title: Patterns of dietary intake and psychological distress in older Australians: benefits not just from a Mediterranean diet.
abstract: BACKGROUND
  Anxiety and depression contribute to morbidity in elderly adults and may be associated with diet. We investigated the association between diet and psychological distress as a marker for depression.
  
  
  METHODS
  Dietary patterns were defined by factor analysis or the Mediterranean Diet Score (MDS); depression and anxiety were assessed 12 years later. A total of 8,660 generally healthy men and women born in Australia and aged 50-69 years from the Melbourne Collaborative Cohort Study were included. At baseline (1990-1994), diet (food frequency questionnaire), education, Socio-Economic Indexes for Areas (SEIFA) - Index of Relative Socio-economic Disadvantage, medication use, social engagement, physical activity, smoking status, alcohol use, and health conditions were assessed; at follow-up (2003-2007), psychological distress was assessed using the Kessler Psychological Distress Scale (K10). Logistic regression was used to identify associations between diet and a K10 score ≥20, indicative of psychological distress.
  
  
  RESULTS
  The MDS was inversely associated with psychological distress, with the odds ratio in the top-scoring group relative to the lowest scoring group being 0.72 (95% confidence interval = 0.54-0.95). Stronger adherence to a traditional Australian-style eating pattern was also associated with a lower K10 score at follow-up, with the odds ratio for having a K10 score indicative of psychological distress for the top 20% of adherence to this pattern relative to the lowest being 0.61 (95% confidence interval = 0.40-0.91).
  
  
  CONCLUSIONS
  A Mediterranean-style diet was associated with less psychological distress, possibly through provision of a healthy nutrient profile. The Australian dietary pattern, which included some foods high in fat and sugar content along with whole foods, also showed a weak inverse association. Adherence to this pattern may reflect a feeling of belonging to the community associated with less psychological distress.
authors.affiliation: Cancer Epidemiology Centre, Cancer Council Victoria, Carlton, Victoria, Australia. allison.hodge@cancervic.org.au
authors.forename: Allison
authors.initials: A
authors.lastname: Hodge
authors.forename: Osvaldo P
authors.initials: OP
authors.lastname: Almeida
authors.forename: Dallas R
authors.initials: DR
authors.lastname: English
authors.forename: Graham G
authors.initials: GG
authors.lastname: Giles
authors.forename: Leon
authors.initials: L
authors.lastname: Flicker
mesh_terms: D000368:Aged; D001007:Anxiety; D001315:Australia; D003863:Depression; D038441:Diet, Mediterranean / Q000523:psychology*; D002149:Energy Intake; D005163:Factor Analysis, Statistical; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological; D011795:Surveys and Questionnaires