Association Between Anti-Inflammatory Diet, Dietary Diversity, and Depressive Symptoms Among Chinese Pregnant Women

<b>Background</b>: Dietary inflammatory potential and dietary diversity during pregnancy may program depression, yet these associations remain poorly characterized. This study aimed to assess an anti-inflammatory diet and dietary diversity in relation to depressive symptoms. <b>Methods</b>: We analyzed data from 2244 pregnant women in the prospective longitudinal study. Depressive symptoms were defined as an Edinburgh Postnatal Depression Scale (EPDS) score ≥ 9.5. An anti-inflammatory diet was assessed using the reverse energy-adjusted Dietary Inflammatory Index (rEDII), derived from food frequency questionnaires. Dietary diversity was classified as either adequate or inadequate. Generalized estimating equations were performed. <b>Results</b>: Our findings demonstrated that a higher rEDII was associated with lower EPDS scores (β: -0.25; 95% CI: -0.37, -0.12) and a 13% reduction in the risk of depressive symptoms (RR: 0.87; 95% CI: 0.81, 0.93). Adequate dietary diversity was linked to a 22% lower risk of depressive symptoms (RR: 0.78; 95% CI: 0.64, 0.95). A significant interaction was observed between rEDII and dietary diversity in relation to depressive symptoms. Among women with inadequate dietary diversity, a higher rEDII was associated with a 15% reduction in depressive symptom risk (RR: 0.85; 95% CI: 0.80, 0.90). <b>Conclusions</b>: An anti-inflammatory diet was associated with a lower risk of depressive symptoms; this association was greater among women with inadequate dietary diversity.