Vegetable and Fruit Consumption and Psychological Distress: Findings from Australian National Health Survey Data, 2011–2018
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Primary Objectives
- To investigate the association between vegetable and fruit consumption and the prevalence of psychological distress;
- To investigate the association between other modifiable lifestyle factors and sociodemographic variables and the prevalence of psychological distress;
- To evaluate sex differences in the relationships between lifestyle factors and psychological distress.
2.3. Assessment of Psychological Distress
2.4. Independent Variables
2.5. Data Analysis
3. Results
3.1. Demographic Characteristics
3.2. Correlates of Psychological Distress
3.3. Stratefied Analysis by Sex
4. Discussion
5. Strengths and Limitations
6. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
ABS | Australian Bureau of Statistics. |
BMI | Body Mass Index. |
K10 | Kessler Psychological Distress Scale. |
NHMRC | National Health and Medical Research Council. |
NHS | National Health Survey. |
SES | Socioeconomic Status. |
UPF | Ultra-Processed Foods |
References
- Arias, D.; Saxena, S.; Verguet, S. Quantifying the global burden of mental disorders and their economic value. eClinicalMedicine 2022, 54, 101675. [Google Scholar] [CrossRef] [PubMed]
- Tanji, F.; Tomata, Y.; Zhang, S.; Otsuka, T.; Tsuji, I. Psychological distress and completed suicide in Japan: A comparison of the impact of moderate and severe psychological distress. Prev. Med. 2018, 116, 99–103. [Google Scholar] [CrossRef]
- McLachlan, K.J.J.; Gale, C.R. The effects of psychological distress and its interaction with socioeconomic position on risk of developing four chronic diseases. J. Psychosom. Res. 2018, 109, 79–85. [Google Scholar] [CrossRef] [PubMed]
- Barry, V.; Stout, M.E.; Lynch, M.E.; Mattis, S.; Tran, D.Q.; Antun, A.; Ribeiro, M.J.; Stein, S.F.; Kempton, C.L. The effect of psychological distress on health outcomes: A systematic review and meta-analysis of prospective studies. J. Health Psychol. 2020, 25, 227–239. [Google Scholar] [CrossRef]
- Sharp, J.; Theiler, S. A Review of Psychological Distress Among University Students: Pervasiveness, Implications and Potential Points of Intervention. Int. J. Adv. Couns. 2018, 40, 193–212. [Google Scholar] [CrossRef]
- Clemente-Suárez, V.J.; Beltrán-Velasco, A.I.; Redondo-Flórez, L.; Martín-Rodríguez, A.; Tornero-Aguilera, J.F. Global impacts of western diet and its effects on metabolism and health: A narrative review. Nutrients 2023, 15, 2749. [Google Scholar] [CrossRef]
- Adolph, T.E.; Tilg, H. Western diets and chronic diseases. Nat. Med. 2024, 30, 2133–2147. [Google Scholar] [CrossRef] [PubMed]
- Zhang, H.; Li, M.; Mo, L.; Luo, J.; Shen, Q.; Quan, W. Association between western dietary patterns, typical food groups, and behavioral health disorders: An updated systematic review and meta-analysis of observational studies. Nutrients 2024, 16, 125. [Google Scholar] [CrossRef]
- Pagliai, G.; Dinu, M.; Madarena, M.P.; Bonaccio, M.; Iacoviello, L.; Sofi, F. Consumption of ultra-processed foods and health status: A systematic review and meta-analysis. Br. J. Nutr. 2021, 125, 308–318. [Google Scholar] [CrossRef]
- Monteiro, C.A.; Cannon, G.; Levy, R.B.; Moubarac, J.-C.; Louzada, M.L.C.; Rauber, F.; Khandpur, N.; Cediel, G.; Neri, D.; Martinez-Steele, E.; et al. Ultra-processed foods: What they are and how to identify them. Public Health Nutr. 2019, 22, 936–941. [Google Scholar] [CrossRef]
- Jardim, M.Z.; Costa, B.V.d.L.; Pessoa, M.C.; Duarte, C.K. Ultra-processed foods increase noncommunicable chronic disease risk. Nutr. Res. 2021, 95, 19–34. [Google Scholar] [CrossRef]
- Chong, C.P.; Shahar, S.; Haron, H.; Din, N.C. Habitual sugar intake and cognitive impairment among multi-ethnic Malaysian older adults. Clin. Interv. Aging 2019, 14, 1331–1342. [Google Scholar] [CrossRef]
- Hu, D.; Cheng, L.; Jiang, W. Sugar-sweetened beverages consumption and the risk of depression: A meta-analysis of observational studies. J. Affect. Disord. 2019, 245, 348–355. [Google Scholar] [CrossRef]
- Gillespie, K.M.; Kemps, E.; White, M.J.; Bartlett, S.E. The impact of free sugar on human health-A narrative review. Nutrients 2023, 15, 889. [Google Scholar] [CrossRef] [PubMed]
- Gillespie, K.M.; White, M.J.; Kemps, E.; Moore, H.; Dymond, A.; Bartlett, S.E. The impact of free and added sugars on cognitive function: A systematic review and meta-analysis. Nutrients 2023, 16, 75. [Google Scholar] [CrossRef] [PubMed]
- Beecher, K.; Alvarez Cooper, I.; Wang, J.; Walters, S.B.; Chehrehasa, F.; Bartlett, S.E.; Belmer, A. Long-term overconsumption of sugar starting at adolescence produces persistent hyperactivity and neurocognitive deficits in adulthood. Front. Neurosci. 2021, 15, 670430. [Google Scholar] [CrossRef] [PubMed]
- Guasch-Ferré, M.; Willett, W.C. The Mediterranean diet and health: A comprehensive overview. J. Intern. Med. 2021, 290, 549–566. [Google Scholar] [CrossRef]
- Huang, Q.; Jia, X.; Zhang, J.; Huang, F.; Wang, H.; Zhang, B.; Wang, L.; Jiang, H.; Wang, Z. Diet-Cognition Associations Differ in Mild Cognitive Impairment Subtypes. Nutrients 2021, 13, 1341. [Google Scholar] [CrossRef]
- Galbete, C.; Kröger, J.; Jannasch, F.; Iqbal, K.; Schwingshackl, L.; Schwedhelm, C.; Weikert, C.; Boeing, H.; Schulze, M.B. Nordic diet, Mediterranean diet, and the risk of chronic diseases: The EPIC-Potsdam study. BMC Med. 2018, 16, 99. [Google Scholar] [CrossRef]
- Gomez-Pinilla, F.; Tyagi, E. Diet and cognition: Interplay between cell metabolism and neuronal plasticity. Curr. Opin. Clin. Nutr. Metab. Care 2013, 16, 726–733. [Google Scholar] [CrossRef]
- Głąbska, D.; Guzek, D.; Groele, B.; Gutkowska, K. Fruit and Vegetable Intake and Mental Health in Adults: A Systematic Review. Nutrients 2020, 12, 115. [Google Scholar] [CrossRef]
- Hosseinpour-Niazi, S.; Malmir, H.; Mirmiran, P.; Shabani, M.; Hasheminia, M.; Azizi, F. Fruit and vegetable intake modifies the association between ultra-processed food and metabolic syndrome. Nutr. Metab. 2024, 21, 58. [Google Scholar] [CrossRef]
- Dharmayani, P.N.A.; Juergens, M.; Allman-Farinelli, M.; Mihrshahi, S. Association between fruit and vegetable consumption and depression symptoms in young people and adults aged 15–45: A systematic review of cohort studies. Int. J. Environ. Res. Public Health 2021, 18, 780. [Google Scholar] [CrossRef] [PubMed]
- Conner, T.S.; Brookie, K.L.; Richardson, A.C.; Polak, M.A. On carrots and curiosity: Eating fruit and vegetables is associated with greater flourishing in daily life. Br. J. Health Psychol. 2015, 20, 413–427. [Google Scholar] [CrossRef]
- Mihrshahi, S.; Dobson, A.J.; Mishra, G.D. Fruit and vegetable consumption and prevalence and incidence of depressive symptoms in mid-age women: Results from the Australian longitudinal study on women’s health. Eur. J. Clin. Nutr. 2015, 69, 585–591. [Google Scholar] [CrossRef] [PubMed]
- Sánchez-Villegas, A.; Verberne, L.; De Irala, J.; Ruíz-Canela, M.; Toledo, E.; Serra-Majem, L.; Martínez-González, M.A. Dietary Fat Intake and the Risk of Depression: The SUN Project. PLoS ONE 2011, 6, e16268. [Google Scholar] [CrossRef] [PubMed]
- Nguyen, B.; Ding, D.; Mihrshahi, S. Fruit and vegetable consumption and psychological distress: Cross-sectional and longitudinal analyses based on a large Australian sample. BMJ Open 2017, 7, e014201. [Google Scholar] [CrossRef]
- Akbaraly, T.N.; Sabia, S.; Shipley, M.J.; Batty, G.D.; Kivimaki, M. Adherence to healthy dietary guidelines and future depressive symptoms: Evidence for sex differentials in the Whitehall II study. Am. J. Clin. Nutr. 2013, 97, 419–427. [Google Scholar] [CrossRef]
- Firth, J.; Solmi, M.; Wootton, R.E.; Vancampfort, D.; Schuch, F.B.; Hoare, E.; Gilbody, S.; Torous, J.; Teasdale, S.B.; Jackson, S.E.; et al. A meta-review of “lifestyle psychiatry”: The role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders. World Psychiatry 2020, 19, 360–380. [Google Scholar] [CrossRef]
- Kingsbury, M.; Dupuis, G.; Jacka, F.; Roy-Gagnon, M.-H.; McMartin, S.E.; Colman, I. Associations between fruit and vegetable consumption and depressive symptoms: Evidence from a national Canadian longitudinal survey. J. Epidemiol. Community Health 2016, 70, 155. [Google Scholar] [CrossRef]
- Hoare, E.; Hockey, M.; Ruusunen, A.; Jacka, F.N. Does fruit and vegetable consumption during adolescence predict adult depression? A longitudinal study of US adolescents. Front. Psych. 2018, 13, 581. [Google Scholar] [CrossRef]
- Winpenny, E.M.; van Harmelen, A.-L.; White, M.; van Sluijs, E.M.F.; Goodyer, I.M. Diet quality and depressive symptoms in adolescence: No cross-sectional or prospective associations following adjustment for covariates. Public. Health Nutr. 2018, 21, 2376–2384. [Google Scholar] [CrossRef] [PubMed]
- Singh, B.; Olds, T.; Curtis, R.; Dumuid, D.; Virgara, R.; Watson, A.; Szeto, K.; Connor, E.; Ferguson, T.; Eglitis, E.; et al. Effectiveness of physical activity interventions for improving depression, anxiety and distress: An overview of systematic reviews. Br. J. Sports Med. 2023, 57, 1203. [Google Scholar] [CrossRef]
- Chai, W.; Nigg, C.R.; Pagano, I.S.; Motl, R.W.; Horwath, C.; Dishman, R.K. Associations of quality of life with physical activity, fruit and vegetable consumption, and physical inactivity in a free living, multiethnic population in Hawaii: A longitudinal study. Int. J. Behav. Nutr. Phys. Act. 2010, 7, 83. [Google Scholar] [CrossRef] [PubMed]
- Tuck, N.-J.; Farrow, C.; Thomas, J.M. Assessing the effects of vegetable consumption on the psychological health of healthy adults: A systematic review of prospective research. AJCN 2019, 110, 196–211. [Google Scholar] [CrossRef]
- Noble, N.; Paul, C.; Turon, H.; Oldmeadow, C. Which modifiable health risk behaviours are related? A systematic review of the clustering of Smoking, Nutrition, Alcohol and Physical activity (‘SNAP’) health risk factors. Prev. Med. 2015, 81, 16–41. [Google Scholar] [CrossRef] [PubMed]
- Kessler, R.C.; Andrews, G.; Colpe, L.J.; Hiripi, E.; Mroczek, D.K.; Normand, S.L.T.; Walters, E.E.; Zaslavsky, A.M. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol. Med. 2002, 32, 959–976. [Google Scholar] [CrossRef]
- Thelin, C.; Mikkelsen, B.; Laier, G.; Turgut, L.; Henriksen, B.; Olsen, L.R.; Larsen, J.K.; Arnfred, S. Danish translation and validation of Kessler’s 10-item psychological distress scale—K10. Nord. J. Psychiatry 2017, 71, 411–416. [Google Scholar] [CrossRef]
- Donker, T.; Comijs, H.; Cuijpers, P.; Terluin, B.; Nolen, W.; Zitman, F.; Penninx, B. The validity of the Dutch K10 and extended K10 screening scales for depressive and anxiety disorders. Psychiatry Res. 2010, 176, 45–50. [Google Scholar] [CrossRef]
- Andrews, G.; Slade, T. Interpreting scores on the Kessler Psychological Distress Scale (K10). Aust. N. Z. J. Public. Health 2001, 25, 494–497. [Google Scholar] [CrossRef]
- Cornelius, B.L.R.; Groothoff, J.W.; van der Klink, J.J.L.; Brouwer, S. The performance of the K10, K6 and GHQ-12 to screen for present state DSM-IV disorders among disability claimants. BMC Public. Health 2013, 13, 128. [Google Scholar] [CrossRef] [PubMed]
- National Health and Medical Research Council (NHMRC). Australian Dietary Guidelines; NHMRC: Canberra, Australian, 2013. [Google Scholar]
- National Health and Medical Research Council (NHMRC). Australian GUIDELINES to reduce Health Risks from Drinking Alcohol; NHMRC: Canberra, Australian, 2020. [Google Scholar]
- Australian Bureau of Statistics (ABS). National Health Survey methodology. Available online: https://www.abs.gov.au/methodologies/national-health-survey-methodology/2022 (accessed on 2 June 2025).
- Lee, J.; Allen, J. Gender Differences in Healthy and Unhealthy Food Consumption and Its Relationship with Depression in Young Adulthood. Community Ment. Health J. 2021, 57, 898–909. [Google Scholar] [CrossRef] [PubMed]
- Osayomi, T.; Adegboye, O.A. Gender and Psychological Distress: A Geographical Perspective. Pap. Appl. Geogr. 2017, 3, 30–43. [Google Scholar] [CrossRef]
- Barrett, C.E.; Jiang, M.; O’Flaherty, B.G.; Dias, B.G.; Rainnie, D.G.; Young, L.J.; Menigoz, A. Early life exposure to high fructose diet induces metabolic dysregulation associated with sex-specific cognitive impairment in adolescent rats. J. Nutr. Biochem. 2023, 114, 109220. [Google Scholar] [CrossRef]
- Kloster, A.; Hyer, M.M.; Dyer, S.; Salome-Sanchez, C.; Neigh, G.N. High Fructose Diet Induces Sex-specific Modifications in Synaptic Respiration and Affective-like Behaviors in Rats. Neuroscience 2021, 454, 40–50. [Google Scholar] [CrossRef]
- Lewis, M.; Lee, A.J. Dietary inequity? A systematic scoping review of dietary intake in low socio-economic groups compared with high socio-economic groups in Australia. Public. Health Nutr. 2021, 24, 393–411. [Google Scholar] [CrossRef] [PubMed]
- Giskes, K.; Turrell, G.; Patterson, C.; Newman, B. Socio-economic differences in fruit and vegetable consumption among Australian adolescents and adults. Public. Health Nutr. 2002, 5, 663–669. [Google Scholar] [CrossRef]
- Alpers, S.E.; Pallesen, S.; Vold, J.H.; Haug, E.; Lunde, L.-H.; Skogen, J.C.; Mamen, A.; Mæland, S.; Fadnes, L.T. The association between psychological distress and alcohol consumption and physical activity: A population-based cohort study. Front. Psychiatry 2023, 14, 1181046. [Google Scholar] [CrossRef]
- Viertiö, S.; Kiviruusu, O.; Piirtola, M.; Kaprio, J.; Korhonen, T.; Marttunen, M.; Suvisaari, J. Factors contributing to psychological distress in the working population, with a special reference to gender difference. BMC Public. Health 2021, 21, 611. [Google Scholar] [CrossRef]
- Piumatti, G.; Lietz, F.; Aresi, G.; Bjegovic-Mikanovic, V. Alcohol use, psychological distress, and subjective well-being among young adult university students: A cross-national study between Serbia and Italy. J. Ethn. Subst. Abus. 2019, 18, 511–529. [Google Scholar] [CrossRef]
- Dharmayani, P.N.A.; Mihrshahi, S. The prevalence of psychological distress and its associated sociodemographic factors in the Australian adults aged 18–64 years during COVID-19: Data from the Australian National Health Survey. J. Affect. Disord. 2025, 368, 312–319. [Google Scholar] [CrossRef] [PubMed]
- Farhane-Medina, N.Z.; Luque, B.; Tabernero, C.; Castillo-Mayén, R. Factors associated with gender and sex differences in anxiety prevalence and comorbidity: A systematic review. Sci. Prog. 2022, 105, 00368504221135469. [Google Scholar] [CrossRef] [PubMed]
- Salk, R.H.; Hyde, J.S.; Abramson, L.Y. Gender differences in depression in representative national samples: Meta-analyses of diagnoses and symptoms. Psychol. Bull. 2017, 143, 783–822. [Google Scholar] [CrossRef] [PubMed]
- Australian Bureau of Statistics (ABS). Long-Term Health Conditions. Available online: https://www.abs.gov.au/articles/long-term-health-conditions (accessed on 10 December 2024).
- Vicente, A.R.; Manganaris, G.A.; Darre, M.; Ortiz, C.M.; Sozzi, G.O.; Crisosto, C.H. Chapter 19—Compositional determinants of fruit and vegetable quality and nutritional value. In Postharvest Handling, 4th ed.; Florkowski, W.J., Banks, N.H., Shewfelt, R.L., Prussia, S.E., Eds.; Academic Press: San Diego, CA, USA, 2022; pp. 565–619. [Google Scholar]
- Sahle, B.W.; Reavley, N.J.; Li, W.; Morgan, A.J.; Yap, M.B.H.; Reupert, A.; Jorm, A.F. The association between adverse childhood experiences and common mental disorders and suicidality: An umbrella review of systematic reviews and meta-analyses. Eur. Child. Adolesc. Psychiatry 2022, 31, 1489–1499. [Google Scholar] [CrossRef]
Item | Number (%) of Respondents | |
---|---|---|
Psychological distress | ||
Low distress | 30,862 (67.5%) | |
Moderate distress | 9094 (19.9%) | |
High distress | 3832 (8.4%) | |
Very high distress | 1914 (4.2%) | |
Usual daily servings of vegetables | ||
1 or less | 12,854 (28.1%) | |
2 servings | 12,714 (27.8%) | |
3 to 4 servings | 15,725 (34.4%) | |
5 or more | 4424 (9.7%) | |
Usual daily servings of fruit | ||
1 or less | 22,690 (49.6%) | |
2 servings | 13,323 (29.1%) | |
3 to 4 servings | 8656 (18.9%) | |
5 or more | 1048 (2.3%) | |
Year | ||
2012 | 15,387 (33.7%) | |
2015 | 14,469 (31.6%) | |
2018 | 15,861 (34.7%) | |
Sex | ||
Male | 21,068 (46.1%) | |
Female | 24,649 (53.9%) | |
Age | ||
18–29 | 6975 (15.3%) | |
30–44 | 12,617 (27.6%) | |
45–59 | 11,900 (26.0%) | |
60–74 | 9875 (21.6%) | |
75 and over | 4350 (9.5%) | |
Level of exercise undertaken in past week | ||
High | 4920 (10.8%) | |
Moderate | 10,046 (22.0%) | |
Low | 14,514 (31.8%) | |
Sedentary | 16,218 (35.5%) | |
Alcohol exceeded drinking guidelines | ||
No | 33,867 (75.0%) | |
Yes | 11,284 (25.0%) | |
Frequency of alcohol consumption | ||
Less than once per month | 15,251 (33.8%) | |
1 to 3 days per month | 7983 (17.7%) | |
1 to 2 days per week | 9389 (20.8%) | |
3 to 7 days per week | 12,436 (27.6%) | |
Smoking status | ||
Never smoked | 22,619 (49.5%) | |
Ex smoker | 15,087 (33.0%) | |
Current smoker | 8011 (17.5%) | |
Income quintiles | ||
First quintile (lowest 20%) | 5754 (14.1%) | |
Second quintile | 9323 (22.8%) | |
Third quintile | 8552 (20.9%) | |
Fourth quintile | 8620 (21.1%) | |
Fifth quintile (highest 20%) | 8573 (21.0%) | |
Highest education level achieved | ||
Year 11 and below | 11,955 (26.2%) | |
Year 12 or Certificate | 16,621 (36.4%) | |
Diploma or Advanced Diploma | 4936 (10.8%) | |
Bachelor or Postgraduate qualification | 12,205 (26.7%) | |
Bodily pain experienced in the past four weeks | ||
No pain | 13,828 (30.2%) | |
Very mild or mild pain | 18,780 (41.1%) | |
Moderate pain | 8951 (19.6%) | |
Severe or very severe pain | 4158 (9.1%) | |
Number of Long-Term Current Conditions | ||
No conditions | 4465 (9.8%) | |
1 to 2 | 14,874 (32.5%) | |
3 to 5 | 15,635 (34.2%) | |
6 or more | 10,743 (23.5%) | |
Body Mass Index (BMI) | ||
Underweight | 527 (1.2%) | |
Healthy weight | 14,010 (32.5%) | |
Overweight | 15,541 (36.0%) | |
Obese | 13,080 (30.3%) | |
Self-assessed Health | ||
Fair or poor | 7586 (16.6%) | |
Good | 13,544 (29.6%) | |
Very good | 16,013 (35.0%) | |
Excellent | 8574 (18.8%) |
Psychological Distress | χ2 | p-Value | Sex | χ2 | p-Value | ||||
---|---|---|---|---|---|---|---|---|---|
Item | Low or Moderate | High or Very High | Male | Female | |||||
Psychological distress | |||||||||
Low distress | 49.97 | 50.03 | 136.22 | <0.001 | |||||
Moderate distress | 41.60 | 58.40 | |||||||
High distress | |||||||||
Very high distress | |||||||||
Usual daily servings of vegetables | |||||||||
1 or less | 83.88 | 16.12 | 304.87 | <0.001 | 56.40 | 43.60 | 474.55 | <0.001 | |
2 servings | 88.66 | 11.34 | 48.35 | 51.65 | |||||
3 to 4 servings | 90.05 | 9.95 | 44.72 | 55.28 | |||||
5 or more | 90.65 | 9.35 | 42.53 | 57.47 | |||||
Usual daily servings of fruit | |||||||||
1 or less | 86.02 | 13.98 | 156.1 | <0.001 | 53.88 | 46.12 | 480.72 | <0.001 | |
2 servings | 89.96 | 10.04 | 43.11 | 56.89 | |||||
3 to 4 servings | 89.71 | 10.29 | 44.34 | 55.66 | |||||
5 or more | 88.39 | 11.61 | 52.23 | 47.77 | |||||
Year | |||||||||
2012 | 89.13 | 10.87 | 52.88 | <0.001 | 48.12 | 51.88 | 2.13 | <0.001 | |
2015 | 88.19 | 11.81 | 49.14 | 50.86 | |||||
2018 | 86.46 | 13.54 | 48.49 | 51.51 | |||||
Sex | |||||||||
Male | 89.73 | 10.27 | 136.22 | <0.001 | |||||
Female | 86.17 | 13.83 | |||||||
Age | |||||||||
18–29 | 86.12 | 13.88 | 70.6 | <0.001 | 50.86 | 49.14 | 39.05 | <0.001 | |
30–44 | 88.58 | 11.42 | 48.81 | 51.19 | |||||
45–59 | 87.16 | 12.84 | 48.69 | 51.31 | |||||
60–74 | 89.06 | 10.94 | 49.03 | 50.97 | |||||
75 and over | 90.35 | 9.65 | 50.86 | 49.14 | |||||
Level of exercise undertaken in past week | |||||||||
High | 93.32 | 6.68 | 612 | <0.001 | 61.59 | 38.41 | 489.71 | <0.001 | |
Moderate | 91.53 | 8.47 | 51.13 | 48.87 | |||||
Low | 88.67 | 11.33 | 44.68 | 55.32 | |||||
Sedentary | 83.15 | 16.85 | 47.21 | 52.79 | |||||
Alcohol exceeded drinking guidelines | |||||||||
No | 87.51 | 12.49 | 26.29 | <0.001 | 42.78 | 57.22 | 2252.87 | <0.001 | |
Yes | 89.32 | 10.68 | 68.79 | 31.21 | |||||
Frequency of alcohol consumption | |||||||||
Less than once per month | 84.57 | 15.43 | 286.16 | <0.001 | 35.74 | 64.26 | 2157.43 | <0.001 | |
1 to 3 days per month | 87.88 | 12.12 | 46.96 | 53.04 | |||||
1 to 2 days per week | 90.34 | 9.66 | 55.55 | 44.45 | |||||
3 to 7 days per week | 90.44 | 9.56 | 62.90 | 37.10 | |||||
Smoking status | |||||||||
Never smoked | 90.57 | 9.43 | 881.45 | <0.001 | 42.10 | 57.90 | 925.2 | <0.001 | |
Ex smoker | 88.72 | 11.28 | 56.16 | 43.84 | |||||
Current smoker | 77.86 | 22.14 | 57.00 | 43.00 | |||||
Income quintiles | |||||||||
First quintile (lowest 20%) | 82.61 | 17.39 | 972.73 | <0.001 | 38.71 | 61.29 | 2462.72 | <0.001 | |
Second quintile | 81.29 | 18.71 | 38.51 | 61.49 | |||||
Third quintile | 87.32 | 12.68 | 43.92 | 56.08 | |||||
Fourth quintile | 91.41 | 8.59 | 55.53 | 44.47 | |||||
Fifth quintile (highest 20%) | 94.69 | 5.31 | 70.78 | 29.22 | |||||
Highest education level achieved | |||||||||
Year 11 and below | 82.87 | 17.13 | 594.06 | <0.001 | 43.18 | 56.82 | 613.95 | <0.001 | |
Year 12 or Certificate | 86.89 | 13.11 | 56.17 | 43.83 | |||||
Diploma or Advanced Diploma | 89.37 | 10.63 | 43.94 | 56.06 | |||||
Bachelor or Postgraduate qualification | 93.09 | 6.91 | 45.66 | 54.34 | |||||
Bodily pain experienced in the past four weeks | |||||||||
No pain | 94.16 | 5.84 | 2597.38 | <0.001 | 52.07 | 47.93 | 226.4 | <0.001 | |
Very mild or mild pain | 90.32 | 9.68 | 50.07 | 49.93 | |||||
Moderate pain | 81.38 | 18.62 | 44.79 | 55.21 | |||||
Severe or very severe pain | 66.42 | 33.58 | 40.66 | 59.34 | |||||
Number of long-term current conditions | |||||||||
No conditions | 95.73 | 4.27 | 3037.22 | <0.001 | 59.36 | 40.64 | 512.95 | <0.001 | |
1 to 2 | 93.89 | 6.11 | 51.45 | 48.55 | |||||
3 to 5 | 88.43 | 11.57 | 47.22 | 52.78 | |||||
6 or more | 72.10 | 27.90 | 41.30 | 58.70 | |||||
Body Mass Index (BMI) ^ | |||||||||
Underweight | 84.72 | 15.28 | 189.72 | <0.001 | 32.87 | 67.13 | 1182.66 | <0.001 | |
Healthy weight | 88.97 | 11.03 | 39.37 | 60.63 | |||||
Overweight | 89.75 | 10.25 | 93.41 | 6.59 | |||||
Obese | 84.73 | 15.27 | 50.29 | 49.71 | |||||
Self-assessed Health ^ | |||||||||
Fair or poor | 64.12 | 35.88 | 4687.53 | <0.001 | 49.26 | 50.74 | 10.38 | 0.086 | |
Good | 87.46 | 12.54 | 50.00 | 50.00 | |||||
Very good | 93.39 | 6.61 | 48.29 | 51.71 | |||||
Excellent | 96.53 | 3.47 | 48.39 | 51.61 |
Model 1 | Model 2 | Model 3 | |||||
---|---|---|---|---|---|---|---|
OR (95%CI) | p | OR (95%CI) | p | OR (95%CI) | p | ||
Usual daily serving of vegetables | |||||||
1 or less | 1.00 (Ref) | 1.00 (Ref) | 1.00 (Ref) | ||||
2 servings | 0.68 (0.61–0.76) | <0.001 | 0.74 (0.65–0.83) | <0.001 | 0.77 (0.68–0.88) | <0.001 | |
3 to 4 servings | 0.60 (0.54–0.67) | <0.001 | 0.66 (0.59–0.73) | <0.001 | 0.66 (0.58–0.75) | <0.001 | |
5 or more | 0.56 (0.48–0.66) | <0.001 | 0.66 (0.56–0.78) | <0.001 | 0.61 (0.50–0.74) | <0.001 | |
Usual daily serving of fruit | |||||||
1 or less | 1.00 (Ref) | 1.00 (Ref) | 1.00 (Ref) | ||||
2 servings | 0.72 (0.65–0.80) | <0.001 | 0.82 (0.74–0.91) | <0.001 | 0.89 (0.80–0.99) | 0.027 | |
3 to 4 servings | 0.78 (0.68–0.88) | <0.001 | 0.90 (0.79–1.03) | 0.11 | 0.92 (0.80–1.11) | 0.22 | |
5 or more | 0.91 (0.70–1.19) | 0.47 | 0.96 (0.71–1.29) | 0.78 | 1.03 (0.71–1.51) | 0.86 | |
Year | |||||||
2012 | 1.00 (Ref) | 1.00 (Ref) | 1.00 (Ref) | ||||
2015 | 1.08 (0.98–1.20) | 0.11 | 1.12 (1.02–1.24) | 0.024 | 1.10 (0.99–1.22) | 0.07 | |
2018 | 1.28 (1.18–1.39) | <0.001 | 1.33 (1.22–1.44) | <0.001 | 1.31 (1.19–1.44) | <0.001 | |
Sex | |||||||
Male | 1.00 (Ref) | 1.00 (Ref) | 1.00 (Ref) | ||||
Female | 1.53 (1.42–1.64) | <0.001 | 1.45 (1.34–1.58) | <0.001 | 1.08 (0.98–1.19) | 0.13 | |
Age | |||||||
18–29 | 1.00 (Ref) | 1.00 (Ref) | 1.00 (Ref) | ||||
30–44 | 0.82 (0.72–0.94) | 0.006 | 0.75 (0.65–0.87) | <0.001 | 0.75 (0.65–0.88) | <0.001 | |
45–59 | 0.98 (0.86–1.13) | 0.79 | 0.85 (0.74–0.98) | 0.030 | 0.43 (0.36–0.50) | <0.001 | |
60–74 | 0.85 (0.74–0.98) | 0.027 | 0.75 (0.64–0.88) | <0.001 | 0.19 (0.17–0.23) | <0.001 | |
75 and over | 0.73 (0.61–0.88) | 0.001 | 0.58 (0.48–0.71) | <0.001 | 0.11 (0.09–0.14) | <0.001 | |
Level of exercise undertaken in past week | |||||||
High | 1.00 (Ref) | 1.00 (Ref) | |||||
Moderate | 1.25 (1.05–1.49) | 0.012 | 1.16 (0.95–1.42) | 0.14 | |||
Low | 1.60 (1.35–1.89) | <0.001 | 1.31 (1.08–1.59) | 0.007 | |||
Sedentary | 2.24 (1.89–2.65) | <0.001 | 1.61 (1.33–1.96) | <0.001 | |||
Frequency of alcohol consumption | |||||||
Less than once per month | 1.00 (Ref) | 1.00 (Ref) | |||||
1 to 3 days per month | 0.78 (0.70–0.86) | <0.001 | 0.85 (0.76–0.96) | 0.01 | |||
1 to 2 days per week | 0.62 (0.55–0.70) | <0.001 | 0.77 (0.67–0.88) | <0.001 | |||
3 to 7 days per week | 0.60 (0.54–0.66) | <0.001 | 0.74 (0.66–0.83) | <0.001 | |||
Smoking status | |||||||
Never smoked | 1.00 (Ref) | 1.00 (Ref) | |||||
Ex-smoker | 1.48 (1.34–1.64) | <0.001 | 1.20 (1.08–1.35) | 0.002 | |||
Current smoker | 2.75 (2.48–3.04) | <0.001 | 2.07 (1.82–2.36) | <0.001 | |||
Income quintiles | |||||||
First quintile (lowest 20%) | 1.00 (Ref) | ||||||
Second quintile | 0.99 (0.87–1.12) | 0.84 | |||||
Third quintile | 0.67 (0.59–0.77) | <0.001 | |||||
Fourth quintile | 0.49 (0.42–0.57) | <0.001 | |||||
Fifth quintile (highest 20%) | 0.39 (0.33–0.47) | <0.001 | |||||
Highest education level achieved | |||||||
Year 11 and below | 1.00 (Ref) | ||||||
Year 12 or Certificate | 0.81 (0.73–0.91) | <0.001 | |||||
Diploma or Advanced Diploma | 0.79 (0.65–0.94) | 0.011 | |||||
Bachelor’s or Postgraduate qualification | 0.63 (0.53–0.73) | <0.001 | |||||
Bodily pain experienced in the past four weeks | |||||||
No pain | 1.00 (Ref) | ||||||
Very mild or mild pain | 1.40 (1.21–1.61) | <0.001 | |||||
Moderate pain | 2.23 (1.89–2.62) | <0.001 | |||||
Severe or very severe pain | 4.01 (3.42–4.69) | <0.001 | |||||
Number of Long-Term Current Conditions | |||||||
No conditions | 1.00 (Ref) | ||||||
1 to 2 | 1.93 (1.49–2.49) | <0.001 | |||||
3 to 5 | 4.30 (3.37–5.47) | <0.001 | |||||
6 or more | 12.33 (9.42–16.13) | <0.001 |
Male | Female | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Model 1 | Model 2 | Model 3 | Model 1 | Model 2 | Model 3 | ||||||||
OR (95%CI) | p | OR (95%CI) | p | OR (95%CI) | p | OR (95%CI) | p | OR (95%CI) | p | OR (95%CI) | p | ||
Usual daily serving of vegetables | |||||||||||||
1 or less | 1.00 (Ref) | 1.00 (Ref) | 1.00 (Ref) | 1.00 (Ref) | 1.00 (Ref) | 1.00 (Ref) | |||||||
2 serving | 0.66 (0.56–0.77) | <0.001 | 0.79 (0.60–0.84) | <0.001 | 0.81 (0.66–0.98) | 0.033 | 0.68 (0.59–0.78) | <0.001 | 0.74 (0.64–0.85) | <0.001 | 0.73 (0.62–0.86) | 0.66 (0.56–0.77) | |
3 to 4 serving | 0.67 (0.56–0.791) | <0.001 | 0.72 (0.60–0.86) | <0.001 | 0.74 (0.59–0.94) | 0.014 | 0.55 (0.49–0.63) | <0.001 | 0.61 (0.54–0.70) | <0.001 | 0.60 (0.52–0.68) | 0.67 (0.56–0.791) | |
5 or more | 0.76 (0.57–1.00) | 0.05 | 0.86 (0.64–1.15) | 0.29 | 0.87 (0.61–1.25) | 0.45 | 0.46 (0.37–0.56) | <0.001 | 0.55 (0.44–0.68) | <0.001 | 0.47 (0.38–0.59) | 0.76 (0.57–1.00) | |
Usual daily serving of fruit | |||||||||||||
1 or less | 1.00 (Ref) | 1.00 (Ref) | 1.00 (Ref) | 1.00 (Ref) | 1.00 (Ref) | 1.00 (Ref) | |||||||
2 servings | 0.80 (0.68–0.93) | 0.005 | 0.90 (0.76–1.06) | 0.20 | 0.99 (0.84–1.18) | 0.92 | 0.67 (0.59, 0.765) | <0.001 | 0.78 (0.68–0.89) | <0.001 | 0.83 (0.71–0.97) | 0.017 | |
3 to 4 servings | 0.80 (0.64–1.00) | 0.046 | 0.93 (0.74–1.16) | 0.49 | 0.94 (0.73, 1.22) | 0.64 | 0.76 (0.67–0.86) | <0.001 | 0.88 (0.77–1.00) | 0.05 | 0.90 (0.76–01.06) | 0.21 | |
5 or more | 1.10 (0.69–1.75) | 0.68 | 1.15 (0.71–1.86) | 0.58 | 1.28 (0.70–2.34) | 0.41 | 0.75 (0.55–1.01) | <0.001 | 0.79 (0.55–1.13) | 0.19 | 0.83 (0.55–1.253) | 0.37 | |
Year | |||||||||||||
2012 | 1.00 (Ref) | 1.00 (Ref) | 1.00 (Ref) | REF | 1.00 (Ref) | REF | |||||||
2015 | 1.10 (0.95–1.28) | 0.18 | 1.13 (0.97–1.31) | 0.11 | 1.15 (0.97–1.35) | 0.10 | 1.07 (0.94–1.22) | 0.28 | 1.13 (0.99–1.28) | 0.07 | 1.09 (0.95–1.24) | 0.21 | |
2018 | 1.39 (1.20–1.60) | <0.001 | 1.41 (1.22–1.63) | <0.001 | 1.39 (1.17– 1.66) | <0.001 | 1.22 (1.09–1.35) | 0.001 | 1.28 (1.14–1.43) | <0.001 | 1.28 (1.10–1.48) | 0.001 | |
Age | |||||||||||||
18–29 | 1.00 (Ref) | 1.00 (Ref) | 1.00 (Ref) | 1.00 (Ref) | 1.00 (Ref) | 1.00 (Ref) | |||||||
30–44 | 0.88 (0.79–1.28) | 0.27 | 0.79 (0.63–1.00) | 0.05 | 0.88 (0.68–1.14) | 0.34 | 0.79 (0.67–0.92) | 0.004 | 0.73 (0.62–0.86) | <0.001 | 0.69 (0.57–0.82) | <0.001 | |
45–59 | 0.98 (0.79–1.22) | 0.84 | 0.84 (0.67–1.05) | 0.13 | 0.44 (0.34–0.58) | <0.001 | 0.99 (0.85–1.17) | 0.94 | 0.87 (0.74–1.03) | 0.10 | 0.42 (0.34–0.50) | <0.001 | |
60–74 | 0.89 (0.73–1.10) | 0.28 | 0.76 (0.60–0.95) | 0.019 | 0.19 (0.15–0.24) | <0.001 | 0.83 (0.70–0.98) | 0.032 | 0.75 (0.63–0.90) | 0.002 | 0.20 (0.16–0.24) | <0.001 | |
75 and over | 0.78 (0.59–1.03) | 0.08 | 0.60 (0.44–0.82) | 0.002 | 0.12 (0.08–0.17) | <0.001 | 0.69 (0.54–0.90) | 0.006 | 0.56 (0.42–0.73) | <0.001 | 0.10 (0.08–0.14) | <0.001 | |
Level of exercise undertaken in past week | |||||||||||||
High | 1.00 (Ref) | 1.00 (Ref) | 1.00 (Ref) | 1.00 (Ref) | |||||||||
Moderate | 1.19 (0.94–1.51) | 0.14 | 1.10 (0.86–1.41) | 0.043 | 1.36 (1.05–1.75) | 0.02 | 1.27 (0.97–1.67) | 0.09 | |||||
Low | 1.58 (1.27–1.95) | <0.001 | 1.32 (1.02–1.7) | 0.036 | 1.68 (0.64–0.91) | 0.001 | 1.37 (1.01–1.87) | 0.045 | |||||
Sedentary | 2.04 (1.65–2.52) | <0.001 | 1.42 (1.12–1.82) | 0.005 | 2.49 (1.91–3.24) | <0.001 | 1.86 (1.39–2.48) | <0.001 | |||||
Frequency of alcohol consumption | |||||||||||||
Less than once per month | 1.00 (Ref) | 1.00 (Ref) | 1.00 (Ref) | 1.00 (Ref) | |||||||||
1 to 3 days per month | 0.66 (0.55–0.78) | <0.001 | 0.73 (0.59–0.91) | 0.005 | 0.86 (0.75–0.97) | 0.019 | 0.94 (0.81–1.08) | 0.35 | |||||
1 to 2 days per week | 0.47 (0.40–0.54) | <0.001 | 0.59 (0.50, 0.71) | <0.001 | 0.76 (0.64–0.91) | 0.003 | 0.94 (0.77–1.14) | 0.50 | |||||
3 to 7 days per week | 0.50 (0.43–0.57) | <0.001 | 0.62 (0.53–0.72) | <0.001 | 0.69 (0.60–0.80) | <0.001 | 0.86 (0.73–1.01) | 0.07 | |||||
Smoking status | |||||||||||||
Never smoked | 1.00 (Ref) | 1.00 (Ref) | 1.00 (Ref) | 1.00 (Ref) | |||||||||
Ex-smoker | 1.57 (1.33–1.86) | <0.001 | 1.22 (0.99–1.50) | 0.062 | 1.39 (1.24–1.56) | <0.001 | 1.15 (1.0–1.30) | 0.035 | |||||
Current smoker | 2.78 (2.35–3.17) | <0.001 | 2.01 (1.66–2.44) | <0.001 | 2.77 (2.43–3.15) | <0.001 | 1.10 (1.80–2.46) | <0.001 | |||||
Income quintiles | |||||||||||||
First quintile (lowest 20%) | 1.00 (Ref) | 1.00 (Ref) | |||||||||||
Second quintile | 1.05 (0.85–1.29) | 0.66 | 0.95 (0.81–1.12) | 0.54 | |||||||||
Third quintile | 0.66 (0.53–0.84) | 0.001 | 0.68 (0.56–0.81) | <0.001 | |||||||||
Fourth quintile | 0.43 (0.33–0.57) | <0.001 | 0.55 (0.45–0.66) | <0.001 | |||||||||
Fifth quintile (highest 20%) | 0.36 (0.27–0.47) | <0.001 | 0.44 (0.35–0.56) | <0.001 | |||||||||
Highest education level achieved | |||||||||||||
Year 11 and below | 1.00 (Ref) | 1.00 (Ref) | |||||||||||
Year 12 or Certificate | 0.83 (0.71–0.96) | <0.001 | 0.80 (0.68–0.93) | 0.005 | |||||||||
Diploma or Advanced Diploma | 0.87 (0.65–1.16) | <0.001 | 0.73 (0.59–0.89) | 0.003 | |||||||||
Bachelor or Postgraduate qualification | 0.71 (0.57–0.88) | <0.001 | 0.57 (0.47–0.70) | <0.001 | |||||||||
Bodily pain experienced in the past four weeks | |||||||||||||
No pain | 1.00 (Ref) | 1.00 (Ref) | |||||||||||
Very mild or mild pain | 1.49 (1.21–1.83) | <0.001 | 1.35 (1.11–1.64) | 0.003 | |||||||||
Moderate pain | 2.43 (1.93–3.06) | <0.001 | 2.10 (1.73–2.55) | <0.001 | |||||||||
Severe or very severe pain | 4.91 (3.83–6.29) | <0.001 | 3.51 (2.90–4.24) | <0.001 | |||||||||
Number of Long-Term Current Conditions | |||||||||||||
No conditions | 1.00 (Ref) | 1.00 (Ref) | |||||||||||
1 to 2 | 1.82 (1.28–2.60) | 0.001 | 2.03 (1.35–3.05) | 0.001 | |||||||||
3 to 5 | 3.98 (2.76–5.73) | <0.0001 | 4.61 (3.21–6.61) | <0.001 | |||||||||
6 or more | 12.05 (8.18–17.73) | <0.001 | 12.70 (8.48–19.02) | <0.001 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Gillespie, K.M.; White, M.J.; Kemps, E.; Bartlett, S.E. Vegetable and Fruit Consumption and Psychological Distress: Findings from Australian National Health Survey Data, 2011–2018. Int. J. Environ. Res. Public Health 2025, 22, 1037. https://doi.org/10.3390/ijerph22071037
Gillespie KM, White MJ, Kemps E, Bartlett SE. Vegetable and Fruit Consumption and Psychological Distress: Findings from Australian National Health Survey Data, 2011–2018. International Journal of Environmental Research and Public Health. 2025; 22(7):1037. https://doi.org/10.3390/ijerph22071037
Chicago/Turabian StyleGillespie, Kerri M., Melanie J. White, Eva Kemps, and Selena E. Bartlett. 2025. "Vegetable and Fruit Consumption and Psychological Distress: Findings from Australian National Health Survey Data, 2011–2018" International Journal of Environmental Research and Public Health 22, no. 7: 1037. https://doi.org/10.3390/ijerph22071037
APA StyleGillespie, K. M., White, M. J., Kemps, E., & Bartlett, S. E. (2025). Vegetable and Fruit Consumption and Psychological Distress: Findings from Australian National Health Survey Data, 2011–2018. International Journal of Environmental Research and Public Health, 22(7), 1037. https://doi.org/10.3390/ijerph22071037