Thorough research was conducted on depression and anxiety among women due to improper or poor dietary habits. Several databases were searched and the results are presented in Table 1.

Table 1

Introduction

Poor eating habits are likely to reduce a person’s overall physical or mental health (Keel & Forney, 2013). They can directly affect an individual’s mental health, for example by leading to the development of anxiety disorder, bipolar disorder or depression. Eating practices play a significant role in maintaining a healthy diet and improving mental health. Eating disorders occur when a person’s eating practices are inadequate, for example if they are eating excessively, skip meals or indulge in a high intake of sugar-rich food. This harms their mental and physical health in a number of ways. A dramatic increase or decrease in body weight and a change in body shape may occur due to poor eating habits and this affects mental health due to body perfection stereotypes (Ebneter & Latner, 2013).

studies have shown a strong relationship between poor eating practices and mental health. According to Mond et al. (2010), females are more likely to develop mental health issues such as emotional problems, depression or anxiety because female adolescents face more problems in society than males. Pressure is placed on them to maintain their body shape and weight so that they look good. Young women especially tend to eat little so that they can control their body weight and look thin, as per the demands of society. These unhealthy dietary practices affect the mental health of women; they become depressed, they are unable to cope and develop low self-esteem. This in turn leads to several issues that affect their behaviour and mental conduct.

Moreover, the study of Mond et al. (2008) shows that females are affected by poor eating habits due to the demands of their multiple roles at home and in society. They are busy with house chores; they have to manage their family and work hard to cope with every aspect of life. This means that they may be unable to follow a healthy diet. Henderson and Ellison (2015) also found that young and middle-aged women are busy with their home and job, resulting in unhealthy eating habits. They are not consuming the nutrients required by their body and brain and therefore both their physical and mental health are at risk. Consuming excessive fats and sugar-rich food leads to a gain in body weight, which in women ultimately results in a psychotic pressure to get thin to look pretty. Thus, they get depressed and are unable to concentrate on their work and family properly (Farhangi, Dehghan, & Jahangiry, 2018).

An unhealthy diet has been proven to have an impact on female adolescents’ mental health. Dietary patterns such as elevated intakes of whole and saturated fats, refined grains and sugars, processed meat and sodium, and a minimum consumption of fruits, vegetables, fibre and omega-3 fatty acids, lead to an unbalanced diet with inappropriate amounts of healthy foods that are full of protein, carbohydrates, fibre and fats. Healthy diet practices improve the mental health of adolescents (Wattick, Hagedorn, & Olfert, 2018).

In order to reduce anxiety and depression among females it is necessary to introduce dietary education and lifestyle interventions. Van Dammen et al. (2018) demonstrated that dietary education and lifestyle interventions are effective ways of reducing anxiety and depression among women who are obese or overweight. For this reason, weight management sessions and healthy eating education should be introduced.

Introduction

Findings released by the World Health Organization (WHO) (2017) reveal that mental health issues amongst adolescents, particularly female adolescents, cast a negative influence not only on the health and wellbeing of the adolescents but also extend to their adverse effects on their parents and the entire family. The health related quality of life of the patient has a profound impact on his/her risk factors for a mental illness, and this involves the physical, emotional, social and mental wellbeing of the individual. Adolescence is characterized as a period of transition that maps out a child’s journey towards adulthood. This is a time of dramatic changes and development, and adolescence can give birth to a wide range of unhealthy eating patterns.

Female adolescents are more likely to consume unhealthy fast food, eating away from home, consume excessive amounts of added sugars, and skip meals and higher intakes of saturated fats. Lack of sufficient nutrition and healthy food items is a significant factor in the development of brain diseases and mental health ailments, particularly cognitive disorders. Unhealthy eating patterns and behaviors are a vital determining factor of some of the most common mental health issues, including depression, conductive issues amongst adolescents, and hyperactivity disorder.

There is well-supported evidence to suggest a link between mental health complications amongst adolescents and unhealthy eating patterns. There is a significant association between hyperactivity or convenient disorder and oppositional disorders amongst adolescents with unhealthy heating habits that involve “convenient snacking” and “junk” food items. Diets that are rich in high amounts of saturated fats, sugars, refined grains, processed meats, excessive amounts of sodium, and a reduced consumption of vegetables, fruits, fiber and omega-3 fatty acids had a higher vulnerability to be diagnosed with attention deficit hyperactivity disorders

(Schlack et al., 2016) revealed that female adolescents have a greater likelihood to suffer from internalizing mental health issues, such as anxiety, depression and emotional problems. This is primarily because internalizing mechanisms are far more common amongst female adolescents as opposed to their male counterparts. Females are more likely to face their problems and challenges as opposed to escaping them. It is pertinent to mention here that there are two major categories of emotional issues and mental health behaviours: internalizing and externalizing problems. Externalizing problems include abnormal behaviours and mental health challenges, such as cognitive dysfunction or attention disorders, such as attention deficit hyperactivity disorder (ADHD) or oppositional defiant disorder (ODD). Internalizing emotional problems, which are more common amongst females, are categorized by an emotional failure to overpower negative emotions, such as anxiety, sadness, solitude, loneliness and depression. Men are more likely to experience externalizing mental health problems, while females more commonly experience internalizing problems. These internalizing problems are widely associated with unhealthy diets and poor eating patterns, which tend to be more common amongst women and female adolescents. Teenage girls, particularly, suffer from more internalizing issues as they consume insufficient amounts of healthy food items as compared to other gender and population groups. These unhealthy eating habits and poor diet patterns are also triggered by certain mental and emotional issues amongst females, such as dissatisfaction with body image, lack of self-esteem, body image distortion, and the ideals of thinness and beauty promoted in contemporary society.

An evidence-based review by the WHO (2000) demonstrated that unhealthy diet patterns amongst women are associated with a wide array of mental health disorders and problems, including eating disorders, anxiety disorders, depression and bipolar disorders. There is a prevalent gender bias as these mental health disorders are much more common amongst women as compared to men, and this bias is particularly common amongst mental health problems such as somatic issues, depression and anxiety. Women come into contact with a wide array of societal roles that make them more vulnerable to the risk factors of suffering from mental disorders as opposed to other genders and population groups.

There is well-supported evidence to demonstrate the greater prevalence of depression, anxiety, stress and mental distress amongst women than man. Multiple other well-supported studies have associated unhealthy eating patterns with anxiety and depressive disorders. Dietary education treatments and nutrition therapies have been used as a medium to bring about enhancements in diet quality and improve healthy eating patterns to bring about improvements in the mental health conditions of adolescents. These dietary improvements focus on reversing the eating patterns of skipping breakfast, and consuming high amounts of sugar through sweets, desserts and beverages, which are associated with multiple mental health ailments. Academics have highlighted the potential link between lack of dietary nutrition and unhealthy eating patterns with a wide array of mental health ailments amongst adolescents.

The association between mental health ailments amongst female adolescents and unhealthy eating patterns can be explained through various biological paradigms. First and foremost, an unhealthy diet that lacks nutrient-rich food items can lead to a wide array of mental health challenges. For instance, a diet that lacks sufficient amounts of omega-3 fatty acids, zinc, magnesium, and folate is associated with the onset of anxiety disorders and major depressive disorder. Secondly, the daily diet of an individual has a direct impact on the biological mechanisms and pathological pathways that given rise to mental ailments and disorders. We will examine these factors in more detail in the next section.

Literature Review

Depression is one of the major causes of a wide array of mental and physical ailments, and major depressive disorders are common amongst 6% of the total population in the world, of which, women constitute a clear majority. (Ferrari et al., 2013)

Penninx et al., (2014) explains depression as a recurrent and chronic mental health disorder that can cast a negative influence on the normal functioning of the patient and lead to a wide array of adverse effects on the somatic wellbeing. Depression is largely correlated with anxiety disorders, and the two mental health ailments are highly likely to manifest together or one after the other. Whitaker et al., (2014) demonstrated that depression is widely associated with poor eating habits and lack of sufficient dietary nutrition, which allows depressive disorders to trigger various somatic illnesses. Cross-sectional research reveals that diets that include excessive consumption of calories consumed from sugars, saturated fat and sweet foods are associated with intense bouts of depression and severe depressive disorders. Payne et al., (2012) has demonstrated that an increased consumption of vegetables fruits and antioxidants can alleviate the symptoms of clinical depression and restore mental wellbeing.

However, as we examine the impact of an overall diet, it is important to understand the impact of various different food groups, in order to understand the impact of consuming various foods in relation one another. Gibson (2006) highlights that amongst certain women and population groups, stressful situations and anxious thoughts can trigger depression, which can in turn promote poor eating habits and unhealthy food choices. The American Psychiatric Association (APA) (2013) highlights that according to the Diagnostic and Statistical Manual of Mental Disorders V (DSM V), changes in the dietary patterns and appetite are one of the major symptoms of depression. Lack of energy, perpetual exhaustion, and reduced interests in hobbies and activities are some other major symptoms of depression that tend to promote unhealthy diets and poor eating habits as they can trigger lack of interest or motivation in enjoying or preparing meals.

Molendijk et al., (2018) demonstrated that it is important to note that depressive disorders can lead to unhealthy food choices and poor dietary patterns, while unhealthy food choices can also trigger the symptoms of depression. The relationship between dietary nutrition quality and depression is complex and multifaceted, and a wide majority of evidence-based research reveals that healthier eating patterns and food choices are associated with a reduced risk for suffering from depression and anxiety disorders. Anxiety disorders also tend to have a negative impact on dietary patterns and nutrient intake. They trigger symptoms such as panic attacks, abdominal pain, discomfort and nausea, which also affect dietary choices and encourage unhealthy eating habits and food choices.

As we examine the relationship between depression and unhealthy eating patterns amongst female students, we notice higher levels of stress and depressive symptoms. Mokhtari et al., (2013) demonstrated that female students encounter significantly higher levels of stress due to immense academic pressure and stressful environments, increase in the number of students and complex material expectations. This stress poses severely adverse influences on that tend to encourage the development of mental health issues. The material expectations from students include constructive criticism, educational environments, expectations from various examinations and assignments, lectures and academic materials, regard for student beliefs, and others. Financial problems, domestic responsibilities and increased burden of academic responsibilities are other causes that fuel the stressful lifestyles of students. The burden of holding a job while attending school is another stressful life experience that can promote both, depressive symptoms and unhealthy eating patterns. Hezomi et al., (2018) highlights that the stressors that impact the mental wellbeing of students can be categorized in to three major classifications. These include the personal factors, which are comprised of academic responsibilities, physical and mental health conditions, sleeping habits, and unhealthy eating habits. The academic factors include poor grades, increased hours of studying, increased workload, language barriers and difficulties, and procrastination. The environmental factors that lead to stress include poor living conditions, negative thoughts related to future prospects, lack of vacations and study breaks, divorced parents, and others. It is important to understand the relationships between unhealthy dietary patterns and mental health ailments, particularly depression, amongst female students, particularly teenage girls.

Jacka et al., (2011a) highlights that unhealthy dietary patterns and food choices are one of the major contributors to a wide array of mental and physiological diseases. Diets that include a higher consumption of fruits, vegetables, fish, poultry, legumes and whole grains are associated with reduced risk factors of depression, anxiety and other mental health disorders. One other than, typical western diets that include higher consumption of red meat, desserts, processed meats, fried foods and refined grains are associated with higher risk factors of depression and other mental health complications. These unhealthy food patterns and food choices are widely associated with greater depressive symptoms amongst women, alongside increased markers of systematic inflammation. Research reveals that healthy diets that offer greater nutritional value and include a higher consumption of essential dietary nutrients, including vitamins B-group, magnesium, healthy fats, and zinc, alongside an increased consumption of seafood items are associated with reduced risk factors of depression. However, it is pertinent to mention here that as we examine the impact of individual nutrients in relation to depression and other mental health ailments, we encounter many challenges and limitations. The daily diet of an average individual interacts with complex combinations and interactions of essential nutrients. The daily diet and food choices are multifaceted and varied, and therefore, it is always challenging to attribute certain symptoms or diseases with one nutrient or food item.

A cohort study conducted by Okubo et al., (2011) revealed no relationship between a healthy diet and the risk factors of depression. Moreover, there is a relationship between an unhealthy diet and depression amongst women, however, this relationship is not observed in the case of men. Chatzi et al., (2011) demonstrated a significant relationship between healthy eating patterns and reduced vulnerability to the symptoms of depression, a relationship that was largely observed amongst women. Adhering to a healthy and well-balanced diet consisting of whole foods can help women overcome their vulnerability to develop the risk factors of depression. The consumption of a traditional diet comprising of fruits, vegetables, lean meat, and whole grains is associated with reduced risk factors for depression.

Jacka et al., (2011b) reveals an insightful investigation on the association between diet patterns and anxiety, and concludes that the two are directly related, alongside highlighting some compelling gender differences. Healthy eating habits and nutritional diets are associated with reduced symptoms of anxiety amongst women, while unhealthy dietary patterns are associated with increased risk factors of anxiety women. Western and modern diets that are rich in processed meats, fried foods and saturated fats are widely associated with increased symptoms of depression and anxiety.

Bakhtiyari et al., (2013) demonstrated a relationship between unhealthy diets rich in processed foods and symptoms of anxiety amongst Iranian female adults. Weng et al., (2012) demonstrated that diet patterns that are focused on animal foods and snacks are associated with increased risk factors for suffering from anxiety, as seen amongst Chinese adolescents. These results are more likely to demonstrate a severe impact amongst girls as compared to boys. Poor diet quality, lack of nutrient variety and nutrient deficiencies are associated with intense feelings of anxiety, sadness and unhappiness.

Alipour et al., (2015) revealed heightened risk factors of mental health complications amongst female adolescents with unhealthy diets. Moreover, a significant association was established between poor eating patterns and mental health problems amongst females, regardless of their BMI or age. The habits of snacking as per convenience, skipping meals, and planning ahead were established as some of the major indicators of mental health disorders and emotional problems. The diet patterns of consuming low-fat meals were associated with reduced risk factors of hyperactivity disorder. Iranian females tend to experience higher risk factors of mental health disorders and complications due to their various roles in society and domestic responsibilities. Their eating patterns are disrupted by the impact of modernization, and the influence of social media in defining body and thin ideals, which leads to greater body dissatisfaction, lack of self-esteem, and body image distortion, in turn leading to unhealthy eating habits and the eventual onset of mental health ailments, particularly anxiety disorders and depression.

Jacka et al., (2012) demonstrated a clear association between unhealthy eating patterns consisting of insufficient nutrient density and mental health problems. Eating patterns and diets that lack sufficient amounts of nutrient-dense food times are largely associated with a higher prevalence of mental health problems amongst women, as seen as a direct impact of the diet on the immune system markets, inflammatory parameters, and the biomarkers of oxidative stress that lead to the onset of mental health disorders, primarily anxiety and depression. Unhealthy food items, such as saturated fats and sugar can cause chemical imbalances and hinder the development of the brain, and thereby, rendering women vulnerable to depressive symptoms and other mental health ailments.

Jacka et al., (2010) has examined the association between eating patterns amongst adolescents and mental health ailments. These findings reported that unhealthy eating patterns are largely associated with depressive disorders, anxiety disorders and attention deficit hyperactivity disorder (ADHD). The unhealthy eating patterns of skipping meals, and consuming food items containing higher levels of sugar, such as desserts, sodas and soft drinks, have been largely associated with mental health problems and depressive symptoms amongst female adolescents.

Oellingrath et al., (2014) undertook an examination of diets and unhealthy dietary patterns and demonstrated an association between behavioural eating patterns and mental health disorders amongst female adolescents. There are various different examinations of dietary behaviours and mental health challenges, which can make it challenging to compare different results. However, it is evident that diets that are rich in nutrient-dense food items and eating habits, such as regular meals, fish, seafood, unrefined grains, legumes, fruits and vegetables, are associated with reduced risk factors of depressive disorders and other psychiatric illnesses. On the other hand, unhealthy eating patterns and frequent habits of snacking and convenience are associated with higher risk factors of psychiatric disorders, primarily depression and anxiety. It is also important to note that these relationships between eating habits and depressive symptoms are bidirectional, and it is likely that mental health complications can encourage unhealthy eating habits and vice versa. In simpler words, eating behaviours and habits can adversely impact the mental wellbeing of women by reinforcing unhealthy eating patterns. These unhealthy eating habits and food choices are reinforced amongst women by making them feel psychologically rewarded and better, and in certain cases, it is also possible that unhealthy eating habits can make women feel emotionally rewarded and happy.

Rabbani et al., (2012) reveals an increased associated between unhealthy eating patterns and mental health complications regardless of any significant differences in BMI comparisons, and the nutrient intakes of the subjects. It is important to note that the examination of one single nutrient or food group can cause deductions to be misleading as it fails to take into account the complex nature of female diets, and the increased nutritional and biochemical interaction that takes place amongst nutrients when they enter the body. As opposed to examining one single nutrients, dietary patterns examine the impact of the overall food choices, ingredients and nutrients. They offer a comprehensive and extensive overview of the nutrients and food items consumed, and therefore, dietary patterns offer more reliable predictive patterns of various chronic and mental health ailments.

Sawyer et al., (2002) highlighted a relationship between poor dietary patterns and reduced life and health quality, which was associated with negative emotional experiences, negative behaviors and prevalence of hyperactivity disorders amongst female adolescents. Patients suffering from mental health disorders, primarily depression, have reduced life and health quality, which also impacts their dietary patterns and eating habits.

As we examine the impact of poor eating habits and unhealthy dietary patterns on depressive symptoms and anxiety disorders amongst women, it is also important to examine their impact amongst pregnant women. Baskin et al., (2015) demonstrates a relationship between unhealthy prenatal diets and antenatal depressive symptoms, which further give birth to anxiety and stress amongst women. Moreover, unhealthy prenatal diets and prenatal depressive symptoms are widely associated with increased levels of emotional-behavioural deregulation amongst children. The impact of diet extends to a wide array of bodily processes and interconnected pathways that are related to the development of depressive symptoms and mental disorders, including inflammatory markers, the biomarkers of oxidative stress, gut microbiota, and brain-induced neurotropic elements. Improvements in prenatal eating habits and dietary patterns can make significant contributions towards presenting mental disorders and postpartum depression amongst mothers, alongside preventing the intergenerational transmission for depression and mental health ailments to children.

Paskulin et al., (2017) examined the prenatal dietary patterns of 712 women from Southern Brazil and observed patterns of lesser consumption of healthy food items and higher consumption of refined sugars during pregnancy. These unhealthy eating habits were associated with an increased prevalence of depressive symptoms and the maternal mental disorder. More importantly, these unhealthy eating habits were largely related with the symptoms of generalized anxiety and major depressive disorder. Women who consumed standard Brazilian diets consisting of French rolls, sugar-rich coffee, sugar-packed sodas and juices, rice, noodles and margarine, had much higher risk factors of suffering from major depressive disorders as opposed to women who were consuming healthier and varied diets. After analysing the food groups in comparison with other diets and nutrient intakes, the symptoms of major depressive disorder were more prevalent amongst women who consumed a lower intake of fruits and vegetables, and had higher consumption rates of refined sugars. Dash et al., (2015) demonstrated that the symptoms of generalized anxiety disorder were prevalent amongst women who had a higher intake of processed foods and a lower intake of beans. This leads to the deduction that the fermentable fibre present in beans leads to a series of functional differences in the gut microbiota, which can influence the prevalence of anxiety disorders and depressive symptoms. Basically, fermentable fibre impacts the composition of gut microbiota and encourages the formation of short chain fatty acids, which tend to enhance mood and influence the production of essential neurotransmitters, such as serotonin, which are also known as happy hormones.

Conclusion

Jacka et al., (2017) reveals that the impact of unhealthy diets and eating habits on the prevalence of depressive and anxiety disorders amongst women, men and other population groups has emerged as a prevalent connection that needs to be researched in more detail to eliminate limitations in examining dietary patters and individual food groups. Reports and findings suggest that mental health professionals and nutritionists need to focus on helping women understand the impact of unhealthy eating habits and diets as they tend to have a much greater impact on their mental health and risk factors for suffering from depression as compared to men.

Begdache (2020) reveals that unhealthy diet patterns and eating habits can prove more dangerous for the mental wellbeing of women as compared to men. Diets impact men and women in strikingly different manners. Men are less likely to experience mental health complications and depressive symptoms with unhealthy diets, unless, they experience severe deficiencies of essential nutrients. On the other hand, women are at a greater risk of suffering from depressive symptoms and anxiety disorders if they maintain unhealthy eating habits. Women need to maintain healthy eating habits and well-balanced, nutrient-dense diets alongside a healthy lifestyle to maintain their mental health and wellbeing. Data mining techniques were used to identify various eating habits and dietary patterns that encouraged the development of depression and distressed. Women with partially healthy eating habits tend to experience lesser depressive symptoms and mental distressed as opposed to women with extremely unhealthy diets.

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