The Adverse Childhood Experiences (ACEs) researchers report that childhood adversity is relatively common, often co-occurs with multiple types of exposures, and has a dose-response relationship to many leading causes of morbidity and mortality in the U.S. Prolonged exposure to stress during early brain development can lead to inflammation and oxidative stress that disrupts brain functioning associated with depressive symptoms. Flavonoids may protect the brain through anti-inflammatory, antioxidant, and additional mechanisms to assist in the survival, maintenance, and growth of neurons. Thus, flavonoids may buffer depressive symptoms after ACEs exposure. In the current longitudinal study, we will examine the relationship between ACEs, perceived stress, depression, and flavonoid intake while controlling for demographic characteristics (e.g., age, gender, ethnicity, education, difficulty meeting expenses, energy). The study sample consisted of 6404 (67.4% female, 67.9% white, Mage = 61.9, SD = 12.7) participants who completed the Adventist Health Study-2 (AHS-2), and both waves of the Biopsychosocial Religion and Health Study (BRHS). The study aim was to examine whether early chronic stress exposure leads to stress sensitivity and depressive symptoms that can be ameliorated with dietary flavonoids. No studies to date have examined the relationship between dietary flavonoids and mental health after stress risk exposures. Study findings indicate that perceived stress significantly mediated the relationship between ACEs and depressive symptoms; and flavonoids significantly moderated the relationship between perceived stress and depressive symptoms; higher consumption of flavonoids was associated with less depressive symptoms after ACE exposure. More human studies are needed to understand the relationship between flavonoids and mental health and whether diet is sufficient to produce the positive effects found in clinical studies.

LLU Discipline





School of Behavioral Health

First Advisor

Kelly R. Morton

Second Advisor

Richard Hartman

Third Advisor

Grace J. Lee

Fourth Advisor

Jerry Lee

Degree Name

Doctor of Philosophy (PhD)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Major Depression; Protective Factors; Symptoms; Polyphenol; Childhood Adversity; Perceived Stress



Page Count

67 p.

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