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European Journal of Nutrition

, Volume 57, Issue 6, pp 2295–2306 | Cite as

Consumption of fruit and vegetables in relation with psychological disorders in Iranian adults

  • Faezeh Saghafian
  • Hanieh Malmir
  • Parvane Saneei
  • Ammar Hassanzadeh Keshteli
  • Mohammad Javad Hosseinzadeh-Attar
  • Hamid Afshar
  • Fereydoun Siassi
  • Ahmad Esmaillzadeh
  • Peyman Adibi
Original Contribution

Abstract

Objective

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.

Methods

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.

Results

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.

Conclusion

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.

Keywords

Fruit Vegetables Depression Anxiety Distress 

Abbreviations

FFQ

Food frequency questionnaire

GPPAQ

General Practice Physical Activity Questionnaire

GHQ

General Health Questionnaire

HADS

Hospital Anxiety and Depression Scale

OR

Odds ratios

95% CI

95% confidence interval

SEPAHAN

Study on the Epidemiology of Psychological-Alimentary Health and Nutrition

IUMS

Isfahan University of Medical Sciences

SES

Socioeconomic status

ANOVA

Analysis of variance

ANCOVA

Analysis of covariance

Notes

Acknowledgements

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).

Author contributions

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.

Funding

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.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Faezeh Saghafian
    • 1
    • 2
  • Hanieh Malmir
    • 1
    • 2
  • Parvane Saneei
    • 8
  • Ammar Hassanzadeh Keshteli
    • 3
    • 4
  • Mohammad Javad Hosseinzadeh-Attar
    • 5
  • Hamid Afshar
    • 6
  • Fereydoun Siassi
    • 2
  • Ahmad Esmaillzadeh
    • 2
    • 7
    • 8
  • Peyman Adibi
    • 4
    • 9
  1. 1.Students’ Scientific Research CenterTehran University of Medical SciencesTehranIran
  2. 2.Department of Community Nutrition, School of Nutritional Sciences and DieteticsTehran University of Medical SciencesTehranIran
  3. 3.Department of MedicineUniversity of AlbertaEdmontonCanada
  4. 4.Integrative Functional Gastroenterology Research CenterIsfahan University of Medical SciencesIsfahanIran
  5. 5.Department of Clinical Nutrition, School of Nutritional Sciences and DieteticsTehran University of Medical SciencesTehranIran
  6. 6.Department of Psychiatry, Psychosomatic Research CenterIsfahan University of Medical SciencesIsfahanIran
  7. 7.Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences InstituteTehran University of Medical SciencesTehranIran
  8. 8.Department of Community Nutrition, School of Nutrition and Food ScienceIsfahan University of Medical SciencesIsfahanIran
  9. 9.Department of Internal Medicine, School of MedicineIsfahan University of Medical SciencesIsfahanIran

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