Relationship between dietary pattern and depressive symptoms: an international multicohort study

Association Between Dietary Inflammatory Index and Depression Symptoms in Chronic Kidney Disease

Objective: The study is aimed at investigating the relationship between dietary inflammatory index (DII) score and depression symptoms in chronic kidney disease (CKD), exploring its potential role as an indicator of depression risk and offering new insights into dietary interventions for this vulnerable population. Materials and Methods: The cross-sectional investigation included CKD patients aged ≥ 18 in the 2007-2018 National Health and Nutrition Examination Survey. The Patient Health Questionnaire-9 (PHQ-9) was administered to evaluate depression symptoms. Dietary information was obtained from a 24-h dietary recall interview. The relationship between DII and depression was explored through weighted univariate and multivariate logistic regression models, adjusting for relevant covariates identified via backward selection. Results were expressed as odds ratios (ORs) with 95% confidence intervals (CIs). To further investigate the association, restricted cubic spline (RCS) and subgroup analyses were conducted. Results: Totally, 489 (11.55%) patients with CKD had depression symptoms. A high DII score was linked to elevated depression symptoms incidence in CKD (OR: 1.67, 95% CI: 1.06-2.65). Adjusting all covariates, the relationship between DII score and depression symptoms still existed in patients aged ≥ 60 years (OR: 1.80, 95% CI: 1.16-2.79), males (OR: 2.05, 95% CI: 1.16-3.59), smokers (OR: 1.70, 95% CI: 1.06-2.75), and those without sleep disorders (OR: 1.81, 95% CI: 1.01-3.23). Conclusion: DII score was associated with depression symptoms in patients with CKD. The findings suggest that diet plays a role in mental health, particularly in chronic conditions like CKD. The results underscore the importance of exploring anti-inflammatory dietary interventions to mitigate depression symptoms in this population. Further longitudinal research is necessary to establish causality and determine the efficacy of targeted dietary modifications in CKD patients with depression. Limitations: As a cross-sectional study, causality cannot be inferred from these findings. Additionally, the reliance on self-reported dietary data may introduce bias, and unmeasured confounders could influence the observed associations.

Meat-egg-dairy consumption and depressive symptoms among Chinese older adults: exploring rural/urban and gender disparities

Introduction

This study examines the association between Meat, Egg, and Dairy (MED) product consumption and depressive symptoms among older adults in China, focusing on rural/urban and gender differences.

Methods

This study employed data from the latest wave (year 2018) of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), and Ordinary Least Squares (OLS) models were applied to examine the association between MED consumption and depression levels.

Findings

The findings revealed a consistent negative relationship between MED consumption and depression, with higher MED intake associated with lower depression levels. Urban residents and males exhibited higher MED consumption, which correlated with less depressive symptoms. However, the impact of MED consumption on depression varied by subgroups; urban older adults benefited more from MED consumption than their rural counterparts, and the relationship between MED intake and depression was more pronounced in males than in females. The study highlighted the influence of socio-demographic factors, such as literacy, income, and self-rated health, on depression levels.

Discussion

The results suggested that MED consumption may offer protective effects on mental health in older adults, although the association may not be causal. The study underscored the need for further research to explore the complex interplay between diet and mental health in older adults, particularly in diverse cultural contexts.

The effect of diet quality and body mass index on depression in older adults: a growth curve analysis

BACKGROUND

Nutrition not only plays an important role in one's physical health, but also mental health. The causal association between nutrition and mental health remains unclear. While a healthy dietary pattern may protect one against mental illness, it is also possible that poor mental health could lead to unhealthy eating habits or choices. Furthermore, emerging studies suggest that a higher body mass index (BMI) is associated with a lower risk of depressive symptoms in older adults, contrasting the effect observed in other populations. With an ageing population, this study aimed to investigate the long-term impact of a healthy dietary pattern, BMI, and other covariates on depressive symptoms in older adults.

METHODS

We conducted a cohort study between 2014 and 2017, with each follow-up assessment being one year apart. A total of 2081 participants above 65 years old (M = 79.65, SD = 7.94) completed the baseline assessment in 2014, which included basic demographics, self-reported eating habits, depressive symptoms, and the measurement of height and weight. Distance to supermarkets and fast food was calculated based on participants' residential addresses. Two growth models were performed to assess the trajectory of change in depressive symptoms over time.

RESULTS

Older adults experienced a significant decrease in depressive symptoms over time (intercept = 2.68, p < .001; slope = -0.25, p < .001). At baseline, a higher diet quality (B = -0.95, p < .001), higher BMI (B = -0.09, p < .001), younger age (B = 0.40, p = .001), being a male (B = 0.76, p < .001), and having fewer chronic diseases (B = 0.39, p < .001) were associated with lower levels of depressive symptoms. Over time, a higher diet quality (B = 0.14, p = .05), higher BMI (B = 0.02, p = .04), and fewer chronic diseases (B = -0.08, p < .001) predicted lower levels of depressive symptoms over time.

CONCLUSIONS

A higher diet quality and higher BMI may serve as protective factors for depressive symptoms in older adults. Potential implications are being discussed.

Dietary pattern modifies the risk of MASLD through metabolomic signature

Background & Aims

The EAT-Lancet Commission in 2019 advocated a plant-centric diet for health and environmental benefits, but its relation to metabolic dysfunction-associated steatotic liver disease (MASLD) is unclear. We aimed to discover the metabolite profile linked to the EAT-Lancet diet and its association with MASLD risk, considering genetic predisposition.

Methods

We analyzed data from 105,752 UK Biobank participants with detailed dietary and metabolomic information. We constructed an EAT-Lancet diet index and derived a corresponding metabolomic signature through elastic net regression. A weighted polygenic risk score for MASLD was computed from associated risk variants. The Cox proportional hazards model was employed to estimate hazard ratios (HRs) and 95% CIs for the risk of MASLD (defined as hospital admission or death).

Results

During a median follow-up period of 11.6 years, 1,138 cases of MASLD were documented. Participants in the highest group for the EAT-Lancet diet index had a multivariable HR of 0.79 (95% CI 0.66-0.95) for MASLD compared to the lowest group. The diet's impact was unaffected by genetic predisposition to MASLD (p = 0.42). Moreover, a robust correlation was found between the metabolomic signature and the EAT-Lancet diet index (Pearson r = 0.29; p <0.0001). Participants in the highest group for the metabolomic signature had a multivariable HR of 0.46 (95% CI 0.37-0.58) for MASLD, in comparison to those in the lowest group.

Conclusions

Higher intake of the EAT-Lancet diet and its associated metabolite signature are both linked to a reduced risk of MASLD, independently of traditional risk factors.

Impact and implications

Our analysis leveraging the UK Biobank study showed higher adherence to the EAT-Lancet diet was associated with a reduced risk of metabolic dysfunction-associated steatotic liver disease (MASLD). We identified a unique metabolite signature comprising 81 metabolites associated with the EAT-Lancet diet, potentially underlying the diet's protective mechanism against MASLD. These findings suggest the EAT-Lancet diet may offer substantial protective benefits against MASLD.

Association between 29 food groups of diet quality questionnaire and perceived stress in Chinese adults: a prospective study from China health and nutrition survey

PURPOSE

Diet plays a fundamental role in promoting resilience against stress-related disorders. We aimed to examine the overall and sex-specific association between food groups and perceived stress in adults.

METHODS

We analyzed the prospective data of 7,434 adults who completed both the 2011 and 2015 surveys of the China Health and Nutrition Survey (CHNS). The Diet Quality Questionnaire (DQQ) was used to code all the food items of 2011 dietary intake into 29 food groups, and perceived stress in 2015 was measured using a 14-item perceived stress scale (PSS-14). Univariate analysis and logistic regression models were used to examine the relationship between food groups and perceived stress.

RESULTS

People who perceived a higher level of stress (PSS-14 total score > 25) made up 41.5% and 45.1% of the male and female groups, respectively (χ2 = 9.605, p = 0.002). Individuals with increased intake of food groups such as legumes, other vegetables, other fruits, yogurt, poultry, fish & seafood, fluid milk, and fruit juice were less likely to experience a higher level of psychological stress (OR range: 0.544-0.892, p < 0.05). Additionally, we found sex-specific associations between food groups and perceived stress. The difference in the proportion of food groups, such as fluid milk and fish & seafood, between the two stress groups in men was statistically significant (p < 0.025). In the female group, the distribution of eight food groups, like legumes and nuts & seeds, between the two stress groups was statistically significant (p < 0.025).

CONCLUSION

This study indicated that food groups were differentially associated with perceived stress.

Association between dietary sugar intake and depression in US adults: a cross-sectional study using data from the National Health and Nutrition Examination Survey 2011-2018

BACKGROUND

Studies examining whether diet sugar intake increases the risk of depression have produced inconsistent results. Therefore, we investigated this relationship, using the US' National Health and Nutrition Examination Survey (NHANES) database.

METHODS

This cross-sectional study included 18,439 adults (aged ≥ 20 years) from NHANES (2011-2018). Depressive symptoms were assessed using the nine-item version of the Patient Health Questionnaire (PHQ-9). Covariates, including age, sex, race/ethnicity, poverty-income ratio, education, marital status, hypertension, diabetes mellitus, cardiovascular disease, alcohol intake, smoking status, physical activity, and dietary energy intake, were adjusted in multivariate logistic regression models. Subgroup and threshold saturation effect analyses were performed.

RESULTS

After adjusting for potential confounders, we found that a 100 g/day increase in dietary sugar intake correlated with a 28% higher prevalence of depression (odds ratio = 1.28, 95% confidence interval = 1.17-1.40, P < 0.001).

CONCLUSION

Dietary sugar intake is positively associated with depression in US adults.

Association between healthy eating and depression symptoms among Chinese older adults: A cross-sectional study based on the Chinese Longitudinal Healthy Longevity survey

Introduction

This study aimed to assess the relationship between the healthy eating index (HEI) and depression symptoms in an older adult population using the Chinese Longevity Health Survey.

Methods

The HEI was constructed based on the frequency of intake of 13 dietary variables, with higher scores indicating better diet quality. Depression symptoms was assessed by the Center for Epidemiologic Studies Depression-10 scale. We used multivariate binary logistic regression to explore the association between the HEI and depression symptoms and reported as odds ratio (OR) and 95 % confidence interval (95 % CI).

Results

A total of 12,078 older adults were included. The average HEI for this group of older adults was 26.4 ± 7.1. After adjusting for covariates, compared with participants in the lowest quartile of a healthy eating index, those in the second to the fourth quartile group had a 0.93- (95 % CI: 0.83 to 1.03), 0.84- (95 % CI: 0.75 to 0.95) and 0.69- (95 % CI: 0.62 to 0.77) fold risk of depression symptoms, respectively. Restricted cubic spline curves showed that the risk of depression symptoms decreased with increasing HEI, especially above 26, and for each unit increase in the HEI, the risk of depression symptoms in older adults decreased by 3 % (OR = 0.97; 95 % CI: 0.96 to 0.99).

Conclusions

This study found an association between higher levels of the HEI and reduced risk of depression symptoms in older Chinese adults. This result emphasizes the need to focus on dietary diversity in older adults to promote healthy aging.