Sustainable eating for a healthy mind: Association between the EAT-Lancet diet and depression subtypes in a Swiss cohort

BACKGROUND: Higher adherence to healthy dietary patterns appears to play a role in the prevention of Major Depressive Disorder (MDD). However, the association between the EAT-Lancet diet, developed to promote both human health and environmental sustainability, and MDD remains largely unexplored. OBJECTIVE: To explore the association between adherence to the EAT-Lancet diet and MDD subtypes and assess how dietary patterns among individuals with and without MDD align with EAT-Lancet recommendations. METHODS: We conducted a cross-sectional analysis of 3558 adults from the CoLaus|PsyCoLaus cohort. Adherence to the EAT-Lancet diet was scored based on intake of 12 food components and categorized into tertiles (low, medium, high). Psychiatric information was obtained using the Diagnostic Interview for Genetic Studies. MDD subtypes (melancholic, atypical, and unspecified) were diagnosed according to DSM-IV specifiers. Multinomial logistic regression models assessed associations between diet adherence and MDD subtypes. RESULTS: High EAT-Lancet adherence was associated with a lower relative risk of atypical MDD (RRR: 0.68, 95% CI: 0.55-0.84). No clear associations were observed for melancholic or unspecified MDD. Across all groups, intake of unsaturated oils, legumes, and whole grains was insufficient, while red meat, potatoes, and added sugars exceeded recommendations. CONCLUSIONS: The association of a sustainable and healthy diet with MDD differs across clinical subtypes, suggesting that diet may play distinct roles in the pathophysiology of each. Improving specific dietary components may support mental health and sustainability goals.