HEI-2015 Scores Among Adults Experiencing Anxiety and Depression: NHANES 2015–2016

Abstract

Objectives: Diet quality is associated with overall health and may reduce risks of certain diseases. People with mental health issues such as depression and anxiety may exhibit behavioral symptoms that can compromise diet quality and increase risk for nutritional deficiencies. The Healthy Eating Index (HEI) is a measure of diet quality that scores thirteen individual dietary components to assess how well a diet meets the Dietary Guidelines for Americans 2015-2016. The objective of this study was to compare HEI-2015 scores among individuals with varying degrees of self-reported anxiety and depression. Methods: Data were analyzed from the 2015-2016 NHANES (National Health and Nutrition Examination Survey). Healthy Eating Index 2015 scores were calculated for each day of dietary intake. Usual intake for total HEI-2015 score was estimated using the NCI (National Cancer Institute) method. Usual HEI scores were compared across reported anxiety and depression levels using multiple linear regression. Covariates included age, sex, ethnicity, Family Income to Poverty ratio, and BMI. Results: Mean HEI score for the total sample of adults (n = 5087) was 46.59. Mean HEI scores for individuals experiencing anxiety daily, weekly, monthly, and a few times a year were not significantly different from each other. Mean HEI scores for individuals experiencing feelings of depression daily (40.6 ± 1.8) were different (P < 0.05) from those experiencing depression weekly, monthly, yearly, or never (46.8 ± 1.1, 47.4 ± 0.9, 47.9 ± 0.5, and 46.1 ± 0.7, respectively). Conclusions: Overall, the mean HEI scores for all individuals and subgroups examined were suboptimal. These results indicate that people who experience depression daily may be at increased risk for nutritional deficiencies and may require additional attention to improve intake and support overall health.