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

Parvane Saneei; Maryam Hajishafiee; Ammar Hassanzadeh Keshteli; Hamid Afshar; Ahmad Esmaillzadeh; Peyman Adibi

doi:10.1017/S0007114516001926

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

Br J Nutr. 2016 Jul;116(2):335-42. doi: 10.1017/S0007114516001926. Epub 2016 May 18.

Authors

Parvane Saneei¹, Maryam Hajishafiee¹, Ammar Hassanzadeh Keshteli², Hamid Afshar³, Ahmad Esmaillzadeh⁴, Peyman Adibi⁵

Affiliations

¹ 1Food Security Research Center,Isfahan University of Medical Sciences,PO Box 81745-151,Isfahan,Iran.
² 4Department of Medicine,University of Alberta,PO Box 7-142,Edmonton,Alberta,Canada.
³ 6Psychosomatic Research Center,Department of Psychiatry,Isfahan University of Medical Sciences,PO Box 81745-151,Isfahan,Iran.
⁴ 7Department of Community Nutrition,School of Nutritional Sciences and Dietetics,Tehran University of Medical Sciences,PO Box 14155/6117,Tehran,Iran.
⁵ 5Integrative Functional Gastroenterology Research Center,Isfahan University of Medical Sciences,PO Box 81745-151,Isfahan,Iran.

PMID: 27188471
DOI: 10.1017/S0007114516001926

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.

Keywords: AHEI Alternative Healthy Eating Index; Alternative Healthy Eating Index; Anxiety; Depression; Diet quality.

MeSH terms

Adult
Age Factors
Anxiety / epidemiology
Anxiety / prevention & control*
Anxiety Disorders / prevention & control*
Cross-Sectional Studies
Depression / epidemiology
Depression / prevention & control*
Depressive Disorder / prevention & control*
Diet
Diet, Healthy*
Feeding Behavior*
Female
Humans
Iran / epidemiology
Male
Nutrition Policy
Prevalence
Prospective Studies
Sex Factors
Surveys and Questionnaires