ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutritional Epidemiology
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1680741
Comparative Analysis of Dietary Patterns and Depression Risk: Significant Inverse Association with HEI-2015 and Mediating Role of BMI
Provisionally accepted
- 1Tongling People's Hospital, Tongling, China
- 2Maanshan People's Hospital, Ma'anshan, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Objective:Depression is a severe global mental disorder closely associated with dietary habits. This study aimed to evaluate associations between four dietary patterns (assessed by Dietary Inflammatory Index(DII),Healthy Eating Index-2015(HEI-2015),Dietary Index for Gut Microbiota(DI-GM), and Composite Dietary Antioxidant Index(CDAI)) and depression risk. For any dietary pattern showing significant association, we further examined whether BMI mediated this relationship.Methods:Data from the National Health and Nutrition Examination Survey (NHANES, 2007-2018) were analyzed. Four dietary indices were calculated using two 24-hour dietary recalls:DII,HEI-2015,DI-GM, and CDAI. Depression severity was assessed via the Patient Health Questionnaire-9 (PHQ-9). Logistic regression and mediation analysis were employed to examine diet-depression associations and BMI's mediating effect.For any dietary pattern showing significant association with depression, employ SHapley Additive exPlanations(SHAP) analysis to identify which specific dietary components contribute most to this association.Results:HEI-2015 showed a significant negative correlation with depression (OR=0.99, 95% CI: 0.98–1.00, P=0.002). Compared to the lowest HEI-2015 quartile (Q1), the highest quartile (Q4) had significantly reduced depression risk (OR=0.66, 95% CI: 0.50–0.87, P=0.003). No significant associations were observed for DII, DI-GM, or CDAI. Mediation analysis revealed BMI partially mediated the HEI-2015–depression relationship (mediation proportion=6.39%, P<0.0001). SHAP analysis identified added sugars, whole fruits, and saturated fats as key HEI-2015 components: added sugars and whole fruits reduced depression risk, while saturated fats increased it.Conclusion:This study confirms a significant inverse association between HEI-2015 and depression risk, with BMI acting as a partial mediator. Reducing intake of added sugars and saturated fats while increasing whole fruits consumption may mitigate depression risk.
Keywords: Depression, Dietary patterns, HEI-2015, Body Mass Index, Mediation analysis, SHAP analysis
Received: 06 Aug 2025; Accepted: 20 Oct 2025.
Copyright: © 2025 Fang, Shi and Cui. 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: Qin Cui, cuiqing1210@foxmail.com
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.