Lan Ying, Chen Lvlin, Lin Zhimei, Tang Haoxian, Zhang Xuan
Department of Critical Care Medicine, Affiliated Hospital of Chengdu University, Chengdu, China.
Department of Hematology and Oncology, The 3RD Affiliated Hospital of Chengdu Medical College, Chengdu Pidu District People's Hospital, Chengdu, China.
BMC Psychiatry. 2025 May 30;25(1):556. doi: 10.1186/s12888-025-06987-x.
Given the changes in global environmental conditions and dietary patterns, understanding the potential impact of dietary factors on the risk of depression is crucial. The Planetary Health Diet Index (PHDI) is a dietary scoring system that integrates human health and environmental sustainability. This study aims to evaluate the association between the PHDI, the risk of depression, and mortality.
Data from the National Health and Nutrition Examination Survey 2005-2018. Depression was assessed using Patient Health Questionnaire-9 (PHQ-9), with a score ≥ 10 indicating depression. PHDI calculated from 14 self-reported dietary groups, ranges from 0 to 140. Multivariable weight logistic and linear regression explored the association of PHDI with depression and total PHQ-9 score. Cox proportional hazards regression examined PHDI associations with mortality. Additional analyses included restricted cubic spline (RCS), threshold analyses, subgroup analyses, and multiple imputation.
Adjusting for confounding variables, each 10-point increase in PHDI was associated with an 11% lower risk of depression (OR = 0.89, 95% CI = 0.84, 0.94), 0.13 score of total PHQ (β=-0.13, 95% CI=-0.18, -0.08), and 17% of all-cause mortality (HR = 0.83, 95% CI = 0.73, 0.95). RCS indicated an inverse L-shaped association between PHDI and depression, and threshold effects analyses showed that the above associations were more significant in those with PHDI ≥ 76.01.
Adherence to the PHDI dietary pattern is associated with a reduced risk of both depression and all-cause mortality. PHDI may provide dietary guidance for the early prevention and intervention of depression.
鉴于全球环境条件和饮食模式的变化，了解饮食因素对抑郁症风险的潜在影响至关重要。行星健康饮食指数（PHDI）是一种将人类健康与环境可持续性相结合的饮食评分系统。本研究旨在评估PHDI、抑郁症风险和死亡率之间的关联。
数据来自2005 - 2018年国家健康与营养检查调查。使用患者健康问卷-9（PHQ-9）评估抑郁症，得分≥10表明患有抑郁症。PHDI由14个自我报告的饮食组计算得出，范围从0到140。多变量加权逻辑回归和线性回归探讨了PHDI与抑郁症及总PHQ-9得分之间的关联。Cox比例风险回归分析了PHDI与死亡率的关联。额外的分析包括受限立方样条（RCS）、阈值分析、亚组分析和多重填补。
在调整混杂变量后，PHDI每增加10分，抑郁症风险降低11%（OR = 0.89，95% CI = 0.84，0.94），总PHQ得分降低0.13分（β = -0.13，95% CI = -0.18，-0.08），全因死亡率降低17%（HR = 0.83，95% CI = 0.73，0.95）。RCS表明PHDI与抑郁症之间呈倒L形关联，阈值效应分析表明，上述关联在PHDI≥76.01的人群中更为显著。
坚持PHDI饮食模式与降低抑郁症风险和全因死亡率相关。PHDI可能为抑郁症的早期预防和干预提供饮食指导。
