Dietary quality in bipolar disorder compared to unipolar depression (current and remitted) and healthy controls: The netherlands study of depression and anxiety

A critical area of concern in managing bipolar disorder (BD) is the heightened susceptibility to cardiovascular diseases. The potential role of dietary habits in this context remains under-explored, especially regarding the implications of Western dietary patterns. This study aims to elucidate dietary quality among individuals with BD, unipolar depression (UD), and healthy controls.

The investigation included a sample of 1,358 individuals from the Netherlands Study of Depression and Anxiety (NESDA). Participants were divided into four distinct groups: those with BD (n = 100, 48.0% male, mean age 50.9), current UD (n = 199, 28.0% male, mean age 52.4), remitted UD (n = 722, 29.8% male, mean age 52.4), and healthy controls (HC, n = 337, 40.7% male, mean age 51.2). Dietary assessment was conducted using a comprehensive 238-item Food Frequency Questionnaire (FFQ), which enabled calculation of the Mediterranean Diet Score (MDS). Statistical analyses applied included multivariate regression to compare dietary scores across groups while controlling for sociodemographic factors, physical activity, and smoking behavior.

The findings revealed that individuals with BD exhibited significantly lower MDS scores than those with remitted UD (p = 0.01) and healthy controls (p = 0.02), while no significant differences were observed when comparing BD patients to those with current UD. The effect sizes calculated were 0.24 for BD versus remitted UD and 0.25 for BD versus HC. Additionally, BD patients had a greater average waist circumference (p = 0.03) and body mass index (BMI) (p = 0.02) than healthy control participants.

This research emphasizes that the dietary quality of patients with BD is notably poorer than that of their counterparts with remitted UD and healthy individuals. Such dietary deficiencies may be linked to the higher waist circumference and elevated BMI observed in this population, highlighting potential adverse health implications. [NPID: Diet quality, major depressive disorder, bipolar disorder, diet, Mediterranean Diet]

Year: 2026

Reference: Riedinger, M. A., Koenders, M., Jeuring, H. W., Molendijk, M. L., Penninx, B. W. J. H., van der Wee, N. J. A., de Leeuw, M., & Giltay, E. J. (2026). Dietary Quality in Bipolar Disorder Compared to Unipolar Depression (Current and Remitted) and Healthy Controls: The Netherlands Study of Depression and Anxiety. Bipolar disorders, 28(3), e70104. https://doi.org/10.1111/bdi.70104

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