Sex- and Age-Specific Associations Between Eating Behaviors and Psychological Distress: A Cross-Sectional Analysis of 8,781 Community-Dwelling Adults in the Yamagata Cohort Study

In this study, we examined whether the associations between eating behaviors and psychological distress differed simultaneously by sex and age in a large community-based Japanese population.Particular focus was placed on eating speed, meal timing, and snacking frequency.A cross-sectional analysis was conducted using baseline data from 8,781 adults aged 40-74 years in the Yamagata Cohort Study who underwent community-based health checkups in Yamagata Prefecture, Japan.Multivariate logistic regression models were used to assess associations between eating behaviors and psychological distress, defined as a Kessler 6 score ≥ 10.Analyses were stratified by sex and age (<65 and ≥65 years).Psychological distress was prevalent among women and adults aged <65 years.Associations between eating behaviors and distress varied by sex-age group.Among older men, snacking almost daily and eating dinner within 2 h of bedtime were associated with higher odds of distress than rarely snacking.Among younger women, daily snacking was associated with reduced odds of distress, whereas among older women, fast eating was associated with increased odds of distress.No significant associations were observed in younger men.We concluded that eating behaviors were differentially associated with psychological distress across sex-age subgroups.Snacking exhibited particularly heterogeneous patterns, suggesting that its psychological meaning may differ by demographic context, reflecting diverse coping styles, physiological pathways, and sociocultural norms.These subgroup-specific patterns may inform the development of additional tailored behavioral approaches to support mental health.