A cross-sectional study: relationship between diet and mental health in the Korea National Health and Nutrition Examination Survey 2022

Introduction Anxiety and depressive disorders pose a major public health challenge in South Korea. Diet may be a key factor associated with mental health, particularly anxiety and depression. This study investigates associations between Global Burden of Disease-defined food groups and nutrients association with anxiety and depression using the Korea National Health and Nutrition Examination Survey ( KNHANES), aligning with the Global burden of disease Lifestyle And mental Disorders (GLAD) project to inform global evidence on nutritional determinants of mental health. Methods 4550 individuals (56.7% females) from the 2022 KNHANES dataset met inclusion criteria for the study sample. Dietary exposures were derived from 24-hour recalls. Probable depressive and anxiety disorders were defined by total score ≥10 on Patient Health Questionnaire-9 and General Anxiety Disorder-7, respectively. Following assumption validation, logistic regression estimated odds ratios between dietary exposures and probable anxiety or depression across four models: 1) unadjusted, 2) minimally adjusted with age, sex and education, 3) energy-adjusted using Willet’s method and 4) fully adjusted. Results Higher intake of fatty acids was generally associated with lower odds of probable depression and anxiety disorder across models. Monounsaturated (MUFA) and polyunsaturated (PUFA) fatty acids were associated with lower probable depression and n-3, saturated fatty acid and MUFA significantly associated with lower probable anxiety disorder across all models. Increased vegetables and sugar-sweetened beverage intake was associated with increased odds of probable depression, while fruit intake was associated with increased odds of probable anxiety disorder.