European Journal of Nutrition

, Volume 56, Issue 1, pp 309–320 | Cite as

Adherence to the DASH diet in relation to psychological profile of Iranian adults

  • Ghazaleh Valipour
  • Ahmad Esmaillzadeh
  • Leila Azadbakht
  • Hamid Afshar
  • Ammar Hassanzadeh
  • Peyman Adibi
Original Contribution



Although empirically derived dietary patterns have been examined in relation to depression, limited data are available linking theory-based dietary patterns and psychological health.


We aimed to investigate the association between adherence to DASH-style diet and psychological health among Iranian adults.


This cross-sectional study was done among 3846 general public adults in Isfahan, Iran. Dietary assessment was conducted using a validated 106-item dish-based semiquantitative food frequency questionnaire. To investigate participants’ adherence to DASH-style diet, we created DASH score based on earlier publications focusing on eight components (fruits, vegetables, nuts and legumes, dairy products, grains, sweetened beverages and sweets, sodium, and red and processed meats). Participants were classified into three categories based on their DASH score [low (≤40), moderate (41–50), and high adherence (≥51)]. This categorization, instead of distribution-based classification, was used due to low adherence to the DASH dietary pattern in the study population. Psychological health was examined by means of validated Hospital Anxiety and Depression Scale and General Health Questionnaire. Depression, anxiety, and psychological distress were defined based on standard criteria.


We found that moderate adherence to DASH-style diet was associated with lower odds of depression (OR 0.73; 95 % CI 0.59–0.90, P trend = 0.63) compared with those with the lowest adherence. In our stratified analyses, these associations remained significant for women (0.70; 0.54–0.91) and for normal-weight participants (0.70; 0.52–0.92). Moreover, after controlling for potential confounders, an inverse association was observed between high adherence to DASH-style diet and anxiety in normal-weight participants (0.61; 0.37–0.98). Such associations were also seen between moderate adherence to DASH-eating style and anxiety in overweight or obese individuals (0.63; 0.42–0.95). We failed to find any significant association between consumption of DASH-style diet and psychological distress.


We found an inverse association between moderate adherence to DASH dietary pattern and depression. Further prospective studies are required to confirm these findings.


Diet Healthy eating Psychological health Depression Anxiety Mood 



We would like to thank the authorities of SEPAHAN study to let us work on that dataset and also the research council of Food Security Research Center for funding the study. We also appreciate the generous cooperation of Dr. Awat Feizi. This manuscript is based on the M.Sc. thesis (no. 392592) of Isfahan University of Medical Sciences, Isfahan, Iran. This study was financially supported by Research Council of the Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Compliance with ethical standards

Conflict of interest

GV and AE declared no potential personal or financial conflicts of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Ghazaleh Valipour
    • 1
    • 2
  • Ahmad Esmaillzadeh
    • 1
    • 2
    • 3
  • Leila Azadbakht
    • 1
    • 2
    • 3
  • Hamid Afshar
    • 4
  • Ammar Hassanzadeh
    • 5
  • Peyman Adibi
    • 6
    • 7
  1. 1.Food Security Research CenterIsfahan University of Medical SciencesIsfahanIran
  2. 2.Department of Community Nutrition, School of Nutrition and Food ScienceIsfahan University of Medical SciencesIsfahanIran
  3. 3.Department of Community Nutrition, School of Nutritional Sciences and DieteticsTehran University of Medical SciencesTehranIran
  4. 4.Psychosomatic Research CenterIsfahan University of Medical SciencesIsfahanIran
  5. 5.Department of MedicineUniversity of AlbertaEdmontonCanada
  6. 6.Integrative Functional Gastroenterology Research CenterIsfahan University of Medical SciencesIsfahanIran
  7. 7.Department of Internal Medicine, School of MedicineIsfahan University of Medical SciencesIsfahanIran

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