Mental health is associated with nutrient patterns and Index of Nutritional Quality (INQ) in adolescent girls - an analytical study

Introduction: Mental health in adolescents is among the most critical health issues worldwide. The association between diet and mental health is undeniable. Nutrient patterns (NPs) and Index of Nutritional Quality (INQ) assessments are novel and valid methods for discovering nutritional effects on diseases. The INQ is an index that qualifies the individual's intake based on the amount of nutrients recommendations and the individual's energy intake. Principal Component Analysis is applied to the nutrients computed from the food record questionnaire to derive NPs. This study was designed to determine the association between the NPs/INQ and mental health among adolescents. We hypothesized that having a high-quality diet rich in nutrients has a protective effect(s) against psychological problems. Method: This study included 365 female adolescents from five regions of Tabriz, Iran. The Depression, Anxiety, and Stress Scale was used to assess mental health. A 3-day food record questionnaire was used to assess dietary intakes. Food record-derived nutritional data were used in the modeling NPs and following formulae to calculate INQ= consumed the amount of a nutrient per 1000 kcal/RDA or AI of that nutrient per 1000 kcal. Results: Four major NPs were identified: NP1: high intakes of essential amino acids, zinc, B-complex, phosphorus, selenium, and cholesterol; NP2: high intakes of fatty acids, biotin, vitamin E, folate, magnesium, chromium, copper, iron, sodium, potassium; NP3: high intakes of amino acids, and NP4: high intakes of calcium, 5 carotene, vitamin A, D, K, C, and dietary fiber. Subjects in the fourth quartile of NP1 and NP4 had lower depression, anxiety and stress scores than those in the first quartile. Beta estimates showed an inverse association between INQ of vitamins A (B=-3.83, p=0.002), D (B=-2.82, p=0.017), K (B=-0.61, p=0.025), B6 (B=-0.46, p=0.035), B12 (B=-0.94, p=0.040), and folate (B=-1.15, p=0.037) and anxiety and also a positive association between INQ of manganese (B=2.01, p=0.019) and stress. Conclusion: High intake of calcium, 5 carotene, vitamins A, D, K, C, and dietary fiber led to lower depression, anxiety and stress. Also, essential amino acids, zinc, B-complex, phosphorus, selenium, and cholesterol had an inverse association with depression, anxiety and stress. According to the INQ analysis, vitamins A, D, K, B6, B12, and folate had protective effects against anxiety.