Summary of Descriptive Characteristics and Risk of Bias of All Included Studies in the Systematic Review
| Study (year), country . | Type of study . | Participants . | Investigation . | Method of analysis . | Depression symptoms/depression (measure) . | Key findings . | Risk of bias . | |
|---|---|---|---|---|---|---|---|---|
| Age . | No. of participants (gender) . | |||||||
| A priori dietary pattern | ||||||||
| Cong et al (2020),45 England | Cohort | 18 | 6939 (F/M) | FFQ (90 items) | IDP | CIS-R | After all covariates were adjusted, higher IDP in childhood seems not to be associated with higher depression risk in the late adolescence. | Moderate, 63.4% |
| Jacka et al (2010),25 Australia | Cross-sectional | 10-14 | 7114 (F/M) | Dietary questionnaire (14 items) |
| SMFQ | Adolescents in the highest quintile of the healthy dietary pattern reduced almost half the probability of being symptomatic. Individuals in the highest quintile of unhealthy diet increased the likelihood of depression symptoms by almost 80%. | Low, 75% |
| Jacka et al (2012),27 England | Cohort | 11-14 | Baseline: 2789; follow-up: 2093 (F/M) | Dietetic questionnaire based on questions from HABITS |
| SMFQ | Association between higher scores for unhealthy diet and increased for depression symptoms at baseline. No relationships were observed between the scores of any dietary measurement and the SMFQ scores in the follow-up. | High, 36.4% |
| Vejrup et al (2023),33 Norway | Cohort | 6 and 18 mo and 3 and 7 y | 39 138; 36 865; 33 464; 34 588 | FFQ | NDD score | SMFQ | Inverse continuous association was observed between NND scoring at 3- and 7-y depression symptom scores at 8 y | High, 45.6% |
| Winpenny et al (2018),42 England | Cohort | 14 | 603 | 4-Day diet diaries | MDS | MFQ | There were no significant associations between diet quality (MDS),and depressive symptoms at baseline, or between baseline MDS and depressive symptoms at 3-y follow-up. | Low, 72.7% |
| Xie et al (2024),36 China | Cross-sectional | 12-16 | 1749 | FFQ | Diet Quality Questionnaire (DQQ) | CES-D | The overall GDR score was not significantly associated with depressive symptoms. | Low, 87.5% |
| Zhang et al (2024),38 China | Cross-sectional | 6-15 | 6478 | FFQ (105 items) | CCDI | CDI-S | Poor diet quality was associated with higher odds of depression. | Low, 87.5% |
| Darabi et al (2024),35 Iran | Cross-sectional | 12-18 | 733 (F) | FFQ (147 items) | LLDS | BDI | Adolescent girls in the highest quartile of LLDS compared with the participants in the lowest quartile had a 41% lower probability of having depressive symptoms. | Low, 87.5% |
| Beigrezaei et al (2024),34 Iran | Cross-sectional | 12-18 | 733 (F) | FFQ (147 items) | GDQS | BDI | Adolescent girls in the highest tertile of GDQS compared with the lowest tertile had a 41% lower odds of depressive symptoms. | Low, 75% |
| Jiménez-López et al (2024),37 Spain | Cross-sectional | 12-17 | 698 | FFQ (45 items) | KIDMED | DASS-21 | Compared with individuals with low adherence to the MD, those with moderate and high adherence had lower odds of experiencing depressive symptoms. | Low, 75% |
| Zohrabi et al (2022),39 Iran | Cross-sectional | 12-18 | 741 (F) | FFQ (147 items) | DTAC | BDI | Subjects in the highest quartile of DTAC had a 39% lower odds of depression compared with those in the first quartile. | Low, 75% |
| Jacka et al (2011),26 Australia | Cohort | 11-18 | Baseline: 2915; follow-up: 1949 (F/M) | Dietary questionnaire |
| PedsQL | Cross-sectional analyses showed positive relationships between healthy diet scores and PedsQL score Unhealthy diet scores were inversely associated with PedsQL score at baseline. Higher scores for a healthy diet at the beginning of the study also predicted higher PedsQL scores (lower depressive symptoms) at follow-up. There was no prospective association between higher scores for quality of unhealthy diet and lower PedsQL (higher depressive symptoms). | High, 36.4% |
| Khayyatzadeh et al (2017),28 Iran | Cross-sectional | 12-18 | 535 (F) | FFQ (168 items) | DASH score | BDI | A high adherence to a DASH-style diet (for individuals in the upper quartile) was associated with a lower odds of depression compared with subjects with lower adherence (those in the lowest quartile). | Low, 62.5% |
| Shivappa et al (2016)30; Tehrani et al (2016)32; and Tehrani et al (2018),31 Iran | Cross-sectional | 15-18 | 300 (F); 280 (F); 263 (F) | FFQ (168 items) | DII; MSDPS | DASS-21 (Persian version) | A significant positive association between increased inflammatory potential of diet (T3) and depression symptoms compared with females in first tertile. MSDPS may be associated with a reduced chance of developing depressive symptoms. Adolescents in the highest quintile of the MSDPS had a lower prevalence of depressive symptoms (58%) compared with those in the lower quintile of MSDPS. | Low, 75% |
| Sangouni et al (2022),44 Iran | Cross-sectional | 12-18 | 733 (F) | FFQ (147 items) | DPI score | BDI-II (Persian version) | The participants in the fourth quartile of DPI compared with the first quartile had a 50% lower odds of depression. | Moderate, 62.5% |
| A posteriori dietary pattern | ||||||||
| Khayyatzadeh et al (2018),28 Iran | Cross-sectional | 12-18 | 750 (F) | FFQ (147 items) | PCA | BDI | Adolescents in the fourth highest quartile of the healthy eating pattern were less likely to present depressive symptoms. There were no significant associations between the traditional and Western standard diet with depression symptoms. | Moderate, 62.5% |
| Hemmati et al (2021),47 Iran | Cross-sectional | 14-17 | 347 (F) | 24HRs | PCA | BDI-II (Persian version) | A positive association was observed between the Western dietary pattern and depression, while the healthy dietary pattern was inversely related to depression. | Low, 87.5 % |
| Sinclair et al (2016),43 Fiji | Cross-sectional | 13-18 | Baseline: 7237 (F/M); follow-up: 2948 (F/M) | Questions extracted from the ABAKQ questionnaire (83 items) | FA | PedsQL | The association was significant between the healthy diet and lower depressive symptomatology for both sexes. No association was found between the unhealthy diet and depressive symptoms for both sexes. Associations between healthy diet quality and depressive symptoms were found for both sexes in the follow-up. No association was found between the unhealthy diet and depressive symptoms in follow-up for both sexes. | Moderate, 62.5% |
| Hayward et al (2016),46 Australia | Cross-sectional | 14-19 | 3295 (F/M) | SDQ | PCA | SMFQ | Higher scores in the unhealthy dietary pattern were associated with a higher probability of depressive symptoms in male adolescents. No association was observed between healthy dietary pattern and the snacks dietary pattern with depressive symptoms for both sexes. | Low, 75% |
| Weng et al (2012),41 China | Cross-sectional | 11-16 | 5003 (F/M) | FFQ (38 items) | PCA | DSRS (Chinese version) | The traditional dietary pattern was associated with a lower probability of depressive symptoms. Higher tertile scores in the snacks pattern were associated with higher chances of depressive symptoms. | Moderate, 62.5% |
| Qian et al (2023),40 China | Cross-sectional | 13.10 ± 0.70 | 853 (F/M) | FFQ | FA | PHQ-9 (Chinese version) | Modern and snack-aquatic patterns were associated with an increased risk of depression in Chinese adolescents, and vegetarian patterns were associated with a reduced risk of depression. | Low, 75% |
| Study (year), country . | Type of study . | Participants . | Investigation . | Method of analysis . | Depression symptoms/depression (measure) . | Key findings . | Risk of bias . | |
|---|---|---|---|---|---|---|---|---|
| Age . | No. of participants (gender) . | |||||||
| A priori dietary pattern | ||||||||
| Cong et al (2020),45 England | Cohort | 18 | 6939 (F/M) | FFQ (90 items) | IDP | CIS-R | After all covariates were adjusted, higher IDP in childhood seems not to be associated with higher depression risk in the late adolescence. | Moderate, 63.4% |
| Jacka et al (2010),25 Australia | Cross-sectional | 10-14 | 7114 (F/M) | Dietary questionnaire (14 items) |
| SMFQ | Adolescents in the highest quintile of the healthy dietary pattern reduced almost half the probability of being symptomatic. Individuals in the highest quintile of unhealthy diet increased the likelihood of depression symptoms by almost 80%. | Low, 75% |
| Jacka et al (2012),27 England | Cohort | 11-14 | Baseline: 2789; follow-up: 2093 (F/M) | Dietetic questionnaire based on questions from HABITS |
| SMFQ | Association between higher scores for unhealthy diet and increased for depression symptoms at baseline. No relationships were observed between the scores of any dietary measurement and the SMFQ scores in the follow-up. | High, 36.4% |
| Vejrup et al (2023),33 Norway | Cohort | 6 and 18 mo and 3 and 7 y | 39 138; 36 865; 33 464; 34 588 | FFQ | NDD score | SMFQ | Inverse continuous association was observed between NND scoring at 3- and 7-y depression symptom scores at 8 y | High, 45.6% |
| Winpenny et al (2018),42 England | Cohort | 14 | 603 | 4-Day diet diaries | MDS | MFQ | There were no significant associations between diet quality (MDS),and depressive symptoms at baseline, or between baseline MDS and depressive symptoms at 3-y follow-up. | Low, 72.7% |
| Xie et al (2024),36 China | Cross-sectional | 12-16 | 1749 | FFQ | Diet Quality Questionnaire (DQQ) | CES-D | The overall GDR score was not significantly associated with depressive symptoms. | Low, 87.5% |
| Zhang et al (2024),38 China | Cross-sectional | 6-15 | 6478 | FFQ (105 items) | CCDI | CDI-S | Poor diet quality was associated with higher odds of depression. | Low, 87.5% |
| Darabi et al (2024),35 Iran | Cross-sectional | 12-18 | 733 (F) | FFQ (147 items) | LLDS | BDI | Adolescent girls in the highest quartile of LLDS compared with the participants in the lowest quartile had a 41% lower probability of having depressive symptoms. | Low, 87.5% |
| Beigrezaei et al (2024),34 Iran | Cross-sectional | 12-18 | 733 (F) | FFQ (147 items) | GDQS | BDI | Adolescent girls in the highest tertile of GDQS compared with the lowest tertile had a 41% lower odds of depressive symptoms. | Low, 75% |
| Jiménez-López et al (2024),37 Spain | Cross-sectional | 12-17 | 698 | FFQ (45 items) | KIDMED | DASS-21 | Compared with individuals with low adherence to the MD, those with moderate and high adherence had lower odds of experiencing depressive symptoms. | Low, 75% |
| Zohrabi et al (2022),39 Iran | Cross-sectional | 12-18 | 741 (F) | FFQ (147 items) | DTAC | BDI | Subjects in the highest quartile of DTAC had a 39% lower odds of depression compared with those in the first quartile. | Low, 75% |
| Jacka et al (2011),26 Australia | Cohort | 11-18 | Baseline: 2915; follow-up: 1949 (F/M) | Dietary questionnaire |
| PedsQL | Cross-sectional analyses showed positive relationships between healthy diet scores and PedsQL score Unhealthy diet scores were inversely associated with PedsQL score at baseline. Higher scores for a healthy diet at the beginning of the study also predicted higher PedsQL scores (lower depressive symptoms) at follow-up. There was no prospective association between higher scores for quality of unhealthy diet and lower PedsQL (higher depressive symptoms). | High, 36.4% |
| Khayyatzadeh et al (2017),28 Iran | Cross-sectional | 12-18 | 535 (F) | FFQ (168 items) | DASH score | BDI | A high adherence to a DASH-style diet (for individuals in the upper quartile) was associated with a lower odds of depression compared with subjects with lower adherence (those in the lowest quartile). | Low, 62.5% |
| Shivappa et al (2016)30; Tehrani et al (2016)32; and Tehrani et al (2018),31 Iran | Cross-sectional | 15-18 | 300 (F); 280 (F); 263 (F) | FFQ (168 items) | DII; MSDPS | DASS-21 (Persian version) | A significant positive association between increased inflammatory potential of diet (T3) and depression symptoms compared with females in first tertile. MSDPS may be associated with a reduced chance of developing depressive symptoms. Adolescents in the highest quintile of the MSDPS had a lower prevalence of depressive symptoms (58%) compared with those in the lower quintile of MSDPS. | Low, 75% |
| Sangouni et al (2022),44 Iran | Cross-sectional | 12-18 | 733 (F) | FFQ (147 items) | DPI score | BDI-II (Persian version) | The participants in the fourth quartile of DPI compared with the first quartile had a 50% lower odds of depression. | Moderate, 62.5% |
| A posteriori dietary pattern | ||||||||
| Khayyatzadeh et al (2018),28 Iran | Cross-sectional | 12-18 | 750 (F) | FFQ (147 items) | PCA | BDI | Adolescents in the fourth highest quartile of the healthy eating pattern were less likely to present depressive symptoms. There were no significant associations between the traditional and Western standard diet with depression symptoms. | Moderate, 62.5% |
| Hemmati et al (2021),47 Iran | Cross-sectional | 14-17 | 347 (F) | 24HRs | PCA | BDI-II (Persian version) | A positive association was observed between the Western dietary pattern and depression, while the healthy dietary pattern was inversely related to depression. | Low, 87.5 % |
| Sinclair et al (2016),43 Fiji | Cross-sectional | 13-18 | Baseline: 7237 (F/M); follow-up: 2948 (F/M) | Questions extracted from the ABAKQ questionnaire (83 items) | FA | PedsQL | The association was significant between the healthy diet and lower depressive symptomatology for both sexes. No association was found between the unhealthy diet and depressive symptoms for both sexes. Associations between healthy diet quality and depressive symptoms were found for both sexes in the follow-up. No association was found between the unhealthy diet and depressive symptoms in follow-up for both sexes. | Moderate, 62.5% |
| Hayward et al (2016),46 Australia | Cross-sectional | 14-19 | 3295 (F/M) | SDQ | PCA | SMFQ | Higher scores in the unhealthy dietary pattern were associated with a higher probability of depressive symptoms in male adolescents. No association was observed between healthy dietary pattern and the snacks dietary pattern with depressive symptoms for both sexes. | Low, 75% |
| Weng et al (2012),41 China | Cross-sectional | 11-16 | 5003 (F/M) | FFQ (38 items) | PCA | DSRS (Chinese version) | The traditional dietary pattern was associated with a lower probability of depressive symptoms. Higher tertile scores in the snacks pattern were associated with higher chances of depressive symptoms. | Moderate, 62.5% |
| Qian et al (2023),40 China | Cross-sectional | 13.10 ± 0.70 | 853 (F/M) | FFQ | FA | PHQ-9 (Chinese version) | Modern and snack-aquatic patterns were associated with an increased risk of depression in Chinese adolescents, and vegetarian patterns were associated with a reduced risk of depression. | Low, 75% |
Abbreviations:F, Female; M, Male; FFQ, Food-frequency Questionnaire, IDP, inflammatory dietary pattern; CIS-R, Clinical Interview Schedule–Revised; SMFQ, Moods and Feelings Questionnaire–Short; HABITS, Health and Behaviors of Teenagers Study; NDD, Nordic Diet; MDS, Mediterranean Diet Score; MFQ, Moods and Feelings Questionnaire; DQQ, Diet Quality Questionnaire; CES-D, Center for Epidemiological Studies–Depression Scale; GDR, Global Dietary Recommendations; CCDI, Chinese Children Dietary Index; CDI-S, Children's Depression Inventory–Short Form; LLDS, Lifelines Diet Score; BDI, Beck Depression Inventory; GDQS, Global Diet Quality Score; KIDMED, Mediterranean Diet Quality Index in Children and Adolescent; DASS-21, 21-item Depression, Anxiety, and Stress Scale; DTAC, Dietary total antioxidant capacity; PedsQL, Pediatric Quality of Life Inventory; DASH, Dietary Approaches to Stop Hypertension; DII, Dietary Inflammatory Index; MSDPS, Mediterranean-Style Dietary Pattern Score; T3, third tertile; 24HR, 24-h dietary recall; PCA, Principal Components Analysis; BDI-II, Beck Depression Inventory–Second Edition; DPI, Dietary Phytochemical Index, ABAKQ, Adolescent Behaviors, Attitudes and Knowledge Questionnaire; FA, Factor Analysis; SDQ, Simple Dietary Questionnaire; DSRS, Depression Self-Rating Scale for Children; MD, Mediterranean diet; PHQ-9, 9-item Patient Health Questionnaire.
Summary of Descriptive Characteristics and Risk of Bias of All Included Studies in the Systematic Review
| Study (year), country . | Type of study . | Participants . | Investigation . | Method of analysis . | Depression symptoms/depression (measure) . | Key findings . | Risk of bias . | |
|---|---|---|---|---|---|---|---|---|
| Age . | No. of participants (gender) . | |||||||
| A priori dietary pattern | ||||||||
| Cong et al (2020),45 England | Cohort | 18 | 6939 (F/M) | FFQ (90 items) | IDP | CIS-R | After all covariates were adjusted, higher IDP in childhood seems not to be associated with higher depression risk in the late adolescence. | Moderate, 63.4% |
| Jacka et al (2010),25 Australia | Cross-sectional | 10-14 | 7114 (F/M) | Dietary questionnaire (14 items) |
| SMFQ | Adolescents in the highest quintile of the healthy dietary pattern reduced almost half the probability of being symptomatic. Individuals in the highest quintile of unhealthy diet increased the likelihood of depression symptoms by almost 80%. | Low, 75% |
| Jacka et al (2012),27 England | Cohort | 11-14 | Baseline: 2789; follow-up: 2093 (F/M) | Dietetic questionnaire based on questions from HABITS |
| SMFQ | Association between higher scores for unhealthy diet and increased for depression symptoms at baseline. No relationships were observed between the scores of any dietary measurement and the SMFQ scores in the follow-up. | High, 36.4% |
| Vejrup et al (2023),33 Norway | Cohort | 6 and 18 mo and 3 and 7 y | 39 138; 36 865; 33 464; 34 588 | FFQ | NDD score | SMFQ | Inverse continuous association was observed between NND scoring at 3- and 7-y depression symptom scores at 8 y | High, 45.6% |
| Winpenny et al (2018),42 England | Cohort | 14 | 603 | 4-Day diet diaries | MDS | MFQ | There were no significant associations between diet quality (MDS),and depressive symptoms at baseline, or between baseline MDS and depressive symptoms at 3-y follow-up. | Low, 72.7% |
| Xie et al (2024),36 China | Cross-sectional | 12-16 | 1749 | FFQ | Diet Quality Questionnaire (DQQ) | CES-D | The overall GDR score was not significantly associated with depressive symptoms. | Low, 87.5% |
| Zhang et al (2024),38 China | Cross-sectional | 6-15 | 6478 | FFQ (105 items) | CCDI | CDI-S | Poor diet quality was associated with higher odds of depression. | Low, 87.5% |
| Darabi et al (2024),35 Iran | Cross-sectional | 12-18 | 733 (F) | FFQ (147 items) | LLDS | BDI | Adolescent girls in the highest quartile of LLDS compared with the participants in the lowest quartile had a 41% lower probability of having depressive symptoms. | Low, 87.5% |
| Beigrezaei et al (2024),34 Iran | Cross-sectional | 12-18 | 733 (F) | FFQ (147 items) | GDQS | BDI | Adolescent girls in the highest tertile of GDQS compared with the lowest tertile had a 41% lower odds of depressive symptoms. | Low, 75% |
| Jiménez-López et al (2024),37 Spain | Cross-sectional | 12-17 | 698 | FFQ (45 items) | KIDMED | DASS-21 | Compared with individuals with low adherence to the MD, those with moderate and high adherence had lower odds of experiencing depressive symptoms. | Low, 75% |
| Zohrabi et al (2022),39 Iran | Cross-sectional | 12-18 | 741 (F) | FFQ (147 items) | DTAC | BDI | Subjects in the highest quartile of DTAC had a 39% lower odds of depression compared with those in the first quartile. | Low, 75% |
| Jacka et al (2011),26 Australia | Cohort | 11-18 | Baseline: 2915; follow-up: 1949 (F/M) | Dietary questionnaire |
| PedsQL | Cross-sectional analyses showed positive relationships between healthy diet scores and PedsQL score Unhealthy diet scores were inversely associated with PedsQL score at baseline. Higher scores for a healthy diet at the beginning of the study also predicted higher PedsQL scores (lower depressive symptoms) at follow-up. There was no prospective association between higher scores for quality of unhealthy diet and lower PedsQL (higher depressive symptoms). | High, 36.4% |
| Khayyatzadeh et al (2017),28 Iran | Cross-sectional | 12-18 | 535 (F) | FFQ (168 items) | DASH score | BDI | A high adherence to a DASH-style diet (for individuals in the upper quartile) was associated with a lower odds of depression compared with subjects with lower adherence (those in the lowest quartile). | Low, 62.5% |
| Shivappa et al (2016)30; Tehrani et al (2016)32; and Tehrani et al (2018),31 Iran | Cross-sectional | 15-18 | 300 (F); 280 (F); 263 (F) | FFQ (168 items) | DII; MSDPS | DASS-21 (Persian version) | A significant positive association between increased inflammatory potential of diet (T3) and depression symptoms compared with females in first tertile. MSDPS may be associated with a reduced chance of developing depressive symptoms. Adolescents in the highest quintile of the MSDPS had a lower prevalence of depressive symptoms (58%) compared with those in the lower quintile of MSDPS. | Low, 75% |
| Sangouni et al (2022),44 Iran | Cross-sectional | 12-18 | 733 (F) | FFQ (147 items) | DPI score | BDI-II (Persian version) | The participants in the fourth quartile of DPI compared with the first quartile had a 50% lower odds of depression. | Moderate, 62.5% |
| A posteriori dietary pattern | ||||||||
| Khayyatzadeh et al (2018),28 Iran | Cross-sectional | 12-18 | 750 (F) | FFQ (147 items) | PCA | BDI | Adolescents in the fourth highest quartile of the healthy eating pattern were less likely to present depressive symptoms. There were no significant associations between the traditional and Western standard diet with depression symptoms. | Moderate, 62.5% |
| Hemmati et al (2021),47 Iran | Cross-sectional | 14-17 | 347 (F) | 24HRs | PCA | BDI-II (Persian version) | A positive association was observed between the Western dietary pattern and depression, while the healthy dietary pattern was inversely related to depression. | Low, 87.5 % |
| Sinclair et al (2016),43 Fiji | Cross-sectional | 13-18 | Baseline: 7237 (F/M); follow-up: 2948 (F/M) | Questions extracted from the ABAKQ questionnaire (83 items) | FA | PedsQL | The association was significant between the healthy diet and lower depressive symptomatology for both sexes. No association was found between the unhealthy diet and depressive symptoms for both sexes. Associations between healthy diet quality and depressive symptoms were found for both sexes in the follow-up. No association was found between the unhealthy diet and depressive symptoms in follow-up for both sexes. | Moderate, 62.5% |
| Hayward et al (2016),46 Australia | Cross-sectional | 14-19 | 3295 (F/M) | SDQ | PCA | SMFQ | Higher scores in the unhealthy dietary pattern were associated with a higher probability of depressive symptoms in male adolescents. No association was observed between healthy dietary pattern and the snacks dietary pattern with depressive symptoms for both sexes. | Low, 75% |
| Weng et al (2012),41 China | Cross-sectional | 11-16 | 5003 (F/M) | FFQ (38 items) | PCA | DSRS (Chinese version) | The traditional dietary pattern was associated with a lower probability of depressive symptoms. Higher tertile scores in the snacks pattern were associated with higher chances of depressive symptoms. | Moderate, 62.5% |
| Qian et al (2023),40 China | Cross-sectional | 13.10 ± 0.70 | 853 (F/M) | FFQ | FA | PHQ-9 (Chinese version) | Modern and snack-aquatic patterns were associated with an increased risk of depression in Chinese adolescents, and vegetarian patterns were associated with a reduced risk of depression. | Low, 75% |
| Study (year), country . | Type of study . | Participants . | Investigation . | Method of analysis . | Depression symptoms/depression (measure) . | Key findings . | Risk of bias . | |
|---|---|---|---|---|---|---|---|---|
| Age . | No. of participants (gender) . | |||||||
| A priori dietary pattern | ||||||||
| Cong et al (2020),45 England | Cohort | 18 | 6939 (F/M) | FFQ (90 items) | IDP | CIS-R | After all covariates were adjusted, higher IDP in childhood seems not to be associated with higher depression risk in the late adolescence. | Moderate, 63.4% |
| Jacka et al (2010),25 Australia | Cross-sectional | 10-14 | 7114 (F/M) | Dietary questionnaire (14 items) |
| SMFQ | Adolescents in the highest quintile of the healthy dietary pattern reduced almost half the probability of being symptomatic. Individuals in the highest quintile of unhealthy diet increased the likelihood of depression symptoms by almost 80%. | Low, 75% |
| Jacka et al (2012),27 England | Cohort | 11-14 | Baseline: 2789; follow-up: 2093 (F/M) | Dietetic questionnaire based on questions from HABITS |
| SMFQ | Association between higher scores for unhealthy diet and increased for depression symptoms at baseline. No relationships were observed between the scores of any dietary measurement and the SMFQ scores in the follow-up. | High, 36.4% |
| Vejrup et al (2023),33 Norway | Cohort | 6 and 18 mo and 3 and 7 y | 39 138; 36 865; 33 464; 34 588 | FFQ | NDD score | SMFQ | Inverse continuous association was observed between NND scoring at 3- and 7-y depression symptom scores at 8 y | High, 45.6% |
| Winpenny et al (2018),42 England | Cohort | 14 | 603 | 4-Day diet diaries | MDS | MFQ | There were no significant associations between diet quality (MDS),and depressive symptoms at baseline, or between baseline MDS and depressive symptoms at 3-y follow-up. | Low, 72.7% |
| Xie et al (2024),36 China | Cross-sectional | 12-16 | 1749 | FFQ | Diet Quality Questionnaire (DQQ) | CES-D | The overall GDR score was not significantly associated with depressive symptoms. | Low, 87.5% |
| Zhang et al (2024),38 China | Cross-sectional | 6-15 | 6478 | FFQ (105 items) | CCDI | CDI-S | Poor diet quality was associated with higher odds of depression. | Low, 87.5% |
| Darabi et al (2024),35 Iran | Cross-sectional | 12-18 | 733 (F) | FFQ (147 items) | LLDS | BDI | Adolescent girls in the highest quartile of LLDS compared with the participants in the lowest quartile had a 41% lower probability of having depressive symptoms. | Low, 87.5% |
| Beigrezaei et al (2024),34 Iran | Cross-sectional | 12-18 | 733 (F) | FFQ (147 items) | GDQS | BDI | Adolescent girls in the highest tertile of GDQS compared with the lowest tertile had a 41% lower odds of depressive symptoms. | Low, 75% |
| Jiménez-López et al (2024),37 Spain | Cross-sectional | 12-17 | 698 | FFQ (45 items) | KIDMED | DASS-21 | Compared with individuals with low adherence to the MD, those with moderate and high adherence had lower odds of experiencing depressive symptoms. | Low, 75% |
| Zohrabi et al (2022),39 Iran | Cross-sectional | 12-18 | 741 (F) | FFQ (147 items) | DTAC | BDI | Subjects in the highest quartile of DTAC had a 39% lower odds of depression compared with those in the first quartile. | Low, 75% |
| Jacka et al (2011),26 Australia | Cohort | 11-18 | Baseline: 2915; follow-up: 1949 (F/M) | Dietary questionnaire |
| PedsQL | Cross-sectional analyses showed positive relationships between healthy diet scores and PedsQL score Unhealthy diet scores were inversely associated with PedsQL score at baseline. Higher scores for a healthy diet at the beginning of the study also predicted higher PedsQL scores (lower depressive symptoms) at follow-up. There was no prospective association between higher scores for quality of unhealthy diet and lower PedsQL (higher depressive symptoms). | High, 36.4% |
| Khayyatzadeh et al (2017),28 Iran | Cross-sectional | 12-18 | 535 (F) | FFQ (168 items) | DASH score | BDI | A high adherence to a DASH-style diet (for individuals in the upper quartile) was associated with a lower odds of depression compared with subjects with lower adherence (those in the lowest quartile). | Low, 62.5% |
| Shivappa et al (2016)30; Tehrani et al (2016)32; and Tehrani et al (2018),31 Iran | Cross-sectional | 15-18 | 300 (F); 280 (F); 263 (F) | FFQ (168 items) | DII; MSDPS | DASS-21 (Persian version) | A significant positive association between increased inflammatory potential of diet (T3) and depression symptoms compared with females in first tertile. MSDPS may be associated with a reduced chance of developing depressive symptoms. Adolescents in the highest quintile of the MSDPS had a lower prevalence of depressive symptoms (58%) compared with those in the lower quintile of MSDPS. | Low, 75% |
| Sangouni et al (2022),44 Iran | Cross-sectional | 12-18 | 733 (F) | FFQ (147 items) | DPI score | BDI-II (Persian version) | The participants in the fourth quartile of DPI compared with the first quartile had a 50% lower odds of depression. | Moderate, 62.5% |
| A posteriori dietary pattern | ||||||||
| Khayyatzadeh et al (2018),28 Iran | Cross-sectional | 12-18 | 750 (F) | FFQ (147 items) | PCA | BDI | Adolescents in the fourth highest quartile of the healthy eating pattern were less likely to present depressive symptoms. There were no significant associations between the traditional and Western standard diet with depression symptoms. | Moderate, 62.5% |
| Hemmati et al (2021),47 Iran | Cross-sectional | 14-17 | 347 (F) | 24HRs | PCA | BDI-II (Persian version) | A positive association was observed between the Western dietary pattern and depression, while the healthy dietary pattern was inversely related to depression. | Low, 87.5 % |
| Sinclair et al (2016),43 Fiji | Cross-sectional | 13-18 | Baseline: 7237 (F/M); follow-up: 2948 (F/M) | Questions extracted from the ABAKQ questionnaire (83 items) | FA | PedsQL | The association was significant between the healthy diet and lower depressive symptomatology for both sexes. No association was found between the unhealthy diet and depressive symptoms for both sexes. Associations between healthy diet quality and depressive symptoms were found for both sexes in the follow-up. No association was found between the unhealthy diet and depressive symptoms in follow-up for both sexes. | Moderate, 62.5% |
| Hayward et al (2016),46 Australia | Cross-sectional | 14-19 | 3295 (F/M) | SDQ | PCA | SMFQ | Higher scores in the unhealthy dietary pattern were associated with a higher probability of depressive symptoms in male adolescents. No association was observed between healthy dietary pattern and the snacks dietary pattern with depressive symptoms for both sexes. | Low, 75% |
| Weng et al (2012),41 China | Cross-sectional | 11-16 | 5003 (F/M) | FFQ (38 items) | PCA | DSRS (Chinese version) | The traditional dietary pattern was associated with a lower probability of depressive symptoms. Higher tertile scores in the snacks pattern were associated with higher chances of depressive symptoms. | Moderate, 62.5% |
| Qian et al (2023),40 China | Cross-sectional | 13.10 ± 0.70 | 853 (F/M) | FFQ | FA | PHQ-9 (Chinese version) | Modern and snack-aquatic patterns were associated with an increased risk of depression in Chinese adolescents, and vegetarian patterns were associated with a reduced risk of depression. | Low, 75% |
Abbreviations:F, Female; M, Male; FFQ, Food-frequency Questionnaire, IDP, inflammatory dietary pattern; CIS-R, Clinical Interview Schedule–Revised; SMFQ, Moods and Feelings Questionnaire–Short; HABITS, Health and Behaviors of Teenagers Study; NDD, Nordic Diet; MDS, Mediterranean Diet Score; MFQ, Moods and Feelings Questionnaire; DQQ, Diet Quality Questionnaire; CES-D, Center for Epidemiological Studies–Depression Scale; GDR, Global Dietary Recommendations; CCDI, Chinese Children Dietary Index; CDI-S, Children's Depression Inventory–Short Form; LLDS, Lifelines Diet Score; BDI, Beck Depression Inventory; GDQS, Global Diet Quality Score; KIDMED, Mediterranean Diet Quality Index in Children and Adolescent; DASS-21, 21-item Depression, Anxiety, and Stress Scale; DTAC, Dietary total antioxidant capacity; PedsQL, Pediatric Quality of Life Inventory; DASH, Dietary Approaches to Stop Hypertension; DII, Dietary Inflammatory Index; MSDPS, Mediterranean-Style Dietary Pattern Score; T3, third tertile; 24HR, 24-h dietary recall; PCA, Principal Components Analysis; BDI-II, Beck Depression Inventory–Second Edition; DPI, Dietary Phytochemical Index, ABAKQ, Adolescent Behaviors, Attitudes and Knowledge Questionnaire; FA, Factor Analysis; SDQ, Simple Dietary Questionnaire; DSRS, Depression Self-Rating Scale for Children; MD, Mediterranean diet; PHQ-9, 9-item Patient Health Questionnaire.
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