The association between Healthy Beverage Index and psychological disorders among overweight and obese women: a cross-sectional study

Niloufar Rasaei, Rasool Ghaffarian-Ensaf, Farideh Shiraseb, Faezeh Abaj, Fatemeh Gholami, Cain C.T. Clark, Khadijeh Mirzaei

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    2 Citations (Scopus)
    49 Downloads (Pure)


    Background and aims: The Healthy Beverage Index (HBI) is a valuable technique to estimate the synergistic effects of overall beverage consumption. Several studies have evaluated the associations between HBI and beneficial changes in the health status. however, there is no study on the association between patterns of beverage consumption and mental health status. Therefore, this study sought to examine the association between HBI and psychological disorders among overweight and obese women. Methods: 199 overweight and obese women, between the ages of 18 and 55 y, were enrolled in this cross-sectional study in Tehran, Iran. To collect beverage dietary data, a validated semi-quantitative food-frequency questionnaire (FFQ) was used. Furthermore, the DASS-21 questionnaire was used to assess psychological profile states. Results: The association of total depression anxiety stress (DASS) score with healthy beverage index (HBI) tertiles in models was marginally significant (OR =: 0.78; 95% CI 0.30–2.02; P-value = 0.074; (OR = 0.77; 95% CI 0.28–2.16; P-value = 0.062), respectively. In terms of stress, anxiety, and depression, after adjusting for confounders, participants with higher HBI in the third tertile had lower odds of depression vs. the first tertile (OR = 0.99; 95% CI 0.35–2.81; P-trend = 0.040). Conclusion: We demonstrate that the total DASS score was associated with HBI tertiles. We also found that participants with higher HBI had lower odds of depression. However, additional well-designed studies are needed to confirm the veracity of these findings.

    Original languageEnglish
    Article number295
    Number of pages11
    JournalBMC Women's Health
    Issue number1
    Early online date15 Jul 2022
    Publication statusPublished - Dec 2022

    Bibliographical note

    © The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver (http://creativeco applies to the data made available in this article, unless otherwise stated in a credit line to the data.


    This study was supported by TUMS and grant ID was 99-3212-51715.


    • Anxiety
    • Depression
    • Healthy beverage index
    • Mental health
    • Obesity
    • Stress

    ASJC Scopus subject areas

    • Reproductive Medicine
    • Obstetrics and Gynaecology


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