Optimism and Diet Quality in the Women's Health Initiative
Open accessAbstract
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.
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Some studies suggest that psychological health may influence compliance with other cardiac health-modifying behaviors such as cardiac rehabilitation or related interventions.
“In addition, some studies suggest that psychological health may influence compliance with other cardiac health-modifying behaviors such as cardiac rehabilitation or related interventions. 56,68,159,160”
From Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association (2021) · cites this paper as [56]
The Introduction (page not provided) reports that optimism predicted adherence to a low-fat eating pattern after a dietary intervention and that optimistic people are more likely to follow medical advice. This supports a link between psychological health and adherence to a health-related intervention, but the paper does not examine compliance with cardiac rehabilitation specifically. (LLM, conf=0.85)
Experimental — accuracy not yet measuredLongitudinal studies suggest that it is the presence of positive psychological states that contributes to better future lifestyle practices.
“Although the issue of bidirectionality has been raised, longitudinal studies suggest that it is the presence of positive psychological states that contributes to better future lifestyle practices. 56,144-146”
From Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association (2021) · cites this paper as [56]
Optimism is associated with healthier behaviors such as more physical activity, not smoking, healthy diet score, better sleep quality, and higher composite cardiovascular health scores.
“Multiple studies have found that optimism is associated with healthier behaviors such as more physical activity, not smoking, 55 healthy diet score, 56 better sleep quality, 57 and higher composite cardiovascular health scores. 57-59”
From Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association (2021) · cites this paper as [56]
Studies have consistently found links between increased positive psychological states and greater participation in health behaviors in medical populations.
“Studies have consistently found links between increased positive psychological states and greater participation in health behaviors in medical populations.”
From Positive Psychological Interventions for Patients with Type 2 Diabetes: Rationale, Theoretical Model, and Intervention Development (2015) · cites this paper as [31]
Optimism is associated with greater improvement in dietary quality over one year in postmenopausal women, controlling for baseline diet.
“A pair of analyses found optimism to be associated with greater improvement in dietary quality, controlling for baseline diet, over one year in postmenopausal women [31, 32].”
From Positive Psychological Interventions for Patients with Type 2 Diabetes: Rationale, Theoretical Model, and Intervention Development (2015) · cites this paper as [31]
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- Authors
- Hingle, M. D., Wertheim, B. C., Tindle, H. A., Tinker, L., Seguin, R. A., Rosal, M. C., & Thomson, C. A.
- Affiliations
- University of Arizona (US)
- University of Pittsburgh (US)
- Fred Hutch Cancer Center (US)
- University of Massachusetts Chan Medical School (US)
- Corresponding author
- Hingle, Melanie D.
- ORCID
- Venue
- Journal of the Academy of Nutrition and Dietetics
- Publisher
- Elsevier BV
- Published
- 2014-07
- Volume
- 114
- Issue
- 7
- Pages
- 1036-1045
- ISSN
- 2212-2672 (ISSN-L)
- PMC
- PMC4071123
- OpenAlex
- W2052923963
- Cited by
- 80
- References
- 32
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 6 · 2023: 12 · 2022: 11 · 2021: 11 · 2020: 5 · 2019: 7 · 2018: 6 · 2017: 7 · 2016: 6 · 2015: 4 · 2014: 2
- FWCI
- 6.28
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of the Academy of Nutrition and Dietetics (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- The Journal of the American Medical Association (JAMA) Network (American Medical Association) (submittedVersion)
- Funders
- U.S. Department of Health and Human Services (HHSN268201100002C, HHSN2682011 00003C, HHSN 268201100001C, HHSN268201100046C, HHSN268201100004C, HHSN-271-2011-00004C)
- National Institutes of Health (HHSN268201100004C, n01wh32115-26-0-1, HHSN268201100046C, HHSN271201100004C, HHSN268201100001C, HHSN268201100002C, HHSN268201100003C, N01 WH032115)
- National Institute on Aging (HHSN-271-2011-00004C,)
- National Heart, Lung, and Blood Institute (HHSN2682011-00001I, HHSN2682011-00002I, HHSN268201100004C, K01HL108807, HHSN271201100004C, HHSN2682011‐00004I, HHSN26820-1100002C, HHSN268201100046C, HHSN268201100001C, HHSN2682011-00003I, HHSN268201100003C)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Social Sciences › Psychology › Applied Psychology › Optimism, Hope, and Well-being
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Nutrition, Genetics, and Disease
- Keywords
- optimism, diet quality, Alternative Healthy Eating Index, postmenopausal women, dietary intervention, Life Orientation Test-Revised, effect modification, Women's Health Initiative
- MeSH terms
- Aged, Energy Intake, Cross-Sectional Studies, Diet, Emotions, Feeding Behavior, Female, Humans, Life Style, Middle Aged, Risk Factors, Body Mass Index, Randomized Controlled Trials as Topic, Women's Health, Postmenopause
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