Beiranvand Reza, Mansournia Mohammad Ali, Vahid Farhad, Nejatisafa Ali-Akbar, Nedjat Saharnaz
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Nutrition and Health Group, School of Heath, Arak University of Medical Science, Arak, Iran.
Front Nutr. 2024 Jan 12;11:1288793. doi: 10.3389/fnut.2024.1288793. eCollection 2024.
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.
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.
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 ( < 0.001).
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.
饮食炎症指数（DII）是一种综合营养指数，在过去十年中因其与身心健康的关联而备受关注。为了准确评估DII对健康结果的精确影响，需要对营养素和食物的影响进行调整。本研究旨在使用多水平模型来尽量减少先前方法的偏差，从而调查DII与精神障碍（抑郁、焦虑和压力）之间的关联。
本横断面分析研究使用了德黑兰医科大学员工队列研究（TEC）初始阶段的数据。营养信息通过基于菜肴的半定量食物频率问卷（DFQ）获得，而心理数据则使用抑郁、焦虑和压力量表（DASS - 42）收集。通过SAS软件中的GLIMMIX对获取的数据在三个水平（分别为食物、营养素和DII）上进行多水平建模分析。
共有3501人参与了本研究。多水平模型的结果表明，在调整基线特征、营养素和食物后，DII与精神障碍之间存在显著的统计学关联。DII每增加一个单位，压力、焦虑和抑郁的平均得分分别增加3.55、4.26和3.02（<0.001）。
基于多水平模型的研究结果，建议尽量减少促炎营养素和食物的摄入以增进心理健康。在涉及嵌套数据的营养研究中，也建议进行多水平数据分析以获得更准确和合理的估计。
