Association between Dietary Inflammatory Index (DII®) and depression and anxiety in the Mashhad Stroke and Heart Atherosclerotic Disorder (MASHAD) Study population

Abstract

Background: Systemic inflammation is emerging as an important factor in the etiology of psychiatric disorders such as depression and anxiety. Therefore, the inflammatory potential of the diet may also be an etiological factor for these conditions, and this may be estimated by calculating the dietary inflammatory index (DII®) score. We aimed to investigate the association between DII score and incidence of depression and anxiety among a representative sample in northeastern Iran. Methods: This cross-sectional study undertook in a sub-sample of 7083 adults aged 35 to 65 years recruited as part of Mashhad stroke and heart atherosclerotic disorder (MASHAD) cohort study population, and after excluding subjects with incomplete data. All participants completed the Beck Anxiety Inventory (BAI), the Beck Depression Inventory II (BDI-II), and a validated 65-item food frequency questionnaire (FFQ). Logistic regression was used to evaluate the association between DII score and depression/anxiety score. Results: Of the study participants, 37.1% (n = 2631) were found to have mild to severe depression, and 50.5% (n = 3580) were affected by mild to severe anxiety. After adjusting for confounding factors, in women, the third (OR: 1.41, 95% CI: 1.06-1.88, p-values< 0.05) and fourth quartiles (OR: 1.37, 95% CI: 1.03-1.83, p-values< 0.05) of DII score were associated with increased risk of a high depression score compared to the first quartile of DII score. Conclusion: There was a significant association between DII score and severe depression among women but not men in this Iranian population. In order to confirm the association between DII food score, depression, and anxiety, further research is required in different populations, and perhaps an intervention study.