Dietary components can modulate stress, inflammatory indicators, and health risk. This study examined the relationship among diet, metabolic disease risk, and perceived stress in Korean adult females using the 2017-2018 Korea National Health and Nutrition Examination Survey. A total of 4,353 adult women aged 19-64 years were classified into four groups according to perceived stress level: very high stress group (VHSG, n=225), high stress group (HSG, n=1,079), moderate stress group (MSG, n=2,532), and low stress group (LSG, n=517). Data collection included the sociodemographics, anthropometrics, blood profile, and dietary survey. After adjusting for covariates, those in the VHSG had a higher body mass index (p=0.013) and obesity rate (p=0.053) with a shorter sleep time than the LSG group. The VHSG also tended to have a higher plasma LDL-cholesterol, hsC-reactive protein and lower levels of HDL-cholesterol, vitamin A, and vitamin E than the low stress group. High stress subjects demonstrated increased breakfast skipping frequency (p<0.0001), decreased fiber intake (p=0.001), potassium (p=0.041), and vitamin A (p=0.011) than the low stress ones. Therefore the perceived stress level was associated with the inflammatory indicators, obesity, and lack of anti-inflammatory or antioxidant nutrients. The dietary components may be an important mediator of stress and metabolic disease.