{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T13:31:29Z","timestamp":1781789489388,"version":"3.54.5"},"reference-count":52,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T00:00:00Z","timestamp":1743033600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Previous studies have shown a connection between diet and mental health. However, there is limited evidence on how emerging diets, particularly the EAT-Lancet reference diet (ELD), relate to depression and anxiety. This study aims to investigate the potential impact of ELD adherence on these mental health conditions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and materials<\/jats:title><jats:p>This cross-sectional study recruited 1,970 Iranian adults using a stratified multistage random cluster sampling method, part of a community-based investigation conducted in five cities from February 2018 to July 2019. Participants\u2019 regular dietary intake was assessed using a validated food frequency questionnaire. The ELD was formulated based on the consumption of the 14 dietary components outlined in the ELD. Anxiety and depression were evaluated using a validated Iranian version of the Hospital Anxiety and depression Scale.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the fully adjusted model, there was no significant association between ELD adherence and depressive symptoms (aOR<jats:sub>T3 vs. T1<\/jats:sub> =\u202f0.89; 95% CI: 0.66, 1.19; <jats:italic>p<\/jats:italic> trend\u202f=\u202f0.42) and anxiety (aOR <jats:sub>T3 vs. T1<\/jats:sub> =\u202f0.93; 95% CI: 0.70, 1.23; <jats:italic>p<\/jats:italic> trend =\u202f0.62) in the whole population. In stratified analysis by sex, a significant inverse association was found only between ELD and depression among men (aOR <jats:sub>T3 vs. T1<\/jats:sub> =\u202f0.66; 95% CI: 0.40, 1.07; <jats:italic>p<\/jats:italic> trend =\u202f0.047) but not women (aOR\u202f= 0.71, 95% CI: 0.44, 1.15; <jats:italic>p<\/jats:italic> trend =\u202f0.103). No significant association was observed between ELD and anxiety either in men or women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Despite a null association between ELD and depressive symptoms and anxiety in the whole population, higher adherence to ELD was associated with a lower risk of depressive symptoms in males.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fnut.2025.1524652","type":"journal-article","created":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T23:04:43Z","timestamp":1743116683000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Adherence to the Eat-Lancet diet and its association with depression and anxiety among Iranian adults: a cross-sectional multicentric study"],"prefix":"10.3389","volume":"12","author":[{"given":"Ghazaal Alavi","family":"Tabatabaei","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noushin","family":"Mohammadifard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahimeh","family":"Haghighatdoost","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamed","family":"Rafiee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehdi","family":"Abbasi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farid","family":"Najafi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hossein","family":"Farshidi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masoud","family":"Lotfizadeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tooba","family":"Kazemi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamidreza","family":"Roohafza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nizal","family":"Sarrafzadegan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,3,27]]},"reference":[{"key":"ref1","year":""},{"key":"ref2","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1016\/S2215-0366(21)00395-3","article-title":"Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990\u20132019: a systematic analysis for the global burden of disease study 2019","volume":"9","year":"2022","journal-title":"Lancet Psychiatry"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1007\/7854_2016_31","article-title":"Does diet matter? 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