ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutrition, Psychology and Brain Health
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1601129
Evaluating and Modifying the PHDI for Depression Prevention: Insights from NHANES 2005-2018
Provisionally accepted
- 1Department of Clinical Research, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, 530021, China
- 2Department of Neurosurgery, Guangxi Medical University Cancer Hospita, Nanning, Guangxi, China
- 3Department of Respiratory Oncology, Guangxi Medical University Cancer Hospital, Nanning 530021, China
- 4Wuming Hospital of Guangxi Medical University, Nanning, Guangxi, China
- 5Department of Cardiology, Liuzhou People’s Hospital, Affiliated of Guangxi Medical University, Liuzhou, China
- 6Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- 7Department of Neurosurgery, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, China
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Background: Depression is a significant focus in mental health research, emerging as a pressing public health concern globally. The Planetary Health Diet Index (PHDI), recently proposed by The Lancet to balance health and environmental sustainability, remains unclear in its role in preventing depression-our study aims to investigate this association and seeks to optimize this dietary index.: A cross-sectional analysis was conducted using 2005-2018 NHANES data from 27,868 participants. Dietary quality was measured using PHDI-US, and depressive symptoms were assessed with the Patient Health Questionnaire-9 (PHQ-9; score ≥10 indicating depressive symptoms). Associations between dietary indices and depressive symptoms were analyzed using multivariable logistic regression and restricted cubic splines. Machine learning identified key PHDI-US components, leading to the recalibration of PHDI-US to create PHDI-Fruits.Findings: Except for the Dietary Inflammatory Index (DII), the PHDI-US, HEI-2020, AHEI, and MEDI all demonstrated protective effects against depression. However, the benefits of PHDI-US were weaker compared to the other indices, particularly among participants with high adherence. Among the components of PHDI-US, fruits had the most significant impact. After recalibrating the PHDI-Fruits component, its ability to reduce depression incidence improved substantially, surpassing that of the other dietary indices.Interpretation: Optimizing the preventive effect of PHDI on depression, the recalibrated PHDI-Fruits significantly enhances its ability to prevent depression, effectively improving the applicability of PHDI in populations affected by depression.
Keywords: EAT-Lancet diet, Planetary Health Diet Index, Depression, machine learning, Logistic regression, Diatary
Received: 28 Mar 2025; Accepted: 08 May 2025.
Copyright: © 2025 Tan, Li, Mo, Zhou, Miao, Ruan, Teng and Gong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yi-Zhen Gong, Department of Clinical Research, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, 530021, China
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