{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T17:29:58Z","timestamp":1787246998119,"version":"build-2736575974"},"reference-count":50,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,23]],"date-time":"2025-11-23T00:00:00Z","timestamp":1763856000000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Healthy dietary patterns such as DASH and Mediterranean diets may improve mental well\u2010being. However, the relationship between the PURE diet\u2014emphasizing moderate consumption of animal foods and whole\u2010fat dairy\u2014and mental disorders is unclear. This study aimed to investigate the association between the PURE diet score and depression and anxiety in Iranian adults at high risk of cardiovascular disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter cross\u2010sectional study included 1120 subjects from nine ethnicities who underwent angiography, with no stenosis detected. Dietary intake was assessed using a validated semi\u2010quantitative food frequency questionnaire, and the PURE score was calculated based on fruit, vegetables, legumes, nuts, fish, and dairy consumption. Mental health was measured using the Hospital Anxiety and Depression Scale (HADS). Data were analyzed using logistic regression and adjusted for confounders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Participants' mean (SD) age was 52.08\u2009\u00b1\u20098.25 years. In the overall population, higher PURE diet scores were significantly associated with lower odds of both depression and anxiety after adjustment for potential confounders (depression: OR\u2009=\u20090.55, 95% CI 0.36\u20130.86,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03; anxiety: OR\u2009=\u20090.63, 95% CI 0.40\u20130.99,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). In sex\u2010stratified analyzes, these inverse associations were significant among women (depression: OR\u2009=\u20090.56, 95% CI 0.33\u20130.95,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02; anxiety: OR\u2009=\u20090.52, 95% CI 0.30\u20130.92,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01), but not among men (depression: OR\u2009=\u20090.49, 95% CI 0.22\u20131.10,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.08; anxiety: OR\u2009=\u20090.78, 95% CI 0.34\u20131.79,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.43).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this cross\u2010sectional study, higher adherence to the PURE diet was significantly associated with lower odds of both depression and anxiety, particularly among women. No significant associations were observed among men. Prospective cohort studies and clinical trials are needed to confirm these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.71540","type":"journal-article","created":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T07:59:58Z","timestamp":1763971198000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association Between PURE Diet Score and Mental Disorders in Patients At\u2010Risk of Cardiovascular Disease: Findings From the Iran Premature Coronary Artery Disease (IPAD) Study, a Multicenter Cross\u2010Sectional Study"],"prefix":"10.1002","volume":"8","author":[{"given":"Noushin","family":"Mohammadifard","sequence":"first","affiliation":[{"name":"Isfahan Cardiovascular Research Center, Cardiovascular Research Institute Isfahan University of Medical Sciences Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Emamjomeh","sequence":"additional","affiliation":[{"name":"Department of Cardiology, School of Medicine Isfahan University of Medical Sciences Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4766-6267","authenticated-orcid":false,"given":"Fahimeh","family":"Haghighatdoost","sequence":"additional","affiliation":[{"name":"Isfahan Cardiovascular Research Center, Cardiovascular Research Institute Isfahan University of Medical Sciences Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ehsan","family":"Zarepur","sequence":"additional","affiliation":[{"name":"Heart Failure Research Center, Cardiovascular Research Institute Isfahan University of Medical Sciences Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8402-8104","authenticated-orcid":false,"given":"Mehdi","family":"Abbasi","sequence":"additional","affiliation":[{"name":"Isfahan Cardiovascular Research Center, Cardiovascular Research Institute Isfahan University of Medical Sciences Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmadreza","family":"Assareh","sequence":"additional","affiliation":[{"name":"Atherosclerosis Research Center Ahvaz Jundishapur University of Medical Sciences Ahvaz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahboobeh","family":"Gholipour","sequence":"additional","affiliation":[{"name":"Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine Guilan University of Medical Sciences Rasht Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatemeh","family":"Moslemi","sequence":"additional","affiliation":[{"name":"Heart Failure Research Center, Cardiovascular Research Institute Isfahan University of Medical Sciences Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6828-2169","authenticated-orcid":false,"given":"Nizal","family":"Sarrafzadegan","sequence":"additional","affiliation":[{"name":"Isfahan Cardiovascular Research Center, Cardiovascular Research Institute Isfahan University of Medical Sciences Isfahan Iran"},{"name":"Iranian Network of Cardiovascular Research (INCVR)  Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,23]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11920-019-0997-0"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.34172\/aim.2022.35"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.4103\/jrms.jrms_343_22"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000019"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2025.03.023"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/nutrit\/nuad038"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-022-04128-2"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40519-021-01294-2"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12144-020-01065-9"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1139\/apnm-2023-0550"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu16060777"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehad269"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32252-3"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/nqaa448"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00394-018-1652-y"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/jech-2015-205858"},{"issue":"4","key":"e_1_2_13_18_1","first-page":"204","article-title":"Cardiovascular Disease in Iran in the Last 40 Years: Prevalence, Mortality, Morbidity, Challenges and Strategies for Cardiovascular Prevention","volume":"22","author":"Sarrafzadegan N.","year":"2019","journal-title":"Archives of Iranian Medicine"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-9-47"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gheart.2015.08.003"},{"issue":"6","key":"e_1_2_13_21_1","first-page":"295","article-title":"Rationale, Design, and Preliminary Results of the Iran\u2010Premature Coronary Artery Disease Study (I\u2010PAD): A Multi\u2010Center Case\u2010Control Study of Different Iranian Ethnicities","volume":"16","author":"Zarepur E.","year":"2020","journal-title":"ARYA Atherosclerosis"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2014.07.013"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.5812\/asjsm.34781"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/1747-0080.12666"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7525-1-1"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1139\/apnm-2024-0347"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41514-025-00217-0"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2014.09.006"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00394-017-1582-0"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.924977"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-11-208"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2009.05.009"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.108.058925"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2009.09060881"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-019-7298-8"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2025.1546564"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.3945\/jn.109.113878"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.1503\/jpn.150205"},{"key":"e_1_2_13_39_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41380-020-00925-x"},{"key":"e_1_2_13_40_1","doi-asserted-by":"publisher","DOI":"10.1177\/13591053241306874"},{"key":"e_1_2_13_41_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-018-1956-8"},{"key":"e_1_2_13_42_1","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-11-200"},{"key":"e_1_2_13_43_1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.114.103846"},{"key":"e_1_2_13_44_1","doi-asserted-by":"publisher","DOI":"10.1097\/PSY.0b013e318222831a"},{"key":"e_1_2_13_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2013.05.008"},{"key":"e_1_2_13_46_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980018002628"},{"key":"e_1_2_13_47_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-017-0791-y"},{"key":"e_1_2_13_48_1","doi-asserted-by":"publisher","DOI":"10.1002\/fsn3.4073"},{"key":"e_1_2_13_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2017.02.006"},{"key":"e_1_2_13_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jand.2013.11.017"},{"key":"e_1_2_13_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3999(01)00296-3"}],"container-title":["Health Science Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hsr2.71540","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hsr2.71540","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hsr2.71540","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T17:14:59Z","timestamp":1787246099000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hsr2.71540"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":50,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1002\/hsr2.71540"],"URL":"https:\/\/doi.org\/10.1002\/hsr2.71540","archive":["Portico"],"relation":{},"ISSN":["2398-8835","2398-8835"],"issn-type":[{"value":"2398-8835","type":"print"},{"value":"2398-8835","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11]]},"assertion":[{"value":"2025-08-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71540"}}