Energy-adjusted Dietary Inflammatory Index mediates the association between obesity and depressive symptoms: a population-based analysis of the National Health and Nutrition Examination Survey 2007–2018

< 0·050). After adjusting for all covariates, E-DII accounted for 4 % of the obesity-depression association. Despite this modest proportion, the finding identifies dietary-induced inflammation as a statistically significant, modifiable pathway. In conclusion, obesity and pro-inflammatory diets are linked to an increased risk of depressive symptoms, with E-DII serving as a modest but significant modifiable pathway. These findings highlight dietary intervention as a potential strategy for mitigating depressive symptoms in individuals with obesity.