Posttraumatic stress disorder and changes in diet quality over 20 years among US women
Open accessAbstract
Background: Individuals with posttraumatic stress disorder (PTSD) are at increased risk of various chronic diseases. One hypothesized pathway is via changes in diet quality. This study evaluated whether PTSD was associated with deterioration in diet quality over time. Methods: Data were from 51 965 women in the Nurses' Health Study II PTSD sub-study followed over 20 years. Diet, assessed at 4-year intervals, was characterized via the Alternative Healthy Eating Index-2010 (AHEI). Based on information from the Brief Trauma Questionnaire and Short Screening Scale for DSM-IV PTSD, trauma/PTSD status was classified as no trauma exposure, prevalent exposure (trauma/PTSD onset before study entry), or new-onset (trauma/PTSD onset during follow-up). We further categorized women with prevalent exposure as having trauma with no PTSD symptoms, trauma with low PTSD symptoms, and trauma with high PTSD symptoms, and created similar categories for women with new-onset exposure, resulting in seven comparison groups. Multivariable linear mixed-effects spline models tested differences in diet quality changes by trauma/PTSD status over follow-up. Results: Overall, diet quality improved over time regardless of PTSD status. In age-adjusted models, compared to those with no trauma, women with prevalent high PTSD and women with new-onset high PTSD symptoms had 3.3% and 3.6% lower improvement in diet quality, respectively, during follow-up. Associations remained consistent after adjusting for health conditions, sociodemographics, and behavioral characteristics. Conclusions: PTSD is associated with less healthy changes in overall diet quality over time. Poor diet quality may be one pathway linking PTSD with a higher risk of chronic disease development.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Longitudinal studies show that negative psychological factors precede and predict poorer health-related behaviors and faster rate of weight gain.
“Although the question of bidirectionality exists between the presence of negative psychological states and these cardiac risk factors, longitudinal studies show that negative psychological factors precede and predict poorer health-related behaviors and faster rate of weight gain. 136-138”
From Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association (2021) · cites this paper as [136]
The Discussion > Conclusions (page unavailable) reports a prospective association between PTSD symptoms and less healthy dietary behavior in US women, supporting the health-behavior part of the claim. It discusses obesity as a possible downstream risk but does not report a faster rate of weight gain; the claim also generalizes from PTSD symptoms to negative psychological factors broadly. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThose studies found a steeper decline in physical activity after the onset of PTSD symptoms.
“Moreover, they found a steeper decline in physical activity after the onset of PTSD symptoms. 136-138”
From Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association (2021) · cites this paper as [136]
The Introduction (page not provided) reports a prospective association between PTSD and physical inactivity, and the Discussion conclusions say higher PTSD symptoms can lead to reduced physical activity, citing Winning et al. (2017). This paper does not report a steeper decline in physical activity after symptom onset; its before-and-after-onset findings concern diet quality. (LLM, conf=0.86)
Experimental — accuracy not yet measuredSeparate studies following up 50,000 women over 20 years found that higher PTSD symptom levels were associated with more future weight gain and with less healthy changes in diet quality over time.
“For example, separate studies following up 50 000 women over 20 years found that higher PTSD symptom levels were associated with more future weight gain and with less healthy changes in diet quality over time. 136,137”
From Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association (2021) · cites this paper as [136]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Moffitt, T. E., Caspi, A., Taylor, A., Kokaua, J., Milne, B. J., Polanczyk, G., & Poulton, R. (2010) · Psychological Medicine · doi:10.1017/s0033291709991036 · Cited by 938 · see citing works
Groenwold, R. H. H., White, I. R., Donders, A. R. T., Carpenter, J. R., Altman, D. G., & Moons, K. G. M. (2012) · Canadian Medical Association Journal · doi:10.1503/cmaj.110977 · Cited by 538 · see citing works
Rosenbaum, S., Stubbs, B., Ward, P. B., Steel, Z., Lederman, O., & Vancampfort, D. (2015) · Metabolism · doi:10.1016/j.metabol.2015.04.009 · Cited by 246 · see citing works
Pleasurable behaviors reduce stress via brain reward pathways
Ulrich-Lai, Y. M., Christiansen, A. M., Ostrander, M. M., Jones, A. A., Jones, K. R., Choi, D. C., Krause, E. G., Evanson, N. K., Furay, A. R., Davis, J. F., et al. (2010) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1007740107 · Cited by 231 · see citing works
Post-traumatic Stress Disorder and Cardiovascular Disease
Coughlin, S. S. (2011) · The Open Cardiovascular Medicine Journal · doi:10.2174/1874192401105010164 · Cited by 216 · see citing works
van den Berk-Clark, C., Secrest, S., Walls, J., Hallberg, E., Lustman, P. J., Schneider, F. D., & Scherrer, J. F. (2018) · Health Psychology · doi:10.1037/hea0000593 · Cited by 212 · see citing works
Post-traumatic Stress Disorder and Cardiovascular Disease
Burg, M. M., & Soufer, R. (2016) · Current Cardiology Reports · doi:10.1007/s11886-016-0770-5 · Cited by 72 · see citing works
Flagged first, then by citations
Research works printed but not linked: 35
- Arenson MB & Cohen BE (2017). Posttraumatic Stress Disorder and Cardiovascular Disease. PTSD Research Quarterly 28, 1– 9.
- Breslau N, Peterson EL, Kessler RC & Schultz LR (1999). Short screening scale for DSM-IV posttraumatic stress disorder. American Journal of Psychiatry 156, 908– 11. 10360131
- Cassidy A, Huang T, Rice MS, Rimm EB & Tworoger SS (2014). Intake of dietary flavonoids and risk of epithelial ovarian cancer. American Journal of Clinical Nutrition 100, 1344– 51. PMC4196485 25332332
- Cassidy A, O’Reilly EJ, Kay C, Sampson L, Franz M, Forman JP, Curhan G. & Rimm EB (2011). Habitual intake of flavonoid subclasses and incident hypertension in adults. American Journal of Clinical Nutrition 93, 338– 47. PMC3021426 21106916
- Chang SC, Cassidy A, Willett WC, Rimm EB, O’Reilly EJ & Okereke OI (2016). Dietary flavonoid intake and risk of incident depression in midlife and older women. American Journal of Clinical Nutrition 104, 704– 14. PMC4997290 27413131
- Chiuve SE, Fung TT, Rimm EB, Hu FB, McCullough ML, Wang M, Stampfer MJ & Willett WC (2012). Alternative dietary indices both strongly predict risk of chronic disease. Journal of Nutrition 142, 1009– 18. PMC3738221 22513989
- Edmondson D. & Cohen BE (2013). Posttraumatic Stress Disorder and Cardiovascular Disease. Progress in Cardiovascular Diseases 55, 548– 556. 23621964 PMC3639489
- Gavrieli A, Farr OM, Davis CR, Crowell JA & Mantzoros CS (2015). Early life adversity and/or posttraumatic stress disorder severity are associated with poor diet quality, including consumption of trans fatty acids, and fewer hours of resting or sleeping in a US middle-aged population: A cross-sectional and prospective study. Metabolism 64, 1597– 610. 26404481 PMC4609606
- Gradus JL, Farkas DK, Svensson E, Ehrenstein V, Lash TL, Milstein A, Adler N. & Sorensen HT (2015). Posttraumatic stress disorder and cancer risk: a nationwide cohort study. European Journal of Epidemiology 30, 563– 8. 25957083 PMC4519360
- Hirth JM, Rahman M. & Berenson AB (2011). The association of posttraumatic stress disorder with fast food and soda consumption and unhealthy weight loss behaviors among young women. J Womens Health (Larchmt) 20, 1141– 9. 21751875 PMC3153863
- Ivey KL, Jensen MK, Hodgson JM, Eliassen AH, Cassidy A. & Rimm EB (2017). Association of flavonoid-rich foods and flavonoids with risk of all-cause mortality. British Journal of Nutrition 117, 1470– 1477. PMC7233415 28606222
- Jacka FN, Cherbuin N, Anstey KJ & Butterworth P. (2015). Does reverse causality explain the relationship between diet and depression? Journal of Affective Disorders 175, 248– 50. 25658499
- Jung SJ, Winning A, Roberts AL, Nishimi K, Chen Q, Gilsanz P, Sumner JA, Fernandez CA, Rimm EB, Kubzansky LD & Koenen KC (2019). Posttraumatic stress disorder symptoms and television viewing patterns in the Nurses’ Health Study II: A longitudinal analysis. PLoS One 14, e0213441. PMC6428392 30897111
- Kessler RC (2000). Posttraumatic stress disorder: the burden to the individual and to society. Journal of Clinical Psychiatry 61 Suppl 5, 4– 12; discussion 13–4. 10761674
- Kessler RC, Sonnega A, Bromet E, Hughes M. & Nelson CB (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry 52, 1048– 60. 7492257
- Koenen KC, De Vivo I, Rich-Edwards J, Smoller JW, Wright RJ & Purcell SM (2009). Protocol for investigating genetic determinants of posttraumatic stress disorder in women from the Nurses’ Health Study II. BMC Psychiatry 9, 29. 19480706 PMC2698903
- Kubzansky LD, Bordelois P, Jun HJ, Roberts AL, Cerda M, Bluestone N. & Koenen KC (2014). The weight of traumatic stress: a prospective study of posttraumatic stress disorder symptoms and weight status in women. JAMA Psychiatry 71, 44– 51. 24258147 PMC4091890
- Lassale C, Batty GD, Baghdadli A, Jacka F, Sanchez-Villegas A, Kivimaki M. & Akbaraly T. (2018). Healthy dietary indices and risk of depressive outcomes: a systematic review and meta-analysis of observational studies. Molecular Psychiatry. PMC6755986 30254236
- Lee YC, Agnew-Blais J, Malspeis S, Keyes K, Costenbader K, Kubzansky LD, Roberts AL, Koenen KC & Karlson EW (2016). Post-Traumatic Stress Disorder and Risk for Incident Rheumatoid Arthritis. Arthritis Care & Research 68, 292– 8. 26239524 PMC4740283
- Mason SM, Frazier PA, Austin SB, Harlow BL, Jackson B, Raymond NC & Rich-Edwards JW (2017). Posttraumatic Stress Disorder Symptoms and Problematic Overeating Behaviors in Young Men and Women. Annals of Behavioral Medicine 51, 822– 832. 28425019 PMC5648630
- Mitchell KS & Wolf EJ (2016). PTSD, food addiction, and disordered eating in a sample of primarily older veterans: The mediating role of emotion regulation. Psychiatry Research 243, 23– 9. 27344589 PMC5014719
- Morgan CA 3rd, Hazlett G, Wang S, Richardson EG Jr., Schnurr P. & Southwick SM (2001). Symptoms of dissociation in humans experiencing acute, uncontrollable stress: a prospective investigation. American Journal of Psychiatry 158, 1239– 47. 11481157
- O’Donnell ML, Creamer M. & Pattison P. (2004). Posttraumatic stress disorder and depression following trauma: understanding comorbidity. American Journal of Psychiatry 161, 1390– 1396. 15285964
- Rimm EB, Williams P, Fosher K, Criqui M. & Stampfer MJ (1999). Moderate alcohol intake and lower risk of coronary heart disease: meta-analysis of effects on lipids and haemostatic factors. BMJ 319, 1523– 8. 10591709 PMC28294
- Roberts AL, Agnew-Blais JC, Spiegelman D, Kubzansky LD, Mason SM, Galea S, Hu FB, Rich-Edwards JW & Koenen KC (2015). Posttraumatic stress disorder and incidence of type 2 diabetes mellitus in a sample of women: a 22-year longitudinal study. JAMA Psychiatry 72, 203– 10. 25565410 PMC4522929
- Roberts AL, Austin SB, Corliss HL, Vandermorris AK & Koenen KC (2010). Pervasive trauma exposure among US sexual orientation minority adults and risk of posttraumatic stress disorder. Am J Public Health 100, 2433– 41. 20395586 PMC2978167
- Roberts AL, Huang T, Koenen KC, Kim Y, Kubzansky LD & Tworoger SS (2019). Posttraumatic stress disorder (PTSD) is associated with increased risk of ovarian cancer: a prospective and retrospective longitudinal cohort study. Cancer Research pii: canres.1222.2019. PMC6774860 31488422
- Shah RC, Janos AL, Kline JE, Yu L, Leurgans SE, Wilson RS, Wei P, Bennett DA, Heilman KM & Tsao JW (2013). Cognitive decline in older persons initiating anticholinergic medications. PloS One 8, e64111. 23741303 PMC3669362
- Suliman S, Anthonissen L, Carr J, du Plessis S, Emsley R, Hemmings SM, Lochner C, McGregor N, van den Heuvel L. & Seedat S. (2016). Posttraumatic Stress Disorder, Overweight, and Obesity: A Systematic Review and Meta-analysis. Harvard Review of Psychiatry 24, 271– 93. 27384397
- Sumner JA, Kubzansky LD, Elkind MS, Roberts AL, Agnew-Blais J, Chen Q, Cerda M, Rexrode KM, Rich-Edwards JW, Spiegelman D, Suglia SF, Rimm EB & Koenen KC (2015). Trauma Exposure and Posttraumatic Stress Disorder Symptoms Predict Onset of Cardiovascular Events in Women. Circulation 132, 251– 9. 26124186 PMC4519406
- Vilija M. & Romualdas M. (2014). Unhealthy food in relation to posttraumatic stress symptoms among adolescents. Appetite 74, 86– 91. 24326148
- Wang T, Heianza Y, Sun D, Huang T, Ma W, Rimm EB, Manson JE, Hu FB, Willett WC & Qi L. (2018). Improving adherence to healthy dietary patterns, genetic risk, and long term weight gain: gene-diet interaction analysis in two prospective cohort studies. BMJ 360, j5644. 29321156 PMC5759092
- Winning A, Gilsanz P, Koenen KC, Roberts AL, Chen Q, Sumner JA, Rimm EB, Maria Glymour M. & Kubzansky LD (2017). Post-traumatic Stress Disorder and 20-Year Physical Activity Trends Among Women. American Journal of Preventive Medicine 52, 753– 760. 28325517 PMC5438780
- Yamazaki S, Fukuhara S. & Green J. (2005). Usefulness of five-item and three-item Mental Health Inventories to screen for depressive symptoms in the general population of Japan. Health Qual Life Outcomes 3, 48. 16083512 PMC1201161
- Yuan C, Spiegelman D, Rimm EB, Rosner BA, Stampfer MJ, Barnett JB, Chavarro JE, Rood JC, Harnack LJ, Sampson LK & Willett WC (2018). Relative Validity of Nutrient Intakes Assessed by Questionnaire, 24-Hour Recalls, and Diet Records as Compared With Urinary Recovery and Plasma Concentration Biomarkers: Findings for Women. Am J Epidemiol 187, 1051– 1063. 29036411 PMC5928456
Cited by
Sorted by citations
Levine, G. N., Cohen, B. E., Commodore-Mensah, Y., Fleury, J., Huffman, J. C., Khalid, U., Labarthe, D. R., Lavretsky, H., Michos, E. D., Spatz, E. S., et al. (2021) · Circulation · doi:10.1161/cir.0000000000000947 · Cited by 865 · see citing works
Self-citation
- Authors
- Kim, Y., Roberts, A. L., Rimm, E. B., Chibnik, L. B., Tworoger, S. S., Nishimi, K. M., Sumner, J. A., Koenen, K. C., & Kubzansky, L. D.
- Affiliations
- Harvard University (US)
- Brigham and Women's Hospital (US)
- Columbia University Irving Medical Center (US)
- Corresponding author
- Kim, Yongjoo
- ORCID
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2019-11-26
- Volume
- 51
- Issue
- 2
- Pages
- 310-319
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- PMC
- PMC8063582
- OpenAlex
- W2991184811
- Cited by
- 23
- References
- 7
- Citations by year
- 2025: 5 · 2024: 5 · 2023: 6 · 2022: 4 · 2021: 2 · 2020: 1
- FWCI
- 2.04
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Cancer Institute (UM1CA176726, U01CA176726)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Keywords
- post-traumatic stress disorder, diet quality, Alternative Healthy Eating Index-2010, women, trauma exposure, chronic disease risk, dietary change over time, Nurses' Health Study II
- MeSH terms
- Adult, Chronic Disease, Diet, Female, Humans, Longitudinal Studies, Surveys and Questionnaires, Risk Factors, Stress Disorders, Post-Traumatic, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
