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This is a Cross-Sectional Study study.

February 2, 2026BMC Public Health0 citationsOpen Access

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

XLXiaojun LiuFujian Medical University YCYating ChenFujian Medical University HCHuajing ChangFujian Medical University

Key Points

To examine the relationship between dietary behavior and the prevalence of anxiety, depression, and comorbidity in rural Chinese adults.
Cross-sectional study utilizing the Adult Chronic Disease and Nutrition Surveillance program
Dietary behavior was assessed through healthy diet scores and patterns
Two-Step Cluster Analysis categorized dietary patterns
Anxiety and depression were measured with GAD-7 and PHQ-9
Binary logistic regression models explored associations with mental health outcomes.
Residents with low healthy diet scores showed significantly higher prevalence of anxiety and depression
Moderately healthy and unhealthy dietary patterns were associated with increased rates of anxiety, depression, and comorbidity
Promoting healthier dietary habits may improve mental health outcomes in rural populations.

Abstract

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.

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