Adherence to the dietary guidelines for Americans is associated with psychological resilience in young adults : a cross-sectional study / Laura J. Lutz, Erin Gaffney-Stomberg, Kelly W. Williams, Susan M. McGraw, Philip J. Niro, J. Philip Karl, Sonya J. Cable, Thomas L. Cropper, James P. McClung

Background: The 2010 Healthy Eating Index (HEI-2010), a measure of diet quality, is used to quantify adherence to the Dietary Guidelines for Americans. Better HEI scores have been associated with positive health outcomes; however, the relationship between diet quality and psychological resilience, a mental health attribute for coping with adversity, has not been assessed. Objective: The objective of the present study was to assess the relationship between diet quality and psychological resilience, and the relationship between resilience and demographics, anthropometrics, socioeconomic status, and health behavior. Design: In this cross-sectional study, HEI-2010 scores and resilience were assessed using the Block food frequency questionnaire and the Connor-Davidson Resilience Scale. Other factors that can affect the relationship between HEI-2010 scores and resilience were assessed using surveys, and height and weight were measured to calculate body mass index. Participants/setting: Male and female Army and Air Force recruits (n=834) enrolled in a randomized controlled trial and 656 (mean±standard deviation [SD] age=21±3.3 years) were included in this analysis. Data were collected before the initiation of military training at Fort Sill, OK (2012-2013) and Lackland Air Force Base, TX (2013-2014). Statistical analysis performed: Participants were split into low- and high-resilience groups based on Connor-Davidson Resilience Scale scores. Student's t test and χ2 tests were used to determine differences between groups for continuous and categorical variables, respectively. Logistic regression was utilized to identify predictors of resilience. Results: Better diet quality was associated with resilience; higher HEI predicted an increased likelihood (odds ratio=1.02; 95% CI 1.01 to 1.04) of a participant being in the high-resilience group after including race, ethnicity, education, smoking, age, body mass index, sex, and military branch in the full model. The data indicate that with every 10-point increase in HEI score, there was a 22% increased likelihood of being in the high-resilience group. Conclusions: Registered dietitian nutritionists should continue to encourage attainable changes to improve diet; study data suggest that small improvements in diet quality can be associated with better psychological resilience.

Nutrition.