Adherence to empirically derived dietary patterns and risk of depression symptoms and anxiety disorder: The Maastricht Cohort Study.

BACKGROUND

Previous studies on mental disorders have yielded inconsistent findings regarding the relationship between dietary patterns (DPs) and psychological disorders, with most evidence derived from cross-sectional studies.

OBJECTIVES

This study aims to examine the association between major DPs and risk of depression symptoms (DepS) and anxiety disorder (AnxD).

METHODS

This study used data from The Maastricht Study [participants included in analyses for DepS: n = 6967, mean age (SD): 59.94 (8.66) y, female: 49.40%; for AnxD: n = 6634, mean age (SD): 59.94 (8.60) y, female: 49.40%]. A validated food frequency questionnaire was used to assess dietary intakes. DPs were derived using principal component analysis. The Patient Health Questionnaire-9 and the Generalized Anxiety Disorder 7-item questionnaire were used annually to assess DepS and AnxD, respectively. A Cox proportional hazards regression analysis was incorporated to examine the associations. Stratified analyses were performed based on the status of diabetes, sex, body mass index, and smoking.

RESULTS

Three DPs were identified: "high vegetables and legumes," "high fast food and sugar," and "vegetarian-like". After adjustment for all possible confounders, adherence to the "high fast food and sugar" DP was associated with a higher risk of DepS {hazard ratio [HR] [95% confidence intervals (CIs)] Q5 compared with Q1: 2.13 [1.55, 2.92], P < 0.001, Ptrend < 0.001} and AnxD [HR (95% CIs) Q5 compared with Q1: 2.03 (1.33, 3.10), P = 0.001, Ptrend < 0.001] in the total population. No association was found for other DPs in the total population. A significant interaction was observed between the "vegetarian-like" DP and smoking status on risk of AnxD [interaction term, HR (95% CIs): 0.76 (0.64, 0.90), P = 0.001]. Opposite but nonsignificant associations were noted in never-smokers [HR (95% CIs) Q5 compared with Q1: 1.47 (0.83, 2.60), P = 0.19, Ptrend = 0.06] and former/current smokers [HR (95% CIs) Q5 compared with Q1: 0.62 (0.37, 1.04), P = 0.07, Ptrend = 0.046].

CONCLUSIONS

A diet high in fast foods, confectionery, fried potatoes, sauces, sugar-sweetened beverages, and refined grains might be associated with an increased risk of depression and anxiety in adults.