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The relationship between the World Index for Sustainability and Health (WISH) score and mental health in women: a cross-sectional study

Published online by Cambridge University Press:  29 April 2024

Alireza Jafari Open the ORCID record for Alireza Jafari [Opens in a new window] ,
Keyhan Lotfi Open the ORCID record for Keyhan Lotfi [Opens in a new window] ,
Hadis Mozaffari ,
Behzad Zamani ,
Manije Darooghegi Mofrad ,
Ali Sheikhi ,
Pamela J. Surkan  and
Leila Azadbakht Open the ORCID record for Leila Azadbakht [Opens in a new window]
Alireza Jafari
Affiliation:
Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
Keyhan Lotfi
Affiliation:
Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
Hadis Mozaffari
Affiliation:
Faculty of Land and Food Systems, University of British Columbia, Vancouver, Canada
Behzad Zamani
Affiliation:
Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
Manije Darooghegi Mofrad
Affiliation:
Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
Ali Sheikhi
Affiliation:
Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
Pamela J. Surkan
Affiliation:
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
Leila Azadbakht*
Affiliation:
Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Science, Isfahan, Iran
*
*Corresponding author: Leila Azadbakht, email azadbakhtleila@gmail.com
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Abstract

Diet quality has been associated with mental health, and recently, there has been growing interest in the association between the sustainability of diets and human health. The objective of this cross-sectional study was to explore the relationship between a newly developed dietary index for health and sustainability and psychological disorders among Iranian women. Participants in this cross-sectional study included 479 women living in Tehran with no history of chronic disease. A validated 168-item FFQ was used to assess dietary intake. The World Index for Sustainability and Health was calculated, consisting of four sub-scores: less healthy, healthy, low environmental impact and high environmental impact. Participants’ psychological status was assessed using the Depression Anxiety Stress Scale-21. Logistic regression models were used to examine the association between the World Index for Sustainability and Health and psychological disorders. Participant ages ranged from 20 to 50 years, with a mean age of 31·86 (sd 7·68) years. After adjusting for potential confounders (age, energy, BMI, marital status, education, family history of chronic disease, body satisfaction, socio-economic status, physical activity, smoking), women in the highest tertile of the healthy sub-score had significantly lower odds of experiencing depression (OR 0·40; 95 % CI 0·24, 0·67), anxiety (OR 0·45; 95 % CI 0·23, 0·87) and psychological distress (OR 0·46; 95 % CI 0·28, 0·77) compared with the reference group. Similarly, the less healthy sub-score was significantly associated with depression (OR 0·51; 95 % CI 0·32, 0·89), anxiety (OR 0·44; 95 % CI 0·25, 0·78) and psychological distress (OR 0·57; 95 % CI 0·36, 0·90). An inverse association was observed between the low environmental impact sub-score and depression (OR 0·32; 95 % CI 0·19, 0·54), anxiety (OR 0·38; 95 % CI 0·18, 0·76) and psychological distress (OR 0·30; 95 % CI 0·17, 0·51). However, no further significant associations were found with the high environmental impact sub-score, except with depression (OR 0·57; 95 % CI 0·33, 0·96). The healthy and low environmental impact sub-scores of the World Index for Sustainability and Health were found to be inversely associated with depression, anxiety and psychological distress. However, due to the cross-sectional study design, causality cannot be inferred. Further prospective studies are required to validate and expand upon these findings and explore potential mechanisms and alternative explanations, such as reverse causation. While this study suggests that choosing a diet that is both healthy for individuals and sustainable for the environment may be associated with a lower risk of mental health issues among women, more research is needed.

Keywords

Sustainable dietPsychological distressDepressionAnxietyMental disorders
Type
Research Article
Information
British Journal of Nutrition , Volume 132 , Issue 2 , 28 July 2024 , pp. 151 - 161
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Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of The Nutrition Society

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