Association between dietary patterns and symptoms of depression and anxiety in college students: a cross-sectional study

Despite the high prevalence of depression and anxiety among college students, few studies investigate dietary patterns in this population. The purpose of this study was to investigate the dietary patterns of Chinese college students and the association with depression and anxiety symptoms. A cross-sectional sample of 1,090 students from Zhengzhou University completed the Zung Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), and Food Frequency Questionnaire (FFQ). Factor analysis identified dietary patterns. Logistic regression and restricted cubic splines evaluated associations between dietary patterns and depression and anxiety symptoms. Factor analysis identified four dietary patterns. The "Soy-Non-fried staple food" pattern (Q3: OR = 0.640, 95% CI: 0.436-0.940) and "Fruit-Snack" pattern (Q4: OR = 0.640, 95% CI: 0.442-0.928 [depression]; OR = 0.550, 95% CI: 0.338-0.895 [anxiety]) showed a negative association. The "Grain-Potato-Egg" pattern (Q4: OR = 1.738, 95% CI: 1.064-2.837) was positively associated with anxiety symptoms. For depression symptoms, restricted cubic splines revealed a linear dose-response relationship in the "Soy-Non-fried staple food" pattern, the "Meat-based" pattern, and the "Grain-Potato-Egg" pattern (all p(total) < 0.05, p(nonlinear) > 0.05). A nonlinear dose-response relationship was found in the "Fruit-Snack" pattern (p(total) < 0.001, p(nonlinear) = 0.007). For anxiety symptoms, a nonlinear dose-response relationship was observed in the "Grain-Potato-Egg" pattern (p(total) < 0.05, p(nonlinear) = 0.03). These findings provide evidence for dietary interventions to improve mental health in college students, thus filling critical gaps in young adult mental health research.