The association of the Prime Diet Quality Score (PDQS) with depression and anxiety symptoms: the Isfahan functional disorders (ISFUN) cohort study

ABSTRACT

Background: Due to scarce epidemiologic data regarding the Prime Diet Quality Score (PDQS) and mental health disorders, this study aimed to investigate the association of PDQS with depression and anxiety symptoms in Iranian adults.

Methods: This cross-sectional analysis was performed using the baseline data collected for the Isfahan functional disorders (ISFUN) cohort study. ISFUN was established in 2017 and enrolled apparently healthy adults, aged 18–65 years in Isfahan, Iran. Information on usual dietary intakes was collected using a validated Dish-based, 106-item food frequency questionnaire. The severity of depression and anxiety was assessed using a validated Iranian version of the Hospital Anxiety and Depression Scale.

Results: A total number of1892 participants were enrolled in the present study. In total, 54.50% of subjects were female. In the fully adjusted model, participants with PDQS lower than median compared with those with PDQS higher than median had higher risk of depression (OR =   1.62; 95% CI: 1.11, 2.37) and anxiety (OR: 1.57; 95% CI: 1.08, 2.27). In stratified analysis by sex, males with PDQS lower than median compared with those with PDQS higher than median had greater risk for depressive (OR: 1.57) and anxiety symptoms (OR =   1.52). However, in females, no significant association was found between PDQS and odds of depression, and anxiety in the fully adjusted model.

Conclusion: We found evidence indicating a significant inverse association between PDQS and depression and anxiety symptoms among Iranian adults. Further studies, in particular with prospective design, are required to confirm these findings.

KEYWORDS:

• Prime diet quality score
• diet quality
• anxiety
• depression
• mental health disorders

Acknowledgment

We wish to thank all participants and their families for their commitment to this study. We acknowledge the management of Isfahan province health center and also Isfahan health center #1 for their administrative supports. We also acknowledge the staff and health workers at Kerdabad health center for their gracious role in recruiting and following the participants.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author statement

Contributors: PA, HR were responsible for the organization and coordination of the study, developed the study design and provided feedback on methods, results and discussion parts of all manuscript revised versions. FH, PH contributed to the writing the first draft of the manuscript and the reviewing and editing of the final manuscript. AF performed data analysis and contributed to the reviewing and editing of the final manuscript. FH, PH, and AF designed and developed the figures and tables. HSh, AA contributed to the management or administration of the study. All authors approved the final version of the manuscript.

Additional information

Funding

This work has been supported by the Iranian Ministry of Health and Medical Education (700/144), Isfahan University of Medical Sciences (195149), the Iranian National Institute for Medical Research Development (NIMAD) (972 953) and the Ethics Committee of Isfahan University of Medical Sciences (240365).

Notes on contributors

Fahimeh Haghighatdoost

Fahimeh Haghighatdoost, PhD, an assistant professor of nutrition, has an interest in nutritional epidemiology with a focus on mental disorders and cardiovascular disease.

Awat Feizi

Awat Feizi, PhD, a full professor of biostatistics at the department of biostatistics and epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran. He was selected twice as a distinguished researcher in the field of medical science in 2017 and 2023 in Isfahan Province. He is the author or co-author of more than 630 papers in national and international refereed journals.

Parisa Hajihashemi

Parisa Hajihashemi, PhD, an assistant professor of nutrition, with her work focused on chronic disease and functional disorders.

Hassan Shahoon

Hassan Shahoon, MD, has an interest in the psychosomatic field.

Alireza Ani

Alireza Ani is a medical doctor and researcher specializing in bioinformatics and data analysis. His main focus is on understanding complex biological systems and employing advanced computational techniques to study biological processes.

Hamidreza Roohafza

Dr. Hamidreza Roohafza is a psychiatrist and fellowship of psychosomatic from Freiburg, Germany. He has been working at Isfahan Cardiovascular Research Institute since 2001. He worked as a vice-chancellor of deputy of research, research manager, and head of the Tobacco Control Unit at this Institute and he has been the head of the Psychocardiology Unit since 2001. His first research line is psychosomatic tends to psycho-cardiology. He has conducted research on stress management in cardiology and cardiac rehabilitation fields and his second research line is public health focused on smoking. In these fields, he has conducted several projects and published many articles in national and international journals. He collaborates with the department of psychosomatic medicine and psychotherapy at Freiburg University Medical Center, Isfahan Province Health Center, Isfahan Province Education Organization and Isfahan Province Welfare Organization. He was awarded with a distinguished researcher of Isfahan University of Medical Sciences in 2012.

Peyman Adibi

Peyman Adibi, MD, a professor and head of Isfahan Gastroenterology and Hepatology Research Center and has an interest in functional gastrointestinal disorders.