Consumption of fruit and vegetables in relation with psychological disorders in Iranian adults
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Findings from observational studies on the relationship between fruit and vegetables consumption and risk of mental disorders are contradictory. We aimed to examine the association between fruit and vegetables intake and prevalence of depression, anxiety, and psychological distress in a large group of Iranian adults.
This cross-sectional study was conducted on 3362 people of Iranian adults working in 50 health centers. Dietary data were collected using a validated dish-based 106-item semi-quantitative food frequency questionnaire (FFQ). The Iranian-validated version of Hospital Anxiety and Depression Scale (HADS) was used to screen for anxiety and depression. The General Health Questionnaire (GHQ) was used to assess psychological distress.
The prevalence of depression, anxiety, and high psychological distress among the study population was 30.0, 15.2, and 25.0%, respectively. Women in the top quintile of fruit intake, compared with those in the bottom quintile, had 57, 50, and 60% lower odds of depression, anxiety, and psychological distress. Consumption of vegetables was significantly associated with lower odds of depression (OR 0.65; 95% CI 0.46, 0.93) in women and lower odds of anxiety (OR 0.43; 95% CI 0.22, 0.87) in men. In addition, after adjustment for potential confounders, women in the highest quintile of fruit and vegetables intake, compared with those in the bottom quintile, had significantly lower odds of depression (OR 0.55; 95% CI 0.37, 0.80) and psychological distress (OR 0.60; 95% CI 0.40, 0.90). Furthermore, high intake of total fruit and vegetables was associated with lower odds of psychological distress (OR 0.42; 95% CI 0.21, 0.81) in men.
We found significant inverse associations between high intake of fruit with depression, anxiety, and psychological distress in Iranian women. High consumption of vegetables was also associated with lower risk of depression and anxiety, respectively, in women and men. In addition, high intake of total fruit and vegetable was associated with lower odds of depression and psychological distress in women and men.
KeywordsFruit Vegetables Depression Anxiety Distress
Food frequency questionnaire
General Practice Physical Activity Questionnaire
General Health Questionnaire
Hospital Anxiety and Depression Scale
- 95% CI
95% confidence interval
Study on the Epidemiology of Psychological-Alimentary Health and Nutrition
Isfahan University of Medical Sciences
Analysis of variance
Analysis of covariance
We wish to thank all staff of Isfahan University of Medical Sciences who kindly participated in our study and staff of Public Relations Unit, and other authorities of IUMS for their excellent cooperation. Dr. Ahmad Esmaillzadeh was supported by a grant from Iran National Science Foundation (INSF).
FS, HM, PS, AHK, MJH, HA, AF, FS, AE, and PA contributed in conception, design, data collection, statistical analyses, data interpretation, manuscript drafting, approval of the final version of the manuscript, and agreed for all aspects of the work.
The financial support for conception, design, data analysis and manuscript drafting comes from National Institute for Medical Research Development (NIMAD) (project number: 963472).
Compliance with ethical standards
Conflict of interest
None of the authors had any personal or financial conflicts of interest.
- 1.World Health Organization (2017) Media Center, Depression. Factsheet Number: 369. http://www.who.int/mediacentre/factsheets/fs369/en. Accessed June 2017
- 2.Alonso J, Angermeyer MC, Bernert S et al. (2004) Prevalence of mental disorder in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatr Scand Suppl. 420:21–27Google Scholar
- 27.Ghaffarpour M, Houshiar-Rad A, Kianfar H (1999) The manual for household measures, cooking yields factors and edible portion of foods. Nashre Olume Keshavarzy, Tehran, pp 1–40Google Scholar
- 28.US Department of Agriculture (2015) National nutrient database for standard reference release 28(database on the internet). USDA, Washington, DC. http://nal.usda.gov/fnic/foodcomp. Accessed Mar 2016
- 34.Aminianfar S, Saneei P, Nouri M et al (2015) Validation study of self-reported anthropometric indices among the Staff of the Isfahan University of Medical Sciences, Isfahan, Iran. J Isfahan Med Sch 33:1318–1327Google Scholar
- 35.Department of Health L (2006) The general practice physical activity questionnaireGoogle Scholar
- 36.WHO (2004) The global burden of disease: 2004 update. World Health Organization, GenevaGoogle Scholar
- 39.Saghafian F, Malmir H, Saneei P, Milajerdi A, Larijani B, Esmaillzadeh A (2018) Fruit and vegetable consumption and risk of depression: accumulative evidence from an updated systematic review and meta-analysis of epidemiological studies. Br J Nutr (Accepted) Google Scholar
- 51.Rink SM, Mumford SL, Poudrier JK et al (2013) Self-report of fruit and vegetable intake that meets the 5 a day recommendation is associated with reduced levels of oxidative stress biomarkers and increased levels of antioxidant defense in premenopausal women. J Acad Nutr Diet 113:776–785CrossRefPubMedPubMedCentralGoogle Scholar