Optimism and Diet Quality in the Women's Health Initiative

Published:February 18, 2014DOI:https://doi.org/10.1016/j.jand.2013.12.018

      Abstract

      Diet quality has not been well studied in relation to positive psychological traits. Our purpose was to investigate the relationship between optimism and diet quality in postmenopausal women enrolled in the Women's Health Initiative observational study (OS) and clinical trials (CTs), and to determine whether optimism was associated with diet change after a 1-year dietary intervention. Diet quality was scored with the Alternate Healthy Eating Index (AHEI) and optimism assessed with the Life Orientation Test-Revised. Baseline characteristics were compared across AHEI quintiles or optimism tertiles using regression models with each variable of interest as a function of quintiles or tertiles (OS, n=87,630; CT, n=65,360). Association between optimism and baseline AHEI and change in AHEI over 1 year were tested using multivariate linear regression (CT, n=13,645). Potential interaction between optimism and trial arm and demographic/lifestyle factors on AHEI change was tested using likelihood ratio test (CT intervention, n=13,645; CT control, n=20,242). Women reporting high AHEI were non-Hispanic white, educated, physically active, past or never smokers, hormone therapy users, had lower body mass index and waist circumference, and were less likely to have chronic conditions. In the CT intervention, higher optimism was associated with higher AHEI at baseline and with greater change over 1 year (P=0.001). Effect modification by intervention status was observed (P=0.014), whereas control participants with highest optimism achieved threefold greater AHEI increase compared with those with the lowest optimism. These data support a relationship between optimism and dietary quality score in postmenopausal women at baseline and over 1 year.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of the Academy of Nutrition and Dietetics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Pressman S.D.
        • Cohen S.
        Does positive affect influence health?.
        Psychol Bull. 2005; 131: 925-971
        • Boehm J.K.
        • Kubzansky L.D.
        The heart's content: The association between positive psychological well-being and cardiovascular health.
        Psychol Bull. 2012; 138: 655-691
        • Chida Y.
        • Steptoe A.
        Positive psychological well-being and mortality: A quantitative review of prospective observational studies.
        Psychosom Med. 2008; 70: 741-756
        • Steptoe A.
        • Demakakos P.
        • de Oliveira C.
        • Wardle J.
        Distinctive biological correlates of positive psychological well-being in older men and women.
        Psychosom Med. 2012; 74: 501-508
        • Segerstrom S.C.
        • Sephton S.E.
        Optimistic expectancies and cell-mediated immunity: The role of positive affect.
        Psychol Sci. 2010; 21: 448-455
        • Steptoe A.
        • Dockray S.
        • Wardle J.
        Positive affect and psychobiological processes relevant to health.
        J Pers. 2009; 77: 1747-1776
        • Kubzansky L.D.
        • Thurston R.C.
        Emotional vitality and incident coronary heart disease: Benefits of healthy psychological functioning.
        Arch Gen Psychiatry. 2007; 64: 1393-1401
        • Walter-Ginzburg A.
        • Shmotkin D.
        • Blumstein T.
        • Shorek A.
        A gender-based dynamic multidimensional longitudinal analysis of resilience and mortality in the old-old in Israel: The cross-sectional and longitudinal aging study (CALAS).
        Soc Sci Med. 2005; 60: 1705-1715
        • Ikeda A.
        • Schwartz J.
        • Peters J.L.
        • et al.
        Optimism in relation to inflammation and endothelial dysfunction in older men: The VA Normative Aging Study.
        Psychosom Med. 2011; 73: 664-671
        • Roy B.
        • Diez-Roux A.V.
        • Seeman T.
        • Ranjit N.
        • Shea S.
        • Cushman M.
        Association of optimism and pessimism with inflammation and hemostasis in the Multi-Ethnic Study of Atherosclerosis (MESA).
        Psychosom Med. 2010; 72: 134-140
        • Giltay E.J.
        • Kamphuis M.H.
        • Kalmijn S.
        • Zitman F.G.
        • Kromhout D.
        Dispositional optimism and the risk of cardiovascular death: The Zutphen Elderly Study.
        Arch Intern Med. 2006; 166: 431-436
        • Tindle H.A.
        • Chang Y.F.
        • Kuller L.H.
        • et al.
        Optimism, cynical hostility, and incident coronary heart disease and mortality in the Women's Health Initiative.
        Circulation. 2009; 120: 656-662
        • Scheier M.F.
        • Carver C.S.
        • Bridges M.W.
        Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): A reevaluation of the Life Orientation Test.
        J Pers Soc Psychol. 1994; 67: 1063-1078
      1. Progovac A, Chang YF, Matthews K, et al. Psychological attitudes predict smoking cessation over time in the Women's Health Initiative (WHI). Abstract #POS4-16. Presented at Society for Research on Nicotine and Tobacco International Meeting, Boston, MA, March 13-16, 2013.

        • Tindle H.
        • Belnap B.H.
        • Houck P.R.
        • et al.
        Optimism, response to treatment of depression, and rehospitalization after coronary artery bypass graft surgery.
        Psychosom Med. 2012; 74: 200-207
        • Tinker L.F.
        • Rosal M.C.
        • Young A.F.
        • et al.
        Predictors of dietary change and maintenance in the Women's Health Initiative Dietary Modification Trial.
        J Am Diet Assoc. 2007; 107: 1155-1166
        • Boehm J.K.
        • Williams D.R.
        • Rimm E.B.
        • Ryff C.
        • Kubzansky L.D.
        Association between optimism and serum antioxidants in the midlife in the United States study.
        Psychosom Med. 2013; 75: 2-10
        • Ritenbaugh C.
        • Patterson R.E.
        • Chlebowski R.T.
        • et al.
        The Women's Health Initiative Dietary Modification trial: Overview and baseline characteristics of participants.
        Ann Epidemiol. 2003; 13: S87-S97
        • Rasmussen H.N.
        • Wrosch C.
        • Scheier M.F.
        • Carver C.S.
        Self-regulation processes and health: The importance of optimism and goal adjustment.
        J Pers. 2006; 74: 1721-1747
        • Hays J.
        • Hunt J.R.
        • Hubbell F.A.
        • et al.
        The Women's Health Initiative recruitment methods and results.
        Ann Epidemiol. 2003; 13: S18-S77
        • Patterson R.E.
        • Kristal A.R.
        • Tinker L.F.
        • Carter R.A.
        • Bolton M.P.
        • Agurs-Collins T.
        Measurement characteristics of the Women's Health Initiative food frequency questionnaire.
        Ann Epidemiol. 1999; 9: 178-187
        • Schakel S.F.
        • Sievert Y.A.
        • Buzzard I.M.
        Sources of data for developing and maintaining a nutrient database.
        J Am Diet Assoc. 1988; 88: 1268-1271
        • Chiuve S.E.
        • Fung T.T.
        • Rimm E.B.
        • et al.
        Alternative dietary indices both strongly predict risk of chronic disease.
        J Nutr. 2012; 142: 1009-1018
        • McCullough M.L.
        • Feskanich D.
        • Stampfer M.J.
        • et al.
        Diet quality and major chronic disease risk in men and women: Moving toward improved dietary guidance.
        Am J Clin Nutr. 2002; 76: 1261-1271
        • McCullough M.L.
        • Willett W.C.
        Evaluating adherence to recommended diets in adults: The Alternate Healthy Eating Index.
        Public Health Nutr. 2006; 9: 152-157
        • Belin R.J.
        • Greenland P.
        • Allison M.
        • et al.
        Diet quality and the risk of cardiovascular disease: The Women's Health Initiative (WHI).
        Am J Clin Nutr. 2011; 94: 49-57
        • Fung T.T.
        • McCullough M.
        • van Dam R.M.
        • Hu F.B.
        A prospective study of overall diet quality and risk of type 2 diabetes in women.
        Diabetes Care. 2007; 30: 1753-1757
        • Koenig H.
        • King D.
        • Carson V.B.
        Health behaviors.
        in: Koenig H. King D. Carson V.B. Handbook of Religion and Health. Oxford University Press, Oxford, UK2012: 538-539
        • Turner-McGrievy G.M.
        • Barnard N.D.
        • Cohen J.
        • Jenkins D.J.
        • Gloede L.
        • Green A.A.
        Changes in nutrient intake and dietary quality among participants with type 2 diabetes following a low-fat vegan diet or a conventional diabetes diet for 22 weeks.
        J Am Diet Assoc. 2008; 108: 1636-1645
        • Gillham J.E.
        • Reivich K.J.
        • Freres D.R.
        • et al.
        School-based prevention of depressive symptoms: A randomized controlled study of the effectiveness and specificity of the Penn Resiliency Program.
        J Consult Clin Psychol. 2007; 75: 9-19
        • Boehm J.K.
        • Lyubomirsky S.
        • Sheldon K.M.
        A longitudinal experimental study comparing the effectiveness of happiness-enhancing strategies in Anglo Americans and Asian Americans.
        Cogn Emot. 2011; 25: 1263-1272

      Biography

      M. D. Hingle is an assistant professor, Department of Nutritional Sciences, College of Agriculture & Life Sciences, University of Arizona, Tucson.

      Biography

      C. A. Thomson is a professor, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson.

      Biography

      B. C. Wertheim is an assistant scientific investigator, University of Arizona Cancer Center, Tucson, and at the University of Arizona, Tucson.

      Biography

      H. A. Tindle is an assistant professor of medicine, Center for Research on Healthcare, University of Pittsburgh, Pittsburgh, PA.

      Biography

      L. Tinker is a nutrition scientist, Fred Hutchinson Cancer Research Center, Seattle, WA.

      Biography

      R. A. Seguin is an assistant professor, Division of Nutritional Sciences, College of Human Ecology, Cornell University, Ithaca, NY.

      Biography

      M. C. Rosal is an associate professor, Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester.