Association of dietary patterns and healthy diet scores with anxiety, depression, and their comorbidity among rural Chinese adults

Mental health issues pose a significant public health challenge. Anxiety and depression are among the most prevalent mental health problems. However, the association between dietary behavior and these mental health conditions among the rural population is unclear. This study examined the relationship between dietary behavior and the prevalence of anxiety, depression, and comorbidity among rural residents in China. This cross-sectional study used data from the Adult Chronic Disease and Nutrition Surveillance program in Pingnan. Dietary behavior was evaluated by healthy diet scores and dietary patterns. Two-Step Cluster Analysis (TCA) was employed to categorize the dietary patterns. Anxiety and depression symptoms were measured using the Generalized Anxiety Disorder-7 (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9), respectively. Binary logistic regression models were conducted to explore the impacts of healthy diet scores and dietary patterns on anxiety, depression, and comorbidity. Binary logistic regression results showed that rural residents with a healthy diet score of 0 and 1 had a significantly higher prevalence of anxiety (OR = 2.53, 95% CI = 1.29–4.96; OR = 2.31, 95% CI = 1.23–4.36), depression (OR = 2.65, 95% CI = 1.24–5.66; OR = 2.47, 95% CI = 1.20–5.05), and comorbidity (OR = 3.15, 95% CI = 1.27–7.84; OR = 2.42, 95% CI = 1.01–5.78). Individuals with a “moderately healthy pattern” and an “unhealthy pattern” also exhibited a significantly elevated prevalence of anxiety (OR = 1.67, 95% CI = 1.20–2.34; OR = 1.69, 95% CI = 1.14–2.50), depression (OR = 1.67, 95% CI = 1.17–2.39; OR = 1.61, 95% CI = 1.05–2.45), and comorbidity (OR = 1.88, 95% CI = 1.20–2.95; OR = 2.15, 95% CI = 1.29–3.57). Unhealthy dietary behavior is significantly associated with an increased prevalence of anxiety, depression, and comorbid conditions among rural residents in China. Promoting healthy dietary habits may help reduce the incidence and severity of anxiety and depression, thereby enhancing the overall mental health of rural communities.