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<p>Diet is a key modifiable factor influencing depression, with its impact well-documented in clinical studies. However, research on the combined effect of multiple dietary indices remains limited. This study investigates the relationship between four dietary indices and depression in American adults using data from 5030 participants in the 2017–2020 NHANES dataset. Depression was diagnosed using the Patient Health Questionnaire-9 (PHQ-9), with scores ≥ 10 indicating depression. Dietary indices were derived using the “dietary index” package, based on 24-hour dietary recall data. Various analytical methods, including multivariate logistic regression, sensitivity test, subgroup analysis, receiver operating characteristic (ROC) curves, and decision curve analysis (DCA), were used to assess the associations. Results showed that the Healthy Eating Index 2020 (HEI2020) and Dietary Inflammation Index (DII) were significantly associated with depression after adjusting for confounders. Sensitivity tests validated the strength of these results. Subgroup stratification indicated modified correlations between dietary quality scores and depression across multiple population characteristics, with significant interactive heterogeneity observed only for MEDI and DII. ROC analysis indicates that HEI2020 had the highest AUC among the indices (AUC = 0.606), although its discriminatory performance was modest, with clinical decision curves indicating potential value for depression risk stratification. A meta-analysis of protective factors revealed a notable correlation indicating lowered depression probability (OR = 0.58, 95% <i>CI</i>: 0.49–0.70, <i>P</i> &lt; 0.001). Through the combined evaluation of risk factors, a significantly higher depression rate was observed (OR = 1.59, 95% <i>CI</i>: 1.34–1.88, <i>P</i> &lt; 0.001). These findings suggest that healthy dietary patterns combined with anti-inflammatory diets may serve a function in lowering the chances of depression onset among American adults.</p>

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Exploring the link between dietary indices and depression in American adult population: NHANES 2017–2020 data analysis

  • 期刊论文

  • 发表日期：

    2026年5月19日

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  • Li Zhang,
  • Rongrong Li,
  • Xiaoqing Li,
  • Li Shu

摘要

Diet is a key modifiable factor influencing depression, with its impact well-documented in clinical studies. However, research on the combined effect of multiple dietary indices remains limited. This study investigates the relationship between four dietary indices and depression in American adults using data from 5030 participants in the 2017–2020 NHANES dataset. Depression was diagnosed using the Patient Health Questionnaire-9 (PHQ-9), with scores ≥ 10 indicating depression. Dietary indices were derived using the “dietary index” package, based on 24-hour dietary recall data. Various analytical methods, including multivariate logistic regression, sensitivity test, subgroup analysis, receiver operating characteristic (ROC) curves, and decision curve analysis (DCA), were used to assess the associations. Results showed that the Healthy Eating Index 2020 (HEI2020) and Dietary Inflammation Index (DII) were significantly associated with depression after adjusting for confounders. Sensitivity tests validated the strength of these results. Subgroup stratification indicated modified correlations between dietary quality scores and depression across multiple population characteristics, with significant interactive heterogeneity observed only for MEDI and DII. ROC analysis indicates that HEI2020 had the highest AUC among the indices (AUC = 0.606), although its discriminatory performance was modest, with clinical decision curves indicating potential value for depression risk stratification. A meta-analysis of protective factors revealed a notable correlation indicating lowered depression probability (OR = 0.58, 95% CI: 0.49–0.70, P < 0.001). Through the combined evaluation of risk factors, a significantly higher depression rate was observed (OR = 1.59, 95% CI: 1.34–1.88, P < 0.001). These findings suggest that healthy dietary patterns combined with anti-inflammatory diets may serve a function in lowering the chances of depression onset among American adults.