Mediterranean diet (MD) may have many health benefits for depression and anxiety symptoms on adults.
Aim:
to evaluate the adherence to the MD and mental health symptoms.
Methods:
Cross-sectional study with 199 adults (Mage = 31.35 ± 9.12; 71.36% female) from a health care center in São Paulo, Brazil. Mental health symptoms were evaluated using the Becky's Depression and Anxiety Inventory and MD via 78-item food frequency questionnaire. Sleep patterns were also evaluated as potential influences. Chi-square and ANOVA analysis were used to evaluate differences between mental health symptoms and MD.
Results:
The average dietary MD scores of participants was 4.86 ± 1.45 out of 7 requiring improvement. Higher adherence to the MD was associated with lower depression scores (T1 = 12.88 ± 8.51 vs. T3 = 10.19 ± 7.96). Mean anxiety (M = 10.27) and sleepiness scores (M = 7.96) were below cut-offs for moderate to severe symptoms. Significant differences in depression symptoms were found for saturated fat intake and the MUFA/SFA ratio.
Conclusion:
Greater severity of depression and anxiety symptoms was associated with lower MD adherence. Larger studies are needed to confirm these findings.
VentriglioASancassianiFContuMP, et al.Mediterranean Diet and its benefits on health and mental health: a literature review. Clin Pract Epidemiol Ment Health2020; 16: 156–164.
2.
KeysAMenottiAKarvonenMJ, et al.The diet and 15-year death rate in the seven countries study. Am J Epidemiol1986; 124: 903–915.
3.
BucklandGGonzálezCAAgudoA, et al.Adherence to the Mediterranean Diet and risk of coronary heart disease in the Spanish EPIC cohort study. Am J Epidemiol2009; 170: 1518–1529.
4.
GodosJGrossoGFerriR, et al.Mediterranean Diet, mental health, cognitive status, quality of life, and successful aging in southern Italian older adults. Exp Gerontol2023; 175: 112143.
5.
MantzorouMVadikoliasKPavlidouE, et al.Mediterranean Diet adherence is associated with better cognitive status and less depressive symptoms in a Greek elderly population. Aging Clin Exp Res2021; 33: 1033–1040.
6.
BastosAANogueiraLRNetoJV, et al.Association between the adherence to the Mediterranean dietary pattern and common mental disorders among community-dwelling elders: 2015 Health Survey of São Paulo, SP, Brazil. J Affect Disord2020; 265: 389–394.
7.
LemeACBNatacciLCda Silva TorresEAF. Overall diet quality, food groups and mental health disorders among Brazilians older than 15 years old: Brazilian National Health Survey - 2019. J Affect Disord2024; 356: 284–291.
8.
Gibson-SmithDBotMBrouwerIA, et al.Diet quality in persons with and without depressive and anxiety disorders. J Psychiatr Res2018; 106: 1–7.
9.
Gibson-SmithDBotMBrouwerIA, et al.Association of food groups with depression and anxiety disorders. Eur J Nutr2020; 59: 767–778.
10.
GBD Mental Disorders Collaborators. Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Psychiatry2022; 9: 137–150.
11.
FisbergRMColucciACAMorimotoJM,et al.Questionário de freqüência alimentar para adultos com base em estudo populacional. Rev Saúde Pública2008; 42: 550–554.
12.
PanagiotakosDBPitsavosCStefanadisC. Dietary patterns: a Mediterranean diet score and its relation to clinical and biological markers of cardiovascular disease risk. Nutr Metab Cardiovasc Diseases2006; 16: 559–568.
13.
PhilippiSTAquinoRdCda SilvaEAFT,et al.Healthy lifestyle and sustainable behaviours: a proposal to the food pyramid for the Brazilian context. Nutrition2025; 135: 112771.
14.
Dietary Guidelines Advisory Committee. Scientific Report of the 2020 Dietary Guidelines Advisory Committee: Advisory Report to the Secretary of Agriculture and Secretary of Health and Human Services [Internet]. U.S. Department of Agriculture, Agricultural Research Service, https://www.dietaryguidelines.gov/2020-advisory-committee-report (2020 jul [citado 9 de fevereiro de 2024]).
15.
BrassardDElvidge MuneneLASt-PierreS, et al.Evaluation of the Healthy Eating Food Index (HEFI)-2019 measuring adherence to Canada’s Food Guide 2019 recommendations on healthy food choices. Appl Physiol Nutr Metab2022; 47: 582–594.
16.
Shams-WhiteMMPannucciTELermanJL, et al.Healthy eating index-2020: review and update process to reflect the dietary guidelines for Americans, 2020–2025. J Acad Nutr Diet2023; 123: 1280–1288.
17.
ThompsonFEKirkpatrickSISubarAF, et al.The National Cancer Institute’s dietary assessment primer: a resource for diet research. J Acad Nutr Diet2015; 115: 1986–1995.
18.
TapsellLCNealeEPSatijaA,et al.Foods, nutrients, and dietary patterns: interconnections and implications for dietary guidelines. Adv Nutr2016; 7: 445–454.
19.
LemeACBPhilippiST. Development and evaluation of Diet Quality Index for Brazilians based on the updated version of the 2024 Food Pyramid: Nutrition focus House Budget Survey, 2017–18. Rev Esp Nutr Hum Diet2025.
20.
SwanGEPowellNAKnowlesBL, et al.A definition of free sugars for the UK. Public Health Nutr2018; 21: 1636–1638.
21.
CoelhoKSBistriche GiuntiniEGrandeF, et al.12th IFDC 2017 special issue – Brazilian Food Composition Table (TBCA): development and functionalities of the online version. J Food Compos Anal2019; 84: 103287.
22.
U.S. Department of Agriculture, Agricultural Research Service, Human Nutrition Research Center. FoodData Central [Internet]. Beltsville, MD, https://fdc.nal.usda.gov/.
23.
BastosAAFélixPVCastroMA, et al.Comparison and convergent validity of five Mediterranean dietary indexes applied to Brazilian adults and older adults: data from a population-based study (2015 ISA-Nutrition). J Nutr Sci2023; 12: e12.
BertolaziANFagondesSCHoffLS, et al.Validação da escala de sonolência de Epworth em português para uso no Brasil. J Bras Pneumol2009; 35: 877–883.
26.
CraigCLMarshallALSjöströmM, et al.International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc2003; 35: 1381–1395.
27.
WHO. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser2000; 894: i–xii, 1–253.
28.
SchwingshacklLBogensbergerBHoffmannG. Diet quality as assessed by the healthy eating index, alternate healthy eating index, dietary approaches to stop hypertension score, and health outcomes: an updated systematic review and meta-analysis of cohort studies. J Acad Nutr Diet2018; 118: 74–100.e11.
29.
GodosJFerriRLanzaG, et al.Mediterranean Diet and sleep features: a systematic review of current evidence. Nutrients2024; 16: 282.
30.
PottsKSWallaceMEGustatJ, et al.Sleep apnoea symptoms and sleepiness associate with future diet quality: a prospective analysis in the Bogalusa Heart Study. Br J Nutr2024: 1–10.
31.
NatacciLM MarchioniDC GoulartA, et al.Omega 3 consumption and anxiety disorders: a cross-sectional analysis of the Brazilian longitudinal study of adult health (ELSA-Brasil). Nutrients2018; 10: 663.
32.
JackaFNPascoJAWilliamsLJ, et al.Dietary intake of fish and PUFA, and clinical depressive and anxiety disorders in women. Br J Nutr2013; 109: 2059–2066.
33.
Jiménez-LópezEMesasAEVisier-AlfonsoME, et al.Adherence to the Mediterranean diet and depressive, anxiety, and stress symptoms in Spanish adolescents: results from the EHDLA study. Eur Child Adolesc Psychiatry2024; 33: 2637–2646.
34.
YinWLöfMChenR, et al.Mediterranean Diet and depression: a population-based cohort study. Int J Behav Nutr Phys Activity2021; 18: 153.
35.
HibbelnJRGowRV. The potential for military diets to reduce depression, suicide, and impulsive aggression: a review of current evidence for omega-3 and omega-6 fatty acids. Mil Med2014; 179: 117–128.
36.
FernandezMAMaximovaKFulkersonJA,et al.Associations between cooking skills, cooking with processed foods, and health: a cross-sectional study. Appl Physiol Nutr Metab2024; 49: 330–339.
