Exploring associations between diet and levels of anxiety and depression symptoms in early pregnancy

Abstract Rationale Pregnancy is frequently accompanied by considerable psychological distress, which may impact diet. However, this association remains insufficiently investigated. Purpose The objective was to explore associations between levels of anxiety and depression symptoms and diet quality and dietary intakes. The secondary objective was to compare diet quality and dietary intakes between pregnant individuals with high and low levels of anxiety or depression symptoms. Methods In the first trimester (11–14 weeks of pregnancy), 29 pregnant individuals were recruited through email outreach and posters displayed in hospitals and research centers in the province of Quebec. Participants completed three Web-based 24 h dietary recalls, from which the Healthy Eating Food Index (HEFI-2019), an overall diet quality score, and total dietary intakes were derived. The Psychiatric Symptom Index (PSI) questionnaire was also completed. Participants were categorized according to levels of anxiety and depression symptoms, based on a clinically relevant threshold of PSI ≥20 (high) and PSI <20 (low). Spearman correlations and independent samples t-tests were conducted. Results Higher levels of anxiety symptoms were associated with a lower percentage of energy from fat ( r =-0.41, p = 0.03), a higher percentage of energy from carbohydrates ( r = 0.42, p = 0.02), and greater total sugar intake ( r = 0.44, p = 0.02). Additionally, higher intakes of free sugars were positively associated with both higher levels of depression ( r = 0.38, p = 0.04) and anxiety ( r = 0.44, p = 0.02) symptoms. Participants in the high anxiety and depression groups had similar total HEFI-2019 score compared to the low anxiety and depression groups, except for the free sugars component, which was lower for participants in the high depression (Δ -1.9 pts, p = 0.04) and high anxiety (Δ -1.9 pts; p = 0.03) groups. Conclusion Psychological distress was associated with free and/or total sugars consumption during pregnancy, highlighting a potential target for nutritional interventions. However, confirmation in a larger, more diverse sample to assess clinical significance is needed.