Table 3.

Adjusted ORs for the prevalence and incidence of high-to-very high levels of psychological distress (K10*≥22 vs K10*<22) by baseline fruit and vegetable consumption and stratified by sex

	Cross-sectional analysis
	Male						Female
	Unadjusted OR (95% CI)	p Value	Age-adjusted OR (95% CI)	p Value	Fully adjusted OR† (95% CI)	p Value	Unadjusted OR (95% CI)	p Value	Age-adjusted OR (95% CI)	p Value	Fully adjusted OR† (95% CI)	p Value
Tertiles
Fruit
0 to 1 serve/day	1.0 (reference)		1.0 (reference)		1.0 (reference)		1.0 (reference)		1.0 (reference)		1.0 (reference)
>1 to 2 serves/day	0.69 (0.59 to 0.79)	<0.001	0.71 (0.61 to 0.82)	<0.001	0.78 (0.67 to 0.91)	0.002	0.59 (0.52 to 0.66)	<0.001	0.61 (0.54 to 0.69)	<0.001	0.67 (0.59 to 0.77)	<0.001
>2 serves/day	0.80 (0.69 to 0.93)	0.003	0.83 (0.72 to 0.96)	0.02	0.99 (0.84 to 1.17)	0.95	0.61 (0.54 to 0.68)	<0.001	0.65 (0.57 to 0.73)	<0.001	0.79 (0.69 to 0.91)	0.001
Vegetables
0 to 2 serves/day	1.0 (reference)		1.0 (reference)		1.0 (reference)		1.0 (reference)		1.0 (reference)		1.0 (reference)
>2 to 4 serves/day	0.70 (0.61 to 0.80)	<0.001	0.71 (0.62 to 0.82)	<0.001	0.80 (0.69 to 0.93)	0.004	0.66 (0.59 to 0.75)	<0.001	0.68 (0.60 to 0.77)	<0.001	0.80 (0.70 to 0.92)	0.001
>4 serves/day	0.82 (0.71 to 0.95)	0.007	0.88 (0.76 to 1.01)	0.07	0.91 (0.78 to 1.06)	0.23	0.64 (0.57 to 0.72)	<0.001	0.68 (0.60 to 0.77)	<0.001	0.80 (0.70 to 0.92)	0.001
Fruit and vegetables
0 to 4 serves/day	1.0 (reference)		1.0 (reference)		1.0 (reference)		1.0 (reference)		1.0 (reference)		1.0 (reference)
>4 to 7 serves/day	0.80 (0.70 to 0.91)	0.001	0.82 (0.72 to 0.94)	0.003	0.92 (0.80 to 1.07)	0.28	0.60 (0.53 to 0.67)	<0.001	0.62 (0.55 to 0.70)	<0.001	0.73 (0.64 to 0.83)	<0.001
>7 serves/day	0.79 (0.67 to 0.93)	0.004	0.84 (0.72 to 0.99)	0.04	0.91 (0.76 to 1.09)	0.30	0.57 (0.50 to 0.65)	<0.001	0.61 (0.54 to 0.70)	<0.001	0.75 (0.65 to 0.87)	<0.001

	Longitudinal analysis‡
	Male						Female
	Unadjusted OR (95% CI)	p Value	Age-adjusted OR (95% CI)	p Value	Fully adjusted OR† (95% CI)	p Value	Unadjusted OR (95% CI)	p Value	Age-adjusted OR (95% CI)	p Value	Fully adjusted OR† (95% CI)	p Value
Tertiles
Fruit
0 to 1 serve/day	1.0 (reference)		1.0 (reference)		1.0 (reference)		1.0 (reference)		1.0 (reference)		1.0 (reference)
>1 to 2 serves/day	0.87 (0.74 to 1.02)	0.09	0.87 (0.74 to 1.02)	0.09	0.95 (0.80 to 1.13)	0.56	0.72 (0.62 to 0.83)	<0.001	0.72 (0.62 to 0.84)	<0.001	0.84 (0.71 to 1.0)	0.04
>2 serves/day	0.90 (0.75 to 1.06)	0.21	0.89 (0.75 to, 1.06)	0.20	0.98 (0.81 to 1.19)	0.85	0.68 (0.58 to 0.80)	<0.001	0.69 (0.59 to 0.81)	<0.001	0.84 (0.70 to 1.0)	0.06
Vegetables
0 to 2 serves/day	1.0 (reference)		1.0 (reference)		1.0 (reference)		1.0 (reference)		1.0 (reference)		1.0 (reference)
>2 to 4 serves/day	0.86 (0.73 to 1.0)	0.05	0.85 (0.73 to 1.0)	0.05	0.94 (0.79 to 1.11)	0.45	0.67 (0.57 to 0.78)	<0.001	0.67 (0.57 to 0.78)	<0.001	0.82 (0.69 to 0.98)	0.03
>4 serves/day	0.96 (0.81 to 1.13)	0.59	0.95 (0.81 to 1.12)	0.55	0.94 (0.78 to 1.13)	0.51	0.75 (0.65 to 0.87)	<0.001	0.76 (0.65 to 0.88)	<0.001	0.89 (0.75 to 1.05)	0.17
Fruit and vegetables
0 to 4 serves/day	1.0 (reference)		1.0 (reference)		1.0 (reference)		1.0 (reference)		1.0 (reference)		1.0 (reference)
>4 to 7 serves/day	0.88 (0.76 to 1.03)	0.11	0.88 (0.76 to 1.03)	0.11	0.98 (0.83 to 1.16)	0.82	0.63 (0.55 to 0.73)	<0.001	0.64 (0.55 to 0.74)	<0.001	0.77 (0.65 to 0.91)	0.002
>7 serves/day	0.96 (0.80 to 1.14)	0.62	0.95 (0.79 to 1.14)	0.57	0.94 (0.77 to 1.15)	0.52	0.71 (0.61 to 0.83)	<0.001	0.72 (0.62 to 0.84)	<0.001	0.86 (0.72 to 1.02)	0.09

*The total K10 score is based on a 10-item questionnaire about anxiety and depression symptoms experienced in the past 4 weeks.²⁴ Possible K10 scores range from 10 to 50 with scores ≥22 indicating high-to-very-high levels of psychological distress.

†Adjusted for baseline age, sex, highest education level, marital status, household annual income, body mass index category, smoking status, alcoholic intake, physical activity levels and a history of chronic disease.

§Participants who reported having been recently treated for depression/anxiety and/or taking antidepressant medication and/or with a K10 score ≥22 (n=6067) at baseline were excluded from longitudinal analyses.

K10, Kessler Psychological Distress Scale.