Fruit and Vegetable Intake and Psychological Resilience Among U.S. Adults: A Cross-Sectional Analysis of BRFSS 2023 Data

Articles in Press

Document Type : Research Paper

Author

Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran

Abstract

Psychological resilience, the ability to adapt to adversity and maintain emotional well-being, protects against mental health challenges. This study investigates its association with fruit and vegetable intake among U.S. adults using 2023 Behavioral Risk Factor Surveillance System (BRFSS) data. Daily fruit and vegetable consumption (grams/day) was estimated from frequency responses, assuming 1.5 servings (135 grams) per instance. Resilience was assessed using a composite index based on poor mental health days (_MENTHLTH ≤5 for high resilience) and emotional support (_EMTSUPP 1-2 for high), categorized as high, moderate, or low. Descriptive statistics, t-tests, ANOVA, and chi-square tests were used, with multivariable regressions adjusting for confounders (income, education, smoking). The high-resilience group consumed 420 grams/day (SD=115), compared to 355 grams/day (SD=105) in the low-resilience group (p<0.01, Cohen’s d=0.58). Sixty-seven percent of high-resilience individuals met the WHO ≥400 grams/day recommendation, versus 46% in the low-resilience group (p<0.001). Women and younger adults (18-24 years) in high-resilience groups had higher intakes (p<0.05). Multivariable logistic regression showed higher intake was associated with high resilience (OR=1.45, p<0.01). These findings suggest that nutrient-dense diets may enhance resilience, though longitudinal studies are needed to confirm causality and explore mechanisms like the gut-brain axis.

Keywords

Main Subjects

References

  1. Southwick SM, Charney DS. Resilience: The science of mastering life's greatest challenges: Cambridge University Press; 2018.
  2. Steel Z, Marnane C, Iranpour C, Chey T, Jackson JW, Patel V, et al. The global prevalence of common mental disorders: a systematic review and meta-analysis 1980-2013. Int J Epidemiol. 2014;43(2):476-93.
  3. Seligman ME, Csikszentmihalyi M. Positive psychology. An introduction. Am Psychol. 2000;55(1):5-14.
  4. Berding K, Vlckova K, Marx W, Schellekens H, Stanton C, Clarke G, et al. Diet and the Microbiota-Gut-Brain Axis: Sowing the Seeds of Good Mental Health. Adv Nutr. 2021;12(4):1239-85.
  5. Firth J, Gangwisch JE, Borisini A, Wootton RE, Mayer EA. Food and mood: how do diet and nutrition affect mental wellbeing? Bmj. 2020;369:m2382.
  6. 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).
  7. Mujcic R, A JO. Evolution of Well-Being and Happiness After Increases in Consumption of Fruit and Vegetables. Am J Public Health. 2016;106(8):1504-10.
  8. Bonaccio M, Di Castelnuovo A, Costanzo S, Pounis G, Persichillo M, Cerletti C, et al. Mediterranean-type diet is associated with higher psychological resilience in a general adult population: findings from the Moli-sani study. European journal of clinical nutrition. 2018;72(1):154-60.
  9. Meléndez G, Valero V, Acevedo-Hernández P, Thomas-Valdés S. Impact of polyphenols on stress and anxiety: a systematic review of molecular mechanisms and clinical evidence. Critical Reviews in Food Science and Nutrition. 2022;64:1-18.
  10. Raise-Abdullahi P, Rezvani M, Yousefi F, Rahmani S, Meamar M, Raeis-Abdollahi E, et al. Natural polyphenols as therapeutic candidates for mitigating neuropsychiatric symptoms in post-traumatic stress disorder: Evidence from preclinical studies. Progress in Neuro-Psychopharmacology and Biological Psychiatry. 2025;136:111230.
  11. Rolle-Lake L, Robbins E. Behavioral risk factor surveillance system. 2020.
  12. Bethell C, Jones J, Gombojav N, Linkenbach J, Sege R. Positive Childhood Experiences and Adult Mental and Relational Health in a Statewide Sample: Associations Across Adverse Childhood Experiences Levels. JAMA Pediatr. 2019;173(11):e193007.
  13. van der Velden PG, Contino C, Das M, van Loon P, Bosmans MWG. Anxiety and depression symptoms, and lack of emotional support among the general population before and during the COVID-19 pandemic. A prospective national study on prevalence and risk factors. J Affect Disord. 2020;277:540-8.
  14. Organization WH. The state of food security and nutrition in the world 2020: transforming food systems for affordable healthy diets: Food & Agriculture Org.; 2020.
  15. Connor KM, Davidson JR. Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC). Depress Anxiety. 2003;18(2):76-82.
  16. Carr AC, Maggini S. Vitamin C and Immune Function. Nutrients. 2017;9(11).
  17. Cryan JF, O'Riordan KJ, Cowan CSM, Sandhu KV, Bastiaanssen TFS, Boehme M, et al. The Microbiota-Gut-Brain Axis. Physiol Rev. 2019;99(4):1877-2013.
  18. Wardle J, Haase AM, Steptoe A, Nillapun M, Jonwutiwes K, Bellisle F. Gender differences in food choice: the contribution of health beliefs and dieting. Ann Behav Med. 2004;27(2):107-16.
  19. Feraco A, Armani A, Amoah I, Guseva E, Camajani E, Gorini S, et al. Assessing gender differences in food preferences and physical activity: a population-based survey. Front Nutr. 2024;11:1348456.
  20. Spencer JP. The impact of fruit flavonoids on memory and cognition. Br J Nutr. 2010;104 Suppl 3:S40-7.
  21. Adam TC, Epel ES. Stress, eating and the reward system. Physiol Behav. 2007;91(4):449-58.
  22. López-Cepero A, O'Neill J, Tamez M, Falcón LM, Tucker KL, Rodríguez-Orengo JF, et al. Associations Between Perceived Stress and Dietary Intake in Adults in Puerto Rico. J Acad Nutr Diet. 2021;121(4):762-9.
  23. Bonanno GA, Mancini AD. The human capacity to thrive in the face of potential trauma. Pediatrics. 2008;121(2):369-75.
  24. Ebrahimi S, Shiraseb F, Ladaninezhad M, Navaei N, Izadi A, Mirzaei K. The association between lifestyle risk score and mental health in Iranian overweight and obese women: a cross-sectional study. Front Nutr. 2025;12:1533453.
  25. Gibson-Smith D, Bot M, Brouwer IA, Visser M, Penninx B. Diet quality in persons with and without depressive and anxiety disorders. J Psychiatr Res. 2018;106:1-7.
  26. Bégin C, Berthod J, Martinez LZ, Truchon M. Use of Mobile Apps and Online Programs of Mindfulness and Self-Compassion Training in Workers: A Scoping Review. J Technol Behav Sci. 2022;7(4):477-515.
  27. Jiang H, Ling Z, Zhang Y, Mao H, Ma Z, Yin Y, et al. Altered fecal microbiota composition in patients with major depressive disorder. Brain Behav Immun. 2015;48:186-94.
Journal of Nutrition,Fasting and Health

Articles in Press, Accepted Manuscript
Available Online from 06 September 2025

Files

History

  • Receive Date: 30 April 2025
  • Revise Date: 05 September 2025
  • Accept Date: 06 September 2025

Share

How to cite

Statistics