This study aimed to evaluate the relationship between nutrient patterns (NPs) / Index of Nutritional Quality (INQ) and mental health among adolescents. Experts hypothesized that a high-quality diet rich in nutrients might protect you against psychological problems.

The most pressing public health issues worldwide are adolescent psychological disorders, which cause anxiety, stress, and depression. Depressive disorders can lead to self-destruction, the most dramatic manifestation, if not treated. It is a chronic and recurrent illness regarded as one of the leading causes of disability. Anxiety disorders tend to become chronic and can devastate individual and social well-being.

While there is limited evidence that diet and dietary factors play a role in the etiology and causality of these disorders, there is undeniable evidence that diet impacts mental health. Furthermore, research suggests that the association between mental health and diet/dietary factors is primarily about diet quality/patterns and nutritional intake.

Research shows that iron, vitamin B6, omega-3 fatty acids, zinc, vitamin B12, folate, and selenium improve depression and anxiety.

A Mediterranean diet, for example, is associated with a lower incidence of mental disorders than a western-style or poor diet; for example, high consumption of red meat, processed meat, saturated fatty acids, and simple sugar is associated with poor health outcomes.

Several studies have examined the relationship between diet quality and various diseases using various nutritional tools and methods. An extensively employed way that can be applied to multiple conditions and outcomes is the Index of Nutritional Quality (INQ). In addition to providing an aggregate view of diet quality, the INQ can adjust total energy consumption.

By evaluating dietary patterns and quality, we can get a more comprehensive view of diet and health than we can by merely considering food or nutrients.


365 female adolescents ( aged 14–16) were recruited from five districts in Tabriz, Iran, and assessed for mental health using the Depression, Anxiety, and Stress Scale.

To determine nutritional intake, a 3-day food record questionnaire was used. Dietary data from the food record were incorporated into the modeling NPs and derived formulae to calculate intake per 1000 kcal or nutrient intake per 1000 kcal.

Four major NPs were identified:

NP1: high intakes of essential amino acids, zinc, B-complex, phosphorus, and selenium

NP2: high intakes of fatty acids, biotin, vitamin E, folate, magnesium, chromium, copper, iron, sodium, potassium

NP3: high intakes of amino acids

NP4: high intakes of calcium, β carotene, vitamins A, D, K, C, and dietary fiber

The experts found that subjects in the fourth quartile of NP1 and NP4 had lower depression, anxiety, and stress scores. According to Beta estimates, INQ for vitamins A, D, K, B6, B12, and folate was inversely associated with anxiety, while INQ for manganese was positively associated with stress.

Calcium, beta-carotene, vitamins A, D, K, C, and dietary fiber intake were associated with lower levels of depression, anxiety, and stress. Essential amino acids, zinc, B-complex vitamins, phosphorus, and selenium were also inversely correlated with depression, anxiety, and stress. A, D, K, B6, B12, and folate were found to be protective against anxiety in the INQ analysis. 

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