Background: Depression and anxiety are prevalent mental health disorders among children and adolescents, with diet quality emerging as a modifiable risk factor. However, evidence regarding the association between comprehensive diet quality and mental health in school-aged children remains limited. Methods: This cross-sectional study included 400 Chinese children aged 8–12 years. Diet quality was assessed using the low-burden Diet Quality Questionnaire (DQQ), from which three Global Diet Recommendations (GDRs) scores were derived: GDR-Healthy, GDR-Limit, and total GDR. Depression and anxiety symptoms were evaluated using the Children’s Depression Inventory (CDI) and the Social Anxiety Scale for Children (SASC), respectively. Log-binomial regression models were used to estimate risk ratios (RRs) and 95% confidence intervals (CIs) for the associations between GDR scores and mental health symptoms (depression, anxiety, comorbidity). Subgroup analyses stratified by age and sex were conducted to explore heterogeneity. Results: Higher total GDR scores were associated with lower risks of depressive symptoms (RR = 0.90, 95% CI: 0.84–0.96), anxiety symptoms (RR = 0.93, 95% CI: 0.88–0.99), and their comorbidity (RR = 0.88, 95% CI: 0.79–0.97) after adjustment for age, sex, zBMI, physical activity, region of residence, only-child status and parental education. The GDR-Healthy score was independently associated with lower risks of depression symptoms (RR = 0.89, 95% CI: 0.83–0.96) and comorbidity (RR = 0.87, 95% CI: 0.79–0.95), while no significant associations between GDR-Limit score and mental health disorders were observed. Subgroup analyses indicated that the association was consistent across sex and age subgroups. Conclusions: Better diet quality and particularly higher intake of health-protective foods is associated with lower risks of depression, anxiety, and their comorbidity symptoms in Chinese school-aged children in this cross-sectional study. These findings support the integration of diet quality monitoring and nutritional interventions into public health strategies to promote mental health in children.
Zhao et al. (Tue,) studied this question.