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. 2025 Mar 27:12:1524652.
doi: 10.3389/fnut.2025.1524652. eCollection 2025.

Adherence to the Eat-Lancet diet and its association with depression and anxiety among Iranian adults: a cross-sectional multicentric study

Ghazaal Alavi Tabatabaei #  1 , Noushin Mohammadifard #  1 , Fahimeh Haghighatdoost  2 , Hamed Rafiee  3 , Mehdi Abbasi  3 , Farid Najafi  4 , Hossein Farshidi  5 , Masoud Lotfizadeh  6 , Tooba Kazemi  7 , Hamidreza Roohafza  8 , Nizal Sarrafzadegan  1
Affiliations

Adherence to the Eat-Lancet diet and its association with depression and anxiety among Iranian adults: a cross-sectional multicentric study

Ghazaal Alavi Tabatabaei et al. Front Nutr. .

Abstract

Background: Previous studies have shown a connection between diet and mental health. However, there is limited evidence on how emerging diets, particularly the EAT-Lancet reference diet (ELD), relate to depression and anxiety. This study aims to investigate the potential impact of ELD adherence on these mental health conditions.

Methods and materials: This cross-sectional study recruited 1,970 Iranian adults using a stratified multistage random cluster sampling method, part of a community-based investigation conducted in five cities from February 2018 to July 2019. Participants' regular dietary intake was assessed using a validated food frequency questionnaire. The ELD was formulated based on the consumption of the 14 dietary components outlined in the ELD. Anxiety and depression were evaluated using a validated Iranian version of the Hospital Anxiety and depression Scale.

Results: In the fully adjusted model, there was no significant association between ELD adherence and depressive symptoms (aORT3 vs. T1 = 0.89; 95% CI: 0.66, 1.19; p trend = 0.42) and anxiety (aOR T3 vs. T1 = 0.93; 95% CI: 0.70, 1.23; p trend = 0.62) in the whole population. In stratified analysis by sex, a significant inverse association was found only between ELD and depression among men (aOR T3 vs. T1 = 0.66; 95% CI: 0.40, 1.07; p trend = 0.047) but not women (aOR = 0.71, 95% CI: 0.44, 1.15; p trend = 0.103). No significant association was observed between ELD and anxiety either in men or women.

Conclusion: Despite a null association between ELD and depressive symptoms and anxiety in the whole population, higher adherence to ELD was associated with a lower risk of depressive symptoms in males.

Keywords: Eat-Lancet diet; anxiety; depression; mental disorders; mental health.

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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.

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