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The aim of the current study was to investigate the association of dietary and blood inflammatory factors with mental health disorders in subjects with vitamin D deficiency, shedding further light on the complex interplay of these conditions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>In this cross\u2010sectional study, 306 subjects completed the validated Depression, Anxiety, and Stress Scale questionnaire to evaluate their depression, anxiety, and stress scores. Dietary inflammatory index (DII) and healthy eating index (HEI) were calculated using a validated 65\u2010item food frequency questionnaire. Blood samples were taken and vitamin D, cytokine, and hs\u2010CRP levels were measured using enzyme\u2010linked immunosorbent assay kits. Platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR) were calculated using standard laboratory methods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The subjects were divided into two groups based on their vitamin D levels: a vitamin <jats:italic>D<\/jats:italic>\u00a0&lt;\u00a020\u00a0\u03bcg\/dl group (<jats:italic>N<\/jats:italic>\u00a0=\u00a0257) and a vitamin D\u00a0\u2265\u00a020\u00a0\u00a0\u03bcg\/dl group (<jats:italic>N<\/jats:italic>\u00a0=\u00a049). Between group analysis revealed that only DII (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.015), platelet (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.04), and hs\u2010CRP (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.015) were significantly different. In adults with vitamin D levels below 20\u00a0\u03bcg\/dl, NLR and DII were significantly higher in subjects with anxiety (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05), and this relationship remained significant only for NLR after adjusting for age and sex. Additionally, PLR and HEI were significantly different in depressed compared to non\u2010depressed subjects, and this association remained significant only for HEI after adjusting for age and sex.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In subjects with vitamin D deficiency, increased levels of PLR, NLR, and DII were associated with depression and anxiety, while HEI was negatively associated with depression. These associations were not found in subjects with vitamin D levels \u226520\u00a0\u03bcg\/dl.<\/jats:p><\/jats:sec>","DOI":"10.1002\/gps.5972","type":"journal-article","created":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T11:09:05Z","timestamp":1691147345000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Association of dietary and blood inflammatory indicators with depression, anxiety, and stress in adults with vitamin D deficiency"],"prefix":"10.1002","volume":"38","author":[{"given":"Payam","family":"Sharifan","sequence":"first","affiliation":[{"name":"Student Research Committee School of Medicine Mashhad University of Medical Sciences  Mashhad Iran"},{"name":"Department of Nutrition School of Medicine Mashhad University of Medical Sciences  Mashhad 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