Association of planetary health diet index with depression and mortality in the United States

Abstract Background 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...

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Main Authors: Ying Lan, Lvlin Chen, Zhimei Lin, Haoxian Tang, Xuan Zhang
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Psychiatry
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Online Access:https://doi.org/10.1186/s12888-025-06987-x
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author Ying Lan
Lvlin Chen
Zhimei Lin
Haoxian Tang
Xuan Zhang
author_facet Ying Lan
Lvlin Chen
Zhimei Lin
Haoxian Tang
Xuan Zhang
author_sort Ying Lan
collection DOAJ
description Abstract Background 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. Methods 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. Results 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. Conclusions 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.
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spelling doaj-art-e11a712d6c0b400a8689c539151d2a512025-08-20T02:03:32ZengBMCBMC Psychiatry1471-244X2025-05-0125111010.1186/s12888-025-06987-xAssociation of planetary health diet index with depression and mortality in the United StatesYing Lan0Lvlin Chen1Zhimei Lin2Haoxian Tang3Xuan Zhang4Department of Critical Care Medicine, Affiliated Hospital of Chengdu UniversityDepartment of Critical Care Medicine, Affiliated Hospital of Chengdu UniversityDepartment of Hematology and Oncology, The 3RD Affiliated Hospital of Chengdu Medical College, Chengdu Pidu District People’s HospitalShantou University Medical CollegeShantou University Medical CollegeAbstract Background 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. Methods 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. Results 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. Conclusions 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.https://doi.org/10.1186/s12888-025-06987-xPHDIDepressionMortalityNHANES
spellingShingle Ying Lan
Lvlin Chen
Zhimei Lin
Haoxian Tang
Xuan Zhang
Association of planetary health diet index with depression and mortality in the United States
BMC Psychiatry
PHDI
Depression
Mortality
NHANES
title Association of planetary health diet index with depression and mortality in the United States
title_full Association of planetary health diet index with depression and mortality in the United States
title_fullStr Association of planetary health diet index with depression and mortality in the United States
title_full_unstemmed Association of planetary health diet index with depression and mortality in the United States
title_short Association of planetary health diet index with depression and mortality in the United States
title_sort association of planetary health diet index with depression and mortality in the united states
topic PHDI
Depression
Mortality
NHANES
url https://doi.org/10.1186/s12888-025-06987-x
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