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The Association Between Habitual Diet Quality and the Common Mental Disorders in Community-Dwelling Adults: The Hordaland Health Study

Jacka, Felice N. PhD; Mykletun, Arnstein PhD; Berk, Michael PhD; Bjelland, Ingvar MD, PhD; Tell, Grethe S. PhD

doi: 10.1097/PSY.0b013e318222831a
Original Article

Objective: Recent evidence suggests a role for diet quality in the common mental disorders depression and anxiety. We aimed to investigate the association between diet quality, dietary patterns, and the common mental disorders in Norwegian adults.

Methods: This cross-sectional study included 5731 population-based men and women aged 46 to 49 and 70 to 74 years. Habitual diet was assessed using a validated food frequency questionnaire, and mental health was measured using the Hospital Anxiety and Depression Scale.

Results: After adjustments for variables including age, education, income, physical activity, smoking, and alcohol consumption, an a priori healthy diet quality score was inversely related to depression (odds ratio [OR] = 0.71, 95% confidence interval [CI] = 0.59-0.84) and anxiety (OR = 0.77, 95% CI = 0.68-0.87) in women and to depression (OR = 0.83, 95% CI = 0.70-0.99) in men. Women scoring higher on a healthy dietary pattern were less likely to be depressed (OR = 0.68, 95% CI = 0.57-0.82) or anxious (OR = 0.87, 95% CI = 0.77-0.98), whereas men were more likely to be anxious (OR = 1.19, 95% CI = 1.03-1.38). A traditional Norwegian dietary pattern was also associated with reduced depression in women (OR = 0.77, 95% CI = 0.64-0.92) and anxiety in men (OR = 0.77, 95% CI = 0.61-0.96). A western-type diet was associated with increased anxiety in men (OR = 1.27, 95% CI = 1.14-1.42) and women (OR = 1.29, 95% CI = 1.17-1.43) before final adjustment for energy intake.

Conclusions: In this study, those with better quality diets were less likely to be depressed, whereas a higher intake of processed and unhealthy foods was associated with increased anxiety.

FFQ = food frequency questionnaire; HADS = Hospital Anxiety and Depression Scale; OR = odds ratio; CI = confidence interval; SD = standard deviation; Kj = kilojoule; PA = physical activity; SES = socioeconomic status; MI = myocardial infarction.

From the Department of Clinical and Biomedical Sciences (F.N.J., M.B.), The University of Melbourne, Barwon Health, Geelong, Australia; The Norwegian Institute of Public Health (A.M.), Oslo; Departments of Education and Health Promotion (A.M.), Public Health and Primary Health Care (I.B., G.S.T.), University of Bergen, Bergen, Norway; Orygen Research Centre (M.B.), The University of Melbourne; and Mental Health Research Institute (M.B.), Melbourne, Australia.

Address correspondence and reprint requests to Felice N. Jacka, BA, PhD, PgGrad Med Sci, Department of Clinical and Biomedical Sciences, The University of Melbourne, Barwon Health, PO Box 281, Geelong 3220, Australia. E-mail:

The Hordaland Health Study was conducted from 1997 to 1999 as a collaboration among the National Health Screening Service, the University of Bergen in Norway, the University of Oslo in Norway, and local health services in the Bergen region. F.J. is funded by a National Health and Medical Research Council Postdoctoral Fellowship. A.M. is funded by the Norwegian Institute of Public Health.

The funding providers played no role in the design or conduct of the study; collection, management, analysis, and interpretation of the data; or in preparation, review, or approval of the article.

Received for publication October 3, 2010; revision received April 14, 2011.

Copyright © 2011 by American Psychosomatic Society
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