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Are dietary patterns differently associated with differentiated levels of mental health problems? Results from a large cross-sectional study among Iranian manufacturing employees
  1. Zahra Heidari1,
  2. Awat Feizi1,2,
  3. Hamidreza Roohafza2,
  4. Katayoun Rabiei3,
  5. Nizal Sarrafzadegan3
  1. 1 Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, The Islamic Republic of Iran
  2. 2 Isfahan Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, The Islamic Republic of Iran
  3. 3 Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, The Islamic Republic of Iran
  1. Correspondence to Dr Awat Feizi; awat_feiz{at}


Objectives The present study aimed to classify participants based on mental health problems profile and to evaluate its relationship with dietary patterns among Iranian manufacturing employees.

Design Observational study with a cross-sectional design.

Setting This study was conducted in Esfahan Steel Company, one of the biggest Iranian industrial manufacturing companies.

Participants Complete data on 2942 manufacturing employees, with a mean (SD) age of 36.68 (7.31) years, were analysed.

Outcome measures Hospital Anxiety and Depression Scale(HADA) and General Health Questionnaire (GHQ-12) were used to evaluate anxiety and depression and psychological distress, respectively.

Results Three major dietary patterns, namely ‘western’, ‘healthy’ and ‘traditional’, were extracted using factor analysis. A two-class, one-factor structure was identified from study participants in terms of mental health problems profile based on the factor mixture model. Two identified classes were labelled as ‘low mental health problems’ (2683 manufacturing employees, 91.2%) and ‘high mental health problems’ (259 individuals, 8.8%). After adjusting for the impact of potential confounders, manufacturing employees in the highest tertile of healthy dietary pattern had lower odds of being in the high mental health problems profile class (OR=0.67, 95% CI 0.49 to 0.92). In contrast, greater adherence to Western and traditional dietary patterns was associated with increased odds of being in the high mental health problems class (OR=1.66, 95% CI: 1.18 to 2.35 and OR=1.52, 95% CI :1.10 to 2.11, respectively).

Conclusions Our study provided informative pathways on the association of dietary patterns and mental health among manufacturing employees. The findings can be used by workplace health promotion policymakers in improving mental health in such study population. Interventional and prospective studies that investigate the effects of change in dietary patterns on the mental health of manufacturing employees are suggested.

  • mental health
  • dietary Pattern
  • manufacturing employees
  • factor mixture model

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  • Patient consent for publication Obtained.

  • Contributors HR, KR and NS contributed to the conception and design of the study, and collection and assembly of the data. ZH and AF contributed to statistical analysis and interpretation of the data, and drafting of the manuscript.

  • Funding The current study was financially supported ‘in part’ by a grant from the Vice Chancellery for Research and Technology, Isfahan University of Medical Sciences (IUMS).

  • Competing interests None declared.

  • Ethics approval The medical research ethics committee of the Isfahan University of Medical Sciences approved the study protocol (research project number: 87115).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

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