Dietary patterns, their covariates, and associations with severity of depressive symptoms among university students in Lebanon: a cross-sectional study

Eur J Nutr. 2019 Apr;58(3):997-1008. doi: 10.1007/s00394-018-1614-4. Epub 2018 Jan 19.


Purpose: The study aims to identify dietary patterns in university students in Lebanon, to determine their associations with socio-demographic, lifestyle, and stress factors, and to assess the link between identified dietary patterns and severity of depressive symptoms, controlling for multiple confounders.

Methods: Four hundred and fifty-seven private university students were surveyed. Information about dietary intake, socio-demographic and lifestyle factors, physical activity, and depressive symptoms were collected by the 73-item food frequency questionnaire, background questionnaire, International Physical Activity Questionnaire-Short Form, and Patient Health Questionnaire (PHQ-9), respectively. Dietary patterns were identified by exploratory factor analysis. Multiple linear regression analyses were conducted to (1) identify covariates that were independently associated with dietary patterns and (2) examine the independent associations between each of the dietary patterns and severity of depressive symptoms.

Results: Five dietary patterns were identified: "traditional Lebanese", "Western fast food", "dairy", "Lebanese fast food" and "fruits". Higher scores of traditional Lebanese and fruits patterns were found to be associated with more meals per day, frequent breakfast consumption, and non-smoking. Higher Western fast food diet scores were shown to be associated with male gender, fewer meals per day, less frequent breakfast consumption, more frequent snacking, and alcohol consumption. Higher scores of the dairy pattern were found to be positively associated with hypertension, non-smoking, and frequency of alcohol consumption. Higher Lebanese fast food pattern scores were found to be associated with higher frequency of meal intake while watching TV and alcohol consumption. None of the five dietary patterns showed a significant association with severity of depressive symptoms after controlling for confounders.

Conclusion: Severity of depressive symptoms showed no independent association with the identified dietary patterns.

Keywords: Depressive symptoms; Dietary patterns; Lifestyle; University students.

MeSH terms

  • Adolescent
  • Adult
  • Cross-Sectional Studies
  • Depressive Disorder / epidemiology*
  • Diet / adverse effects
  • Diet / methods*
  • Diet / statistics & numerical data
  • Feeding Behavior*
  • Female
  • Humans
  • Lebanon / epidemiology
  • Life Style
  • Male
  • Severity of Illness Index
  • Sex Factors
  • Students / statistics & numerical data*
  • Surveys and Questionnaires / statistics & numerical data*
  • Universities
  • Young Adult