ConclusionsThe findings suggested an association between some dietary indicators and mental health amongst emerging adults, however this association may be explained by other sociodemographic and lifestyle factors. Further longitudinal studies in this age group are warranted to investigate the directionality of this association and the relative effects of other lifestyle factors that cluster with diet.