Eating pattern and psychological symptoms: A cross-sectional study based on a national large sample of Chinese...

Previous studies showed inconsistent results of the relationship between eating patterns and mental health in adolescents, and little is known in Chinese adolescents.

A multi-center population-based survey was conducted in 32 schools in 4 provinces across China. A total of 14,500 adolescents at grade 7-12 completed eligible questionnaires. Emotional, conduct and social adaptation problems were assessed using Multi-dimensional Sub-health Questionnaire of Adolescents (MSQA), while eating pattern was collected using the semi-quantitative food frequency questionnaire (SQFFQ).

Four principal components were obtained, including healthy, meat, sugar-sweetened beverages (SSBs) and fast foods patterns. The healthy pattern associated with lower risk of psychological symptoms (adjusted odds ratio (AORs) was 0.59, 0.60, 0.62, 0.53, respectively, all p < 0.01). While the fast foods pattern (AOR was 2.16, 2.04, 1.84, 2.24, respectively, all p < 0.01), the SSBs pattern (AOR was 1.38, 1.34, 1.25, 1.56, respectively, all p < 0.01) and the meats pattern (AOR was 1.24, 1.15, 1.12, 1.28, respectively, all p < 0.05) significantly associated with higher risk of psychological symptoms. Dose-response relationships were observed in all eating patterns with psychological symptoms, except for meats pattern (p-trend < 0.01).

The cross-sectional design limited the ability to infer causality. Meanwhile, it was difficult for estimating the eating quantity accurately by SQFFQ, and can only be assessed by the dietary pattern score.

Our findings highlight the potential importance of eating pattern for mental health during adolescence.