Higher dietary diversity is inversely associated with antenatal anxiety, depression, and their comorbid symptoms: a population-based cross-sectional study in Southwest China.

OBJECTIVE: To examine the associations between dietary diversity and the prevalence of anxiety symptoms, depressive symptoms, and co-morbid anxiety and depressive symptoms (CADs) among Chinese pregnant women. METHODS: Dietary diversity score (DDS) was developed according on the Chinese dietary guidelines and assessed by the consumption of nine food groups. The total score ranged from 0 to 9 and could divide into three levels: insufficient (score of 1–5), moderate (score of 6–7), and adequate (score of 8–9). Anxiety and depressive symptoms were assessed using the Self-Rating Anxiety Scale and the Edinburgh Postnatal Depression Scale, respectively. Multiple logistic regression was applied to investigate the association of DDS with anxiety symptoms, depressive symptoms, and CADs. RESULTS: This study included 11,684 participants in the final analysis. The prevalence of reported antenatal anxiety symptoms, depressive symptoms, and CADs were 2.8%, 9.9%, and 4.3%, respectively. After multivariable adjustment, the adequate DDS group showed lower odds of pure anxiety than the insufficient DDS group (OR = 0.43, 95%CI:0.29, 0.65). Both the moderate and adequate DDS groups had lower odds of pure depression (OR = 0.73, 95%CI:0.62, 0.86 and OR = 0.66, 95%CI:0.54, 0.82, respectively) and CADs (OR = 0.62, 95%CI:0.50,0.77 and OR = 0.42, 95%CI:0.30, 0.59, respectively) compared to the insufficient DDS group. CONCLUSION: This study provided observational evidence that higher dietary diversity was associated with a lower prevalence of anxiety symptoms, depressive symptoms, and CADs among pregnant women in China. This finding highlights the potential of dietary diversity as a modifiable factor for promoting perinatal mental health.