title: The association between stress levels and food consumption among Iranian population.
abstract: BACKGROUND
  Stress has been considered as a highly common disorder that has a complicated relation with dietary intake and has been linked with both increased and decreased dietary intake.
  
  
  OBJECTIVE
  This study was conducted to assess the association between food consumption and stress levels in an Iranian adult population.
  
  
  METHODS
  In this cross-sectional study, data from the third phase of Isfahan Healthy Heart Program (IHHP) that was conducted for cardiovascular diseases prevention and health promotion were used. Nine thousand five hundred forty-nine adults aged ≥ 18 years participated in the study. Dietary habits were assessed by a 49- item Food Frequency Questionnaire (FFQ). Stress levels were assessed by General Health Questionnaire-12 (GHQ-12). The participants were separated on the basis of their stress levels into two groups as the low- and high- stress groups.
  
  
  RESULTS
  Individuals in the low- stress group were significantly younger and tended to have higher physical activity and education level, lower LDL cholesterol, and were less likely to be current smokers. Dietary intake of unsaturated oils, grains, fruits, vegetables, meat, and dairy products was significantly higher in the low- stress group whereas dietary intake of saturated oils was significantly lower; moreover, Global Dietary Index (GDI) was lower in the low- stress group. We found a significant positive association between stress level, GDI (OR: 1.24; 95% CI: 1.14 - 1.35), and saturated oils (OR: 1.17; 95% CI: 1.08 - 1.28) and inverse association between stress level and intake of unsaturated oils (OR: 0.84 ; 95% CI: 0.77 - 0.91), fruits and vegetables (OR: 0.83; 95% CI: 0.76 - 0.90), meat (OR: 0.88; 95%CI: 0.82 - 0.97),and dairy products (OR: 0.88 ; 95% CI: 0.81 - 0.96) after adjustments based on sex, age, smoking, and  physical activity.
  
  
  CONCLUSIONS
  Our results showed a significant positive association between dietary intake and stress. We must have a special attention to dietary intake in stress management program of high- stress individuals, and in dietary recommendations, psychologic aspects should be considered. However, prospective longitudinal studies are needed to assess the causal relationship between stress and dietary factors.
authors: Mental Health Department, Isfahan Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran. m_sadeghi@crc.mui.ac.ir
authors: Hamidreza
authors: H
authors: Roohafza
authors: Nizal
authors: N
authors: Sarrafzadegan
authors: Masoumeh
authors: M
authors: Sadeghi
authors: Mahmoud
authors: M
authors: Rafieian-Kopaei
authors: Firouzeh
authors: F
authors: Sajjadi
authors: Hossein
authors: H
authors: Khosravi-Boroujeni
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004032:Diet / Q000523:psychology*; D004034:Diet Surveys; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D015438:Health Behavior; D006306:Health Surveys; D006801:Humans; D007492:Iran; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult