{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T11:46:03Z","timestamp":1787312763605,"version":"build-2736575974"},"reference-count":66,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2018,3,2]],"date-time":"2018-03-02T00:00:00Z","timestamp":1519948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001381","name":"Singapore National Research Foundation","doi-asserted-by":"publisher","award":["NMRC\/TCR\/004-NUS\/2008"],"award-info":[{"award-number":["NMRC\/TCR\/004-NUS\/2008"]}],"id":[{"id":"10.13039\/501100001381","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001381","name":"Singapore National Research Foundation","doi-asserted-by":"publisher","award":["NMRC\/TCR\/012-NUHS\/2014"],"award-info":[{"award-number":["NMRC\/TCR\/012-NUHS\/2014"]}],"id":[{"id":"10.13039\/501100001381","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Singapore Institute for Clinical Sciences, A*STAR"},{"name":"UK Medical Research Council","award":["MC_UU_12011\/4"],"award-info":[{"award-number":["MC_UU_12011\/4"]}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["NF-SI-0515-10042"],"award-info":[{"award-number":["NF-SI-0515-10042"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"name":"European Union's Eramus+ Capacity-Building ENeASEA Project and Seventh Framework Programme","award":["FP7\/2007-2013"],"award-info":[{"award-number":["FP7\/2007-2013"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Diet in the first month postpartum, otherwise known as \u201cthe confinement diet\u201d in Asia, has unique characteristics that are influenced by traditions, cultures, and beliefs. We aimed to characterize dietary patterns during confinement period in a multi-ethnic Asian cohort and examined their associations with postpartum depression (PPD) and anxiety (PPA). Dietary intakes of 490 women were ascertained in the first month postpartum using 3-day food diaries and dietary patterns were derived by factor analysis. Participants completed the Edinburgh Postnatal Depression Scale (EPDS) and State-Trait Anxiety Inventory (STAI) at three months\u2019 postpartum; higher scores are indicative of more depressive and anxiety symptoms, respectively. Four dietary patterns were identified: Traditional-Chinese-Confinement diet, Traditional-Indian-Confinement diet, Eat-Out diet and Soup-Vegetables-Fruits diet. The Traditional-Indian-Confinement diet was associated with less PPD symptoms [\u03b2 (95% CI) \u22120.62 (\u22121.16, \u22120.09) EPDS score per SD increase in diet score] and a non-significant trend with reduced probable PPD (EPDS scores \u2265 13) [OR (95% CI) 0.56 (0.31, 1.01)]. The Soup-Vegetables-Fruits diet was associated with less PPA symptoms [\u03b2 (95% CI) \u22121.49 (\u22122.56, \u22120.42) STAI-state score]. No associations were observed for other dietary patterns. Independent of ethnicity, adherence to the Traditional-Indian-Confinement diet that is characterized by intake of herbs and legumes, and Soup-Vegetables-Fruits diet high in fruits, vegetables and fish during the postpartum period were associated with less PPD and PPA symptoms, respectively.<\/jats:p>","DOI":"10.3390\/nu10030299","type":"journal-article","created":{"date-parts":[[2018,3,2]],"date-time":"2018-03-02T11:53:40Z","timestamp":1519991620000},"page":"299","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Prospective Associations of Maternal Dietary Patterns and Postpartum Mental Health in a Multi-Ethnic Asian Cohort: The Growing up in Singapore towards Healthy Outcomes (GUSTO) Study"],"prefix":"10.3390","volume":"10","author":[{"given":"Cherlyen","family":"Teo","sequence":"first","affiliation":[{"name":"Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore 117609, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1694-0235","authenticated-orcid":false,"given":"Ai-Ru","family":"Chia","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore 119228, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjorelee","family":"Colega","sequence":"additional","affiliation":[{"name":"Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore 117609, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling-Wei","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore"},{"name":"School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin 4, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doris","family":"Fok","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore 119228, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Pang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore 119228, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4643-0618","authenticated-orcid":false,"given":"Keith","family":"Godfrey","sequence":"additional","affiliation":[{"name":"Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton SO16 6YD, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1945-0266","authenticated-orcid":false,"given":"Kok","family":"Tan","sequence":"additional","affiliation":[{"name":"Duke-National University of Singapore Graduate Medical School, Singapore 169857, Singapore"},{"name":"Department of Maternal Fetal Medicine, KK Women\u2019s and Children\u2019s Hospital, Singapore 229899, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Yap","sequence":"additional","affiliation":[{"name":"Duke-National University of Singapore Graduate Medical School, Singapore 169857, Singapore"},{"name":"Department of Paediatric Endocrinology, KK Women\u2019s and Children\u2019s Hospital, Singapore 229899, Singapore"},{"name":"Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynette","family":"Shek","sequence":"additional","affiliation":[{"name":"Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore 117609, Singapore"},{"name":"Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yap-Seng","family":"Chong","sequence":"additional","affiliation":[{"name":"Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore 117609, Singapore"},{"name":"Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore 119228, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Meaney","sequence":"additional","affiliation":[{"name":"Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore 117609, Singapore"},{"name":"Douglas Mental Health University Institute, McGill University, Montreal, QC H4H 1R3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Chen","sequence":"additional","affiliation":[{"name":"Duke-National University of Singapore Graduate Medical School, Singapore 169857, Singapore"},{"name":"Department of Psychological Medicine, KK Women\u2019s &amp; Children\u2019s Hospital, Singapore 229899, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Chong","sequence":"additional","affiliation":[{"name":"Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore 117609, Singapore"},{"name":"Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2018,3,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1146\/annurev-clinpsy-050212-185612","article-title":"Postpartum depression: Current status and future directions","volume":"9","author":"McCabe","year":"2013","journal-title":"Ann. 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