title: Association between Inflammatory Potential of Diet and Stress Levels in Adolescent Women in Iran.
abstract: BACKGROUND
  The relation between diet and stress has not been widely explored. In this study, we examined the association between the inflammatory potential of diet and levels of stress among adolescent girls in Iran.
  
  
  METHODS
  A total of 299 adolescent girls aged 15-18 years were recruited during 2014-2015. Stress was assessed using the Depression, Anxiety and Stress Scale (DASS)-21 scale. Data were analyzed as continuous DASS scores and as a dichotomous outcome with a cut-off value of 9. The dietary inflammatory index (DII) is a literature-derived population-based dietary. DII scores were index computed from dietary intake assessed using a validated food frequency questionnaire. Multivariable linear and logistic regressions were used to calculate beta estimates and odds ratios adjusting for potential confounding factors.
  
  
  RESULTS
  In total, 84 girls (28% of the entire study sample) had at least a moderate level of stress symptoms (DASS > 9). Girls with the most pro-inflammatory diet (tertile 3) had higher DASS stress scores (β = 2.75; 95% CI = 1.05, 4.46) and were at 3.48 times (95% CI = 1.33, 9.09) risk of having at least moderate level of stress compared to girls with the most anti-inflammatory diets (tertile 1).
  
  
  CONCLUSIONS
  These data suggest that Iranian adolescent girls with a pro-inflammatory diet, as shown by higher DII scores, had higher levels of stress and greater odds of having at least a moderate level of stress symptoms.
authors.affiliation: 1)Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA. 2)Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.
authors.forename: Nitin
authors.initials: N
authors.lastname: Shivappa
authors.affiliation: 1)Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA. 2)Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.
authors.forename: James R
authors.initials: JR
authors.lastname: Hebert
authors.affiliation: Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute (WHO Collaborating Center), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Bahram
authors.initials: B
authors.lastname: Rashidkhani
mesh_terms: D000293:Adolescent; D000886:Anthropometry; D001007:Anxiety / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D004032:Diet / Q000523:psychology*; D015444:Exercise; D005260:Female; D006801:Humans; D007249:Inflammation / Q000453:epidemiology*; D007492:Iran; D016014:Linear Models; D016015:Logistic Models; D015999:Multivariate Analysis; D016017:Odds Ratio; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D013315:Stress, Psychological / Q000453:epidemiology*; D011795:Surveys and Questionnaires