Eating patterns and psychological distress among young women: the moderating role of cognitive reappraisal.

Authors

Aiza Qamar, Ayesha Sarfaraz, Ayesha Khalid, Sara Zaib Mufti, Wahab Ali Khan, Shehla A Yasin

Published in

BMC women's health. Jul 15, 2026. Epub Jul 15, 2026.

Abstract

Psychological distress among university students is a pressing public health concern. Emerging research in nutritional psychology links eating patterns to mental health outcomes, while emotion regulation processes shape individual stress responses. Female university students in Pakistan are particularly vulnerable due to compounding sociocultural pressures, rigorous academic demands, and limited mental health resources. This cross-sectional study investigates the association between eating patterns and psychological distress in this demographic, specifically examining whether cognitive reappraisal (an adaptive emotion regulation strategy) moderates this relationship.
Data were collected via purposive sampling from 354 female university students in Lahore, Pakistan. Assessments utilized the Healthy Eating Index (HEI) for dietary patterns, the Emotion Regulation Questionnaire (ERQ) for cognitive reappraisal, and the Depression Anxiety Stress Scales-21 (DASS-21) for psychological distress. Data were analyzed using Pearson correlations, linear regression, and hierarchical moderation.
Healthier eating patterns were significantly associated with reduced levels of depression (r = - .233, p < .001), anxiety (r = - .174, p < .05), and stress (r = - .192, p < .05). Cognitive reappraisal correlated positively with healthier eating (r = .215, p < .05) and negatively correlated with depression (r = - .412, p < .01), anxiety (r = - .367, p < .01), and stress (r = - .389, p < .01). Regression models confirmed that eating patterns significantly predicted depression (β = - 0.23, p < .01), anxiety (β = - 0.17, p < .05), and stress (β = - 0.19, p < .01). Moderation analyses indicated that cognitive reappraisal significantly moderated the relationship between eating patterns and psychological distress (interaction β range = - 0.12 to - 0.17), explaining an additional 2-3% of variance. Specifically, higher cognitive reappraisal strengthened the protective association between healthier eating patterns and lower psychological distress while attenuating distress associated with unhealthy eating patterns.
Healthier eating patterns and higher levels of cognitive reappraisal were associated with lower psychological distress among young women in academic settings. Cognitive reappraisal appeared to play a protective moderating role by strengthening the beneficial association between healthier eating patterns and lower levels of depression, anxiety, and stress while reducing psychological vulnerability associated with poorer eating habits. These findings highlight the importance of holistic university mental health initiatives that integrate nutritional awareness with adaptive emotion-regulation training to promote psychological well-being among female students.

PMID:
42458510
Bibliographic data and abstract were imported from PubMed on 16 Jul 2026.

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