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The association of whole and refined grains consumption with psychological disorders among Iranian adults



Although several studies have examined the link between different types of carbohydrate consumption and depression and anxiety, limited data are available linking whole and refined grains consumption to psychological disorders. We aimed to investigate the association of whole and refined grains consumption with psychological disorders among Iranian adults.


A total of 3172 adult people with age range of 18–55 years were included in this cross-sectional study. Data on grains consumption were collected using a validated dish-based 106-item semi-quantitative food frequency questionnaire. To assess depression and anxiety, Iranian validated version of Hospital Anxiety and Depression Scale (HADS) was applied. Furthermore, psychological distress was examined using General Health Questionnaire (GHQ). Psychological disorders were defined based on standard criteria.


Mean age of participants was 36.5 ± 7.9 years. Women in the third quartile of whole grains consumption had lower odds for having anxiety (OR 0.62, 95% CI 0.45–0.85) compared with those in the first quartile. This relationship was also seen even after controlling for potential confounders (OR 0.65, 95% CI 0.44–0.96). In contrast, compared with the first quartile, women in the highest quartile of refined grains consumption had greater odds to have depression (OR 1.76, 95% CI 1.00–3.09) and anxiety (OR 2.03, 95% CI 1.00–4.10) after adjusting for covariates. Such relationships were not observed among men.


Moderate consumption of whole grain foods was inversely associated with anxiety in women, but not in men. Furthermore, we found a significant positive association between refined grains consumption, depression and anxiety in women.

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This study was supported by Isfahan University of Medical Sciences. Dr. Ahmad Esmaillzadeh was supported by a grant from Iran National Science Foundation (INSF).

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Correspondence to Ahmad Esmaillzadeh.

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All participants provided signed informed written consent forms. The Bioethics Committee of Isfahan University of Medical Sciences, Isfahan, Iran approved the study [29].

Conflict of interest

Authors declared no personal or financial conflicts of interest.

Additional information

Ammar Hassanzadeh-Keshteli: Co-first author.

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Sadeghi, O., Hassanzadeh-Keshteli, A., Afshar, H. et al. The association of whole and refined grains consumption with psychological disorders among Iranian adults. Eur J Nutr 58, 211–225 (2019).

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  • Anxiety
  • Depression
  • Diet
  • Psychological distress
  • Whole grains