Diet Quality Measured by Healthy Eating Index-2015 is Inversely Associated with Depression: NHANES 2011–2014

Abstract

Abstract Objectives The purpose of this study was to assess the relationship between diet quality and self-reported depressive symptoms in a nationally representative sample of the U.S. population. Methods A total of 8448 adults over the age of 20 were included in this study. Dietary data were based on 24-hour diet recalls and diet quality was measured using the USDA Healthy Eating Index (HEI)-2015. Symptoms of depression were assessed by trained interviewers using the Patient Health Questionnaire-9 (PHQ-9). Logistic regression models determined whether HEI-2015 scores differed between depressed and non-depressed adults after controlling for age, gender, poverty income ratio, and body mass index. Additional logistic regression models examined the association of HEI-2015 diet components and risk of depression. Results The overall prevalence of depression in this sample was 9.3%. Rates of depression were higher among women, middle-aged adults, obese subjects, and those of lower socioeconomic status. Compared to non-depressed adults (n = 7665), depressed adults (n = 783) had a lower total HEI-2015 score. HEI-2015 score was significantly (P < 0.001) and inversely associated with depressive symptoms, both before and after adjusting for covariates. Greater intake of whole fruit, total protein, and lower added sugar intake was associated with a reduced risk of depression. Conclusions Dietitians should be aware that depressed patients may be consuming less-optimal diets than the non-depressed population and should assess diet quality. Lower intakes of whole fruit, total protein, and higher added sugar intake in particular may be prevalent in those with depressive symptoms. All health professionals should encourage a better balanced diet, and a diet pattern that adheres to the 2015–2020 DGA should be promoted for overall health. Funding Sources Central Washington University.