Association between Alternative Healthy Eating Index (AHEI) and Depression and Anxiety in Iranian Adults

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 understudies region of Middle-East. We aimed to examine the association between adherence to healthy eating guidelines, as measured by AHEI, 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 Food Frequency Questionnaire (FFQ). Adherence to healthy eating was quantified using AHEI as suggested by earlier publications. The Iranian validated version of Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depression in study participants. Data on other covariates were gathered using a pre-tested questionnaire.
Overall, the frequency of anxiety and depression was 15.2% and 30.0%, respectively. After taking potential confounders into account, participants with greater adherence to AHEI had 48% lower odds of depression compared with those in the bottom quartile (OR = 0.52; 95% CI: 0.39-0.70). Those in the highest quartile of AHEI had a 29% lower odds of anxiety, compared with those in the lowest quartile (OR=0.71; 95% CI: 0.54-0.94); however, adjustment for dietary intakes and body mass index attenuated the association (OR = 0.75, 95% CI: 0.52-1.09).
Adherence to healthy eating was inversely associated with a lower chance of depression in Iranian adults. Further studies, especially with prospective design, are required to confirm these associations in Middle-Eastern populations.