Abstract
Diet is increasingly being recognized as a modifiable lifestyle factor that plays an important role in neuropsychiatric health. However, existing research has focused on single foods or dietary patterns in relation to specific diseases, limiting their ability to inform precise dietary recommendations. Based on UK Biobank data, we applied Cox regression to assess associations between four healthy dietary patterns and risks of dementia, depression, and anxiety. Moreover, we utilized structural equation modeling to explore potential biological pathways. Our results indicated that Alternate Mediterranean Diet (AMED) demonstrated the strongest protective effect against all-cause dementia (0.92 (0.85-0.99)). Regarding depression, the AMED (0.93 (0.89-0.98)) and Alternative Healthy Eating Index-2010 (AHEI-2010) (0.93 (0.90-0.97)) showed the strongest negative correlation. AMED was also most strongly associated with reduced risk of phobic anxiety disorders (0.87 (0.77-0.99)), whereas AHEI-2010 exhibited the most pronounced inverse association with other anxiety disorders (0.94 (0.91-0.98)). Structural equation modeling indicated that healthy dietary patterns may reduce the risk of neuropsychiatric disorders partly through direct modulation of inflammation and partly by improving metabolic function, which in turn reduces inflammation. Collectively, our findings support the development of precision-targeted dietary recommendations for the diet-immune-brain axis.