Food Consumption in Association with Perceived Stress and Depressive Symptoms: A Cross Sectional Study from Five Universities and Three Colleges in Gaza Strip, Palestine
University/college period is one of the stressful stage of life, and depressive symptoms and stress are health problems among students worldwide. Understanding nutrition mood associations may enable students to make healthier food choices that lead to a healthier life style. The present study investigated the relationship between food consumption and stress and depressive symptoms among university/college students in Gaza strip, Palestine. A cross sectional survey was undertaken among undergraduates enrolled across 5 universities and 3 colleges in Gaza Strip (n=1409) Self administered questionnaires included a 12 item food frequency questionnaire; Cohen's Perceived Stress Scale and modified Beck Depression Inventory. Gender and university comparisons were performed. Univariable and multivariable regression analyses were computed for each of the two outcomes; perceived stress and depressive symptoms. In general, females consumed sweets, snacks, fresh fruits and salad/raw vegetables and cooked vegetables more commonly than males, whereas males generally consumed fast food/canned food and cake/cookies, meat/sausage products, fish/sea food, cereal/cereal products and dairy/dairy products more commonly than females with differences across various universities/colleges. Perceived stress and depressive symptoms scores were generally higher among females than males. The univariable analysis showed that significant associations between various food groups and perceived stress and depressive symptoms were more evident for males. In addition, for males, all food groups were negatively associated with perceived stress as well as with depressive symptoms. For females, the exceptions of such negative associations were observed with meat/sausage products, fish/sea food and cereal/cereal products for perceived stress, and only with cereal/cereal products for depressive symptoms. The multivariable analysis indicated that frequent consumption of 'unhealthy' food such as sweets/cookies/snacks/fast food was significantly associated with lower perceived stress among males only. In addition, frequent consumption of 'healthy' foods such as fruits/vegetables was significantly associated with lower depressive symptoms, but for both sexes. In conclusion, university/college students used food whether 'unhealthy' or/and 'healthy' as a coping strategy to reduce tremendous and continuous stress due to the imposed Israeli siege since the year 2006 which affects all aspects of life in Gaza strip.