The relationship between adherence to the Mediterranean diet, coronavirus anxiety, and cognitive status in university students

Öz

Objective: To determine the relationship between adherence to the Mediterranean Diet, Coronavirus Anxiety, and Cognitive Status in University Students. Methods: This cross-sectional study was conducted on 385 university students. A sociodemographic form, Mediterranean Diet Adherence Screener (MEDAS), Coronavirus Anxiety Scale Short Form (CAS), and Warwick Edinburgh Mental Wellbeing Scale (WEMBS) were used. Statistical analysis was performed to investigate potential predictors of adherence to MD and coronavirus anxiety and psychological well-being. Results: The 19.5% of the sample resulted at high risk of depression (WEMWBS score<40) and the 14.0% at high risk of psychological distress (WEMWBS score 41-45). The median MEDAS score was 6 for men (IQR = 4) and 7 for female (IQR=2) in a range between 0 and 14 (the higher score, the higher is the adhesion) (p = 0.001). The MEDAS score of 7-9 points was associated with a lower risk of depression (p=0.027). Only 12.2% of sample had coronavirus anxiety. The main variable that had a positive correlation with WEMWBS was CAS (r=-0.132; p=0.001). Conclusions: Coronavirus anxiety was not common among students. Adherence to the MD and good mental health seem to be related in a sample of university students. And those with the lowest risk of depression. The potential protective role that MD has for mental health in university students could be used to help developing more comprehensive intervention strategies of health promotion among young people.

Anahtar Kelimeler

• Mediterranean diet score
• Anxiety score
• General Well-Being

Üniversite öğrencilerinde akdeniz diyetine uyum, koronavirüs kaygısı ve bilişsel durum arasındaki ilişki

Öz

Amaç: Üniversite öğrencilerinde Akdeniz Diyetine uyum, Koronavirüs Kaygısı ve Bilişsel Durum arasındaki ilişkinin belirlenmesidir. Metot: Bu kesitsel araştırma 385 üniversite öğrencisi üzerinde yapılmıştır. Sosyodemografik form, Akdeniz Diyetine Uyum Ölçeği (ADUÖ), Koronavirüs Anksiyete Ölçeği (KAÖ) kısa formu ve Warwick Edinburgh Mental İyi Oluş Ölçeği (WEMİOÖ) kullanılmıştır. İstatistiksel analiz, Akdeniz Diyetine (AD) bağlılığın, Koronovirüs ve psikolojik iyi oluşa potansiyel etkisini belirlemek için uygulanmıştır. Bulgular: Örneklemin %19,5’inde yüksek depresyon riski (WEMİOÖ skoru <40) ve %14,0’ı yüksek psikolojik sıkıntı riski (WEMİOÖ skoru 41-45) belirlendi. MEDAS (0 -14 puan) medyan değeri erkekler için 6 (IQR = 4), kadınlar için ise 7 puandır (IQR=2) (puan ne kadar yüksekse bağlılık o kadar yüksek) (p = 0,001). ADUÖ medyan skorunun 7-9 puan olması, daha düşük depresyon riski ile ilişkilidir (p=0,027). Örneklemin sadece %12,2’sinde koronavirüs kaygısı belirlendi. WEMİOÖ ile KAÖ arasında pozitif korelasyon saptandı (r= 0.132; p=0.001). Sonuç: Öğrenciler arasında koronavirüs kaygısı yaygın bulunmamıştır. AD’ye bağlılık ve iyi ruh sağlığı ile en düşük depresyon riski arasında ilişki belirlenmiştir. AD’nin üniversite öğrencileri arasında ruh sağlığı açısından potansiyel koruyucu rolü, gençler arasında sağlığın teşviki ve geliştirilmesine yönelik daha kapsamlı müdahale stratejilerinin geliştirilmesine yardımcı olmak için kullanılabilir.

Anahtar Kelimeler

• akdeniz diyeti skoru
• anksiyete skoru
• genel iyi oluş

Kaynakça

1. Zabetakis I, Lordan R, Norton C, Tsoupras A. COVID-19: the inflammation link and the role of nutrition in potential mitigation. Nutrients. 2020;12(5):1466.
2. Baker RE, Mahmud AS, Miller IF, Rajeev M, Rasambainarivo F, Rice BL, et al. Infectious disease in an era of global change. Nature Reviews Microbiology. 2022;20(4):193-205.
3. Ren Z, Zhou Y, Liu Y. The psychological burden experienced by Chinese citizens during the COVID-19 outbreak: prevalence and determinants. BMC Public Health. 2020;20(1):1-10.
4. Venkatesh A, Edirappuli S. Social distancing in covid-19: what are the mental health implications? Bmj. 2020;369.
5. Wang C, Pan R, Wan X, Tan Y, Xu L, Ho CS, et al. Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China. International Journal of Environmental Research and Public Health. 2020;17(5):1729.
6. Chen G-C, Neelakantan N, Martín-Calvo N, Koh W-P, Yuan J-M, Bonaccio M, et al. Adherence to the Mediterranean diet and risk of stroke and stroke subtypes. European Journal of Epidemiology. 2019;34(4):337-49.
7. Mentella MC, Scaldaferri F, Ricci C, Gasbarrini A, Miggiano GAD. Cancer and Mediterranean Diet: A Review. Nutrients. 2019;11(9):2059.
8. Gómez Sánchez M, Gómez Sánchez L, Patino-Alonso MC, Alonso-Domínguez R, Sánchez-Aguadero N, Lugones-Sánchez C, et al. Adherence to the Mediterranean Diet in Spanish Population and Its Relationship with Early Vascular Aging according to Sex and Age: EVA Study. Nutrients. 2020;12(4):1025.

9. Moro E. The Mediterranean diet from Ancel Keys to the UNESCO cultural heritage. A pattern of sustainable development between myth and reality. Procedia-Social and Behavioral Sciences. 2016;223:655-61.
10. Gotsis E, Anagnostis P, Mariolis A, Vlachou A, Katsiki N, Karagiannis A. Health benefits of the Mediterranean diet: an update of research over the last 5 years. Angiology. 2015;66(4):304-18.
11. Schwingshackl L, Hoffmann G. Adherence to Mediterranean diet and risk of cancer: an updated systematic review and meta‐analysis of observational studies. Cancer medicine. 2015;4(12):1933-47.
12. Schwingshackl L, Missbach B, König J, Hoffmann G. Adherence to a Mediterranean diet and risk of diabetes: a systematic review and meta-analysis. Public health nutrition. 2015;18(7):1292-9.
13. Widmer RJ, Flammer AJ, Lerman LO, Lerman A. The Mediterranean diet, its components, and cardiovascular disease. The American journal of medicine. 2015;128(3):229-38.
14. Dinu M, Pagliai G, Sofi F. A heart-healthy diet: recent insights and practical recommendations. Current cardiology reports. 2017;19(10):1-7.
15. Schwingshackl L, Hoffmann G. Adherence to Mediterranean diet and risk of cancer: a systematic review and meta‐analysis of observational studies. International journal of cancer. 2014;135(8):1884-97.
16. Esposito K, Maiorino MI, Bellastella G, Chiodini P, Panagiotakos D, Giugliano D. A journey into a Mediterranean diet and type 2 diabetes: a systematic review with meta-analyses. BMJ open. 2015;5(8):e008222.
17. Antonopoulou M, Mantzorou M, Serdari A, Bonotis K, Vasios G, Pavlidou E, et al. Evaluating Mediterranean diet adherence in university student populations: Does this dietary pattern affect students' academic performance and mental health? The International journal of health planning and management. 2020;35(1):5-21.
18. Angelino D, Godos J, Ghelfi F, Tieri M, Titta L, Lafranconi A, et al. Fruit and vegetable consumption and health outcomes: an umbrella review of observational studies. Int J Food Sci Nutr. 2019;70(6):652-67.
19. Barberger-Gateau P, Féart C, Samieri C. Mediterranean diet and cognitive decline: what role for omega-3 polyunsaturated fatty acids? Oléagineux, Corps gras, Lipides. 2011;18(4):224-7.
20. Tourlouki E, Polychronopoulos E, Zeimbekis A, Tsakountakis N, Bountziouka V, Lioliou E, et al. The ‘secrets’ of the long livers in Mediterranean islands: the MEDIS study. European Journal of Public Health. 2009;20(6):659-64.
21. Esteban-Cornejo I, Izquierdo-Gomez R, Gómez-Martínez S, Padilla-Moledo C, Castro-Piñero J, Marcos A, et al. Adherence to the Mediterranean diet and academic performance in youth: the UP&DOWN study. European Journal of Nutrition. 2016;55(3):1133-40.
22. Estruch R, Martínez-González MA, Corella D, Salas-Salvadó J, Ruiz-Gutiérrez V, Covas MI, et al. Effects of a Mediterranean-style diet on cardiovascular risk factors: a randomized trial. Annals of internal medicine. 2006;145(1):1-11.
23. Martínez-González MA, García-Arellano A, Toledo E, Salas-Salvadó J, Buil-Cosiales P, Corella D, et al. A 14-item Mediterranean diet assessment tool and obesity indexes among high-risk subjects: the PREDIMED trial. PLoS One. 2012;7(8):e43134.
24. León-Muñoz LM, Guallar-Castillón P, Graciani A, López-García E, Mesas AE, Aguilera MT, et al. Adherence to the Mediterranean diet pattern has declined in Spanish adults. J Nutr. 2012;142(10):1843-50.
25. Pehlivanoğlu EFÖ, Balcıoğlu H, Ünlüoğlu İ. Akdeniz diyeti bağlılık ölçeği’nin türkçe’ye uyarlanması geçerlilik ve güvenilirliği. Osmangazi Tıp Dergisi. 2020;42(2):160-4.
26. Lee SA. Coronavirus Anxiety Scale: A brief mental health screener for COVID-19 related anxiety. Death Stud. 2020;44(7):393-401.
27. Biçer İ, Çakmak C, Demir H, Kurt ME. Koronavirüs anksiyete ölçeği kısa formu: Türkçe geçerlik ve güvenirlik çalışması. Anatolian Clinic the Journal of Medical Sciences. 2020;25(Special Issue on COVID 19):216-25.
28. Tennant R, Hiller L, Fishwick R, Platt S, Joseph S, Weich S, et al. The Warwick-Edinburgh Mental Well-being Scale (WEMWBS): development and UK validation. Health and Quality of Life Outcomes. 2007;5(1):63.
29. Keldal G. Warwick-Edinburgh mental iyi oluş ölçeği’nin Türkçe formu: Geçerlik ve güvenirlik çalışması. The Journal of Happiness & Well-Being. 2015;3(1):103-15.
30. Sofi F, Macchi C, Abbate R, Gensini GF, Casini A. Mediterranean diet and health. Biofactors. 2013;39(4):335-42.
31. Molendijk ML, Bus BA, Spinhoven P, Penninx BW, Kenis G, Prickaerts J, et al. Serum levels of brain-derived neurotrophic factor in major depressive disorder: state-trait issues, clinical features and pharmacological treatment. Mol Psychiatry. 2011;16(11):1088-95.
32. Godos J, Currenti W, Angelino D, Mena P, Castellano S, Caraci F, et al. Diet and Mental Health: Review of the Recent Updates on Molecular Mechanisms. Antioxidants (Basel). 2020;9(4).
33. Kris-Etherton PM, Petersen KS, Hibbeln JR, Hurley D, Kolick V, Peoples S, et al. Nutrition and behavioral health disorders: depression and anxiety. Nutr Rev. 2021;79(3):247-60.
34. Ljungberg T, Bondza E, Lethin C. Evidence of the Importance of Dietary Habits Regarding Depressive Symptoms and Depression. International Journal of Environmental Research and Public Health. 2020;17(5):1616.
35. Quirk SE, Williams LJ, O’Neil A, Pasco JA, Jacka FN, Housden S, et al. The association between diet quality, dietary patterns and depression in adults: a systematic review. BMC Psychiatry. 2013;13(1):175.
36. Lai JS, Hiles S, Bisquera A, Hure AJ, McEvoy M, Attia J. A systematic review and meta-analysis of dietary patterns and depression in community-dwelling adults. Am J Clin Nutr. 2014;99(1):181-97.
37. Shatwan IM, Alhinai EA, Alawadhi B, Surendran S, Aljefree NM, Almoraie NM. High Adherence to the Mediterranean Diet Is Associated with a Reduced Risk of Obesity among Adults in Gulf Countries. Nutrients. 2021;13(3).
38. Agnoli C, Sieri S, Ricceri F, Giraudo MT, Masala G, Assedi M, et al. Adherence to a Mediterranean diet and long-term changes in weight and waist circumference in the EPIC-Italy cohort. Nutrition & Diabetes. 2018;8(1):22.
39. Beunza J-J, Toledo E, Hu FB, Bes-Rastrollo M, Serrano-Martínez M, Sánchez-Villegas A, et al. Adherence to the Mediterranean diet, long-term weight change, and incident overweight or obesity: the Seguimiento Universidad de Navarra (SUN) cohort. The American Journal of Clinical Nutrition. 2010;92(6):1484-93.
40. Romaguera D, Norat T, Mouw T, May AM, Bamia C, Slimani N, et al. Adherence to the Mediterranean Diet Is Associated with Lower Abdominal Adiposity in European Men and Women. The Journal of Nutrition. 2009;139(9):1728-37.
41. Buckland G, Bach A, Serra‐Majem L. Obesity and the Mediterranean diet: a systematic review of observational and intervention studies. Obesity reviews. 2008;9(6):582-93.
42. Rodríguez-López P, Lozano-Sanchez J, Borrás-Linares I, Emanuelli T, Menéndez JA, Segura-Carretero A. Structure–Biological Activity Relationships of Extra-Virgin Olive Oil Phenolic Compounds: Health Properties and Bioavailability. Antioxidants. 2020;9(8):685.
43. Godos J, Castellano S, Marranzano M. Adherence to a Mediterranean Dietary Pattern Is Associated with Higher Quality of Life in a Cohort of Italian Adults. Nutrients. 2019;11(5).
44. Zabetakis I, Lordan R, Norton C, Tsoupras A. COVID-19: The Inflammation Link and the Role of Nutrition in Potential Mitigation. Nutrients. 2020;12(5).
45. Buchanan JL. Prevention of depression in the college student population: a review of the literature. Archives of psychiatric nursing. 2012;26(1):21-42.
46. Stallman HM. Prevalence of psychological distress in university students: Implications for service delivery. Australian Journal of General Practice. 2008;37(8):673.
47. Asif S, Mudassar A, Shahzad TZ, Raouf M, Pervaiz T. Frequency of depression, anxiety and stress among university students. Pak J Med Sci. 2020;36(5):971-6.
48. Ventriglio A, Sancassiani F, Contu MP, Latorre M, Di Slavatore M, Fornaro M, et al. Mediterranean Diet and its Benefits on Health and Mental Health: A Literature Review. Clin Pract Epidemiol Ment Health. 2020;16(Suppl-1):156-64.
49. El Ansari W, Berg-Beckhoff G. Nutritional Correlates of Perceived Stress among University Students in Egypt. Int J Environ Res Public Health. 2015;12(11):14164-76.
50. Chacón-Cuberos R, Zurita-Ortega F, Olmedo-Moreno EM, Castro-Sánchez M. Relationship between Academic Stress, Physical Activity and Diet in University Students of Education. Behav Sci (Basel). 2019;9(6).