Diet quality and mental health problems in adolescents from East London: a prospective study



In this study, we aimed to examine the relationship between diet quality and depression in a prospective study of adolescents from varied ethnic and cultural backgrounds.


In this prospective cohort study, data were collected at two time points (2001 and 2003) from nearly 3,000 adolescents, aged either 11–12 years or 13–14 years, participating in RELACHS, a study of ethnically diverse and socially deprived young people from East London in the UK. Diet quality was measured from dietary questionnaires, and mental health assessed using the Strengths and Difficulties Questionnaire (SDQ) and the Short Mood and Feelings Questionnaire (SMFQ).


In cross-sectional analyses, we found evidence for an association between an unhealthy diet and mental health problems. Compared to those in the lowest quintile of Unhealthy diet score, those in the highest quintile were more than twice as likely to be symptomatic on the SDQ (OR 2.10, 95 %CI 1.38–3.20) after taking all identified confounders into account. There was also some evidence for a cross-sectional inverse association between a measure of healthy diet and mental health problems. A prospective relationship between the highest quintiles of both Healthy (OR 0.63, 95 %CI 0.38–1.05) and Unhealthy (OR 1.75, 95 %CI 1.00–3.06) diet scores and SDQ scores at follow-up was also evident, but was attenuated by final adjustments for confounders.


This study is concordant with previous observational studies in describing relationships between measures of diet quality and mental health problems in adolescents.

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Strengths and Difficulties Questionnaire


Short Mood and Feelings Questionnaire


Odds ratio


Confidence interval


Body Mass Index


  1. 1.

    Jacka FN, Pasco JA, Mykletun A, Williams LJ, Hodge AM, O’Reilly SL, Nicholson GC, Kotowicz MA, Berk M (2010) Association between western and traditional diets and depression and anxiety in women. Am J Psychiatry 167:305–311

    PubMed  Article  Google Scholar 

  2. 2.

    Akbaraly TN, Brunner EJ, Ferrie JE, Marmot MG, Kivimaki M, Singh-Manoux A (2009) Dietary pattern and depressive symptoms in middle age. Br J Psychiatry 195:408–413

    PubMed  Article  Google Scholar 

  3. 3.

    Sanchez-Villegas A, Delgado-Rodriguez M, Alonso A, Schlatter J, Lahortiga F, Majem LS, Martinez-Gonzalez MA (2009) Association of the Mediterranean dietary pattern with the incidence of depression: the Seguimiento Universidad de Navarra/University of Navarra follow-up (SUN) cohort. Arch Gen Psychiatry 66:1090–1098

    PubMed  Article  Google Scholar 

  4. 4.

    Sanchez-Villegas A, Toledo E, de Irala J, Ruiz-Canela M, Pla-Vidal J, Martinez-Gonzalez MA (2012) Fast-food and commercial baked goods consumption and the risk of depression. Public Health Nutr 15:424–432

    PubMed  Article  Google Scholar 

  5. 5.

    Jacka FN, Kremer PJ, Leslie E, Berk M, Patton G, Toumbourou JW, Williams JW (2010) Associations between diet quality and depressed mood in adolescents: results from the Healthy Neighbourhoods study. Aust N Z J Psychiatry 44:435–442

    PubMed  Article  Google Scholar 

  6. 6.

    Oddy WH, Robinson M, Ambrosini GL, O’Sullivan TA, de Klerk NH, Beilin LJ, Silburn SR, Zubrick SR, Stanley FJ (2009) The association between dietary patterns and mental health in early adolescence. Prev Med 49:39–44

    PubMed  Article  Google Scholar 

  7. 7.

    Jacka F, Kremer PJ, Berk M, de Silva-Sanigorski A, Moodie M, Leslie E, Pasco J, Swinburn B (2011) A prospective study of diet quality and mental health in adolescents. PLoS ONE 6:e24805

    PubMed  Article  CAS  Google Scholar 

  8. 8.

    Stansfeld S, Haines MM, Booy R, Taylor SJ, Viner R, Head J (2003) Health of Young People in East London: The RELACHS Study 2001. The Institute of Community Health Sciences. Barts and The London Queen Mary’s School of Medicine & Dentistry, London

    Google Scholar 

  9. 9.

    Stansfeld SA, Haines MM, Head JA, Bhui K, Viner R, Taylor SJ, Hillier S, Klineberg E, Booy R (2004) Ethnicity, social deprivation and psychological distress in adolescents: school-based epidemiological study in east London. Br J Psychiatry 185:233–238

    PubMed  Article  Google Scholar 

  10. 10.

    Wardle J, Sutton S, Jarvis M (1998) HABITS—The Health and Behaviours of Teenagers Study. Department of Epidemiology and Public Health, Health Behaviour Unit, London

    Google Scholar 

  11. 11.

    Angold A, Costello EJ, Messer SC, Pickles A (1995) Development of a short questionnaire for use in epidemiological studies of depression in children and adolescents: factor composition and structure across development. Int J Meth Psych Res 5:237–249

    Google Scholar 

  12. 12.

    Goodman R, Meltzer H, Bailey V (1998) The Strengths and Difficulties Questionnaire: a pilot study on the validity of the self-report version. Eur Child Adolesc Psychiatry 7:125–130

    PubMed  Article  CAS  Google Scholar 

  13. 13.

    Meltzer H, Gatward R, Goodman R, Ford T (2003) Mental health of children and adolescents in Great Britain. Int Rev Psychiatry 15:185–187

    PubMed  Article  CAS  Google Scholar 

  14. 14.

    Leavey G, Hollins K, King M, Barnes J, Papadopoulos C, Grayson K (2004) Psychological disorder amongst refugee and migrant schoolchildren in London. Soc Psychiatry Psychiatr Epidemiol 39:191–195

    PubMed  Article  Google Scholar 

  15. 15.

    Mullick MS, Goodman R (2001) Questionnaire screening for mental health problems in Bangladeshi children: a preliminary study. Soc Psychiatry Psychiatr Epidemiol 36:94–99

    PubMed  Article  CAS  Google Scholar 

  16. 16.

    Goddard E, Higgins V (1999) Smoking, drinking and drug use among young teenagers in 1998. National Centre for Social Research, London

    Google Scholar 

  17. 17.

    Health Education Authority (1997) Young people and health: health behaviour in school-aged children. Health Education Authority, London

    Google Scholar 

  18. 18.

    Zimet G, Dahlem N, Zimet S, Farley G (1988) The Multidimentional Scale of Perceived Social Support. J Pers Assess 52:30–41

    Article  Google Scholar 

  19. 19.

    Rothon C, Head J, Clark C, Klineberg E, Cattell V, Stansfeld S (2009) The impact of psychological distress on the educational achievement of adolescents at the end of compulsory education. Soc Psychiatry Psychiatr Epidemiol 44:421–427

    PubMed  Article  Google Scholar 

  20. 20.

    Rutter M, Caspi A, Moffitt TE (2003) Using sex differences in psychopathology to study causal mechanisms: unifying issues and research strategies. J Child Psychol Psychiatry 44:1092–1115

    PubMed  Article  Google Scholar 

  21. 21.

    Bryan J, Osendarp S, Hughes D, Calvaresi E, Baghurst K, van Klinken JW (2004) Nutrients for cognitive development in school-aged children. Nutr Rev 62:295–306

    PubMed  Article  Google Scholar 

  22. 22.

    Sharma S, Zhuang Y, Gomez-Pinilla F (2012) High-fat diet transition reduces brain DHA levels associated with altered brain plasticity and behaviour. Sci Rep 2:431

    PubMed  Google Scholar 

  23. 23.

    Lopez-Garcia E, Schulze MB, Fung TT, Meigs JB, Rifai N, Manson JE, Hu FB (2004) Major dietary patterns are related to plasma concentrations of markers of inflammation and endothelial dysfunction. Am J Clin Nutr 80:1029–1035

    PubMed  CAS  Google Scholar 

  24. 24.

    Lucas A (2005) Long-term programming effects of early nutrition—implications for the preterm infant. J Perinatol 25(Suppl 2):S2–S6

    PubMed  Article  Google Scholar 

  25. 25.

    Galler JR, Bryce CP, Waber D, Hock RS, Exner N, Eaglesfield D, Fitzmaurice G, Harrison R (2010) Early childhood malnutrition predicts depressive symptoms at ages 11–17. J Child Psychol Psychiatry 51:789–798

    PubMed  Article  CAS  Google Scholar 

  26. 26.

    Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE (2005) Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 62:593–602

    PubMed  Article  Google Scholar 

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We are grateful for the support of the schools, parents and students involved in this study, as well as the Community Advisory Board. We also thank the field team, including Wendy Isenwater, Giash Ahmed, Sarah Brentnall, Sultana Choudry-Dormer, Franca Davenport, Davina Woodley-Jones, Amanda Lawrence, Rachel Cameron and Hannah Bennett. Phase 1 of the RELACHS study was commissioned by the East London and the City Health Authority and Phase 2 by the Teenage Pregnancy Unit at the Department of Health: we thank them for their support. We also thank Tower Hamlets, City and Hackney and Newham Primary Care Trusts for additional funding. Associate Professor Jacka was the recipient of post-graduate scholarship funding from Australian Rotary Health and is supported by a NH&MRC Post-Doctoral Fellowship (#628912). Dr Rothon is funded by a Medical Research Council Special Training Fellowship (G0601707).

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Correspondence to Felice N. Jacka.

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Jacka, F.N., Rothon, C., Taylor, S. et al. Diet quality and mental health problems in adolescents from East London: a prospective study. Soc Psychiatry Psychiatr Epidemiol 48, 1297–1306 (2013).

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  • Diet
  • Nutrition
  • Mental health
  • Depression
  • Adolescents