Associations between dietary intake, diet quality and depressive symptoms in youth: A systematic review of observational studies

The association of Dietary Quality Index-International (DQII) score with anxiety and depression: Results of a population-based study

BACKGROUND

Recent evidence indicates a relationship between diet quality and prevalent psychiatric disorders, though, the nature of this association remains unclear. This study aimed to investigate the association between the Dietary Quality Index-International (DQII) score and the severity of depression and anxiety.

METHODS

This cross-sectional research involved 6472 individuals aged 35-65 from the Mashhad stroke and heart atherosclerotic disorder (MASHAD) study. Dietary intake was assessed using a validated food frequency questionnaire (FFQ), and dietary quality was evaluated using the DQI-I score. The severity scores of depression and anxiety were measured through the Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI).

RESULTS

Participants in the highest tertile of DQI-I had lower anxiety and depression severity scores than those in lower tertiles (P < 0.001). After adjusting for confounders, the association remained significant only for depression score (OR = 0.85; 95 % CI: 0.73-0.98; p = 0.02). Among DQI-I components, only overall balance was significantly associated with depression score (OR = 0.86; 95 % CI: 0.75-1.00; p = 0.04). Higher variety and adequacy scores were linked to lower odds of anxiety score (OR = 0.75; 95 % CI: 0.61-0.93; p < 0.01 and OR = 0.79; 95 % CI: 0.66-0.96; p = 0.02).

LIMITATIONS

The cross-sectional design restricts causal inference, FFQs introduce recall bias, and unmeasured confounding remains a possibility.

CONCLUSION

Individuals in the highest DQI-I tertile had lower odds of severe depression score. Overall balance correlated significantly with depression severity score, while higher variety and adequacy scores were linked to reduced severe anxiety score.

The association of the Prime Diet Quality Score (PDQS) with depression and anxiety symptoms: the Isfahan functional disorders (ISFUN) cohort study

BACKGROUND

Due to scarce epidemiologic data regarding the Prime Diet Quality Score (PDQS) and mental health disorders, this study aimed to investigate the association of PDQS with depression and anxiety symptoms in Iranian adults.

METHODS

This cross-sectional analysis was performed using the baseline data collected for the Isfahan functional disorders (ISFUN) cohort study. ISFUN was established in 2017 and enrolled apparently healthy adults, aged 18-65 years in Isfahan, Iran. Information on usual dietary intakes was collected using a validated Dish-based, 106-item food frequency questionnaire. The severity of depression and anxiety was assessed using a validated Iranian version of the Hospital Anxiety and Depression Scale.

RESULTS

A total number of1892 participants were enrolled in the present study. In total, 54.50% of subjects were female. In the fully adjusted model, participants with PDQS lower than median compared with those with PDQS higher than median had higher risk of depression (OR =   1.62; 95% CI: 1.11, 2.37) and anxiety (OR: 1.57; 95% CI: 1.08, 2.27). In stratified analysis by sex, males with PDQS lower than median compared with those with PDQS higher than median had greater risk for depressive (OR: 1.57) and anxiety symptoms (OR =   1.52). However, in females, no significant association was found between PDQS and odds of depression, and anxiety in the fully adjusted model.

CONCLUSION

We found evidence indicating a significant inverse association between PDQS and depression and anxiety symptoms among Iranian adults. Further studies, in particular with prospective design, are required to confirm these findings.

Risky Behaviors for Non-Communicable Diseases: Italian Adolescents' Food Habits and Physical Activity

BACKGROUND

Driving adolescents to more correct food habits and physical activity is crucial to promoting health and avoiding the increase in morbidity and mortality in adulthood. Literature has focused on these behaviors in the adult population, while studies on adolescents are more limited. This study aims to explore the level of knowledge, attitudes, and behaviors regarding nutrition and physical activity to acquire insight into adolescents and identify the associated predictors.

METHODS

A cross-sectional study was conducted among adolescents aged 10 to 19 years from public middle and high schools randomly selected in the Campania Region, Southern Italy. A self-administered questionnaire, including closed and open-ended questions, assessed socio-demographic and health-related characteristics, dietary habits, physical activity, and sources of health information.

RESULTS

Regarding socio-demographic and health-related characteristics, among 1433 adolescents who completed the survey, the mean age was 15.2 years, 50.5% were boys, 16.8% reported having a non-communicable disease, and 18% were overweight or obese. Multivariate analysis showed that older age, male gender, daily breakfast with at least one parent, higher self-rated knowledge on nutrition, awareness of fruit and vegetables consumption recommendations, correct dietary attitudes (daily breakfast, consumption of fruit and vegetables at least once a day, of legumes at least twice a week, and of carbonated sugary drinks less than once a day), the need for additional dietary information, meeting WHO physical activity recommendations, and less than two hours of daily screen time are determinants of a high quality diet score. Conversely, living with a single family member and current smoking were negatively associated with high quality diet. Older age, male gender, risk of alcohol abuse, higher quality diet, and lower mobile phone use are associated with meeting WHO physical activity recommendations. Since we investigated risky behaviors, potential limitations of this study could include social desirability and recall bias.

CONCLUSIONS

Many adolescents lead unhealthy lifestyles, but younger adolescents and girls appear to be at higher risk of unhealthy behaviors. Targeted initiatives promoting regular physical activity and balanced diets in schools, involving parents and teachers in a collaborative plan, are essential to improving adolescents' health and well-being.

The relationship between anxiety and diet quality in adolescent populations: a cross-sectional analysis

Globally, more than 13 % of adolescents have clinically significant mental health problems, with anxiety and depression comprising over 40 % of cases. Despite the high prevalence of anxiety disorders among youth, dietary research has been focused on youth with depression, resulting in a significant knowledge gap regarding the impact of anxiety on adolescent diet quality. Adolescents with diagnosed anxiety disorders and healthy controls were included in this study. Anxiety symptoms were measured using the Screen for Child Anxiety-Related Disorders. Diagnosis of anxiety disorder was determined using the Kiddie Schedule for Affective Disorders and Schizophrenia interview. Five diet quality indices were scored from FFQ. Diet quality indices associated with anxiety symptoms in the correlation matrix were interrogated using multiple linear regression modelling. All models were adjusted for depression. One hundred and twenty-eight adolescents (mean age 14·8 years (sd: 2·1); 66·4 % female) were included in this cross-sectional analysis. Although healthy controls and outpatient participants had similar unhealthy dietary index subscale scores, outpatient participants had lower healthy index scores. Higher anxiety symptoms were associated with lower healthy dietary indices in univariate analysis; after adjusting for comorbid depression; however, anxiety symptoms were no longer associated with dietary indices following adjustment for multiple testing (P = 0·038 to P = 0·077). The association between anxiety symptoms and a poor diet is attenuated by depression. The results of this study support the need for an integrated approach to the assessment of mental and physical well-being and further research aimed at understanding the unique contribution of depression to healthy dietary patterns.

The Prevalence of Hyperuricemia and the Association Between Hyperuricemia and Age in Patients with Psychiatric Disorders to a General Hospital: A Cross-Section Study

Purpose

In clinical work, it has been found that the prevalence of hyperuricemia (HUA) is significantly higher in younger patients with psychiatric disorders, but there are few studies in this area. The present study aims to evaluate the prevalence of HUA and the relationship between the HUA and age in hospitalized patients with psychiatric disorders in the real world, and to provide a theoretical basis for clinical staff to pay attention to the metabolic indicators of younger patients and for future related studies.

Methods

This is a cross-sectional evaluation of a cohort of 1761 patients with psychiatric disorders of hospitalized. The categories of disorders designed for study included: Depression, Bipolar disorder, Schizophrenia, Anxiety, Obsessive-Compulsive disorder, Acute and transient psychotic disorder, Dissociative(conversion) disorders, Conduct disorders and Tic disorders. In addition, based on age, the participants are stratified into three groups. The authors used Kruskal-Wallis tests, chi-square tests, and multiple linear logistic regression to verify the relationship between HUA and age among hospitalized patients with psychiatric disorders.

Results

Overall, the estimated prevalence of HUA was 35.4%. The prevalence of HUA was significantly higher in individuals with 17 years and under compared to those with 45 years and above (P < 0.001). After adjusting for confounders, the prevalence of HUA remained higher at 17 years and under than at 45 years and above. Bipolar disorder can lead to an increased prevalence of HUA (P<0.05).

Conclusion

The prevalence of HUA was higher in hospitalized patients with psychiatric disorders, and the prevalence was inversely proportional to age.

Childhood psychological maltreatment and adolescent depressive symptoms: Exploring the role of social anxiety and maladaptive emotion regulation strategies

BACKGROUND

Despite emerging evidence for the effect of childhood psychological maltreatment on adolescent depressive symptoms, the underlying processes for this effect are largely under-investigated. This study examined a conceptual framework for the effect of childhood psychological maltreatment on adolescent depressive symptoms through social anxiety disorder (SAD) and maladaptive emotion regulation strategies.

METHODS

The participants were 1649 Chinese middle school students (751 girls and 898 boys) with a mean age of 16.29 ± 1.04 years old. A moderation-mediation model hypothesized that childhood psychological maltreatment predicts adolescent depressive symptoms, with SAD as a mediator and maladaptive emotion regulation strategies as a moderator.

RESULTS

Childhood psychological maltreatment significantly positively predicted adolescent depressive symptoms, while SAD mediated the relation. Maladaptive emotion regulation strategies moderated the pathways from psychological maltreatment to depressive symptoms (but not from psychological maltreatment to SAD) and from SAD to adolescent depressive symptoms.

LIMITATIONS

Subjective measures, and the cross-sectional design are the main limitations.

CONCLUSIONS

SAD plays a mediating role in the relation between childhood psychological maltreatment and depressive symptoms. Maladaptive emotion regulation strategies exacerbate the relation between childhood psychological maltreatment and depressive symptoms, as well as the relation between SAD and depressive symptoms. These results highlight the importance of addressing social anxiety in reducing adolescent depressive symptoms by improving their cognitive emotion regulation strategies.

Exploring Depression and Nutritional Covariates Amongst US Adults using Shapely Additive Explanations

Background

Depression affects personal and public well-being and identification of natural therapeutics such as nutrition is necessary to help alleviate this public health concern.

Objective

The study aimed to identify feature importance in a machine learning model using solely nutrition covariates.

Methods

A retrospective analysis was conducted using a modern, nationally representative cohort, the National Health and Nutrition Examination Surveys (NHANES 2017-2020). Depressive symptoms were evaluated using the validated 9-item Patient Health Questionnaire (PHQ-9), and all adult patients (total of 7929 individuals) who completed the PHQ-9 and total nutritional intake questionnaire were included in the study. Univariable regression was used to identify significant nutritional covariates to be included in a machine learning model and feature importance was reported. The acquisition and analysis of the data were authorized by the National Center for Health Statistics Ethics Review Board.

Results

7929 patients met the inclusion criteria in this study. The machine learning model had 24 out of a total of 60 features that were found to be significant on univariate analysis (p < 0.01 used). In the XGBoost model the model had an Area Under the Receiver Operator Characteristic Curve (AUROC) = 0.603, Sensitivity = 0.943, Specificity = 0.163. The top four highest ranked features by gain, a measure of the percentage contribution of the covariate to the overall model prediction, were Potassium Intake (Gain = 6.8%), Vitamin E Intake (Gain = 5.7%), Number of Foods and Beverages Reported (Gain = 5.7%), and Vitamin K Intake (Gain 5.6%).

Conclusion

Machine learning models with feature importance can be utilized to identify nutritional covariates for further study in patients with clinical symptoms of depression.