Dietary Patterns and Depressive Symptom Severity in the Hungarian Adult Population: Evidence from a Nationally...

Background: Depression represents a major public health burden in Hungary, where prevalence remains higher than the global average. Although diet is an increasingly studied factor associated with mental health, evidence from Central and Eastern Europe is scarce. Methods: This cross-sectional study analyzed data from the Hungarian wave of the European Health Interview Survey (EHIS) 2019, a nationally representative sample of 5603 adults aged ≥15 years. Depressive symptom severity was assessed using the Patient Health Questionnaire-8 (PHQ-8) and categorized as none (0-4), mild (5-9), and moderate-to-severe (≥10). Self-reported frequency of consumption of fruits, vegetables, fruit juice, dairy products, fish, processed meat, sweetened beverages, coffee, and sweeteners was examined. Multivariable ordinal logistic regression models, adjusted for gender, age, education, income, physical activity, smoking, and alcohol consumption, were used to estimate associations with depressive symptom severity. Results: Overall, 77.9% of participants had no depression, 17.0% mild, and 5.1% moderate-to-severe symptoms. After full adjustment, lower consumption of fruits and vegetables, less frequent fruit juice intake, and lower processed meat consumption were associated with higher odds of more severe depressive symptoms. Moderate coffee intake (1-2 cups/day) was associated with lower odds than heavier consumption. Conclusions: In the Hungarian adult population, poorer dietary patterns, particularly low intake of fruits, vegetables, and paradoxically lower processed meat consumption, are significantly associated with greater depressive symptom severity, independent of major sociodemographic and lifestyle factors. These findings underscore the potential role of diet quality in mental health and support public health efforts to promote nutrient-rich dietary patterns in Hungary.