title: Associations between fruit and vegetable consumption and psychological distress: results from a population-based study.
abstract: BACKGROUND
  Several studies observed associations of various aspects of diet with mental health, but little is known about the relationship between following the 5-a-day recommendation for fruit and vegetables consumption and mental health. Thus, we examined the associations of the Swiss daily recommended fruit and vegetable intake with psychological distress.
  
  
  METHODS
  Data from 20,220 individuals aged 15+ years from the 2012 Swiss Health Survey were analyzed. The recommended portions of fruit and vegetables per day were defined as 5-a-day (at least 2 portions of fruit and 3 of vegetables). The outcome was perceived psychological distress over the previous 4 weeks (measured by the 5-item mental health index [MHI-5]). High distress (MHI-5 score ≤ 52), moderate distress (MHI-5 > 52 and ≤ 72) and low distress (MHI-5 > 72 and ≤ 100) were differentiated and multinomial logistic regression analyses adjusted for known confounding factors were performed.
  
  
  RESULTS
  The 5-a-day recommendation was met by 11.6 % of the participants with low distress, 9.3 % of those with moderate distress, and 6.2 % of those with high distress. Consumers fulfilling the 5-a-day recommendation had lower odds of being highly or moderately distressed than individuals consuming less fruit and vegetables (moderate vs. low distress: OR = 0.82, 95 % confidence interval [CI] 0.69-0.97; high vs. low distress: OR = 0.55, 95 % CI 0.41-0.75).
  
  
  CONCLUSIONS
  Daily intake of 5 servings of fruit and vegetable was associated with lower psychological distress. Longitudinal studies are needed to further determine the causal nature of this relationship.
authors.affiliation: Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Hirschengraben 84, CH-8001, Zurich, Switzerland. aline.richard@uzh.ch.
authors.forename: Aline
authors.initials: A
authors.lastname: Richard
authors.affiliation: Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Hirschengraben 84, CH-8001, Zurich, Switzerland. sabine.rohrmann@uzh.ch.
authors.forename: Sabine
authors.initials: S
authors.lastname: Rohrmann
authors.affiliation: Centre for Research in Psychiatric Epidemiology and Psychopathology, Department of Psychiatry, University Hospital of Lausanne, Site de Cery, 1008, Prilly, Switzerland. Caroline.Vandeleur@chuv.ch.
authors.forename: Caroline L
authors.initials: CL
authors.lastname: Vandeleur
authors.affiliation: Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Hirschengraben 84, CH-8001, Zurich, Switzerland. meichun.mohler-kuo@uzh.ch.
authors.forename: Meichun
authors.initials: M
authors.lastname: Mohler-Kuo
authors.affiliation: Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Hirschengraben 84, CH-8001, Zurich, Switzerland. monika.eichholzer@ifspm.uzh.ch.
authors.forename: Monika
authors.initials: M
authors.lastname: Eichholzer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004032:Diet / Q000523:psychology*; D005247:Feeding Behavior / Q000523:psychology; D005260:Female; D005638:Fruit; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D013315:Stress, Psychological / Q000178:diet therapy / Q000453:epidemiology / Q000517:prevention & control*; D013557:Switzerland / Q000453:epidemiology; D014675:Vegetables; D055815:Young Adult