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Associations between dietary patterns and psychological factors

a cross-sectional study among Chinese postmenopausal women

Liu, Zhao-min PhD; Ho, Suzanne C. PhD; Xie, Yao Jie PhD; Chen, Ya-jun PhD; Chen, Yu-ming PhD; Chen, Bailing MD; Wong, Samuel Yeung-shan MD; Chan, Dicken MSc; Wong, Carmen Ka Man MBBCh; He, Qiqiang PhD; Tse, Lap Ah PhD; Woo, Jean MD

doi: 10.1097/GME.0000000000000701
Original Articles

Objective: The aim of this study is to explore the association of dietary patterns with depression, perceived stress, and self-esteem among postmenopausal Chinese women.

Methods: A cross-sectional study was conducted among 906 participants who attended the screening visits for two soy trials. Dietary data were collected using a validated food frequency questionnaire containing 85 food items. Principal component factor analysis was used to derive dietary patterns based on 11 food groups. Psychological factors were assessed by the Center for Epidemiologic Studies Depression Scale, Perceived Stress Scale, and Rosenberg Self-esteem Scale.

Results: We identified three dietary patterns as follows: processed foods (refined grains, preserved foods, fat meat, fried foods, and sweets), whole plant foods (whole grains, vegetables, and fruits), and animal foods (fish, lean meat, and milk products). Multivariable linear regression analyses indicated that whole plant food intake was negatively associated with depression score (P = 0.030). Processed food intake was positively associated with perceived stress (P = 0.025) and depression (P = 0.073), and negatively associated with scores of self-esteem (P = 0.046). The highest tertile of processed foods score was associated with 79.3% increased risk of depression (P for trend = 0.006), whereas the highest tertile of whole plant food score was associated with 26% reduction of depression (P for trend = 0.023) relative to the lowest tertile.

Conclusions: Dietary patterns featuring a low intake of processed foods and/or a high intake of whole plant foods were associated with a reduced risk of depression and perceived stress.

1The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, P.R. China

2School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, P.R. China

3School of Public Health, Sun Yat-sen University, Guangzhou, P.R. China

4Department of Spine Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, P.R. China

5School of Public Health, Wuhan University, Wuhan, P.R. China

6Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, P.R. China.

Address correspondence to: Zhao-min Liu, PhD, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, P.R. China. E-mail:

Received 12 November, 2015

Revised 19 April, 2016

Accepted 19 April, 2016

Z.-.m.L. conceptualized the study, conducted data collection, analyzed the data, and drafted the article. S.C.H., Z.-m.L., Y.-m.C., and J.W. obtained the grants. D.C. provided statistical consultation. All the co-authors critically commented and revised the article.

This study was conducted according to the guidelines laid down in the Declaration of Helsinki, and all procedures involving human participants were approved by the institutional review board of the Chinese University of Hong Kong. Written informed consent was obtained from all participants.

Funding/support: The study was funded by Hong Kong Research Grant Committee—General Research Fund (RGC-GRF465810 and CUHK4450/06 M) and Direct Grant of the Chinese University of Hong Kong (4054150).

Financial disclosure/conflicts of interest: None reported.

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© 2016 by The North American Menopause Society.