The relationship between the World Index for Sustainability and Health (WISH) score and mental health in women: a cross-sectional study
Bibliographic record
Abstract
Diet quality has been associated with mental health, and recently, there has been growing interest in the association between the sustainability of diets and human health. The objective of this cross-sectional study was to explore the relationship between a newly developed dietary index for health and sustainability and psychological disorders among Iranian women. Participants in this cross-sectional study included 479 women living in Tehran with no history of chronic disease. A validated 168-item FFQ was used to assess dietary intake. The World Index for Sustainability and Health was calculated, consisting of four sub-scores: less healthy, healthy, low environmental impact and high environmental impact. Participants' psychological status was assessed using the Depression Anxiety Stress Scale-21. Logistic regression models were used to examine the association between the World Index for Sustainability and Health and psychological disorders. Participant ages ranged from 20 to 50 years, with a mean age of 31·86 (sd 7·68) years. After adjusting for potential confounders (age, energy, BMI, marital status, education, family history of chronic disease, body satisfaction, socio-economic status, physical activity, smoking), women in the highest tertile of the healthy sub-score had significantly lower odds of experiencing depression (OR 0·40; 95 % CI 0·24, 0·67), anxiety (OR 0·45; 95 % CI 0·23, 0·87) and psychological distress (OR 0·46; 95 % CI 0·28, 0·77) compared with the reference group. Similarly, the less healthy sub-score was significantly associated with depression (OR 0·51; 95 % CI 0·32, 0·89), anxiety (OR 0·44; 95 % CI 0·25, 0·78) and psychological distress (OR 0·57; 95 % CI 0·36, 0·90). An inverse association was observed between the low environmental impact sub-score and depression (OR 0·32; 95 % CI 0·19, 0·54), anxiety (OR 0·38; 95 % CI 0·18, 0·76) and psychological distress (OR 0·30; 95 % CI 0·17, 0·51). However, no further significant associations were found with the high environmental impact sub-score, except with depression (OR 0·57; 95 % CI 0·33, 0·96). The healthy and low environmental impact sub-scores of the World Index for Sustainability and Health were found to be inversely associated with depression, anxiety and psychological distress. However, due to the cross-sectional study design, causality cannot be inferred. Further prospective studies are required to validate and expand upon these findings and explore potential mechanisms and alternative explanations, such as reverse causation. While this study suggests that choosing a diet that is both healthy for individuals and sustainable for the environment may be associated with a lower risk of mental health issues among women, more research is needed.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".