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PLoS One. 2016 Aug 25;11(8):e0161709. doi: 10.1371/journal.pone.0161709. eCollection 2016.

The Cross-Sectional Association between Diet Quality and Depressive Symptomology amongst Fijian Adolescents.

Author information

World Health Organization Collaborating Centre for Obesity Prevention, Deakin University, Geelong, Victoria, Australia.
School of Health and Social Development, Deakin University, Burwood, Victoria, Australia.
Pacific Research Centre for the Prevention of Obesity and Non-Communicable Diseases (C-POND), Fiji National University and Deakin University, Suva, Fiji.
IMPACT Strategic Research Centre, Deakin University, Geelong, Victoria, Australia.
Deakin Health Economics, Faculty of Health, Deakin University, Burwood, Victoria, Australia.
Epidemiology and Global Health Unit, Department of Public Health and Clinical Medicine, Umea University, Umea, Sweden.
School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.



To examine the relationship between diet quality and depressive symptomology amongst a community-based sample of Fijian adolescents.


Participants included 7,237 adolescents (52.6% girls; mean age 15.6 years) at baseline (2005) and 2,948 (56% girls; mean age 17.4 years) at follow-up (2007/2008), from the Pacific Obesity Prevention in Communities Project. Intervention schools (n = 7) were selected from Nasinu, near Suva on the main Fijian island Viti Levu, and comparison schools (n = 11) were chosen from towns on the opposite, west side of the island. A dietary questionnaire was used to measure diet quality. Factor analysis clustered dietary variables into two unique and independent factors, referred to as healthy diet quality and unhealthy diet quality. Depressive symptomology was assessed via the emotional subscale of the Paediatric Quality of Life Inventory. Both measures were self-reported and self-administered. Multiple linear regression was used to test cross-sectional associations (at baseline and follow-up) between diet quality and depressive symptomology. Variables controlled for included gender, age, ethnicity, study condition, BMI-z scores, and physical activity.


Strong, positive dose-response associations between healthy diet and high emotional scores (lower depressive symptomology) were found in cross-sectional analyses at baseline and follow-up, among boys and girls. No association was found between emotional health and unhealthy diet.


This study suggests that cross-sectional relationships exist between a high quality diet during adolescence and less depressive symptoms, however more evidence is required to determine if these two variables are linked causally. Trial population health strategies that use dietary interventions as a mechanism for mental health promotion provide an opportunity to further test these associations. If this is indeed a true relationship, these forms of interventions have the potential to be inexpensive and have substantial reach, especially in Low and Middle Income Countries.


Australian New Zealand Clinical Trials Registry ACTRN12608000345381.

[Indexed for MEDLINE]
Free PMC Article

Conflict of interest statement

The authors of this manuscript have the following competing interests: L Millar, S Allender, W Snowdon, B Swinburn, M Moodie and G Waqa’s institutions have received grants from National Health and Medical Research Council. Support was provided to cover the cost of travel to Investigator meetings. The authors were employed by Deakin University. G Waqa’s institution has received grants, and support to cover the cost of travel to Investigator meetings, from Wellcome Trust. G Waqa’s institution also received support in kind such as writing, provision of medicine or equipment, or administrative support, from Secretariat of the Pacific Community grants for school-based interventions. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

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