Dietary macronutrient intake according to sex and trait anxiety level among non-diabetic adults: a cross-sectional study

Abstract

Background Studies suggest that anxiety is correlated with eating behavior, however, little is known about the association between anxiety status as predictor of dietary macronutrient intake. The aim of the present study was to investigate the sex-stratified cross-sectional associations of trait anxiety with intake of various macronutrients in a large population-based sample of non-diabetic adults. Methods N = 20,231 participants (mean age = 53.7 ± 13.6 years) of the NutriNet-Santé web-cohort, who had completed the trait anxiety subscale of the Spielberger State-Trait Anxiety Inventory (T-STAI; 2013–2016) were included in the analyses. Dietary intake was calculated from at least 3 self-administered 24-h dietary records. The associations of interest were assessed by multiple linear regression stratified by sex, owing to significant interaction tests. Results In total, 74.3% (n = 15,033) of the sample were females who had a significantly higher mean T-STAI score than did males (39.0 versus 34.8; p < 0.01). Among females, the fully-adjusted analyses showed significant positive associations of T-STAI with total carbohydrate intake (β = 0.04; p < 0.04), complex carbohydrate intake (β = 0.05; p < 0.02), and percentage energy from carbohydrates (β = 0.01; p < 0.03), as well as a significant inverse association of T-STAI with percentage energy from fat (β = -0.01; p < 0.05). As regards males, the only significant finding was an inverse association between T-STAI and percent of the mean daily energy from protein (fully-adjusted model: β = -0.01; p = 0.05). Conclusion This cross-sectional study found modest sex-specific associations between anxiety status and macronutrient intake among French non-diabetic adults. Prospective studies are needed to further elucidate the observed associations.

A population-based study of macronutrient intake according to mental health status with a focus on pure and comorbid anxiety and eating disorders

“…First, the cross-sectional design does not allow for causal or chronological inference. Prior research has shown that dietary intake and mental health status can mutually impact each other [ 14 , 15 , 58 , 59 ]. Future prospective research in this domain is needed to shed light not only on causality but also on the potential bidirectional association between macronutrient intake and comorbidity of anxiety and ED.…”

“…The higher the score, the greater the proneness to anxiety. Considering the objectives of this study and for purposes of consistency with prior research [ 14 , 15 ], only the trait-anxiety subscale (STAI-T) was used for this analysis. It evaluates trait anxiety, characterized by a relatively stable tendency to exhibit tension and anxiety (i.e., state anxiety) in a variety of situations.…”

“…However, there is a paucity of research on the link between macronutrient intake and anxiety [ 14 – 16 ]. Despite reported associations between trait anxiety and food/nutrient intake [ 14 , 15 , 17 , 19 , 20 ], possible mediating and/or moderating effects of anxiety regarding ED [ 22 – 24 ], and the high ED-anxiety comorbidity [ 3 ], no study, to our knowledge, has investigated dietary/nutrient intake among individuals with such comorbidity. We hypothesized that individuals with anxiety and/or ED have different macronutrient intakes from people without these disorders, and that unfavorable dietary intake (underscored by reduced nutrient diversity) is more pronounced in the case of mental comorbidity.…”

Associations of overall and specific carbohydrate intake with anxiety status evolution in the prospective NutriNet-Santé population-based cohort

“…The higher the score, the greater the proneness to anxiety 42 . Considering the objectives of this study and for purposes of consistency with prior research 10 , 11 , we used only the trait-anxiety subscale (STAI-T). It assesses anxiety proneness as a relatively stable personality feature 31 .…”

“…Regarding anxiety disorders, there is some, albeit inconsistent cross-sectional evidence of the link with overall and specific carbohydrate intake 9 – 11 , glycemic index/load 12 , insulin index 13 , soft drinks 14 , 15 , added sugars 16 , whole grains and fruit intake 17 – 24 . A scoping review of the relationship between diet and prevalence or severity of anxiety concluded that increased intake of sugar and refined carbohydrates was positively associated, while fruit intake was inversely associated with anxiety 25 .…”