Food and Mood Study – Exploring the determinants of dietary behaviours that support wellbeing in young adults with symptoms of depression, anxiety, and/or stress in Aotearoa, New Zealand

Poor mental health symptoms are prevalent amongst young adults in Aotearoa New Zealand, with almost one in four aged 15-24 experiencing high levels of psychological distress in 2023/24 (1) . There is growing evidence for the link between diet quality and positive mental health outcomes in both observational and intervention contexts (2) . However, understanding the holistic and complex determinants of dietary behaviours for wellbeing in young adults with poor mental health has largely been neglected from nutrition research, limiting the development of practical solutions. The ‘Food and Mood’ project aims to explore the determinants of dietary behaviours that support wellbeing in young adults experiencing symptoms of anxiety, depression, and/or stress in Aotearoa New Zealand. A 48-item mixed-methods survey was designed for this project, utilising the COM-B (capability, opportunity, motivation and behaviour) model and the Theoretical Domains Framework (TDF) to inform the survey structure. Young adults aged 18-30y experiencing at least mild symptoms of anxiety, depression, and/or stress according to the DASS-21 were recruited across Aotearoa New Zealand to take part in the cross sectional, anonymous study. Participants were recruited through university channels, community mental health organisations, social media advertising, and flyers. Open-ended questions were analysed through inductive thematic analysis, and Likert scale questions were descriptively analysed. Participants (n=131) were predominantly female (84%) and had a mean age of 23.2 + 4.1 years. Majority of the participants identified as NZ European (76%), with smaller proportions identifying as Māori (14.2%), Chinese (6.3%), Indian (4.7%), and Samoan (2%). Participants demonstrated a high level of psychological capability, where 92% of participants considered it “very” important to eat a diet that supports wellbeing, and 70% agreed that limiting highly processed foods is important for wellbeing. These findings are supported by the key theme of ‘nourishment’ identified in the thematic analysis, where participants highlighted that consuming nourishing foods can support physical wellbeing, which in turn positively influences mental and social health. Although 71% of participants indicated willingness to change their diet if they knew it would improve their mental wellbeing, almost half (48%) reported that they do not have adequate physical capability (e.g., skills and resources) to make these dietary changes. The majority of participants (90%) expressed that their mood influenced the way they eat, where 48% strongly agreed that it is more challenging to eat for wellbeing when mental health is worse. These results are supported by the qualitative theme of ‘emotional barriers’, with participants illustrating that negative emotions such as stress and depression inhibit their ability to engage in behaviours that enhance wellbeing. In conclusion, greater psychological capability appears to support young adults in eating for wellbeing. Poor mental health inhibits automatic motivation, suggesting that nutrition interventions should prioritise addressing emotional barriers to behaviour change.