Association between a vegetarian diet and emotional symptoms: a cross-sectional study among adolescents in four developing countries
Abstract
Background
Studies assessing the association between vegetarianism and mental health have found divergent results. Evidence from adolescents in developing countries is scarce.
Objective
To evaluate the association between a vegetarian diet and emotional symptoms in 15-year-old adolescents from Ethiopia, India, Peru and Vietnam.
Methods
A cross-sectional, secondary analysis of the Young Lives cohort study was used. The exposure variable was the self-report of being a vegetarian (yes or no). The outcome was the level of emotional symptoms, numerically evaluated using the score obtained in the subscale “Emotional Symptoms” of the Strengths and Difficulties Questionnaire (SDQ). We calculated crude and adjusted coefficients (β) with 95% confidence intervals (95% CIs), using generalized linear models of the Gaussian family, considering each sentinel site as a cluster. The analysis was stratified by country. Additionally, we made a global analysis including the four countries.
Results
A total of 3484 adolescents were analyzed. The overall prevalence of vegetarianism was 4.4%, but it varied between countries (from 0.4% in Vietnam to 11.5% in India). The average emotional symptoms score was 3.5 [standard deviation (SD) 2.3] points. The scores were not statistically different between vegetarians and non-vegetarians (p > 0.05). In the adjusted analysis, in Vietnam, vegetarians had lower emotional symptoms scores on average than non-vegetarians [β: −1.79; 95% CI: −3.05 to −0.55]. No differences were found neither in the other countries nor in the overall sample.
Conclusion
There was no association between a vegetarian diet and emotional symptoms in the analyzed adolescents of four developing countries.
Acknowledgment
The authors acknowledges the Young Lives study team and the UK Data Archive.
References
[1] World Health Organization. Mental Health: a state of well-being [Internet]. 2014. [cited 6 May 2017]. Available from: http://www.who.int/features/factfiles/mental_health/en/.Suche in Google Scholar
[2] Barra E, Cerna R, Kramm D, Véliz V. Problemas de salud, estrés, afrontamiento, depresión y apoyo social en adolescentes [Health Problems, Stress, Coping, Depression and Social Support in Adolescents]. Ter psicol. 2006;24(1):55–61.Suche in Google Scholar
[3] Kessler RC, Aguilar-Gaxiola S, Alonso J, Chatterji S, Lee S, Ormel J, et al. The global burden of mental disorders: an update from the WHO World Mental Health (WMH) surveys. Epidemiol Psichiatr Soc. 2009;18(1):23–33.10.1017/S1121189X00001421Suche in Google Scholar
[4] Vargas H, Tovar H, Valverde J. Prevalencia y factores asociados con el episodio depresivo en adolescentes de Lima Metropolitana y Callao [Prevalence and associated factors with depressive episode in teenagers from Lima Metropolitana and Callao]. Rev Peru Epidemiol. 2010;14(2):91–8.Suche in Google Scholar
[5] World Health Organization. Child and adolescent: mental health. [Internet] [Cited 6 May 2017]. Available from: http://www.who.int/mental_health/maternal-child/child_adolescent/en/.Suche in Google Scholar
[6] Roberts RE, Roberts CR, Xing Y. Rates of DSM-IV psychiatric disorders among adolescents in a large metropolitan area. J Psychiatr Res. 2007;41(11):959–67.10.1016/j.jpsychires.2006.09.006Suche in Google Scholar PubMed PubMed Central
[7] Pilis W, Stec K, Zych M, Pilis A. Health benefits and risk associated with adopting a vegetarian diet. Rocz Panstw Zakl Hig. 2014;65(1):9–14.10.5604/01.3001.0003.3173Suche in Google Scholar
[8] Huang RY, Huang CC, Hu FB, Chavarro JE. Vegetarian diets and weight reduction: a meta‐analysis of randomized controlled trials. J Gen Intern Med. 2015;31:109–16.10.1007/s11606-015-3390-7Suche in Google Scholar PubMed PubMed Central
[9] Agrawal S, Millett CJ, Dhillon PK, Subramanian SV, Ebrahim S. Type of vegetarian diet, obesity and diabetes in adult Indian population. Nutr J. 2014;13:89.10.1186/1475-2891-13-89Suche in Google Scholar PubMed PubMed Central
[10] Aune D, Ursin G, Veierod MB. Meat consumption and the risk of type 2 diabetes: a systematic review and meta-analysis of cohort studies. Diabetologia. 2009;52:2277–87.10.1007/s00125-009-1481-xSuche in Google Scholar PubMed
[11] Dinu M, Abbate R, Gensini GF, Casini A, Sofi F. Vegetarian, vegan diets and multiple health outcomes: a systematic review with meta-analysis of observational studies. Crit Rev Food Sci Nutr. 2017;57(17):3640–9.10.1080/10408398.2016.1138447Suche in Google Scholar PubMed
[12] Wang F, Zheng J, Yang B, Jiang J, Fu Y, Li D. Effects of vegetarian diets on blood lipids: a systematic review and meta-analysis of randomized controlled trials. J Am Heart Assoc. 2015;4(10):e002408.10.1161/JAHA.115.002408Suche in Google Scholar PubMed PubMed Central
[13] Huang T, Yang B, Zheng J, Li G, Wahlqvist ML, Li D. Cardiovascular disease mortality and cancer incidence in vegetarians: a meta analysis and systematic review. Ann Nutr Metab. 2012;60(4):233–40.10.1159/000337301Suche in Google Scholar PubMed
[14] Michalak J, Zhang XC, Jacobi F. Vegetarian diet and mental disorders: results from a representative community survey. Int J Behav Nutr Phys Act. 2012;9:67.10.1186/1479-5868-9-67Suche in Google Scholar PubMed PubMed Central
[15] Beezhold B, Radnitz C, Rinne A, DiMatteo J. Vegans report less stress and anxiety than omnivores. Nutr Neurosci. 2015;18(7):289–96.10.1179/1476830514Y.0000000164Suche in Google Scholar PubMed
[16] Northstone K, Joinson C, Emmett P. Dietary patterns and depressive symptoms in a UK cohort of men and women: a longitudinal study. Public Health Nutr. 2017:21(5):831–7.10.1017/S1368980017002324Suche in Google Scholar PubMed PubMed Central
[17] University of Oxford. Young lives [Internet]. Oxford: OX; 2016. [Cited 6 May 2017]. Available from: http://www.younglives.org.uk/content/about-us.Suche in Google Scholar
[18] Strengths and Difficulties Questionnaire. Scoring the Strengths and Difficulties Questionnaire for age 4–17 or 18+ [Internet]. London: Youth in Mind. [Cited 3 October 2017]. Available from: http://www.sdqinfo.com/py/sdqinfo/b3.py?language=Englishqz(UK).Suche in Google Scholar
[19] 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):181–97.10.3945/ajcn.113.069880Suche in Google Scholar PubMed
[20] Melina V, Craig W, Levin S. Position of the Academy of Nutrition and Dietetics: vegetarian diets. J Acad Nutr Diet. 2016;116(12):1970–80.10.1016/j.jand.2016.09.025Suche in Google Scholar PubMed
[21] Baş M, Karabudak E, Kiziltan G. Vegetarianism and eating disorders: association between eating attitudes and other psychological factors among Turkish adolescents. Appetite. 2005;44(3):309–15.10.1016/j.appet.2005.02.002Suche in Google Scholar PubMed
[22] Hibbeln JR, Northstone K, Evans J, Golding J. Vegetarian diets and depressive symptoms among men. J Affect Disord. 2018;225:13–7.10.1016/j.jad.2017.07.051Suche in Google Scholar PubMed
[23] Henry CJ. Dietary intake research in Asian children: significance and challenges. J Nutr Sci Vitaminol (Tokyo). 2015;61:S189–91.10.3177/jnsv.61.S189Suche in Google Scholar PubMed
[24] Figuié M. Vegetable consumption behavior in Vietnam. Project #00005600 funded by the Ministry of Foreign Affairs of France. Available at: https://agritrop.cirad.fr/517071/1/docu ment_517071.pdf.Suche in Google Scholar
[25] Ribeiro SM, Malmstrom TK, Morley JE, Miller DK. Fruit and vegetable intake, physical activity, and depressive symptoms in the African American Health (AAH) study. J Affect Disord. 2017;220:31–7.10.1016/j.jad.2017.05.038Suche in Google Scholar PubMed
[26] McMartin SE, Jacka FN, Colman I. The association between fruit and vegetable consumption and mental health disorders: evidence from five waves of a national survey of Canadians. Prev Med. 2013;56(3–4):225–30.10.1016/j.ypmed.2012.12.016Suche in Google Scholar PubMed
[27] Null G, Pennesi L, Feldman M. Nutrition and lifestyle intervention on mood and neurological disorders. J Evid Based Complementary Altern Med. 2017;22(1):68–74.10.1177/2156587216637539Suche in Google Scholar PubMed PubMed Central
[28] Beezhold BL, Johnston CS. Restriction of meat, fish, and poultry in omnivores improves mood: a pilot randomized controlled trial. Nutr J. 2012;11:9.10.1186/1475-2891-11-9Suche in Google Scholar PubMed PubMed Central
[29] Mullee A, Vermeire L, Vanaelst B, Mullie P, Deriemaeker P, Leenaert T, et al. Vegetarianism and meat consumption: a comparison of attitudes and beliefs between vegetarian, semi-vegetarian, and omnivorous subjects in Belgium. Appetite. 2017;114:299–305.10.1016/j.appet.2017.03.052Suche in Google Scholar PubMed
[30] Larsson CL, Klock KS, Astrom AN, Haugejorden O, Johansson G. Food habits of young Swedish and Norwegian vegetarians and omnivores. Public Health Nutr. 2001;4(5):1005–14.10.1079/PHN2001167Suche in Google Scholar
[31] Orlich MJ, Singh PN, Sabaté J, Fan J, Sveen L, Bennett H, et al. Vegetarian dietary patterns and the risk of colorectal cancers. JAMA Intern Med. 2015;175(5):767–76.10.1001/jamainternmed.2015.59Suche in Google Scholar PubMed PubMed Central
[32] De Backer CJ, Hudders L. From meatless Mondays to meatless Sundays: motivations for meat reduction among vegetarians and semi-vegetarians who mildly or significantly reduce their meat intake. Ecol Food Nutr. 2014;53(6):639–57.10.1080/03670244.2014.896797Suche in Google Scholar PubMed
[33] Kehoe SH, Krishnaveni GV, Veena SR, Guntupalli AM, Margetts BM, Fall CH, et al. Diet patterns are associated with demographic factors and nutritional status in South Indian Children. Matern Child Nutr. 2014;10(1):145–58.10.1111/mcn.12046Suche in Google Scholar PubMed PubMed Central
[34] Chuang SY, Chiu TH, Lee CY, Liu TT, Tsao CK, Hsiung CA, et al. Vegetarian diet reduces the risk of hypertension independent of abdominal obesity and inflammation: a prospective study. J Hypertens. 2016;34(11):2164–71.10.1097/HJH.0000000000001068Suche in Google Scholar PubMed
©2018 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
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- Association between a vegetarian diet and emotional symptoms: a cross-sectional study among adolescents in four developing countries
- A prospective 1-year study on load reduction of school backpacks shows reversible changes of body posture in schoolchildren
- Level, motivation and barriers to participate in physical activity among late adolescents in Puducherry
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Artikel in diesem Heft
- Frontmatter
- Editorial
- Close-in-age exemption laws: focusing on the best interests of children and adolescents
- Review
- Literature review: nutritional factors influencing academic achievement in school age children
- Original Articles
- Appointed by young people – a qualitative study on young patients recruiting hospital staff in Denmark
- Child labor and mental health status of in-school adolescents in a municipal local government area of Lagos state, Nigeria
- Usefulness of hematological parameters for differential diagnosis of endometriomas in adolescents/young adults and older women
- Assessment of the WHO Health Promoting Schools Framework among schools in selected villages of rural Puducherry, South India – a mixed method study
- The development and psychometric evaluation of a new instrument to market healthy breakfast and snacks among adolescents
- Awareness of bicycle light use of young adults
- A brief study on the knowledge and choice of contraception methods in married adolescent girls
- Coverage of and compliance to iron supplementation under the National Iron Plus Initiative among reproductive age-group women in urban Puducherry – a cross-sectional study
- Adolescents’ smartphone use at night, sleep disturbance and depressive symptoms
- Prevalence and determinants of poor quality of sleep among adolescents in rural Puducherry, South India
- Health awareness, lifestyle and dietary behavior of university students in the northeast part of Bangladesh
- The effectiveness of group counseling on prenatal care knowledge and performance of pregnant adolescents in a Kurdish region of Iran
- High adenovirus 36 seroprevalence among a population of Hispanic American youth
- Development and psychometric properties of the female adolescents’ sexual reproductive self-care scale
- “Decide Now, Buy Marlboro”: Examining the influence and appeal of Marlboro’s new brand architecture among Filipino adolescents
- Knowledge, attitude and practice of cigarette smoking among senior secondary school students in Depok, Indonesia
- Factors associated with knowledge of where to access health care among youth in juvenile detention: a mixed methods study
- Association between a vegetarian diet and emotional symptoms: a cross-sectional study among adolescents in four developing countries
- A prospective 1-year study on load reduction of school backpacks shows reversible changes of body posture in schoolchildren
- Level, motivation and barriers to participate in physical activity among late adolescents in Puducherry
- A pilot study to improve sugar and water consumption in Maltese school children
- Deep venous thrombosis of lower limbs in adolescents: a study in a tertiary hospital
- Prevalence and determinants of condom use among male adolescents in Indonesia
- Iranian mothers’ needs for reproductive health education of their adolescent daughters: a qualitative study
- Short Communication
- Psychosocial determinants of stress among adolescents in an urban slum in a city of Western Maharashtra: a cross-sectional study