Megan Holt


Background: Western dietary patterns, characterized by high intakes of trans fatty acids (TFA’s), are associated with numerous preventable chronic diseases. Conversely, a Mediterranean dietary pattern is known to be favorably associated with health. Recent findings suggest a correlation between Mediterranean dietary patterns and positive affect, and an inverse correlation with negative affect. Trans fatty acid intake is also associated with negative affect. Further, affect disturbances are associated with emotion dysregulation. We have yet to understand the association of diet with emotion regulation after taking affect disturbances into consideration. The purpose of this study was to examine effects of Mediterranean diet adherence and TFA intake on emotion regulation in a sample of 4992 adults.

Methods: Existing data was used from Adventist Health Study-II (AHS-2; 2002- 2006), and a sub-study of the AHS-II, the Biopsychosocial Religion and Health Study (BRHS). The BRHS in 2006-2007 measured affect with the Positive and Negative Affect Schedule (PANAS). The Difficulties in Emotion Regulation Scale (DERS) sub-scales for clarity, awareness and regulation strategies were contained in wave two of BRHS from 2010-2011. Multiple linear regression was used to examine associations of a Mediterranean diet score and TFA’s with DERS subscale scores. Negative and positive affect were examined as mediators in the relationship between diet and emotion regulation.

Results. Findings revealed an inverse relationship between Mediterranean diet score and difficulty with clarity (p=0.006), and this relationship was mediated by positive and negative affect. Further, intake of TFA’s directly related to difficulties with awareness (p=0.045), clarity (p=0.012) and regulation strategies (p=0.009), and all three relationships were mediated by positive and negative affect. Positive affect was associated with enhanced emotion regulation, and negative affect with difficulties with emotion regulation.

Conclusions: Intakes characteristic of a Mediterranean diet and low in TFA appear to have a favorable correlation with emotion regulation via positive and negative affect. Future directions include examining whether affect and emotion regulation form a chain of variables mediating the diet and depression correlation, and developing a randomized control trial to clearly assess the relationship between diet and emotion regulation.


School of Public Health

First Advisor

Jerry W. Lee

Second Advisor

Adam Arechiga

Third Advisor

Kelly R. Morton

Fourth Advisor

Serena Tonstad

Degree Name

Doctor of Public Health (DrPH)

Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Diet Therapy; Diet -- psychology; Energy Intake -- physiology; Energy Intake -- psychology; Nutritional Physiological Phenomena; Emotions -- diet therapy; Emotions -- psychology; Health Promotion; Diet Surveys; Cross-Sectional Studies.



Page Count

ix: 109

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website


Loma Linda University. Del E. Webb Memorial Library. University Archives