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Mediterranean-type diet is associated with higher psychological resilience in a general adult population: findings from the Moli-sani study



Psychological resilience is a measure of stress coping ability and has been associated with favourable health outcomes. While evidence on the relationship of dietary habits with a number of psychosocial conditions is available, there is lack of studies on their association with psychological resilience in a general adult population.


Cross-sectional analysis on 10 812 subjects recruited within the cohort of the Moli-sani study (2005–2010). Psychological resilience was measured by the 25-item Connor-Davidson Psychological Resilience Scale. Food intake was recorded by the EPIC food frequency questionnaire and adherence to Mediterranean diet was appraised by both a Greek Mediterranean diet score and an Italian Mediterranean Index. Empirically derived dietary patterns were obtained by principal factor analysis. Multivariable linear regression analysis (95%CI) was used to test the association between dietary scores and psychological resilience.


Higher adherence to Mediterranean-type diets or consumption of a vegetable-based dietary pattern (obtained from principal factor analysis) were positively associated with psychological resilience (β=0.43; 95%CI: 0.19–0.66, β=0.92; 0.69–1.16, and β=1.18; 0.93–1.44, for Greek Mediterranean diet score, Italian Mediterranean Index and the ‘Olive oil and vegetables pattern’, respectively). Dietary polyphenol or antioxidant intakes and greater variety in fruit and vegetable consumption were also positively associated with psychological resilience, while the associations with Western-like diets were weak.


In conclusion, Mediterranean diet, vegetable-based dietary patterns and better diet quality were all positively associated with higher psychological resilience, whereas Western-type diets were not.

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The Moli-sani research group thanks the Associazione Cuore Sano Onlus (Campobasso, Italy) for its cultural and financial support. We thank Professor Marco Sarchiapone for his advice on the selection of resilience questionnaire and Dr Matteo Manzi and Dr Emilia Ruggiero for their valuable support in data input. The enrolment phase of the Moli-sani study was supported by research grants from Pfizer Foundation (Rome, Italy), the Italian Ministry of University and Research (MIUR, Rome, Italy)—Programma Triennale di Ricerca, Decreto no.1588 and Instrumentation Laboratory, Milan, Italy. Funders had no role in study design, collection, analysis, and interpretation of data; in the writing of the manuscript and in the decision to submit the article for publication. Marialaura Bonaccio was supported by a Fondazione Umberto Veronesi Fellowship. Simona Costanzo is the recipient of a Fondazione Umberto Veronesi travel grant. All authors were and are independent from funders. The present analyses were partially supported by the Italian Ministry of Health 2013 (Young investigator grant to MB, number: GR-2013-02356060) and by the Italian Association for Cancer Research (A.I.R.C.) with grant AIRC ‘5x1000’ Ref. n. 12237.

Ethics: The Moli-sani study complies with the Declaration of Helsinki and was approved by the ethical committee of the Catholic University in Rome, Italy. All participants provided written informed consent.

Author contributions

LI, MB and ADC contributed to the conception and design of the work, and interpretation of data; SC, GP and MP managed data collection; MB, ADC analysed the data; MB wrote the paper; CC, MBD, GdG and LI originally inspired the research and critically reviewed the manuscript. All authors approved the final version of the manuscript.

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Correspondence to M Bonaccio.

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The authors declare no conflict of interest.

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Supplementary Information accompanies this paper on European Journal of Clinical Nutrition website

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Bonaccio, M., Di Castelnuovo, A., Costanzo, S. et al. Mediterranean-type diet is associated with higher psychological resilience in a general adult population: findings from the Moli-sani study. Eur J Clin Nutr 72, 154–160 (2018).

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