Article(id=1324050951132291289, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324050876230415089, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202506208, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1749744000000, receivedDateStr=2025-06-13, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793607946427, onlineDateStr=2026-11-02, pubDate=1781020800000, pubDateStr=2026-06-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793607946427, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793607946427, creator=13701087609, updateTime=1793607946427, updator=13701087609, issue=Issue{id=1324050876230415089, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='11', pageStart='1921', pageEnd='2112', issueExtLink='null', onlineDate='null', pubDate='1781020800000', pubDateStr='2026-06-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793607928569, creator='13701087609', updateTime=1793670049253, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324311429322507008, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324050876230415089, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324311429322507009, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324050876230415089, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=1994, endPage=1999, ext={EN=ArticleExt(id=1324050951321034970, articleId=1324050951132291289, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Association between dietary patterns and emotional health among medical students in Tianjin, columnId=1228016572783063333, journalTitle=Modern Preventive Medicine, columnName=Nutrition and Food Hygiene, runingTitle=null, highlight=null, articleAbstract=
Objective

To examine the association between dietary patterns and emotional distress among medical students through a cross-sectional analysis, providing scientific evidence for promoting mental health in this population.

Methods

A cross-sectional survey was conducted among 1 305 medical students from medical colleges in Tianjin from January 2022 to February 2023 using the Symptom Checklist-90 and a food frequency questionnaire. Principal component analysis was used to identify dietary patterns, and the factor scores of each dietary pattern were categorized into T1, T2, and T3 groups according to tertiles. Multivariable logistic regression was used to analyze the association between different dietary patterns and emotional distress.

Results

The proportion of medical students with emotional distress was 16.7%. Three distinct dietary patterns were derived from the analysis: a diverse diet, a beverages-snacks-pickled foods diet, and a nuts-fruits-beans diet. Among them, high intake of the beverages-snacks-pickled foods pattern (T3) was positively associated with emotional distress (OR=1.812, 95% CI: 1.238-2.651, P<0.05), and this association persisted after adjustment (OR=1.992, 95% CI: 1.336-2.971, P<0.05). In contrast, moderate intake of this pattern (T2) was inversely related to emotional distress (OR=0.618, 95% CI: 0.389-0.982, P<0.05). Other associations were non-significant after adjustment (P>0.05).

Conclusion

There is an association between dietary patterns and emotional distress. Medical students should optimize their daily dietary structure and reasonably control sugar and salt intake to prevent emotional distress.

, authors=Jia-xuan XU1, Chen SUN1, Sheng-nan LIU1, Yin-yue LIU1, Xu-mei ZHANG1, 2, 3, Xuan WANG1, 2, 3, authorsList=Jia-xuan XU, Chen SUN, Sheng-nan LIU, Yin-yue LIU, Xu-mei ZHANG, Xuan WANG, authorCompany=null, correspAuthors=Xuan WANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1324050951639802075, articleId=1324050951132291289, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=天津市医学生膳食模式与情绪健康关系研究, columnId=1228016573034721597, journalTitle=现代预防医学, columnName=营养与食品卫生, runingTitle=null, highlight=null, articleAbstract=
目的

通过人群横断面分析,探讨医学生膳食模式与情绪不良的关联,为促进医学生情绪健康提供科学指导。

方法

于2022年1月—2023年2月对天津市医学院校1 305名医学生进行症状自评量表问卷、食物频率问卷调查。利用主成分分析来解析膳食模式,并采用三分位数法对各膳食模式因子得分进行分组,分为T1、T2和T3三个组,使用多因素logistic回归分析不同膳食模式与情绪不良之间的关联。

结果

医学生情绪不良人数占比16.7%。本研究共提取了三种膳食模式:种类丰富膳食模式、饮品-小吃-腌制菜膳食模式和坚果-水果-豆类膳食模式。其中,饮品-小吃-腌制菜模式的高摄入量(T3组)与情绪不良正相关(OR=1.812,95%CI:1.238~2.651,P<0.05)。在调整相关因素后,这种关系依然存在(OR=1.992,95%CI:1.336~2.971,P<0.05)。相反,该模式的中等摄入量(T2组)与情绪不良负相关(OR=0.618,95%CI:0.389~0.982,P<0.05)。其余经调整后其相关性无统计学意义(P>0.05)。

结论

膳食模式与情绪不良存在一定相关性。医学生应优化日常膳食结构,合理摄入糖和盐,以预防情绪不良。

, authors=许嘉璇1, 孙辰1, 刘胜男1, 刘银玥1, 张绪梅1, 2, 3, 王璇1, 2, 3, authorsList=许嘉璇, 孙辰, 刘胜男, 刘银玥, 张绪梅, 王璇, authorCompany=null, correspAuthors=王璇, authorNote=

许嘉璇(2000-),女,硕士在读,研究方向:营养与慢性病

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王璇,E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点,除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=V6AU27Pjw0TqGcexEGzE/A==, magXml=eB5PFAOfbbfRh35g7zOgkQ==, pdfUrl=null, pdf=rkOEk83B2KejFVERGRVlbA==, pdfFileSize=864473, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=yVbVjU6aqDAjDVId0UrsyQ==, mapNumber=null, fund=null)}, authors=[Author(id=1324050952168284388, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050951132291289, orderNo=0, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1324050952252170470, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050951132291289, authorId=1324050952168284388, language=EN, stringName=Jia-xuan XU, firstName=Jia-xuan, middleName=null, lastName=XU, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=1, address=Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin 300070, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1324050952352833767, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050951132291289, authorId=1324050952168284388, language=CN, stringName=许嘉璇, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=1, address=1.天津医科大学公共卫生学院营养与食品卫生学系,天津 300070, bio={"content":"

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2.天津市环境、营养与公共卫生重点实验室,天津 300070
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2.天津市环境、营养与公共卫生重点实验室,天津 300070
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Iranian Journal of Basic Medical Sciences, 2024, 27(12): 1492-1505., articleTitle=Neuroprotective effects of walnut (Juglans regia L.) in nervous system disorders: A comprehensive review, refAbstract=null), Reference(id=1324050964226908478, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050951132291289, doi=null, pmid=null, pmcid=null, year=2025, volume=73, issue=42, pageStart=26780, pageEnd=26792, url=null, language=null, rfNumber=[35], rfOrder=39, authorNames=Xiao X, Ma A, Chen Z, journalName=Journal of Agricultural and Food Chemistry, refType=null, unstructuredReference=Xiao X, Ma A, Chen Z, et al. A Walnut-Derived peptide WSPSGR alleviates Depressive-Like behaviors in mice via IDO1 inhibition and gut Microbiota-Tryptophan axis modulation[J]. Journal of Agricultural and Food Chemistry, 2025, 73(42): 26780-26792., articleTitle=A Walnut-Derived peptide WSPSGR alleviates Depressive-Like behaviors in mice via IDO1 inhibition and gut Microbiota-Tryptophan axis modulation, refAbstract=null), Reference(id=1324050964306600255, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050951132291289, doi=null, pmid=null, pmcid=null, year=2021, volume=31, issue=3, pageStart=210, pageEnd=219, url=null, language=null, rfNumber=[36], rfOrder=40, authorNames=Sun J, Li ZY, Li Y, journalName=Journal of Epidemiology / Japan Epidemiological Association, refType=null, unstructuredReference=Sun J, Li ZY, Li Y, et al. Intakes of specific categories of vegetables and fruits are inversely associated with depressive symptoms among adults[J]. Journal of Epidemiology / Japan Epidemiological Association, 2021, 31(3): 210-219., articleTitle=Intakes of specific categories of vegetables and fruits are inversely associated with depressive symptoms among adults, refAbstract=null), Reference(id=1324050964382097728, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050951132291289, doi=null, pmid=null, pmcid=null, year=2023, volume=185, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[37], rfOrder=41, authorNames=Klatzkin RR, Nadel T, Wilkinson LL, journalName=Appetite, refType=null, unstructuredReference=Klatzkin RR, Nadel T, Wilkinson LL, et al. Lifetime stressor exposure, eating expectancy, and acute social stress-related eating behavior: A pre-registered study of the emotional eating cycle[J]. 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Journal of Health Population and Nutrition, 2024, 43(1): 144., articleTitle=Association between perceived stress, emotional eating, and adherence to healthy eating patterns among Saudi college students: a cross-sectional study, refAbstract=null)], funds=[Fund(id=1324050957562159381, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050951132291289, awardId=B251006205, language=CN, fundingSource=天津市普通高等学校本科教学质量与教学改革研究计划项目(B251006205), fundOrder=null, country=null), Fund(id=1324050959327961366, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050951132291289, awardId=PYGJ-B023, language=CN, fundingSource=天津市教学成果重点培育项目(PYGJ-B023), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1324050951887266012, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050951132291289, xref=1., ext=[AuthorCompanyExt(id=1324050951899848925, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050951132291289, companyId=1324050951887266012, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin 300070, China), AuthorCompanyExt(id=1324050951908237534, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050951132291289, companyId=1324050951887266012, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.天津医科大学公共卫生学院营养与食品卫生学系,天津 300070)]), AuthorCompany(id=1324050951979540703, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050951132291289, xref=2., ext=[AuthorCompanyExt(id=1324050951992123616, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050951132291289, companyId=1324050951979540703, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.天津市环境、营养与公共卫生重点实验室,天津 300070)]), AuthorCompany(id=1324050952059232481, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050951132291289, xref=3., ext=[AuthorCompanyExt(id=1324050952067621090, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050951132291289, companyId=1324050952059232481, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3.环境、营养与公共卫生国际合作研究中心,天津医科大学教育部重大疾病防控重点实验室,天津 300070)])], figs=[ArticleFig(id=1324050956182233357, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050951132291289, language=EN, label=Table 1, caption=

Characteristics of medical students [n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
项目情绪良好
(n=1 118)
情绪不良(n=187)χ2值P值项目情绪良好
(n=1 118)
情绪不良(n=187)χ2值P值
性别4.50.034家庭人均月收入(元)4.30.365
男297(26.6)63(33.7)≥8 000180(16.1)24(12.8)
女821(73.4)124(66.3)6 000-8 000195(17.4)28(15.0)
年级(级)6.10.3004 000-6 000264(23.6)41(21.9)
201880(7.2)14(7.5)2 000-4 000304(27.2)56(30.0)
2019112(10.0)21(11.2)<2 000175(15.7)38(20.3)
2020198(17.7)40(21.4)父亲职业10.10.185
2021152(13.6)15(8.0)公务员80(7.2)11(5.9)
2022576(51.5)97(51.9)医务人员59(5.3)7 (3.7)
民族11.30.001教师78(7.0)11(5.9)
汉族963(86.1)143(76.5)其他事业单位人员122(10.9)26(13.9)
其他155(13.9)44(23.5)农民167(14.9)41(21.9)
身体活动0.90.340工人177(15.8)27(14.4)
不足985(88.1)160(85.6)其他企业人员153(13.7)26(13.9)
达标133(11.9)27 (14.4)其他282(25.2)38(20.3)
饮酒情况3.10.379母亲职业21.90.003
从不637(57.0)100(53.5)公务员25(2.2)11(5.9)
饮酒384(34.3)67(35.8)医务人员67(6.0)8 (4.3)
戒酒97 (8.7)20(10.7)教师137(12.3)18(9.6)
吸烟情况8.20.016其他事业单位人员106(9.5)25(13.4)
从不1 106(98.9)180(96.3)农民199(17.8)47(25.1)
吸烟8(0.7)4(2.1)工人108(9.7)11(5.9)
戒烟4(0.4)3(1.6)其他企业人员129(11.5)15(8.0)
BMI(kg/m2)2.70.190其他347(31.0)52(27.8)
≥24209(18.7)33(17.7)
18.5~23.9720(64.4)113(60.4)
<18.5189(16.9)41(21.9)
), ArticleFig(id=1324050956287090958, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050951132291289, language=CN, label=表1, caption=

医学生的基本情况[n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
项目情绪良好
(n=1 118)
情绪不良(n=187)χ2值P值项目情绪良好
(n=1 118)
情绪不良(n=187)χ2值P值
性别4.50.034家庭人均月收入(元)4.30.365
男297(26.6)63(33.7)≥8 000180(16.1)24(12.8)
女821(73.4)124(66.3)6 000-8 000195(17.4)28(15.0)
年级(级)6.10.3004 000-6 000264(23.6)41(21.9)
201880(7.2)14(7.5)2 000-4 000304(27.2)56(30.0)
2019112(10.0)21(11.2)<2 000175(15.7)38(20.3)
2020198(17.7)40(21.4)父亲职业10.10.185
2021152(13.6)15(8.0)公务员80(7.2)11(5.9)
2022576(51.5)97(51.9)医务人员59(5.3)7 (3.7)
民族11.30.001教师78(7.0)11(5.9)
汉族963(86.1)143(76.5)其他事业单位人员122(10.9)26(13.9)
其他155(13.9)44(23.5)农民167(14.9)41(21.9)
身体活动0.90.340工人177(15.8)27(14.4)
不足985(88.1)160(85.6)其他企业人员153(13.7)26(13.9)
达标133(11.9)27 (14.4)其他282(25.2)38(20.3)
饮酒情况3.10.379母亲职业21.90.003
从不637(57.0)100(53.5)公务员25(2.2)11(5.9)
饮酒384(34.3)67(35.8)医务人员67(6.0)8 (4.3)
戒酒97 (8.7)20(10.7)教师137(12.3)18(9.6)
吸烟情况8.20.016其他事业单位人员106(9.5)25(13.4)
从不1 106(98.9)180(96.3)农民199(17.8)47(25.1)
吸烟8(0.7)4(2.1)工人108(9.7)11(5.9)
戒烟4(0.4)3(1.6)其他企业人员129(11.5)15(8.0)
BMI(kg/m2)2.70.190其他347(31.0)52(27.8)
≥24209(18.7)33(17.7)
18.5~23.9720(64.4)113(60.4)
<18.5189(16.9)41(21.9)
), ArticleFig(id=1324050956391948559, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050951132291289, language=EN, label=Table 2, caption=

Daily food intakes among participants with and without emotional distress [M (P25,P75),g]

, figureFileSmall=null, figureFileBig=null, tableContent=
食物种类情绪良好(n=1 118)情绪不良(n=187)推荐摄入参考量aH值P值
谷薯类533.05(387.62,687.84)553.92(411.13,711.95)250~400-0.8790.380
乳制品类131.70(54.00,226.60)129.60(53.66,229.05)300-0.1310.896
畜禽肉类85.64(54.00,124.33)92.30(59.78,137.73)40~75-0.1920.050
蛋类35.50(18.00,50.00)35.70(18.00,50.00)50-0.3850.700
水产品类12.87(0.00,25.90)16.10(0.00,33.16)40~75-1.8520.064
蔬菜类197.82(129.27,278.25)184.59(134.90,289.86)300-0.0680.945
豆类34.78(14.00,63.90)33.27(11.50,55.71)25~35-1.3210.187
水果类265.48(164.52,417.54)294.83(151.90,484.53)200~350-0.9360.349
坚果类5.36(2.10,12.14)5.40(1.41,13.57)10-0.5490.583
饮品类154.08(56.85,300.85)218.07(88.05,477.70)—b-4.108<0.001
腌制品类4.00(0.57,8.62)5.71(1.13,12.87)—b-2.6260.009
小吃甜点类28.00(10.60,56.11)35.85(14.29,83.31)—b-2.5760.010
), ArticleFig(id=1324050956605858064, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050951132291289, language=CN, label=表2, caption=

情绪不良与情绪良好人群不同种类食物的日摄入量[M(P25,P75),g]

, figureFileSmall=null, figureFileBig=null, tableContent=
食物种类情绪良好(n=1 118)情绪不良(n=187)推荐摄入参考量aH值P值
谷薯类533.05(387.62,687.84)553.92(411.13,711.95)250~400-0.8790.380
乳制品类131.70(54.00,226.60)129.60(53.66,229.05)300-0.1310.896
畜禽肉类85.64(54.00,124.33)92.30(59.78,137.73)40~75-0.1920.050
蛋类35.50(18.00,50.00)35.70(18.00,50.00)50-0.3850.700
水产品类12.87(0.00,25.90)16.10(0.00,33.16)40~75-1.8520.064
蔬菜类197.82(129.27,278.25)184.59(134.90,289.86)300-0.0680.945
豆类34.78(14.00,63.90)33.27(11.50,55.71)25~35-1.3210.187
水果类265.48(164.52,417.54)294.83(151.90,484.53)200~350-0.9360.349
坚果类5.36(2.10,12.14)5.40(1.41,13.57)10-0.5490.583
饮品类154.08(56.85,300.85)218.07(88.05,477.70)—b-4.108<0.001
腌制品类4.00(0.57,8.62)5.71(1.13,12.87)—b-2.6260.009
小吃甜点类28.00(10.60,56.11)35.85(14.29,83.31)—b-2.5760.010
), ArticleFig(id=1324050956702327057, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050951132291289, language=EN, label=Table 3, caption=

Factor loading matrix of dietary patterns (n=1 305)

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食物种类种类丰富膳食模式饮品-小吃-腌制菜膳食模式坚果-水果-豆类膳食模式
畜禽肉类0.724——
蛋类0.681——
蔬菜类0.630——
谷薯类0.598——
乳制品类0.553——
饮品类—0.797—
小吃甜点类—0.743—
腌制品类—0.678—
水产品类—0.562—
水果类—0.5110.536
坚果类——0.762
豆类——0.506
), ArticleFig(id=1324050956979151122, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050951132291289, language=CN, label=表3, caption=

膳食模式的因子载荷矩阵(n=1 305)

, figureFileSmall=null, figureFileBig=null, tableContent=
食物种类种类丰富膳食模式饮品-小吃-腌制菜膳食模式坚果-水果-豆类膳食模式
畜禽肉类0.724——
蛋类0.681——
蔬菜类0.630——
谷薯类0.598——
乳制品类0.553——
饮品类—0.797—
小吃甜点类—0.743—
腌制品类—0.678—
水产品类—0.562—
水果类—0.5110.536
坚果类——0.762
豆类——0.506
), ArticleFig(id=1324050957067231507, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050951132291289, language=EN, label=Table 4, caption=

Logistic regression analysis between dietary pattern and emotional distress [OR(95% CI)]

, figureFileSmall=null, figureFileBig=null, tableContent=
膳食模式模型1模型2模型3
种类丰富膳食模式
T1(-3.32~-0.44)1.001.001.00
T2(-0.43~0.22)0.816(0.549~1.212)0.879(0.585~1.320)0.885(0.587~1.334)
T3(0.23~12.56)1.065(0.718~1.580)1.132(0 .741~1.729)1.099(0.716~1.688)
P for trend0.3780.3210.400
饮品-小吃-腌制菜模式
T1(-2.45~-0.37)1.001.001.00
T2(-0.37~0.06)0.596(0.378~1.238)0.613(0.387~0.971)0.618(0.389~0.982)
T3(0.06~14.85)1.812(1.238~2.651)1.961(1.326~2.901)1.992(1.336~2.971)
P for trend<0.001<0.001<0.001
坚果-水果-豆类膳食模式
T1(-5.33~-0.50)1.001.001.00
T2(-0.50~0.22)0.741(0.504~1.091)0.744(0.502~1.102)0.734(0.493~1.093)
T3(0.22~6.30)0.754(0.515~1.104)0.771(0.524~1.134)0.755(0.510~1.117)
P for trend0.4030.4440.401
), ArticleFig(id=1324050957411164436, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050951132291289, language=CN, label=表4, caption=

膳食模式与情绪不良的logistic 回归分析[OR(95%CI)]

, figureFileSmall=null, figureFileBig=null, tableContent=
膳食模式模型1模型2模型3
种类丰富膳食模式
T1(-3.32~-0.44)1.001.001.00
T2(-0.43~0.22)0.816(0.549~1.212)0.879(0.585~1.320)0.885(0.587~1.334)
T3(0.23~12.56)1.065(0.718~1.580)1.132(0 .741~1.729)1.099(0.716~1.688)
P for trend0.3780.3210.400
饮品-小吃-腌制菜模式
T1(-2.45~-0.37)1.001.001.00
T2(-0.37~0.06)0.596(0.378~1.238)0.613(0.387~0.971)0.618(0.389~0.982)
T3(0.06~14.85)1.812(1.238~2.651)1.961(1.326~2.901)1.992(1.336~2.971)
P for trend<0.001<0.001<0.001
坚果-水果-豆类膳食模式
T1(-5.33~-0.50)1.001.001.00
T2(-0.50~0.22)0.741(0.504~1.091)0.744(0.502~1.102)0.734(0.493~1.093)
T3(0.22~6.30)0.754(0.515~1.104)0.771(0.524~1.134)0.755(0.510~1.117)
P for trend0.4030.4440.401
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天津市医学生膳食模式与情绪健康关系研究
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许嘉璇 1 , 孙辰 1 , 刘胜男 1 , 刘银玥 1 , 张绪梅 1, 2, 3 , 王璇 1, 2, 3
现代预防医学 | 营养与食品卫生 2026,53(11): 1994-1999
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现代预防医学 |营养与食品卫生 2026 , 53 (11) : 1994 -1999
天津市医学生膳食模式与情绪健康关系研究
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许嘉璇(2000-),女,硕士在读,研究方向:营养与慢性病

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许嘉璇1, 孙辰1, 刘胜男1, 刘银玥1, 张绪梅1, 2, 3, 王璇1, 2, 3
作者信息
  • 1.天津医科大学公共卫生学院营养与食品卫生学系,天津 300070
  • 2.天津市环境、营养与公共卫生重点实验室,天津 300070
  • 3.环境、营养与公共卫生国际合作研究中心,天津医科大学教育部重大疾病防控重点实验室,天津 300070
通讯作者:
王璇,E-mail:
作者简介:

许嘉璇(2000-),女,硕士在读,研究方向:营养与慢性病

Association between dietary patterns and emotional health among medical students in Tianjin
Jia-xuan XU1, Chen SUN1, Sheng-nan LIU1, Yin-yue LIU1, Xu-mei ZHANG1, 2, 3, Xuan WANG1, 2, 3
Affiliations
  • Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin 300070, China
出版时间: 2026-06-10 doi: 10.20043/j.cnki.MPM.202506208
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目的

通过人群横断面分析,探讨医学生膳食模式与情绪不良的关联,为促进医学生情绪健康提供科学指导。

方法

于2022年1月—2023年2月对天津市医学院校1 305名医学生进行症状自评量表问卷、食物频率问卷调查。利用主成分分析来解析膳食模式,并采用三分位数法对各膳食模式因子得分进行分组,分为T1、T2和T3三个组,使用多因素logistic回归分析不同膳食模式与情绪不良之间的关联。

结果

医学生情绪不良人数占比16.7%。本研究共提取了三种膳食模式:种类丰富膳食模式、饮品-小吃-腌制菜膳食模式和坚果-水果-豆类膳食模式。其中,饮品-小吃-腌制菜模式的高摄入量(T3组)与情绪不良正相关(OR=1.812,95%CI:1.238~2.651,P<0.05)。在调整相关因素后,这种关系依然存在(OR=1.992,95%CI:1.336~2.971,P<0.05)。相反,该模式的中等摄入量(T2组)与情绪不良负相关(OR=0.618,95%CI:0.389~0.982,P<0.05)。其余经调整后其相关性无统计学意义(P>0.05)。

结论

膳食模式与情绪不良存在一定相关性。医学生应优化日常膳食结构,合理摄入糖和盐,以预防情绪不良。

医学生  /  膳食模式  /  情绪健康  /  情绪不良
Objective

To examine the association between dietary patterns and emotional distress among medical students through a cross-sectional analysis, providing scientific evidence for promoting mental health in this population.

Methods

A cross-sectional survey was conducted among 1 305 medical students from medical colleges in Tianjin from January 2022 to February 2023 using the Symptom Checklist-90 and a food frequency questionnaire. Principal component analysis was used to identify dietary patterns, and the factor scores of each dietary pattern were categorized into T1, T2, and T3 groups according to tertiles. Multivariable logistic regression was used to analyze the association between different dietary patterns and emotional distress.

Results

The proportion of medical students with emotional distress was 16.7%. Three distinct dietary patterns were derived from the analysis: a diverse diet, a beverages-snacks-pickled foods diet, and a nuts-fruits-beans diet. Among them, high intake of the beverages-snacks-pickled foods pattern (T3) was positively associated with emotional distress (OR=1.812, 95% CI: 1.238-2.651, P<0.05), and this association persisted after adjustment (OR=1.992, 95% CI: 1.336-2.971, P<0.05). In contrast, moderate intake of this pattern (T2) was inversely related to emotional distress (OR=0.618, 95% CI: 0.389-0.982, P<0.05). Other associations were non-significant after adjustment (P>0.05).

Conclusion

There is an association between dietary patterns and emotional distress. Medical students should optimize their daily dietary structure and reasonably control sugar and salt intake to prevent emotional distress.

Medical students  /  Dietary patterns  /  Emotional health  /  Emotional distress
许嘉璇, 孙辰, 刘胜男, 刘银玥, 张绪梅, 王璇. 天津市医学生膳食模式与情绪健康关系研究. 现代预防医学, 2026 , 53 (11) : 1994 -1999 . DOI: 10.20043/j.cnki.MPM.202506208
Jia-xuan XU, Chen SUN, Sheng-nan LIU, Yin-yue LIU, Xu-mei ZHANG, Xuan WANG. Association between dietary patterns and emotional health among medical students in Tianjin[J]. Modern Preventive Medicine, 2026 , 53 (11) : 1994 -1999 . DOI: 10.20043/j.cnki.MPM.202506208
随着社会的发展,大学生情绪健康问题受到广泛关注。研究显示,大学生普遍存在不良饮食行为[1]。膳食与情绪健康存在一定联系[2],膳食模式较单一营养素分析更能反映这种关联。国外研究发现健康膳食模式如地中海健康饮食可降低抑郁风险[3-4],在大学生群体中也存在类似关联[5]。我国研究也发现以全谷物、蔬菜、豆类为主的膳食模式与青年抑郁风险降低相关[6],但针对膳食模式与医学生情绪的研究有限。因此,本研究通过横断面调查天津市医学生,分析膳食模式与情绪健康的关系,以期为医学生的情绪健康管理和饮食指导提供针对性的科学依据。
本研究以2022年1月—2023年2月天津市某医学院校医学生为研究对象,采用分层随机整群抽样的方法,先按专业和年级进行分层,再在同专业同年级中随机抽取一个班级,进行网络问卷调查,共发放1 376份问卷。排除答案填写不完整、出现明显异常值的问卷,最终获得有效问卷的总数1 305份,有效率为94.8%。本研究通过天津医科大学伦理委员会批准(TMUhMEC20250002),所有研究对象均知情同意。
收集研究对象的一般人口学特征,包括年级、专业、性别、民族、身高、体重、饮酒情况、睡眠情况、吸烟情况、身体活动情况、父母职业情况、家庭人均月收入情况。
本研究使用症状自评量表(symptom checklist 90,SCL-90)[7]进行情绪状况的评估。其总量表Cronbach α系数为0.97,各分量表的内部一致性信度也均在0.96 以上,具有较好的信度和效度[8],目前已广泛应用于大学生[9]和医学生[10-11]的心理症状评价。该量表共有90个项目,每个项目采用5级评分法(0~4分),分别为没有、很轻、中等、偏重和严重。总分为所有各单项分相加,总分越高,心理健康状况越差。本研究情绪不良判定标准:总分≥160分,或单项分≥1分视为阳性,阳性项目数≥43项[12]。反之为情绪健康。
本研究使用食物频率问卷法调查研究对象近一个月内的膳食营养及饮食习惯,该问卷具有良好的信效度[13]。问卷包括 81 种食物的摄入情况及饮食习惯等,为方便进行膳食模式分析,将问卷中涉及的食物条目按属性类别进行合并,最终归纳总结为12大类食物进行后续分析研究,包括谷薯类、乳制品类、畜禽肉类、蛋类、水产品类、蔬菜类、豆类、水果类、坚果类、饮品类、腌制品类、小吃甜点类。
本研究运用主成分分析法。依据食物之间相互关联的程度来汇总食物,根据碎石图和特征值确定保留的公因子数。对各变量进行KMO检验和Bartlett球形检验,满足KMO值>0.5且Bartlett球形检验P<0.01,判断各变量间具有相关性,可以进行主成分分析。其次,将特征根大于1者确定为公因子,根据每个公因子中各种食物的因子载荷(保留大于0.4者)确定因子名称。
采用回归法计算每个研究对象在各膳食模式上的因子得分。即将各食物组的标准化摄入量与对应的因子得分系数进行线性加权求和,每个研究对象在每个膳食模式上均得到一个连续得分。得分越高,表示对该膳食模式的依从性越强。
在发放调查问卷时,问卷第一页有详细的食物容器大小说明和食物份量大小的模型编号,便于调查对象对食物重量的估计,保证数据的准确性。调查人员和数据录入人员都经过统一的培训。问卷回收后,研究小组对问卷所有填写内容逐一审核。
采用SPSS 25.0 进行数据处理与分析。本研究中涉及的计量资料为12种食物的日摄入量,单样本Kolmogorov-Smirnov Z检验结果均为偏态分布(P<0.05),故使用中位数和四分位数间距进行描述。分类变量使用构成比和例数表示。对连续变量采用 Wilcoxon检验和Kruskal-Wallis检验进行组间比较;分类变量采用χ2检验进行组间比较。采用因子分析确定主要膳食模式,以特征根>1、碎石图确定膳食模式的个数。采用正交旋转,因子负荷表示每种食物与不同膳食模式之间的相关程度大小。计算个人每种膳食模式的因子得分,采用三分位法分组,第一分位(T1)为该膳食模式低摄入量组,第二分位(T2)为中摄入量组,第三分位(T3)为高摄入量组,并以T1为参照,使用logistic回归分析膳食模式与情绪健康间的关系。检验水准α=0.05。
医学生情绪不良人数占比16.7%,情绪良好和情绪不良的医学生在性别、民族、母亲职业及吸烟情况构成上均存在统计学差异(P<0.05)。女生情绪不良者为15.1%,少于男生的17.5%;汉族情绪不良者为12.9%,少于其他民族的22.1%;中年级(2020级)医学生情绪不良者为16.8%,多于高年级(2018级和2019级)的15.4%和低年级(2021级和2022级)的13.3%。见表1。
通过比较可发现,情绪不良组医学生的腌制品类、小吃甜点类、饮品类食物的日摄入量均高于情绪良好的医学生,差异有统计学意义(P<0.05)。见表2。
KMO值为0.796,Bartlett球形检验P<0.001。选择特征根大于1的前3个主成分确定为3种膳食模式,累积提取方差贡献度55.95%。保留因子载荷大于0.4的食物种类,根据因子载荷较高的食物种类分别命名为种类丰富膳食模式、饮品-小吃-腌制菜型膳食模式和坚果-水果-豆类膳食模式。见表3。
饮品-小吃-腌制菜模式与情绪不良存在相关性。以T1组作为参考组,在模型1、2、3中T3组显示出情绪不良的风险是T1组的1.992倍(OR=1.992,95%CI:1.336~2.971,P<0.05)。经调整后,模型2和模型3中T2组均显示该膳食模式与情绪不良呈负相关(P值均<0.01),T2组患情绪不良的风险是T1组的0.618倍(OR=0.618,95%CI:0.389~0.982,P<0.05)。其余膳食模式与情绪不良的相关性无统计学意义(P>0.05)。见表4。
本研究显示天津市医学生情绪不良占比16.7%,高于我国2018年对医学生焦虑状态评估的14.1%[14],低于全球医学生的45%[15]和全球普通大学生的32.0%[16]。说明近年来大学生心理健康问题日益凸显,但医学生作为具备一定专业知识的特殊人群,较普通大学生在情绪问题的自我调节与情绪疏导方面可能展现出更强的专业性。女生较男生情绪问题少,汉族较其他民族轻微,这可能与女生更积极表达情绪和寻求专业帮助[17],少数民族学生需要面临更多文化、社会适应等特殊挑战有关[18]。三年级医学生情绪不良情况最突出,这可能与其正处于从理论学习向临床实践过渡的阶段、医学专业本身的高强度学习要求、在临床实践阶段面临多维人际关系压力源以及当前招生标准多元化所带来的额外竞争压力[19-21]有关。
本研究发现,天津市医学生的饮品-小吃-腌制菜膳食模式与情绪不良存在显著关联,表现为高摄入量增加情绪不良风险,而中等摄入量则具有保护作用,该关联在调整混杂因素后依然稳定。这一非线性关联与普通大学生群体研究结果存在差异:一项研究显示,喜欢烧烤类食物与较高的抑郁评分显著相关[22],脂肪与糖类摄入越高情绪问题风险越高[23],无中等摄入保护效应;香港的一项研究也显示,频繁食用高脂肪、高糖和高钠快餐食品,尤其是牛肉汉堡、薯条、炸鸡和珍珠奶茶,与发生抑郁/焦虑症状的风险显著增加相关[24]。另一项针对非医学专业大学生的研究也证实,碳酸饮料、加工零食等加工食品消费会增加焦虑症状风险[25]。这种差异可能与医学生健康素养更高、能够自我控制摄入量有关。
目前该膳食模式摄入量与情绪健康相关的生物学机制尚未明确,可能的机制如下:长期高糖高盐的高摄入可通过促进炎症、氧化应激等途径损害情绪健康[26-28],而限量蔗糖摄入能抑制下丘脑-垂体-肾上腺(hypothalamic-pituitary-adrenal, HPA)轴活性,短期内提升情绪[29]。且中等摄入量(T2 组)的保护作用,不仅源于对 HPA 轴的急性抑制,还可能与维持 HPA轴正常反应性有关。一项研究表明,适度摄入蛋糕、饮料等超加工食品的个体其皮质醇水平较高,在人群中表现为非线性模式,可能具有更敏感的HPA轴[30],而压力诱发的急性皮质醇升高与负向情绪反应成反比,短暂的皮质醇升高具有情绪缓冲效应[31]。因此我们推测,HPA轴的反应性本身可能是一个适应性指标,在面对日常应激时,中等摄入该膳食模式的食物能够产生适度的皮质醇反应,从而通过上述机制缓冲负向情绪。基于此,T2组(中等摄入)的保护作用可能源于其保留了HPA轴的最优功能,该组个体面对医学生特有的持续性压力时,适度的皮质醇反应可通过适应性情绪调节发挥心理缓冲作用;而T3 组(高摄入)可能因长期过度刺激导致 HPA 轴响应能力受损、皮质醇反应迟钝,最终丧失该保护机制。
坚果-水果-豆类与种类丰富两种模式在医学生整体间未显示出显著关联。其可能原因在于膳食结构不尽合理或者不同种类食物的效应可能存在异质性。有研究发现,每日用56 g杏仁代替150 g主食的、基于杏仁的“低碳水化合物饮食模式”可以显著改善抑郁[32]。也有研究表明,核桃与其他坚果相比更能降低抑郁评分[33],在一定程度上可预防焦虑症和抑郁症[34],其机制可能与核桃源肽通过调节色氨酸代谢和肠道菌群、恢复肠-脑轴稳态有关[35]。一些特定的水果和蔬菜似乎对心理健康有积极影响[36]。且在性别分层后,我们在男生组中观察到这两种膳食模式的保护作用,说明性别可能修饰了膳食与情绪的关联。基于此结果,未来研究需要考察具体食物种类、摄入量及探究其背后的特定营养素与情绪健康的关联,并按性别进行具体分析,才能更精确地揭示健康膳食模式保护情绪健康的本质。
本研究存在一定局限性。首先,横断面设计无法确定膳食模式与情绪问题间的因果关系。观察到的关联可能源于膳食对情绪的影响,也可能由“反向因果”导致——即情绪不良学生可能通过高糖高盐的“安慰性食物”进行情绪调节[37]。因此,该关联很可能是双向作用的结果。其次,医学生虽具备专业知识,但高学习压力可能导致其不健康饮食行为更为普遍[38]。学习压力作为潜在重要混杂因素,本研究未能对其进行控制和探讨,可能对结果造成干扰。后续研究应采用队列研究,并纳入压力等心理变量进行综合分析,更清晰地揭示膳食与情绪间的内在联系。本研究的另一个局限在于,膳食模式分析中的“饮品类”未区分含糖与无糖饮料。此分类可能掩盖了不同糖分饮料与情绪健康的特异性关联,是未来研究可以细化的方向。小吃甜点类模式未根据糖分、脂肪含量或加工程度进行亚类划分,其内部不同组分对情绪的影响可能存在异质性。当前基于因子载荷(>0.4)的命名方式可能掩盖了特定高危零食与情绪健康的特异性关联。
基于本研究饮品-小吃-腌制菜膳食模式高摄入增加情绪不良风险而中等摄入降低风险的结果,建议天津市医学生应特别重视高糖、高盐、腌制菜品为主的膳食模式,有意识地限制含糖饮料、高糖小吃和腌制品的摄入,例如每日饮用含糖饮料不超过1杯(约200~250 ml),每周摄入高糖甜点与腌制品的频率不超过2次,并优先选择坚果、水果或酸奶作为替代零食。并提倡合理膳食、适量运动,增加蔬果、奶类摄入,减少高脂肪、高糖、高盐食品的消费,适量摄入甜食等以预防情绪不良。
  • 天津市普通高等学校本科教学质量与教学改革研究计划项目(B251006205)
  • 天津市教学成果重点培育项目(PYGJ-B023)
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2026年第53卷第11期
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doi: 10.20043/j.cnki.MPM.202506208
  • 接收时间:2025-06-13
  • 首发时间:2026-11-02
  • 出版时间:2026-06-10
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  • 收稿日期:2025-06-13
基金
天津市普通高等学校本科教学质量与教学改革研究计划项目(B251006205)
天津市教学成果重点培育项目(PYGJ-B023)
作者信息
    1.天津医科大学公共卫生学院营养与食品卫生学系,天津 300070
    2.天津市环境、营养与公共卫生重点实验室,天津 300070
    3.环境、营养与公共卫生国际合作研究中心,天津医科大学教育部重大疾病防控重点实验室,天津 300070

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2种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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