Effects of Mediterranean and Western dietary patterns on perceived stress and mental distress.

Compared to the Western diet, the Mediterranean diet has many known benefits for both mental health and physical health; however, little is known about the effect of these dietary patterns on perceived stress and mental distress. To assess the relationship between dietary patterns, perceived stress and mental wellbeing, an anonymous online questionnaire targeting adults 18 and older was distributed via several social media platforms and email listservs. The survey included demographic questions, the Food-Mood Questionnaire, the Perceived Stress Scale and the Kessler Psychological Distress scale (K-6). A total of 1591 participants completed the survey. The data was analyzed using Principal Component Analysis and Pearson Correlation Coefficient in SPSS version 28.0. The results showed significant negative correlations between perceived stress and mental distress with several components of the Mediterranean diet, such as whole grains, seafood, fruits, vegetables, and beans. Despite being attributed to the Western diet, meat produced a negative correlation with perceived stress and mental distress. However, significant positive correlations between perceived stress and mental distress and the Western diet, such as fast food and high glycemic index food, were detected. Our findings provide evidence that dietary patterns modulate the stress response and suggest that incorporating components of the Mediterranean diet is beneficial for mental wellbeing and stress reduction.

Validity and reliability of Turkish version of the Food-Mood Questionnaire for university students.

OBJECTIVE: This study aims to evaluate the validity and reliability of the Turkish version of the Food-Mood Questionnaire (FMQ) for university students. DESIGN: The original questionnaire developed by Begdache et al. (2019) was modified and translated into Turkish. The content validation ratio (CVR) and the content validity index (CVI) were used for content validity assessment. The construct validity was assessed by exploratory factor analysis and confirmatory factor analysis (CFA) on data collected on university students who completed the survey online. Pearson's correlation coefficients and Cronbach's α were used to assess reliability and validity (P < 0·05). SETTING: This study was conducted at five different universities in Turkey. PARTICIPANTS: A total of 251 (67 males and 184 females) undergraduate students participated in the study. Of these, seventy-five students completed a pre- and post-test assessment. RESULTS: In the current study, 251 university students with a mean age of 21·9 ± 4·1 years participated. The mean CVR and CVI were 0·96 and 0·98, respectively. Factor loadings ranged from 0·341 to 0·863, and item total score correlations ranged from 0·142 to 0·749. Cronbach's α coefficient was 0·633 for the whole scale. Five factors were extracted that had a good fit in CFA (χ2/DF = 1·37, root mean error of approximation: 0·039, goodness-of-fit index: 0·911 and comparative fit index: 0·933). CONCLUSIONS: The Turkish FMQ is a valid and a reliable tool for university students. FMQ can be used by clinicians or researchers to examine the mental distress and dietary patterns of university students. Further testing of the FMQ is required for validation in the general population.

Principal component analysis identifies differential gender-specific dietary patterns that may be linked to mental distress in human adults.

Independent reports describe the structural differences between the human male and female brains and the differential gender-susceptibility to mood disorders. Nutrition is one of the modifiable risk factors that has been reported to impact brain chemistry and affect mental health. Objectives: To study dietary patterns in adult men and women in relation to mental distress. Another aim was to develop evidence-based prototypes using System Dynamic Modeling methodology to better describe our findings. Methods: An anonymous internet-based survey was sent through social media platforms to different social and professional networks. Multivariate analyses were used for data mining. Data were stratified by gender and further by tertiles to capture the latent variables within the patterns of interest. Results: Mental distress in men associated with a consumption of a Western-like diet. In women, mental wellbeing associated with a Mediterranean-like diet and lifestyle. No other patterns in both genders were linked to mental distress. Based on the generated prototypes, men are more likely to experience mental wellbeing until nutritional deficiencies arise. However, women are less likely to experience mental wellbeing until a balanced diet and a healthy lifestyle are followed. In men, dietary deficiencies may have a profound effect on the limbic system; whereas dietary sufficiency in women may potentiate the mesocortical regulation of the limbic system. Discussion and conclusion: Our results may explain the several reports in the literature that women are at a greater risk for mental distress when compared to men and emphasize the role of a nutrient-dense diet in mental wellbeing.

Assessment of dietary factors, dietary practices and exercise on mental distress in young adults versus matured adults: A cross-sectional study.

The importance of the diet in modulating mental health is uncovering as many dietary factors have been described to alter brain chemistry. Brain maturation may not complete until the age of 30 which may explain the differential emotional control, mindset, and resilience between young adults and matured adults. As a result, dietary factors may influence mental health differently in these two populations. OBJECTIVES: To study dietary intake, dietary practices and exercise in young adults (YA) (18-29 years) versus matured adults (MA) (30 years and older) in relation to mental distress. Another aim was to assess whether mental well-being potentially stimulates healthy eating, healthy practices, and exercising. METHODS: An anonymous internet-based survey was sent through social media platforms to different professional and social group networks. Best-fit models were constructed using the backward regression analysis to assess the relationship between dietary variables, exercise, and mental distress in YA versus MA. RESULTS: YA mood seems to be dependent on food that increases availability of neurotransmitter precursors and concentrations in the brain (such as frequent meat consumption and exercise, respectively). However, MA mood may be more reliant on food that increases availability of antioxidants (fruits) and abstinence of food that inappropriately activates the sympathetic nervous system (coffee, high glycemic index, and skipping breakfast). DISCUSSION AND CONCLUSION: Level of brain maturation and age-related changes in brain morphology and functions may necessitate dietary adjustments for improving mental well-being.

Validity and reliability of Food-Mood Questionnaire (FMQ).

BACKGROUND: The need for short and validated questionnaires to evaluate dietary patterns (DPs) and mental distress in clinical and research settings is increasing. AIM: The purpose of this study was to develop and validate a Food-Mood Questionnaire (FMQ) to assess DPs in relation to mental distress. METHOD: A standard validation protocol that included item development, pilot-testing, test-retesting, and a series of statistical validation analyses was used. Content, face, internal, construct and external validity as well as reliability were confirmed. Content and face validity were evaluated qualitatively. RESULTS: Principal component analysis (PCA) for construct validity generated five sub-scales which reflected internal consistency (Cronbach's α > 0.70) and internal reliability (intraclass correlation coefficient ranged between 0.619 and 0.884; p < 0.01; confidence interval 95%). External validity was also confirmed. A total of 563 participants from four different continents completed the survey online. PCA generated five different subscales. Mental distress was associated with regular consumption of fast-food, a DP known to induce anxiety and depression. CONCLUSION: The FMQ is a validated and a reliable tool with many potential applications that could be used with prophylactic and therapeutic approaches.

Physical activity self-efficacy online intervention for adults with obesity: protocol for a feasibility study.

BACKGROUND: Even without weight loss, adults with obesity can greatly benefit from regular physical activity. The Physical Activity Self-efficacy (PAS) intervention is an online behavioral intervention newly developed to promote physical activity in adults with obesity by providing capability-enhancing learning opportunities. The objective of this manuscript is to describe the protocol for a feasibility study designed to investigate the feasibility and acceptability of implementing the PAS online intervention for adults with obesity recruited from a local weight management center in the United States of America (USA). METHODS: The study design is a prospective, double-blind, parallel-group individual randomized pilot trial. Thirty participants will be randomly assigned to the PAS group or usual care group to achieve a 1:1 group assignment. Recruitment of participants is scheduled to begin on 1 March 2024 at a local weight management center within a private healthcare system in the USA. There are six eligibility criteria for participation in this study (e.g., a body mass index ≥ 25.00 kg/m2). Eligibility verification and data collection will be conducted online. Three waves of data collection will take up to 14 weeks depending on participants' progress in the study. The primary feasibility outcomes in the study will be: (a) participation rate, (b) engagement behavior, and (c) a preliminary effect size estimate for the effect of the PAS intervention on physical activity. Instruments designed to measure demographic information, anthropometric characteristics, self-efficacy, and acceptability will be included in the survey battery. A research-grade accelerometer will be used to measure free-living physical activity objectively. Data will be analyzed using descriptive statistics and inferential statistical models under an intention-to-treat approach. DISCUSSION: Results are intended to inform the preparation of a future definitive randomized controlled trial. TRIAL REGISTRATION: ClinicalTrials.gov, NCT05935111, registered 7 July 2023.

Bioactive Compounds for Customized Brain Health: What Are We and Where Should We Be Heading?

Many strides have been made in the field of nutrition that are making it an attractive field not only to nutrition professionals but also to healthcare practitioners. Thanks to the emergence of molecular nutrition, there is a better appreciation of how the diet modulates health at the cellular and molecular levels. More importantly, the advancements in brain imaging have produced a greater appreciation of the impact of diet on brain health. To date, our understanding of the effect of nutrients on brain health goes beyond the action of vitamins and minerals and dives into the intracellular, molecular, and epigenetic effects of nutrients. Bioactive compounds (BCs) in food are gaining a lot of attention due to their ability to modulate gene expression. In addition, bioactive compounds activate some nuclear receptors that are the target of many pharmaceuticals. With the emergence of personalized medicine, gaining an understanding of the biologically active compounds may help with the customization of therapies. This review explores the prominent BCs that can impact cognitive functions and mental health to deliver a potentially prophylactic framework for practitioners. Another purpose is to identify potential gaps in the literature to suggest new research agendas for scientists.

Dental Anxiety and Its Association with Dietary Intake and Food Groups: A Cross-Sectional Study.

Although there is an established connection between diet and mental health, the relationship between diet and dental anxiety has not been examined yet. The purpose of this study was to fill this gap by assessing the association between diet quality, mental distress, and dental anxiety. The data was collected through an anonymous Google Forms survey. The survey consisted of a modified version of the validated Food-Mood Questionnaire and the Modified Dental Anxiety Scale with questions about demographics, dental health, and dental health anxieties. Data collection was performed over seven months, from April to October 2021. Data were analyzed using Pearson's correlation coefficient in SPSS version 25.0 and STATA 17 for sample size calculation, data processing and regression analyses. A total of 506 responses were collected. Our data verified that diet quality modulates dental anxiety. Women exhibited a stronger link with dental anxiety than men (p < 0.01). Consumption of sugary foods was associated with different attributes of dental anxiety (p < 0.01). Low-quality energy-dense foods and dairy were associated with dental anxiety, whereas caffeine, meat, nuts, and green leafy vegetables produced a negative correlation. This cross-sectional study provides proof of concept that dietary patterns are potentially associated with dental anxiety.

The Impact of the Different Stages of COVID-19, Time of the Week and Exercise Frequency on Mental Distress in Men and Women.

The COVID-19 pandemic produced life disturbances and loss of routine which affected diet and sleep quality as well as physical exercise frequency. Interestingly, mental distress was higher even in those who exercised. The purpose of this study was to assess exercise frequency in relation to different levels of mental distress severity in men and women while accounting for working days and weekends. A de-identified secondary data set was analyzed. Regression analyses produced models of the different stages of COVID-19 in relation to physical exercise frequency and mental distress levels. Margin analysis generated predictive models that could be used prophylactically to customize physical exercise frequencies in men and women to reduce their risk of mental distress during future pandemics. Mental distress during the lockdown and after ease of restrictions was associated with different physical exercise frequencies, with a noticeable difference between men and women. During a pandemic, sedentary men are more likely to be mentally distressed during working days. Nevertheless, moderately active, but not very active women, may be less distressed during pandemic weekends. These findings may provide a framework to optimize mental health during different stages of a pandemic by customizing physical exercise frequencies based on gender and time of the week.

Dietary Factors, Time of the Week, Physical Fitness and Saliva Cortisol: Their Modulatory Effect on Mental Distress and Mood.

Background: The purpose of the study was to assess the effect of diet quality and physical fitness on saliva cortisol, mood, and mental distress. These relationships were compared between a peak weekday (Wednesday) and a weekend day (Saturday) when mood may fluctuate. Methods: Forty-eight healthy college students participated in the study. Participants completed the Mood and Anxiety Symptom (MASQ) and Kessler Psychological Distress Scale 10 questionnaires on Wednesday and Saturday and recorded their diet for three days. Saliva was collected before and after a workout for cortisol extraction. Results: SA had significantly higher saliva cortisol levels post-workout but lower MASQ scores on Saturday (p < 0.05). There was a very significant association between MASQ scores on Wednesday (p = 0.005), which became less significant on Saturday. In addition, lower BMI values and high-fat consumption were associated with higher cortisol levels after exercise (p < 0.05). Conclusions: There is a strong link between dietary factors, cortisol levels, mood, and time of the week. In addition, our results suggest that saliva cortisol levels may not be directly linked to negative affect but are influenced by diet quality when mental distress exists. In addition, physical fitness may play a role in improving mood during weekends.

Customization of Diet May Promote Exercise and Improve Mental Wellbeing in Mature Adults: The Role of Exercise as a Mediator.

Diet, dietary practices and exercise are modifiable risk factors for individuals living with mental distress. However, these relationships are intricate and multilayered in such a way that individual factors may influence mental health differently when combined within a pattern. Additionally, two important factors that need to be considered are gender and level of brain maturity. Therefore, it is essential to assess these modifiable risk factors based on gender and age group. The purpose of the study was to explore the combined and individual relationships between food groups, dietary practices and exercise to appreciate their association with mental distress in mature men and women. Adults 30 years and older were invited to complete the food-mood questionnaire. The anonymous questionnaire link was circulated on several social media platforms. A multi-analyses approach was used. A combination of data mining techniques, namely, a mediation regression analysis, the K-means clustering and principal component analysis as well as Spearman's rank-order correlation were used to explore these research questions. The results suggest that women's mental health has a higher association with dietary factors than men. Mental distress and exercise frequency were associated with different dietary and lifestyle patterns, which support the concept of customizing diet and lifestyle factors to improve mental wellbeing.

A Differential Threshold of Breakfast, Caffeine and Food Groups May Be Impacting Mental Well-Being in Young Adults: The Mediation Effect of Exercise.

Diet and exercise are known to influence mental health. However, the interaction between diet, dietary practices, and exercise and its impact on the mood of young adults (YA) is poorly understood. YA are inherently at risk for mental distress. They tend to consume a low-quality diet and are generally active. The purpose of the study was to assess these relationships through validating causal loop diagrams (CLD) that describe these connections by using a system dynamic (SD) modeling methodology. Adults 18-29 years were invited to complete the Food-Mood questionnaire. The anonymous questionnaire link was distributed to several institutional listservs and via several social media platforms targeting young adults. A multi-level analysis, including machine learning techniques, was used to assess these relationships. The key findings were then built into gender based CLD, which suggest that a differential repertoire may be needed to optimize diet quality, exercise, and mental well-being. Additionally, a potential net threshold for dietary factors and exercise may be needed to achieve mental well-being in young adults. Moreover, our findings suggest that exercise may boost the enhancing effect of food groups on mental well-being and may lessen the negative impact of dietary impediments of mental well-being.

College Education on Dietary Supplements May Promote Responsible Use In Young Adults.

Dietary supplement (DS) use is increasing among college students. Early adulthood is a critical developmental stage when behavioral trends are established with potential health implications. Many studies have suggested a proper college education on DSs is needed, but no follow-up reports exist in the literature. The purpose of the study was to compare DS use in college students with and without a formal education on DSs. An anonymous survey was sent over electronic mailing lists of different social and professional student groups, including students in the health and wellness studies (HWS) minor (HM) at Binghamton University. A total of 308 students completed the study. A statistical framework using multivariate analyses was designed to assess pattern of use and identify variables of interest. Principal component analysis recognized five patterns collectively contributing to 66.75% of the variance. PC 1 characterized as tobacco use, PC 2 labeled as body weight, PC 3 categorized as exercise, PC 4 labeled as educated use, and PC 5 is considered Greek-life lifestyle. Participants were then partitioned into HM versus HWS nonminor (NM). Common factor analysis was performed to extract significant variables pertaining to each pattern. Results reflected driving forces common to both groups. However, new trends surfaced in HM. A regression analysis suggests that DS use in HM is based on knowledge, whereas NM use is specifically targeted toward certain lifestyles. In addition, HM are more likely to discontinue a DS with formal knowledge. Therefore, college education on DS may be promoting a healthy pattern of supplement use.

Diet, Exercise, Lifestyle, and Mental Distress among Young and Mature Men and Women: A Repeated Cross-Sectional Study.

Customization of mental health therapies needs to consider the differences in degree of brain maturity between young (18-29 years) and mature (30 years or older) adults as well as brain morphology among men and women. The aim of this study was to identify the significant dietary and lifestyle contributors to mental distress in these sub-populations. Independent repeated cross-sectional sampling was performed for over a 5-year period (2014-2019) to collect data from different populations at different time-points and seasons. A backward stepwise regression analysis was used on 2628 records. Mental distress in young women was associated with high consumption of caffeine and fast-food, and it was negatively correlated with moderate-high levels of exercise as well as frequent breakfast consumption. Mature women shared several common factors with young women; however, high fruit consumption was negatively associated with mental distress. For young men, high exercise, moderate consumption of dairy, and moderate-high intake of meat were negatively associated with mental distress. In addition, high fast-food and caffeine consumption were positively associated with mental distress in young men. For mature men, strong negative associations between higher education, moderate intake of nuts and mental distress surfaced. Our results support the need to customize dietary and lifestyle recommendations to improve mental wellbeing.

Prediction of Mental Illness in Heart Disease Patients: Association of Comorbidities, Dietary Supplements, and Antibiotics as Risk Factors.

Comorbidities, dietary supplement use, and prescription drug use may negatively (or positively) affect mental health in cardiovascular patients. Although the significance of mental illnesses, such as depression, anxiety, and schizophrenia, on cardiovascular disease is well documented, mental illnesses resulting from heart disease are not well studied. In this paper, we introduce the risk factors of mental illnesses as an exploratory study and develop a prediction framework for mental illness that uses comorbidities, dietary supplements, and drug usage in heart disease patients. Particularly, the data used in this study consist of the records of 68,647 patients with heart disease, including the patient's mental illness information and the patient's intake of dietary supplements, antibiotics, and comorbidities. Patients in age groups <61, gender differences, and drug intakes, such as Azithromycin, Clarithromycin, Vitamin B6, and Coenzyme Q10, were associated with mental illness. For predictive modeling, we consider applying various state-of-the-art machine learning techniques with tuned parameters and finally obtain the following: Depression: 78.01% accuracy, 79.13% sensitivity, 72.65% specificity, and 86.26% Area Under the Curve (AUC). Anxiety: 82.93% accuracy, 82.86% sensitivity, 83.35% specificity, and 88.45% AUC. Schizophrenia: 87.59% accuracy, 87.70% sensitivity, 85.14% specificity, and 92.73% AUC. Disease: 86.63% accuracy, 95.50% sensitivity, 77.76% specificity, and 91.59% AUC. From the results, we conclude that using heart disease information, comorbidities, dietary supplement use, and antibiotics enables us to accurately predict the mental health outcome.

Common and differential associations between levels of alcohol drinking, gender-specific neurobehaviors and mental distress in college students.

BACKGROUND: Binge drinking is associated with poor academic behaviors and performance. Excessive alcohol drinking induces molecular changes and neurobehaviors that support use of other substances and alter cognitive functions. The purpose of this study was to compare neurobehaviors and academic effort among college students with low alcohol use with those of high alcohol consumption and build conceptual models that represent the integration of the different variables. METHOD: College students from several U.S colleges were assessed through an anonymous online survey for alcohol use, academic performance, lifestyle factors and mental distress. RESULTS: Our results depicted common neurobehaviors and differential responses to high alcohol use. CONCLUSION: The common responses in young men and women with high alcohol use are reflective of a hyperactive limbic system. The different responses involve cognitive aptitudes, typically controlled by cortical regions and affected by levels of brain connectivity known to be dissimilar between men and women.

Comparison of Colorimetric Analyses to Determine Cortisol in Human Sweat.

Colorimetric analysis, which relies on a chemical reaction to facilitate a change in visible color, is a great strategy for detecting cortisol, which is necessary to diagnose and manage the wide variety of diseases related to the hormone, because it is simple in design, inexpensive, and reliable as a standard cortisol analysis technique. In this study, four different colorimetric cortisol analyses that use various chromogens, which include sulfuric acid, Porter-Silber reagent, Prussian blue, and blue tetrazolium, are studied. Modifications to the classic Porter-Silber method are made by increasing the carbon content of the alcohol and adding gold nanoparticles, which result in a twofold increase in reaction rate and a slight decrease in the limit of detection (LoD). After a comparison of the reaction rate, LoD, dynamic range, characteristic peaks, and color stability of all methods, blue tetrazolium demonstrates a low LoD (97 ng/mL), broad dynamic range (0.05-2 µg/mL), and quick reaction rate (color development as fast as 10 min), which are well within the requirements for human biofluids. Cortisol in artificial saliva and sweat and in human sweat was determined while confirming that no excipients or other biomarkers interfered with the reactions. Twenty-one human sweat samples were tested using blue tetrazolium and revealed a significant difference between male and female apocrine cortisol concentrations and showed a highly significant difference between apocrine and eccrine cortisol concentrations. Colorimetric methods of cortisol can compete with existing electrochemical sensors because of their similar accuracy and detection range in certain wearable biosensor applications. The simplicity of colorimetric methods advances potential applications in skin-interfaced bio-electronics and point-of-care devices.

Sweat and saliva cortisol response to stress and nutrition factors.

Cortisol is a biomarker for stress monitoring; however, the biomedical and clinical relevance is still controversial due to the complexity of cortisol secretion mechanisms and their circadian cycles as well as environmental factors that affect physiological cortisol level, which include individual mood and dietary intake. To further investigate this multifaceted relationship, a human pilot study examined cortisol concentration in sweat and saliva samples collected from 48 college-aged participants during aerobic exercise sessions along with mental distress and nutrition surveys. Enzyme-linked immunosorbent assays determined highly significant differences between apocrine-dominant sweat (AP), saliva before exercise (SBE), and saliva after exercise (SAE) cortisol concentration (AP-SBE: p = 0.0017, AP-SAE: p = 0.0102). A significantly greater AP cortisol concentration was detected in males compared to females (p = 0.0559), and significant SAE cortisol concentration differences were also recorded between recreational athletes and non-athletes (p = 0.044). However, Kessler 10 Psychological Distress Scale (K10) scores, an examination administered to deduce overall wellness, provided no significant differences between males and females or athletes and non-athletes in distress levels, which statistically signifies a direct relationship to cortisol was not present. For further analysis, dietary intake from all participants was considered to investigate whether a multiplexed association was prevalent between nutrition, mood, and cortisol release. Significant positive correlations between AP cortisol, SAE cortisol, K10 scores, and fat intake among female participants and athletes were discovered. The various machine learning algorithms utilized the extensive connections between dietary intake, overall well-being, sex factors, athletic activity, and cortisol concentrations in various biofluids to predict K10 scores. Indeed, the understanding of physiochemical stress response and the associations between studied factors can advance algorithm developments for cortisol biosensing systems to mitigate stress-based illnesses and improve an individual's quality of life.

Principal component regression of academic performance, substance use and sleep quality in relation to risk of anxiety and depression in young adults.

Adverse lifestyle factors increase risk of anxiety and depression in young adults. Consequently, neurochemical and neuroanatomical alterations ensue, and may initiate a vicious cycle of mental distress, poor lifestyle choices and academic performance. A total of 558 students from different US colleges completed an anonymous survey on academic performance, daytime sleepiness, substance use and mental distress. Low mental distress in college students positively associated with good academic efforts and limited daytime sleepiness. Mild mental distress correlated with borderline work neglect and with a marginal negative association with Grade-point average (GPA). Severe mental distress correlated with excessive daytime sleepiness and poor academic performance. A System Dynamic model was developed to reflect the integration of these variables with mental distress and academic performance. Our results demonstrate that manageable lifestyle factors contribute to mental health in college students, which become potentially cyclic events that may impact academic performance.