Nafiseh Rashidi Pour Fard - Shaheed Motahari Hospital, Fooladshahr, Isfahan, Iran
Fahimeh Haghighatdoost - Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food science, Isfahan University of Medical Sciences, Isfahan, AND Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University
Awat Feizi - Associate professor, Biostatistics and Epidemiology Department, School of Health and Psychosomatic research center, Isfahan University of Medical Sciences, Isfahan, Iran
Ahmad Esmaillzadeh - Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran

Background and Aim: Evidence supports the relation between water consumption and various health outcomes. However, there is no information regarding the association of water drinking and psychological disorders to our knowledge. The aim of this study is investigating the relation between plain water drinking and risk of depression and anxiety among a large sample of Iranian adults.Methods: A total of 3327 Iranian general adults were included in this cross-sectional study. Validated Iranian version of the Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depression. Water consumption was assessed by asking about the number of glasses of water that consumed daily. Water consumption was categorized into <2, 2-5, and ≥5 glasses of water/d.Results: In the crude model, the lowest level of water drinking (<2 glasses/d) compared with reference group (≥5 glasses/d) doubled the risk of depression and anxiety (P<0.0001). After adjusting potential confounders, this inverse link remained significant for depression (OR: 1.79; 95% CI: 1.32, 2.42; P<0.0001), but not for anxiety (OR: 1.49; 95% CI: 0.98, 2.25; P=0.109). In stratified analyses by sex, after controlling for potential confounders, water drinking < 2 glasses/d was associated with 73% and 54% increment in the risk of depression in men and women, respectively (P<0.05), whilst no significant association was observed for anxiety either in men or in women.Conclusion: We found inverse associations between plain water consumption and depression. Also, these findings showed a tended risky association, but not statistically significant, between lower levels of water consumption and anxiety.

Water; anxiety; depression; psychological disorders