Associations between dietary patterns and psychological factors: A cross-sectional study among Chinese postmenopausal women

Objective: The aim of this study is to explore the association of dietary patterns with depression, perceived stress, and self-esteem among postmenopausal Chinese women. Methods: A cross-sectional study was conducted among 906 participants who attended the screening visits for two soy trials. Dietary data were collected using a validated food frequency questionnaire containing 85 food items. Principal component factor analysis was used to derive dietary patterns based on 11 food groups. Psychological factors were assessed by the Center for Epidemiologic Studies Depression Scale, Perceived Stress Scale, and Rosenberg Self-esteem Scale. Results: We identified three dietary patterns as follows: Processed foods (refined grains, preserved foods, fat meat, fried foods, and sweets), whole plant foods (whole grains, vegetables, and fruits), and animal foods (fish, lean meat, and milk products). Multivariable linear regression analyses indicated that whole plant food intake was negatively associated with depression score (P=0.030). Processed food intake was positively associated with perceived stress (P=0.025) and depression (P=0.073), and negatively associated with scores of self-esteem (P=0.046). The highest tertile of processed foods score was associated with 79.3% increased risk of depression (P for trend=0.006), whereas the highest tertile of whole plant food score was associated with 26% reduction of depression (P for trend=0.023) relative to the lowest tertile. Conclusions: Dietary patterns featuring a low intake of processed foods and/or a high intake of whole plant foods were associated with a reduced risk of depression and perceived stress.