Adherence to Alternative Healthy Eating Index in relation to depression and anxiety in Iranian adults

Abstract

Earlier studies have shown a protective association between adherence to healthy eating guidelines and mental disorders in Western nations; however, data in this regard are limited from the understudied region of Middle East. We examined the association between adherence to healthy eating guidelines, as measured by Alternative Healthy Eating Index (AHEI)-2010, and prevalence of anxiety and depression in a large sample of Iranian adults. In this cross-sectional study, data on dietary intakes of 3363 adult participants were collected using a validated dish-based 106-item semi-quantitative FFQ. Adherence to healthy eating was quantified using AHEI-2010, as suggested by earlier publications. The Iranian validated version of Hospital Anxiety and Depression Scale was used to assess anxiety and depression in study participants. Data on other covariates were gathered using a pre-tested questionnaire. Overall, the prevalence of anxiety and depression was 15·2 % (males 10·8 % and females 18·3 %) and 30·0 % (males 22·9 % and females 35·1 %), respectively. After controlling for potential confounders, those in the top quartile of AHEI-2010 had a 49 % lower chance of anxiety (OR 0·51; 95 % CI 0·35, 0·72) and a 45 % lower odds of depression (OR 0·55; 95 % CI 0·42, 0·72), compared with those in the bottom quartile. Stratified analysis by sex revealed that women in the highest categories of AHEI-2010 had a 49 % lower odds of having anxiety and depression, after adjustment for confounders, but no significant association was found in men. In addition, among individuals who were 40 years old or younger, those with high adherence to AHEI-2010 were 58 and 51 % less likely to have anxiety and depression, compared with those with less adherence. Adherence to healthy eating was inversely associated with a lower chance of anxiety and depression in Iranian adults. Prospective studies are required to confirm these associations in Middle-Eastern populations.

Prospective association between adherence to dietary recommendations and incident depressive symptoms in the French NutriNet-Santé cohort

“…We found a significant inverse association between adherence to the mPNNS-GS, the PANDiet and the DQI-I and the risk of depressive symptoms. Regarding the AHEI-2010, which has been extensively used in the scientific literature, we found a non-significant association, in contrast to other published studies (15,19,24) . In the Seguimiento Universidad de Navarra Cohort study including 15 093 participants, adherence to the AHEI-2010 at baseline was inversely associated with depression risk (HR quintile 5 compared with quintile 1: 0•72; 95 % CI 0•59, 0•88) (15) .…”

“…In the Seguimiento Universidad de Navarra Cohort study including 15 093 participants, adherence to the AHEI-2010 at baseline was inversely associated with depression risk (HR quintile 5 compared with quintile 1: 0•72; 95 % CI 0•59, 0•88) (15) . In the cross-sectional studies published by Saneei et al including 3363 Iranian adults with a mean age of 36•3 (SD 7•9) years, adherence to the AHEI-2010 was also significantly inversely associated with depression risk (19,24) . In addition, a study based on the Whitehall II cohort including 4215 participants aged 35-55 years at baseline reported a significant inverse association between high adherence to the AHEI and recurrent depressive symptoms only among women (OR for a 1-SD increase: 0•59; 95 % CI 0•47, 0•75) (27) .…”

“…Overall, the studies that have investigated the association between adherence to the MD and depression or depressive symptoms showed a protective effect (12)(13)(14)(15)(16)(17)(18) . Other cross-sectional (19)(20)(21)(22)(23)(24) and some prospective studies (15,(25)(26)(27) have also evaluated the associations between different a priori dietary scores (measuring adherence to national dietary guidelines) and the risk of depression or depressive symptoms, but only one study has compared such associations across different diet quality scores (15) . Overall, the different versions of the HEI (15,(19)(20)(21)(22)24,27) and the Australian Recommended Food Score (26) were significantly inversely associated with the risk of depression or depressive symptoms, whereas the Ireland food pyramid recommendations (23) were not significantly associated with the risk of depressive symptoms.…”

The Association between Dietary Diversity Score and Somatoform Complaints Profile among Iranian Adults

“…Compared to the intake of single nutrients or foods, considering the general pattern of diet to assess diet quality could provide a better insight into diet-disease relations and may be more predictive of chronic disease risk (15). In this context, several studies have investigated the association between diet quality and psychiatric disorders (16,17). Dietary diversity score (DDS), as an indicator of diversity within food groups, is a reliable diet quality index (18).…”

Association of the Alternative Healthy Eating Index (AHEI-2010) with depression, stress and anxiety among Iranian military personnel

“…A study on 1118 African-American residents of Baltimore, USA, demonstrated an inverse association between adherence to the HEI-2010 and depression 14. Another study reported a 49% and 45% reduced chance for anxiety and depression among subjects adhering to the Alternative Healthy Eating Index (AHEI-2010) 15. Other studies have also inversely linked adherence to a healthy diet with psychological disorders 16.…”