Nutr Res Pract.  2021 Aug;15(4):516-527. 10.4162/nrp.2021.15.4.516.

Relationship between psychological distress and the adherence to the Korean healthy eating index (KHEI): the Korea National Health and Nutrition Examination Survey (KNHANES) 2013 and 2015

• Yoon YS
• Oh SW

• KMID: 2518764
• DOI: http://doi.org/10.4162/nrp.2021.15.4.516

Abstract

BACKGROUND/OBJECTIVES
This study examined the association of depressive symptoms, stress perception, and suicidal ideation with overall dietary quality using the newly developed Korean healthy eating index (KHEI).
SUBJECTS/METHODS
This study included 9,607 adults (3,939 men and 5,668 women, ≥ 19 years) who participated in the 6th Korea National Health and Nutrition Examination Survey 2013 and 2015. The KHEI scores were calculated using the food frequency questionnaire data. Survey logistic regression analyses were performed to analyze the association between psychiatric distress and dietary quality.
RESULTS
The percentage of subjects with experience of depressive mood, higher stress perception, and suicidal ideation was 8.2%, 25.0%, and 3.7% in men and 15.4%, 27.3%, and 6.0% in women, respectively. The mean KHEI score was 61.5 ± 0.29 in men and 64.8 ± 0.24 in women (P < 0.001). The present study found a difference in the adherence to specific dietary components of the KHEI between sexes. Men experiencing depressive symptoms were less likely to eat meat, fish, eggs, and beans, while depressed women showed lower vegetable intake. Both men and women with suicidal ideation showed a lower intake of vegetables. The men with stress had a lower breakfast eating score than those without stress (7.21 vs. 6.77, P = 0.016). The multivariate-adjusted odds ratios for depressive symptoms, stress perception, and the suicidal idea in women with the highest quartile of KHEI scores compared to the lowest quartile was 0.69 (95% confidence interval, 0.51–0.92), 0.73 (0.58–0.82), and 0.52 (0.33–0.82), respectively and significant dose-response associations were observed (P for trends < 0.05 for all). On the other hand, these associations were not observed in men after adjusting for the confounding variables (P for trends > 0.05 for all).
CONCLUSIONS
Poor adherence to dietary recommendations is associated with psychological distress, especially in women.

Keyword

Healthy eating index; psychological distress; suicidal ideation; depressive symptoms; nutrients

Figure

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  Fig. 1 Prevalence of depressive symptoms, stress perception, and suicidal ideation by the quartiles of Korean healthy eating index scores in men (A) and women (B). Values are reported as the percentage, significant difference determined using a χ2 test.

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