Association between psychosocial stress and cardiovascular disease in relation to low consumption of fruit and vegetables in middle-aged men

Stress has been reported to affect dietary intake and chronic disease. This study aimed to investigate the association between psychosocial stress and cardiovascular disease (CVD) in relation to dietary intake. This cross-sectional analysis was performed on 23,792 men enrolled in the Korean Genome and Epidemiology Study from 2004 to 2013. Stress was assessed by the Psychosocial Well-Being Index. Stress level was positively associated with the risks of CVD (odds ratio (OR) for quartile 4 compared to quartile 1 = 1.30 (95% confidence interval 1.24–1.37), p-trend < 0.0001), including hypertension (OR = 1.26 (1.20–1.33), p-trend < 0.0001), heart disease (OR = 1.55 (1.34–1.80), p-trend = 0.0001), and cerebrovascular disease (OR = 2.47 (1.97–3.09), p-trend < 0.0001). As the level of stress increased, the intake of fruits and vegetables, as well as antioxidant nutrients, was decreased. Stress level showed an inverse association with dietary variety score (p-trend = 0.0001). In addition, dietary variety score was inversely associated with fruits and vegetables consumption (p-trend < 0.0001). These results suggest that the CVD risks for those with higher stress levels may be partially related to the decreased consumption of fruits and vegetables and dietary variety score.