Associations of the Chinese healthy eating index and dietary diversity score with depressive and anxious symptoms among older adults

Abstract

Depression and anxiety significantly contribute to the mental health disease burden. Although healthy dietary patterns may mitigate mental distress, evidence regarding the associations of dietary quality and dietary diversity with mental health remains limited. This study aimed to investigate the independent and joint associations of the Chinese Healthy Eating Index (CHEI) and Dietary Diversity Score (DDS) with depression, anxiety, and their co-occurrence among Chinese older adults. We utilized cross-sectional data from the 2018 Chinese Longitudinal Healthy Longevity Survey, which included a total of 9,455 participants aged 65 years and older. The CHEI and DDS were applied to evaluate dietary quality and dietary diversity, respectively. We employed logistic regression models to examine these associations. In the fully adjusted model, higher CHEI was associated with lower odds of depression (OR [odds ratio] tertile [T] 3 vs. T1= 0.63, 95% CI [confidence interval]: 0.53, 0.75), anxiety (OR T3 vs. T1= 0.61, 95% CI: 0.51, 0.74), and their co-occurrence (OR T3 vs. T1= 0.66, 95% CI: 0.51, 0.84). A 10-unit increment in CHEI was associated with 33% lower odds of depression, 32% lower odds of anxiety, and 32% lower odds of their co-occurrence. Similarly, a higher DDS was inversely associated with the odds of depression (OR T3 vs. T1= 0.59, 95% CI: 0.50, 0.70), anxiety (OR T3 vs. T1= 0.56, 95% CI: 0.47, 0.67), and their co-occurrence (OR T3 vs. T1= 0.60, 95% CI: 0.47, 0.76). Each one-unit increase in DDS was correlated with a 12% lower odds of depression, anxiety, and their co-occurrence. Moreover, compared to the group with low CHEI and low DDS, the group with high CHEI and high DDS showed significantly lower odds of depression, anxiety, and their co-occurrence. The study revealed that higher CHEI and DDS scores were inversely associated with depressive symptoms, anxious symptoms, and their co-occurrence among Chinese older adults. Additional longitudinal research is required to confirm our findings. Not applicable.