title: Adherence to the DASH diet in relation to psychological profile of Iranian adults.
abstract: BACKGROUND
  Although empirically derived dietary patterns have been examined in relation to depression, limited data are available linking theory-based dietary patterns and psychological health.
  
  
  OBJECTIVE
  We aimed to investigate the association between adherence to DASH-style diet and psychological health among Iranian adults.
  
  
  METHODS
  This cross-sectional study was done among 3846 general public adults in Isfahan, Iran. Dietary assessment was conducted using a validated 106-item dish-based semiquantitative food frequency questionnaire. To investigate participants' adherence to DASH-style diet, we created DASH score based on earlier publications focusing on eight components (fruits, vegetables, nuts and legumes, dairy products, grains, sweetened beverages and sweets, sodium, and red and processed meats). Participants were classified into three categories based on their DASH score [low (≤40), moderate (41-50), and high adherence (≥51)]. This categorization, instead of distribution-based classification, was used due to low adherence to the DASH dietary pattern in the study population. Psychological health was examined by means of validated Hospital Anxiety and Depression Scale and General Health Questionnaire. Depression, anxiety, and psychological distress were defined based on standard criteria.
  
  
  RESULTS
  We found that moderate adherence to DASH-style diet was associated with lower odds of depression (OR 0.73; 95 % CI 0.59-0.90, Ptrend= 0.63) compared with those with the lowest adherence. In our stratified analyses, these associations remained significant for women (0.70; 0.54-0.91) and for normal-weight participants (0.70; 0.52-0.92). Moreover, after controlling for potential confounders, an inverse association was observed between high adherence to DASH-style diet and anxiety in normal-weight participants (0.61; 0.37-0.98). Such associations were also seen between moderate adherence to DASH-eating style and anxiety in overweight or obese individuals (0.63; 0.42-0.95). We failed to find any significant association between consumption of DASH-style diet and psychological distress.
  
  
  CONCLUSIONS
  We found an inverse association between moderate adherence to DASH dietary pattern and depression. Further prospective studies are required to confirm these findings.
authors.affiliation: Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.|Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, PO Box 81745-151, Iran.
authors.forename: Ghazaleh
authors.initials: G
authors.lastname: Valipour
authors.affiliation: Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. Esmaillzadeh@hlth.mui.ac.ir.|Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, PO Box 81745-151, Iran. Esmaillzadeh@hlth.mui.ac.ir.|Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran. Esmaillzadeh@hlth.mui.ac.ir.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Esmaillzadeh
authors.affiliation: Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.|Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, PO Box 81745-151, Iran.|Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Leila
authors.initials: L
authors.lastname: Azadbakht
authors.affiliation: Psychosomatic Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Hamid
authors.initials: H
authors.lastname: Afshar
authors.affiliation: Department of Medicine, University of Alberta, Edmonton, AB, Canada.
authors.forename: Ammar
authors.initials: A
authors.lastname: Hassanzadeh
authors.affiliation: Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.|Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Peyman
authors.initials: P
authors.lastname: Adibi
mesh_terms: D000328:Adult; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003611:Dairy Products; D003863:Depression / Q000453:epidemiology*; D000072001:Diet, Healthy; D007887:Fabaceae; D005260:Female; D005638:Fruit; D006801:Humans; D007492:Iran; D016015:Logistic Models; D008297:Male; D008461:Meat Products; D008603:Mental Health; D015999:Multivariate Analysis; D015596:Nutrition Assessment; D009754:Nuts; D010349:Patient Compliance; D015995:Prevalence; D000069466:Red Meat; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014675:Vegetables; D055105:Waist Circumference; D000067348:Whole Grains
keywords: Anxiety; Depression; Diet; Healthy eating; Mood; Psychological health