Psychological stress accompanied by a low-variety diet is positively associated with type 2 diabetes in middle-aged adults

Psychological stress is generally known to affect dietary intakes and cause chronic diseases. This study aims to investigate the association between psychological stress and the risk of type 2 diabetes in relation to dietary variety. A total of 126,405 middle-aged adults were enrolled in the Korean Genome and Epidemiology Study. Stress levels were measured using the psychosocial well-being index. Dietary variety score (DVS) was defined as the number of different foods consumed over a day. Stress levels were positively associated with the risks of diabetes (odds ratio (OR) for tertile 3 compared with tertile 1, men: OR = 1.34 (95% CI: 1.24–1.45); women: OR = 1.29 (1.19–1.4)). As the stress levels rose, the intake of grains increased, and the intake of fruits and vegetables decreased. Participants with higher stress levels showed lower DVS than those with lower stress levels. Furthermore, participants with higher stress levels and lower DVS had a significantly higher OR for diabetes than those with lower stress levels and higher DVS (men: OR = 1.83 (1.58–2.12); women: OR = 1.85 (1.59–2.51)). These results suggest that the high risk of type 2 diabetes for people with high stress levels may be associated with low dietary variety.