Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jan 12:11:1288793.
doi: 10.3389/fnut.2024.1288793. eCollection 2024.

Association between dietary inflammatory index and mental disorders using multilevel modeling with GLIMMIX

Reza Beiranvand  1 , Mohammad Ali Mansournia  1 , Farhad Vahid  2 , Ali-Akbar Nejatisafa  3 , Saharnaz Nedjat  4
Affiliations

Association between dietary inflammatory index and mental disorders using multilevel modeling with GLIMMIX

Reza Beiranvand et al. Front Nutr. .

Abstract

Introduction: The Dietary Inflammatory Index (DII) is a composite nutritional index that has gained significant attention in the past decade due to its association with physical and mental well-being. To accurately assess the precise effects of DII on health outcomes, the effects of nutrients and foods need to be adjusted. This study aimed to investigate the association between DII and mental disorders (depression, anxiety, and stress) using multilevel modeling to minimize the bias of the previous methods.

Methods: This cross-sectional analytical study was conducted using data from the initial phase of the Tehran University of Medical Sciences Employees' Cohort Study (TEC). Nutritional information was obtained through a dish-based semi-quantitative food frequency questionnaire (DFQ), while psychological data were collected using the depression, anxiety and stress scale (DASS-42). The acquired data were analyzed using multilevel modeling in three levels (foods, nutrients, and DII, respectively) through GLIMMIX in the SAS software.

Results: A total of 3,501 individuals participated in this study. The results of the multilevel model demonstrated a significant statistical association between DII and mental disorders after adjusting for baseline characteristics, nutrients and foods. For each unit increase in DII, the mean scores for stress, anxiety, and depression increased by 3.55, 4.26, and 3.02, respectively (p < 0.001).

Conclusion: Based on the multilevel model's findings, it is recommended to minimize the use of pro-inflammatory nutrients and foods to increase the mental health. Multilevel data analysis has also been recommended in nutritional studies involving nested data to obtain more accurate and plausible estimates.

Keywords: DiI; GLIMMIX; dietary inflammatory index; mental disorders; multilevel model.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

References

    1. Greenberg PE, Fournier A-A, Sisitsky T, Pike CT, Kessler RC. The economic burden of adults with major depressive disorder in the United States (2005 and 2010). J Clin Psychiatry. (2015) 76:155–62. doi: 10.4088/JCP.14m09298 - DOI - PubMed
    1. Clarke DM, Currie KC. Depression, anxiety and their relationship with chronic diseases: a review of the epidemiology, risk and treatment evidence. Med J Aust. (2009) 190:S54–60. doi: 10.5694/j.1326-5377.2009.tb02471.x, PMID: - DOI - PubMed
    1. World Health Organization . Mental disorders. (2022). Available from: https://www.who.int/news-room/fact-sheets/detail/mental-disorders.
    1. World Health Organization, Colleges WOoN, Academies, Physicians AAoGPF . Integrating mental health into primary care: a global perspective. World Health Organization; (2008).
    1. Ghazizadeh H, Yaghooti-Khorasani M, Asadi Z, Zare-Feyzabadi R, Saeidi F, Shabani N, et al. . Association between dietary inflammatory index (DII®) and depression and anxiety in the Mashhad stroke and heart atherosclerotic disorder (MASHAD) study population. BMC Psychiatry. (2020) 20:1–11. doi: 10.1186/s12888-020-02663-4 - DOI - PMC - PubMed