Dynamic associations between daily alternate healthy eating index, exercise, sleep, seasonal change and mental distress among young and mature men and women

Background: Diet quality, exercise and sleep are dynamic modifiable factors that impact mental health. However, taking into consideration gender and age-groups as risk factors may be necessary to customize therapies. The purpose of the study was to assess the dynamic interactions between diet quality, and lifestyle factors in relation to mental distress in these sub-groups. Method: A total of 52 adult participants provided 4 week-daily records using the Food-Mood questionnaire. Data were collected for 2 years during the summer and fall seasons. Spearman's correlation as well as multivariate and multilevel regression analyses were used to identify correlations and model the relationships, respectively, between the variables of interest. Results: There was a mild negative correlation between AHEI and K-6 scores;r_s= -0.08 (95% confidence interval = [-0.14, -0.02]). Men and participants aged 30 years or older had lower K-6 scores than women (0.8 vs 1.8, p < 0.001), and younger adults (0.6 vs 1.9, p < 0.001), respectively. Lower K-6 scores associated with 20 min or more exercise compared to days without exercise or exercised less than 20 min (1.2 versus 1.9, p < 0.001). Seasonal changes were associated with alterations in diet quality and mental wellbeing (P < 0.001). Limitations: A convenience sample was used. Conclusion: Our results suggest that adjusting one modifiable factor may lead to improvement in others. In addition, these factors are age and gender dependent. Therefore, customization of dietary and lifestyle factors based on gender and age-groups is recommended to optimize mental wellbeing.