Adherence to the Healthy Eating Index-2015 and Its Association with Depression Score in A Sample of Iranian Adolescent Girls

Background: Depression in adolescents is one of the major public health concerns that can affect educational attainment and social relationships and impose a high economic burden on society. Previous studies have provided limited information on the relationship between a healthy diet and depression in adolescents. The present study aimed to investigate the association of Healthy Eating Index-2015 (HEI-2015) with depression scores among adolescent girls. Methods: This cross-sectional study was conducted on 734 adolescent girls aged 12-18 years. Data on dietary intakes were collected using a valid and reliable food frequency questionnaire (FFQ), and diet quality was assessed based on HEI-2015. The Iranian validated version of Beck Depression Inventory (BDI) was used to evaluate depression. To explore the association between HEI-2015 and depression, logistic regression was used in crude and adjusted models. Results: The prevalence of a high depression score in the study population was 33.8%.  After controlling for potential confounders, girls with the highest adherence to HEI-2015 compared to those with the lowest adherence had a 37% lower prevalence of depression (OR: 0.63; 95% CI 0.40 to 1.00, Ptrend=0.03). This finding remained significant after adjustment for confounding variables (age, energy intakes, physical activity, and BMI percentile). Conclusions: Greater adherence to HEI-2015 was associated with lower odds of depression in female adolescents. Prospective studies are necessary to confirm these results and clarify whether a causal relationship exists.