The Influence of Diet on

Mental Wellbeing
By Michelle K. Pyke
28 January, 2018
Kulkarni and colleagues explore the relationship between habitual dietary choices
and mental health among adolescents within an ethnically diverse population.
Their results suggest that healthier diets translate into a lower risk of developing a
mental health disorder.
 Pyke 1

The primary question of Kulkarni and colleagues' study was whether following a balanced diet

correlated with a lower risk of suffering from a mental health disorder. 1 The scientists proposed that

nutrition does play a role in the development or progression of mental health disorders.

The influence of diet on one’s mental health has been explored on rare occasions. The authors

note that physical and mental development are achieved primarily during adolescence and are dependent

on adequate nutritional intake. Recent decades suggest that the diet quality of this age group is decreasing

due to higher consumption of artificial and processed food and that adolescent depression is more

prevalent as well. Due to the lack of scientific research in this area, the authors wanted to contribute to

this discussion by studying whether nutrition and mental health have a direct relationship.

The researchers relied on baseline and follow-up measurements derived from the Pacific Obesity

Prevention in Communities (OPIC) project, a study conducted in 2011 that focused on high schools

across four countries; New Zealand was the only country relevant to Kulkarni’s study.2 All participating

schools shared a large Pacific Islander population and low socioeconomic backgrounds. The emotional

functioning subscale of the Pediatric Quality of Life (PedsQL) instrument was used to assess mental

health while a questionnaire originally designed for the OPIC study measured dietary intake. Student

responses were standardized and averaged along a scale from 1 to 4 based on how healthy the eating

behavior was; within the questionnaire, certain responses were categorized as “healthy” while others were

considered “unhealthy,” which enabled the authors to evaluate the sample with two separate data sets.

Given each measure, Kulkarni and colleagues assigned the participants into four equal-sized quartiles

based on performance (see Figure 1). Should the hypothesis hold true, mental health scores and dietary

choices should indicate some relationship. As shown in Figure 1 and Figure 2, the results should indicate

that eating habits influence how high or low mental health scores are. If the hypothesis is false, there

should be no distinguishable difference between students (see Figure 3).

Given 4,249 participants, healthy eating was found to be positively associated with mental health

scores (see Figure 1). The average mental health score was 75.6, with females reporting lower scores than

males (74.2 and 77.2 respectively). The data also indicated differences along racial lines and age, with a
 Pyke 2

higher proportion of European students and younger students, in general, choosing healthy eating habits

(table not included in the report). Focusing solely on the relationship between healthy eating and mental

health, a positive trend emerged after adjusting for external variables (see Figure 1). The hypothesis holds

true. This suggests that dietary choices may influence the mental health of adolescents, with those who

follow a more balanced lifestyle less likely to develop depression and other serious disorders. Some

questions that still remain include whether these findings account for the prevalence of obesity, given that

it is correlated with poor diet and self-esteem. Individuals who follow an unhealthy dietary regime may

not necessarily be obese, but the cultural pressures surrounding adolescents (regarding physical

appearance) may cause severe mental anxiety rather than the habits themselves. Another question is why

there were racial elements involved in the results; specifically, why do European students, despite sharing

socioeconomic status with others, appear to have higher scores for dietary choices.

One fundamental flaw in the study is why the authors chose to associate unhealthy eating

behaviors primarily with the nature of the food rather than certain habits (which were prevalent for

healthy eating behaviors). For instance, healthy eating behaviors included a meal schedule and family

involvement while unhealthy eating behaviors pertained to consuming soft drinks, fried or high-fat foods,

and sweets. I suggest that a new study is conducted in which subjects are evaluated based on habits

developed regarding eating. For example, one measure could be the number of times someone returned

for more servings after the first and whether he or she is mindful of how his or her body responds to

certain foods. Similar to Kulkarni and colleagues’ experiment, participants would be evaluated for mental

health using the PedsQL instrument and will be assigned to a certain quartile depending on performance

for eating habits. My hypothesis is that mental health is positively associated with diet. There may not be

as strong of a correlation between the two variables; this is possible as subjects who primarily consume

takeaways (an “unhealthy” behavior) may rely on only one serving while those who eat at home may

choose to consume higher quantities. Regardless of some exceptions, most of the data should reflect a

similar trend as noted in Figure 1 if the hypothesis is proven to be true.

 Pyke 3

Exhibits

Figure 1: The relationship between healthy eating habits and mental health scores from the PedsQL
instrument after adjusting for sample characteristics (age, gender, and ethnicity).

Figure 2: The correlation between healthy eating habits and mental health scores should the hypothesis
prove true given mental health scores deteriorated as the frequency of healthy eating increased.

79
Mental  Health  Scores

77

75

73

71

69
Q1  (least  healthy) Q2 Q3 Q4  (most  healthy)
Quartiles  of  Healthy  Eating
 Pyke 4

Figure 3: The correlation between healthy eating habits and mental health scores should the hypothesis
prove false given no influence of diet on mental health scores.

79
Mental  Health  Scores

77

75

73

71

69
Q1  (least  healthy) Q2 Q3 Q4  (most  healthy)
Quartiles  of  Healthy  Eating
 Pyke 5

Endnotes

                                                                                                               
1
Kulkarni, AA., BA. Swinburn, J. Utter. 2015. Associations between diet quality and mental health in
socially disadvantaged New Zealand adolescents. European Journal of Clinical Nutrition 69: 79 – 83.
2
Swinburn, BA., L. Miller, J. Utter, P. Kremer, M. Moodie, H. Mavoa, W. Snowdon, MP McCabe, M.
Malakellis, M. de Courten, G. Waga, KF. Fotu, G. Roberts, R. Scragg. 2011. The Pacific Obesity
Prevention in Communities project. Obesity Reviews 12: 3 – 11.