Food Research Institute

Kalender, S. – Durmuş, V.
A cross-sectional ecological analysis of the relationship between nutrient intake and mental health burden across income groups, 1990–2018


Veli Durmuş, Kütahya Health Sciences University, The Department of Health Management, Germiyan Campus, Zafertepe Mah., Postal code: 43020, Kütahya, Türkiye. E-mail: velidurmus@gmail.com

Original article
Received 2 February 2026; 1st revised 9 April 2026; accepted 30 April 2026

Summary: Mental health disorders, particularly depression and anxiety, represent a growing global public health concern. Although population-level nutrient intake may be associated with mental health burden, ecological evidence across income groups remains limited. This study examined the association between nutrient intake and mental health burden across 120 countries from 1990 to 2018, stratified by income levels. A cross-sectional ecological analysis was conducted using country-level data from the Global Dietary Database and the Global Burden of Disease study. Nutrients were categorised as potentially beneficial (omega-6 fats, folate, protein) or unhealthy (sugar-sweetened beverages, refined grains, processed meats). Mental health burden was measured using prevalence and disability-adjusted life years. Pearson correlations and multivariable linear regression analyses were employed. Unhealthy nutrient consumption increased globally, particularly in low- and middle-income countries. Omega-6 fats and processed meats were positively associated with depressive (β = 1554.04, p = 0.03) and anxiety disorders (β = 1976.09, p = 0.01). Protein intake was associated only with anxiety (β = 17.51, p = 0.02). Upper-middle-income countries exhibited the largest increase in mental health burden. Public health strategies should prioritise nutrient-dense diets, especially in transitioning economies, to mitigate the rising mental health burden. Future research should explore causal mechanisms and longitudinal effects.

Keywords: mental health; anxiety disorder; depressive disorder; nutrients; income groups