Longitudinal associations between fish consumption and depression in young adults

Adherence to Mediterranean diet is inversely associated with depressive symptoms in older women: findings from the NutBrain Study

Data on the association of the Mediterranean diet (MD) with depressive symptoms in older people at high risk of depression are scarce. This study aimed to investigate the cross-sectional association of the adherence to the MD and its components with depressive symptoms in an Italian cohort of older men and women. A total of 325 men and 473 women aged 65–97 years (2019–2023) answered a 102-item semi-quantitative FFQ, which was used to calculate the Mediterranean diet score (MDS). Depressive symptoms were assessed using the Centre for Epidemiological Studies Depression Scale; subjects with a score of 16 or more were considered to have depression. Multivariable logistic regression was used for statistical analysis. The occurrence of depressive symptoms was 19·8 % (8·0 % men, 27·9 % women). High adherence to MDS (highest tertile) significantly reduced the odds of having depressive symptoms by 54·6 % (OR 0·454, 95 % CI 0·266, 0·776). In sex-stratified analysis, the reduction was evident in women (OR 0·385, 95 % CI 0·206, 0·719) but not in men (OR 0·828, 95 % CI 0·254, 2·705). Looking at the association of MDS components with depressive symptoms, we found an inverse significant association with fish consumption and the MUFA:SFA ratio above the median only in women (OR 0·444, 95 % CI 0·283, 0·697 and OR 0·579, 95 % CI 0·345, 0·971, respectively). High adherence to the MDS, and a high fish intake and MUFA:SFA ratio were associated with lower depressive symptoms in women only. Future longitudinal studies are needed to confirm these findings and to explore the underlying biological mechanisms.

Sex differences in erythrocyte fatty acid composition of first-diagnosed, drug-naïve patients with major depressive disorders

Background: Since depression, sex hormones, and fatty acid status are interrelated, it is important to understand their relationships. In this study, we aimed to investigate sex differences in erythrocyte membrane fatty acid composition among first-diagnosed, drug-naïve patients with major depressive disorders. Methods: The study included 139 individuals with first-diagnosed, drug-naïve depression (male/female = 48/91) and 55 healthy controls (male/female = 24/31). The levels of erythrocyte membrane fatty acids were analyzed to compare the difference between males and females in both patients with depression and healthy controls, as well as to study their correlation with depressive symptoms. Results: In first-diagnosed, drug-naïve patients with major depressive disorders, sex disparities were observed in the levels of erythrocyte saturated fatty acids (SFAs) and n-6 PUFAs (such as C18:0, C20:4n6 and C22:4n6), where higher levels evident in females compared to in males. We found a noteworthy correlation between fatty acid levels and depressive symptoms, in which there is a significant association between female patients and depression but a weaker association between male patients and depression. Conclusion: Our findings demonstrate higher levels of n-6 PUFAs and SFAs in female patients with depression. The relationship between fatty acid composition and depressive symptoms was more prominent in females than males. These findings highlight the significance of considering sex as a crucial and interconnected factor in future investigations and potential adjunctive treatment for mood disorders by targeting fatty acid metabolism.

Krill oil treatment ameliorates lipid metabolism imbalance in chronic unpredicted mild stress-induced depression-like behavior in mice

The pathology of depression involves various factors including the interaction between genes and the environment. The deficiency of n-3 polyunsaturated fatty acids (n-3 PUFAs) in the brain and depressive symptoms are closely related. Krill oil contains abundant amounts of n-3 PUFAs incorporated in phosphatidylcholine. However, the effect of krill oil treatment on depression-like behaviors induced by chronic stress and its molecular mechanism in the brain remain poorly understood. Here, we used a chronic unpredictable mild stress (CUMS) model to evaluate the effect of krill oil on depression-like behaviors and explored its molecular mechanism through lipid metabolomics and mRNA profiles in the whole brain. We observed that CUMS-induced depression-like behaviors were ameliorated by krill oil supplementation in mice. The metabolism of glycerophospholipids and sphingolipids was disrupted by CUMS treatment, which were ameliorated after krill oil supplementation. Further analysis found that differently expressed genes after krill oil supplementation were mainly enriched in the membrane structures and neuroactive ligand-receptor interaction pathway, which may be responsible for the amelioration of CUMS-induced depression-like behaviors. Altogether, our results uncovered the relationship between lipid metabolism and CUMS, and provided new strategies for the prevention and treatment of depression.

Association between Dietary Patterns and Depression in Chinese Older Adults: A Longitudinal Study Based on CLHLS

(1) Objective: This study aimed to investigate the relationship between dietary patterns and depression in Chinese older adults. (2) Method: A cohort study was conducted on the relationship between dietary patterns and the risk of depression in older adults based on the China Health and Longevity Longitudinal Survey (CLHLS) from 2011 to 2014. Exploratory factor analysis was used to identify dietary patterns. The relationship between dietary patterns and the risk of depression after four years was examined using logistic regression, and subgroup analysis was carried out to determine whether the association differed by gender. (3) Results: A total of 2873 older adults were included in our cohort study. Three dietary patterns were identified: vegetable-egg-bean-milk pattern, meat-fish pattern, and salt-preserved vegetable-garlic pattern. The vegetable-egg-beans-milk pattern was negatively correlated with the risk of geriatric depression development (adjusted OR = 0.65 (95%CI: 0.49-0.87)), and the salt-preserved vegetable-garlic pattern was positively associated with aged depression risk (adjusted OR = 1.33 (95CI: 1.00-1.77)). The meat-fish pattern was not associated with the risk of depression in older adults. These associations were consistent in both men and women. (4) Conclusions: In this cohort study, the vegetable-egg-beans-milk dietary pattern was associated with lower risk of depression, while the salt-preserved vegetable-garlic dietary pattern was associated with higher risk of depression, and there were no gender differences in these associations.

Biological Role of Nutrients, Food and Dietary Patterns in the Prevention and Clinical Management of Major Depressive Disorder

Major Depressive Disorder (MDD) is a growing disabling condition affecting around 280 million people worldwide. This complex entity is the result of the interplay between biological, psychological, and sociocultural factors, and compelling evidence suggests that MDD can be considered a disease that occurs as a consequence of an evolutionary mismatch and unhealthy lifestyle habits. In this context, diet is one of the core pillars of health, influencing multiple biological processes in the brain and the entire body. It seems that there is a bidirectional relationship between MDD and malnutrition, and depressed individuals often lack certain critical nutrients along with an aberrant dietary pattern. Thus, dietary interventions are one of the most promising tools to explore in the field of MDD, as there are a specific group of nutrients (i.e., omega 3, vitamins, polyphenols, and caffeine), foods (fish, nuts, seeds fruits, vegetables, coffee/tea, and fermented products) or dietary supplements (such as S-adenosylmethionine, acetyl carnitine, creatine, amino acids, etc.), which are being currently studied. Likewise, the entire nutritional context and the dietary pattern seem to be another potential area of study, and some strategies such as the Mediterranean diet have demonstrated some relevant benefits in patients with MDD; although, further efforts are still needed. In the present work, we will explore the state-of-the-art diet in the prevention and clinical support of MDD, focusing on the biological properties of its main nutrients, foods, and dietary patterns and their possible implications for these patients.

Association between osteoarthritis-related serum biochemical markers over 11 years and knee MRI-based imaging biomarkers in middle-aged adults

OBJECTIVE

To describe the associations between osteoarthritis (OA)-related biochemical markers (COMP, MMP-3, HA) and MRI-based imaging biomarkers in middle-aged adults over 10-13 years.

METHODS

Blood serum samples collected during the Childhood Determinants of Adult Health (CDAH)-1 study (year:2004-06; n = 156) and 10-13 year follow-up at CDAH-3 (n = 167) were analysed for COMP, MMP-3, and HA using non-isotopic ELISA. Knee MRI scans obtained during the CDAH-knee study (year:2008-10; n = 313) were assessed for cartilage volume and thickness, subchondral bone area, cartilage defects, and BML.

RESULTS

In a multivariable linear regression model describing the association of baseline biochemical markers with MRI-markers (assessed after 4-years), we found a significant negative association of standardised COMP with medial femorotibial compartment cartilage thickness (β:-0.070; 95%CI:-0.138,-0.001), and standardised MMP-3 with patellar cartilage volume (β:-141.548; 95%CI:-254.917,-28.179) and total bone area (β:-0.729; 95%CI:-1.340,-0.118). In multivariable Tobit regression model, there was a significant association of MRI-markers with biochemical markers (assessed after 6-9 years); a significant negative association of patellar cartilage volume (β:-0.001; 95%CI:-0.002,-0.00004), and total bone area (β:-0.158; 95%CI-0.307,-0.010) with MMP-3, and total cartilage volume (β:-0.001; 95%CI:-0.001,-0.0001) and total bone area (β:-0.373; 95%CI:-0.636,-0.111) with COMP. No significant associations were observed between MRI-based imaging biomarkers and HA.

CONCLUSION

COMP and MMP-3 levels were negatively associated with knee cartilage thickness and volume assessed 4-years later, respectively. Knee cartilage volume and bone area were negatively associated with COMP and MMP-3 levels assessed 6-9 years later. These results suggest that OA-related biochemical markers and MRI-markers are interrelated in early OA.

Dietary, physical exercises and mental stress in a Chinese population: a cross-sectional study

Background

Mental health is affected by both genetic and environmental factors. However, previous studies have showed conflict findings about the role of lifestyle and little is known about the situation of the Chinese population. The purpose of this study was to explore the relationship between the frequency of food consumption, physical exercise condition and mental health, as well as factors related to mental stress in Chinese.

Methods

We recruited 8160 residents who had health examinations in a public hospital during June 2016 to May 2018. Demographic characteristics, the frequency of food consumption, physical exercise condition and mental health status was collected by a questionnaire. We estimated the association using the odds ratio (OR) and 95% confidence interval (CI) based on Binary or ordinal logistic regression models. A classification and regression tree (CART) demonstrated the prediction of the value of a target variable based on other values.

Results

The logistic regression model and classification tree model both found that the frequency of fresh vegetables or fruit and fried foods consumption and the current state of drinking alcohol were related to mental stress. The degree of mental stress reduced significantly with increasing consumption of fish (OR = 0.80, 95% CI: 0.71–0.90) and regular exercise (OR = 0.55, 95% CI:0.48–0.64) in females and increased consumption of fish (OR = 0.55, 95% CI: 0.48–0.64) and cereal crop (OR = 0.77, 95% CI: 0.68–0.89), fish (OR = 0.87, 95%CI:0.77–0.96) and regular exercise (OR = 0.61, 95%CI:0.53–0.70) in males. On the contrary, the frequency of consumption of desserts (OR = 1.43, 95% CI: 1.26–1.62) and the current of drinking alcohol (OR = 1.47, 95%CI:1.21–1.79) in females and meat (OR = 1.47, 95%CI: 1.31–1.65), pickled and smoked food (OR = 1.18, 95%CI:1.05–1.32) and the current state of drinking alcohol (OR = 1.25, 95%CI:1.12–1.40) in males were related to an increased risk of mental health.

Conclusions

Our study showed that both the frequency of some food consumption and physical exercise condition were associated with mental health and affected the degree of stress, which provided novel insights into interventions.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11189-7.

Association between knee symptoms, change in knee symptoms over 6-9 years, and SF-6D health state utility among middle-aged Australians

OBJECTIVES

Health state utilities (HSUs) are an input metric for estimating quality-adjusted life-years (QALY) in cost-utility analyses. Currently, there is a paucity of data on association of knee symptoms with HSUs for middle-aged populations. We aimed to describe the association of knee symptoms and change in knee symptoms with SF-6D HSUs and described the distribution of HSUs against knee symptoms' severity.

METHODS

Participants (36-49-years) were selected from the third follow-up (completed 2019) of Australian Childhood Determinants of Adult Health study. SF-6D HSUs were generated from the participant-reported SF-12. Association between participant-reported WOMAC knee symptoms' severity, change in knee symptoms over 6-9 years, and HSUs were evaluated using linear regression models.

RESULTS

For the cross-sectional analysis, 1,567 participants were included; mean age 43.5 years, female 54%, BMI ± SD 27.18 ± 5.31 kg/m². Mean ± SD HSUs for normal, moderate, and severe WOMAC scores were 0.820 ± 0.120, 0.800 ± 0.120, and 0.740 ± 0.130, respectively. A significant association was observed between worsening knee symptoms and HSUs in univariable and multivariable analyses after adjustment (age and sex). HSU decrement for normal-to-severe total-WOMAC and WOMAC-pain was - 0.080 (95% CI - 0.100 to - 0.060, p < 0.01) and - 0.067 (- 0.085 to - 0.048, p < 0.01), exceeding the mean minimal clinically important difference (0.04). Increase in knee pain over 6-9 years was associated with a significant reduction in HSU.

CONCLUSION

In a middle-aged population-based sample, there was an independent negative association between worse knee symptoms and SF-6D HSUs. Our findings may be used by decision-makers to define more realistic and conservative baseline and ongoing HSU values when assessing QALY changes associated with osteoarthritis interventions.

Youth diet quality and hazard of mood disorder in adolescence and adulthood among an Australian cohort

BACKGROUND

Prospective studies on youth diet and mood disorders outcomes are limited. We examined if youth diet quality was associated with mood disorder onset over a 25-year follow-up period.

METHODS

In 1985, Australian participants (aged 10-15 years) completed a 24-hour food record. A validated 100-point Dietary Guidelines Index (DGI) assessed diet quality. In 2009-11, 1005 participants (aged 33-41 years) completed the lifetime Composite International Diagnostic Interview for age of first DSM-IV defined mood disorder (depression or dysthymia). Cox proportional hazards regression estimated hazard of mood disorder during the 25-year follow-up according to baseline DGI score. Sensitivity analyses censored the study at 5, 10, and 15 years after baseline and used log binomial regression to estimate relative risk (RR). Covariates included baseline negative affect, BMI, academic performance, smoking, breakfast eating, physical activity, and socioeconomic status.

RESULTS

The mean(SD) youth DGI score was 45.0(11.5). A 10-point higher DGI was not associated with hazard of mood disorder onset over the 25-year follow-up (Hazard Ratio (HR):1.00; 95% Confidence Interval (CI):0.89-1.13). The only indication that higher DGI might be associated with lower risk of mood disorder was within the first 5 years after baseline and this was not statistically significant (RR=0.85; 95% CI:0.60-1.18).

LIMITATIONS

Loss-to-follow-up. A single 24-hour food record may not represent usual diet.

CONCLUSION

Youth diet did not predict mood disorders in adulthood. The suggestions of a lower risk of mood disorder during late adolescence highlights that further prospective studies are needed.

Dietary Restrictions and Depressive Symptoms: Longitudinal Results from the Constances Cohort

Cross-sectional results have suggested a linear association between the number of dietary exclusions and depressive symptoms. This longitudinal study aimed to examine the direction of this association. Methods: In the population-based Constances cohort, depressive symptoms were defined by a score ≥19 on the Centre of Epidemiologic Studies-Depression (CES-D) scale. Diet was measured with a 24-item qualitative food frequency questionnaire (FFQ). Both variables were available at inclusion (from 2012 to 2014) and on follow-up (2015 for the CES-D and 2017 for diet). Food exclusion was categorized into five different groups: No exclusion, exclusion of one, two, three, or ≥4 food groups according to the self-reported number of food groups rarely or never consumed. Logistic regressions were conducted, either taking depressive symptoms as the outcome on follow-up with dietary exclusions at baseline as predictor or with the opposite, adjusting for age, sex, education, income, alcohol intake, smoking, physical activity, and anemia. The path analysis included outcomes and covariates in one model. Results: The median follow-up was three years. A total of 29,337 participants (53.4% women, 48.15 ± 12.9 y.o.) had complete CES-D data and 25,356 (53.56% women, 49.05 ± 12.8 y.o.) FFQ data. Dietary exclusion at inclusion predicted depressive symptoms at follow-up (odds ratio [95% confidence interval]: 2.35 [1.62–3.40] for ≥4 excluded items compared to no exclusions). Depressive symptoms at inclusion predicted dietary exclusions at follow-up (3.45 [1.93–6.16] for ≥4 excluded items). In the path analysis, the standardized estimate of the association between dietary exclusions at inclusion and depressive symptoms at follow-up was by far higher than the opposite (0.1863 and 0.00189, respectively, both p < 0.05). Conclusions: The association of dietary exclusion with subsequent depression is stronger than the opposite association.

Evidence of the Importance of Dietary Habits Regarding Depressive Symptoms and Depression

BACKGROUND

Mental illness is one of the fastest rising threats to public health, of which depression and anxiety disorders are increasing the most. Research shows that diet is associated with depressive symptoms or depression (depression).

AIM

This study aimed to investigate the diets impact on depression, by reviewing the scientific evidence for prevention and treatment interventions.

METHOD

A systematic review was conducted, and narrative synthesis analysis was performed.

RESULT

Twenty scientific articles were included in this review. The result showed that high adherence to dietary recommendations; avoiding processed foods; intake of anti-inflammatory diet; magnesium and folic acid; various fatty acids; and fish consumption had a depression. Public health professionals that work to support and motivate healthy eating habits may help prevent and treat depression based on the evidence presented in the results of this study. Further research is needed to strengthen a causal relationship and define evidence-based strategies to implement in prevention and treatment by public healthcare.

Association of dietary n-3 polyunsaturated fatty acids intake with depressive symptoms in midlife women

BACKGROUND

To study the association of n-3 polyunsaturated fatty acid (n-3 PUFA) intake from diet with depressive symptoms in midlife women.

METHODS

Data for this cross-sectional study were retrieved from baseline assessment of the Study of Women's Health Across the Nation (SWAN). Logistic regression and restricted cubic spline models were performed to examine the association n-3 PUFA intake with depressive symptoms.

RESULTS

A total of 3054 women aged 42-52 years were included in the present study. In overall midlife women, n-3 PUFA intake was not significantly associated with depressive symptoms (CES-D score ≥16) after adjustment for potential confounders. In early perimenopausal women, n-3 PUFA intake was inversely associated with depressive symptoms after adjustment for potential confounders. The fully adjusted OR with 95% CI of depressive symptoms were 0.062 (0.009-0.457) in the highest quartile (n-3 PUFAs intake was categorized by quartiles) compared with the lowest quartile for n-3 PUFA intake. Restricted cubic spline analyses showed that n-3 PUFA intake were dose-response inversely associated with depressive symptoms in early perimenopausal women. However, in premenopausal women, no significant association between depressive symptoms and n-3 PUFA intake was observed.

LIMITATIONS

This was a cross-sectional study, limiting causal inferences.

CONCLUSION

Dietary n-3 PUFA may be inversely associated with depressive symptoms in early perimenopausal women, but not in premenopausal women.

Lipids and Suicide Risk

In the search for biomarkers and modifiable risk factors for suicide, lipid status has garnered considerable interest, although the lipid-suicide connection is not without controversy. Major categories of lipids that have been reported as germane to suicide include sterols and polyunsaturated fatty acids (PUFAs). Research concerning lipid effects on mood and suicide risk includes epidemiologic approaches, cohort studies, and clinical trials. In general, current evidence suggests that higher n-3 relative to n-6 PUFA intake may have beneficial effects on depression and suicide risk, particularly in women, while low cholesterol may be detrimental in both sexes. Additionally, low estrogen in women has been associated with suicide attempts, whereas high androgen loads may contribute to the higher suicide completion rate in men. Basic and translational research provides strong evidence for several potential mechanisms that have been implicated in depression and suicide. Firstly, PUFAs, cholesterol, and estrogen can interact to influence structure and function of membrane microdomains ("lipid rafts"), with potential regulatory effects on inflammation and signal transduction, including monoaminergic signaling. Secondly, PUFAs bind to and activate peroxisome proliferator-activated receptors (PPARs), nuclear receptors that regulate gene expression, with resultant effects on inflammation and bioenergetics. Thirdly, PUFAs are both a target for and a hormetic regulator of oxidative stress. Critical to a greater understanding of lipid status as a suicide risk predictor and treatment target will be studies that map genomic and phenotypic characteristics of individuals whose emotional state is affected most by lipid status. Also important will be a more nuanced understanding of lipid-lipid interactions and the differential roles of lipid subclasses on suicide risk.

Bidirectional associations between food groups and depressive symptoms: longitudinal findings from the Invecchiare in Chianti (InCHIANTI) study

This study investigated bidirectional associations between intake of food groups and depressive symptoms in 1058 Italian participants (aged 20-102 years) of the Invecchiare in Chianti study. Dietary intake, assessed with a validated FFQ, and depressive symptoms, measured with the Center for Epidemiologic Studies Depression scale (CES-D), were assessed at baseline and after 3, 6 and 9 years. Associations of repeated measurements of intakes of thirteen food groups with 3-year changes in depressive symptoms, and vice versa, were analysed using linear mixed models and logistic generalised estimating equations. Fish intake was inversely (quartile (Q)4 v. Q1, B=-0·97, 95 % CI -1·74, -0·21) and sweet food intake positively (Q4 v. Q1, B=1·03, 95 % CI 0·25, 1·81) associated with subsequent CES-D score. In the other direction, higher CES-D scores were associated with decreases in intakes of vegetables (ratio: 0·995, 95 % CI 0·990, 0·999) and red and processed meat (B=-0·006, 95 % CI -0·010, -0·001), an increase in dairy product intake (ratio: 1·008, 95 % CI 1·004, 1·013), and increasing odds of eating savoury snacks (OR: 1·012, 95 % CI 1·000, 1·024). Fruit, nuts and legumes, potatoes, wholegrain bread, olive oil, sugar-sweetened beverages, and coffee and tea were not significantly associated in either direction. Our study confirmed bidirectional associations between food group intakes and depressive symptoms. Fish and sweet food intakes were associated with 3-year improvement and deterioration in depressive symptoms, respectively. Depressive symptoms were associated with 3-year changes in vegetable, meat, dairy product and savoury snack intakes. Trials are necessary to examine the causal associations between food groups and depression.

Linking What We Eat to Our Mood: A Review of Diet, Dietary Antioxidants, and Depression

Studies have shown that diet and nutrition play significant roles in the prevention of depression and its clinical treatment. The present review aims to provide a clear understanding of the associations between diet patterns, specific foods, nutrients such as antioxidants, and depression. As a result, balanced dietary patterns such as the Mediterranean diet and certain foods such as fish, fresh vegetables, and fruits have been associated with a lower risk of depression or depressive symptoms, while high-fat Western diets and sugar-sweetened beverages have been associated with higher risk of depression or depressive symptoms. Dietary antioxidants such as green tea polyphenols or isoflavonoid intake have been negatively associated with depression or depressive symptoms. It is concluded that diet patterns, specific foods, and antioxidants play important roles in the prevention and clinical treatment of depression.

Associations of depressive symptoms and history with three a priori diet quality indices in middle-aged and older adults

BACKGROUND

Evidence for the diet-depression link is growing but longitudinal studies on the reverse association are scarce. We investigated associations of (1) current depressive symptoms, (2) short-term changes in and (3) long-term history of depressive symptoms with three a priori diet quality indices.

METHODS

Data were from participants (≥ 55 years) of the Longitudinal Aging Study Amsterdam (LASA). The Mediterranean Diet Score (MDS), Alternative Healthy Eating Index (AHEI-2010) and Dietary Approaches to Stop Hypertension diet (DASH) were derived in 2014/2015. Depressive symptoms (Center for Epidemiologic Studies Depression scale; CES-D) were assessed in 2014/2015 and at five regular 3-yearly cycles from 2001-2003 to 2015/2016. Associations between three depression determinants and the diet indices were analysed by multivariable linear regression models.

RESULTS

Cross-sectionally (n = 1312), current depressive symptoms (CES-D ≥ 16) were associated with lower MDS (adjusted B = -1.21, 95%CI = -2.41, -0.023) and AHEI (B = -2.72, 95%CI = -5.24, -0.20) scores in men only. Chronic/recurrent depressive symptoms (CES-D ≥ 16 in both 2011-2013 and 2015/2016) were associated with lower MDS scores (n = 1233; B = -2.22, 95%CI = -3.40, -1.04) and a trend for lower AHEI scores (B = -2.37, 95%CI = -4.92, 0.18), compared to no depressive symptoms (twice CES-D < 16). History of depressive symptoms (ever CES-D ≥ 16 from 2001-2003 to 2011-2013; n = 687) was associated with lower MDS (B = -1.87, 95%CI = -3.47, -0.27) and AHEI (B = -4.33, 95%CI = -7.54, -1.13) scores in men only. No associations were found with the DASH score.

LIMITATIONS

Single dietary data collection impeded investigation of prospective depression-diet associations.

CONCLUSIONS

Our study in middle-aged and older adults suggests that current and past depressive symptoms are associated with poorer diet quality, particularly in men.

Seafood Consumption, Omega-3 Fatty Acids Intake, and Life-Time Prevalence of Depression in the PREDIMED-Plus Trial

BACKGROUND

The aim of this analysis was to ascertain the type of relationship between fish and seafood consumption, omega-3 polyunsaturated fatty acids (ω-3 PUFA) intake, and depression prevalence.

METHODS

Cross-sectional analyses of the PREDIMED-Plus trial. Fish and seafood consumption and ω-3 PUFA intake were assessed through a validated food-frequency questionnaire. Self-reported life-time medical diagnosis of depression or use of antidepressants was considered as outcome. Depressive symptoms were collected by the Beck Depression Inventory-II. Logistic regression models were used to estimate the association between seafood products and ω-3 PUFA consumption and depression. Multiple linear regression models were fitted to assess the association between fish and long-chain (LC) ω-3 PUFA intake and depressive symptoms.

RESULTS

Out of 6587 participants, there were 1367 cases of depression. Total seafood consumption was not associated with depression. The odds ratios (ORs) (95% confidence intervals (CIs)) for the 2nd, 3rd, and 4th quintiles of consumption of fatty fish were 0.77 (0.63⁻0.94), 0.71 (0.58⁻0.87), and 0.78 (0.64⁻0.96), respectively, and p for trend = 0.759. Moderate intake of total LC ω-3 PUFA (approximately 0.5⁻1 g/day) was significantly associated with a lower prevalence of depression.

CONCLUSION

In our study, moderate fish and LC ω-3 PUFA intake, but not high intake, was associated with lower odds of depression suggesting a U-shaped relationship.

Fish consumption and risk of depression: Epidemiological evidence from prospective studies

INTRODUCTION

The evidence on the association of fish or omega-3 fatty acid intake with depression is inconsistent. We conducted a systematic review and meta-analysis of prospective cohort studies to examine this association.

METHODS

Database searches in PubMed and Web of Science were conducted to identify relevant articles published up to April 2018, which were supplemented by hand-searches of reference lists of the retrieved articles. Using a random-effects model, we calculated pooled relative risks (RR) of depression in relation to consumption of fish or omega-3 fatty acids after adjusting for potential confounders.

RESULTS

A total of 10 prospective cohort studies with 6672 cases of depression among 109 764 participants were included in the meta-analysis. The pooled adjusted RR of depression for the highest vs lowest category of fish consumption was 0.89 (95% CI: 0.80-0.99). The pooled adjusted RR of depression for the highest vs lowest category of omega-3 intake was 0.87 (95% CI: 0.74-1.04). In the dose-response analysis, the pooled adjusted RRs for an increment of 1 serving/week of fish consumption and 500 mg/day of omega-3 fatty acid intake were 0.89 (95% CI: 0.75-1.04) and 0.99 (95% CI: 0.94-1.04), respectively. There was no evidence of heterogeneity.

DISCUSSION

Our findings provide quantitative evidence for a modest inverse association between fish or omega-3 fatty acid intake and risk of depression, especially in women. These findings from the observational studies need to be confirmed through large randomized clinical trials of fish consumption or omega-3 fatty acid intake and risk of depression.

Cross-Sectional Associations between Dietary Fat-Related Behaviors and Continuous Metabolic Syndrome Score among Young Australian Adults

Dietary guidelines recommend removing visible fat from meat, choosing low-fat options and cooking with oil instead of butter. This study examined cross-sectional associations between fat-related eating behaviors and a continuous metabolic syndrome (cMetSyn) score among young adults. During 2004–2006, 2071 participants aged 26–36 years reported how often they trimmed fat from meat, consumed low-fat dairy products and used different types of fat for cooking. A fasting blood sample was collected. Blood pressure, weight and height were measured. To create the cMetSyn score, sex-specific principal component analysis was applied to normalized risk factors of the harmonized definition of metabolic syndrome. Higher score indicates higher risk. For each behavior, differences in mean cMetSyn score were calculated using linear regression adjusted for confounders. Analyses were stratified by weight status (Body mass index (BMI) < 25 kg/m² or ≥ 25 kg/m²). Mean cMetSyn score was positively associated with consumption of low-fat oily dressing (P_Trend = 0.013) among participants who were healthy weight and frequency of using canola/sunflower oil for cooking (P_Trend = 0.008) among participants who were overweight/obese. Trimming fat from meat, cooking with olive oil, cooking with butter, and consuming low-fat dairy products were not associated with cMetSyn score. Among young adults, following fat-related dietary recommendations tended to not be associated with metabolic risk.

Egg consumption and prevalence of psychological disorders in adults

PURPOSE

No previous study has examined the associations between egg consumption and prevalence of psychological disorders. The present study was conducted to determine the association between egg consumption and depression in a large sample of Iranian adults.

METHODS

This cross-sectional study was conducted on 3172 adults in Isfahan, Iran. Egg consumption was assessed by using a validated, self-administered, dish-based, semi-quantitative food frequency questionnaire. The Iranian validated version of Hospital Anxiety and Depression Scale was used to screen for anxiety and depression. The Iranian validated version of General Health Questionnaire with 12 items was used to assess psychological distress. Depression, anxiety and psychological distress were defined according to standard criteria.

RESULTS

The mean age of the study participants was 36.5 ± 7.9 years. Depression, anxiety and psychological distress were prevalent among 28.4, 13.6 and 23% of the study subjects, respectively. After controlling for potential confounders, no significant association was observed between egg intake and depression (OR for comparing extreme quartiles: 1.08; 95% CIs 0.80-1.45) and anxiety (OR 0.79; 95% CIs 0.54-1.16), as well as psychological distress (OR 1.03; 95% CIs 0.76-1.41) in the whole population. In men, significant positive associations were observed between egg intake and depression before controlling for BMI (OR 1.68; 95% CIs 1.01-2.80); however, the associations became non-significant after taking BMI into account (OR 1.62; 95% CIs 0.96-2.72).

CONCLUSIONS

We found no significant association between egg intake and psychological disorders. Further studies, in particular of prospective design, are warranted.

Antenatal diet and postpartum depressive symptoms: A prospective study

Postnatal depression is a critical public health concern, and gaining a better understanding of possible causes is paramount. Recently, diet quality during pregnancy has emerged as a possible preventative measure in ameliorating postnatal depression, however the evidence-base exploring this association is immature. The aim of this study was to examine the association between consumption of food groups characteristic of a quality diet during pregnancy (that is fruit, vegetable and fish intake) and postnatal depressive symptoms at 12 months postpartum. Pregnant women were recruited at 10-18 weeks gestation via advertising on online pregnancy forums, pregnancy and parenting magazines, and two Australian maternity clinics. Participants (n = 253) completed self-report questionnaires assessing fruit, vegetable and fish intake as well as depressive symptoms at early- to mid- pregnancy. Path analyses were conducted to examine whether fruit, vegetable and fish intake during pregnancy were associated with depressive symptom scores at 12 months postpartum. There were no associations between fruit, vegetable or fish intake in pregnancy and postnatal depressive symptoms. Antenatal diet quality as measured by intake of food groups associated with a healthy diet was not associated with postpartum depressive symptoms at 12 months postpartum. Future research should consider the exploration of dietary quality as a measure of overall adherence to evidence-based dietary guidelines.

Diet and self-rated health among oldest-old Chinese

INTRODUCTION

Dietary behavior is a central modifiable risk factor for human health. This study examined the longitudinal relationship between dietary habits and self-rated health among the oldest-old Chinese.

METHODS

Participants aged 80 years and above (N = 7273) were first interviewed in 1998 and followed in subsequent waves 2-3 years apart till 2011-2012 in the Chinese Longitudinal Healthy Longevity Survey. Cox proportional hazards regressions were performed to estimate the effects of dietary habits on poor self-rated health, adjusting for various individual characteristics.

RESULTS

Compared to those who rarely/never consumed fruit, vegetable, meat, egg, and soybean-derived product, participants consuming such products almost every day were 28%, 20%, 32%, 16%, and 16% less likely to report poor self-rated health during follow-up, respectively. Compared to those who rarely/never consumed fruit, meat, fish, soybean-derived product, and tea, participants consuming such products occasionally were 12%, 24%, 11%, 15%, and 14% less likely to report poor self-rated health during follow-up, respectively. Compared to those who rarely/never consumed sugar, participants consuming sugar almost every day were 14% more likely to report poor self-rated health during follow-up. The effects of dietary habits on self-rated health to some extent differed by sex.

CONCLUSIONS

Oldest-old Chinese could gain health benefit from regular consumption of fruit, vegetable, meat, fish, egg, soybean-derived product, and tea; whereas their sugar consumption may need to be reduced. Future research is warranted to establish the recommended daily nutrient allowances for the oldest-old adults and better address the nutritional needs of this vulnerable population.

Fish consumption and depression in Korean adults: the Korea National Health and Nutrition Examination Survey, 2013-2015

BACKGROUND/OBJECTIVES

There is a growing body of evidence that supports the potential role of fish consumption in relation to depression, but the data in Korean population is scarce. Thus, we examined the association between fish consumption and depression in Korean adults.

SUBJECTS/METHODS

We conducted a cross-sectional study in 9183 Korean adults aged 19-64 years who participated in the 6TH Korea National Health and Nutrition Examination Survey (2013-2015), which is a large nationally representative study of Korean population. Fish consumption and depression status were assessed using questionnaires. Multivariable logistic regression models were used to compute odds ratios (ORs) and 95% confidence intervals (CIs) for physician-diagnosed clinical depression.

RESULTS

Out of the 9183 subjects, 389 (4.2%) were diagnosed with depression. After adjusting for potential confounders, the multivariable-adjusted ORs for clinical depression across fish consumption were 1.00 (reference) for <1 time/week, 0.76 (95% CI: 0.56-1.04) for 1-3 times/week and 0.52 (95% CI: 0.37-0.74) for ≥4 times/week (P for trend = 0.0005). The inverse association for ≥4 times/week of fish consumption was stronger in women (OR = 0.44, 95% CI: 0.29-0.67, P for trend < .0001), but there was no significant association in men.

CONCLUSIONS

Our findings suggest that high consumption of fish is associated with lower odds of depression in Korean adults, particularly in women. These results warrant further prospective studies to verify the association between fish consumption and risk of depression in Korean adults.

Diet quality and depression risk: A systematic review and dose-response meta-analysis of prospective studies

BACKGROUND

It has been claimed that the quality of a diet is associated with the incidence of depressive disorders. We sought to investigate the evidence for this claim.

METHODS

Systematic searches were performed up to March 6th, 2017 in order to identify prospective cohort studies that reported on exposure to dietary patterns or food groups and the incidence of depression/depressive symptoms. Data from 24 independent cohorts (totalling 1,959,217 person-years) were pooled in random-effects meta-analyses.

RESULTS

Adherence to a high-quality diet, regardless of type (i.e., healthy/prudent or Mediterranean), was associated with a lower risk of depressive symptoms over time (odds ratios ranged 0.64-0.78 in a linear dose-response fashion [P < 0.01]). A relatively low dietary inflammatory index was also associated with a somewhat lower incidence of depressive symptom (odds ratio = 0.81), although not in a dose-response fashion. Similar associations were found for the consumption of fish and vegetables (odds ratios 0.86 and 0.82 respectively) but not for other high quality food groups (e.g., fruit). Studies that controlled for depression severity at baseline or that used a formal diagnosis as outcome did not yield statistically significant findings. Adherence to low quality diets and food groups was not associated with higher depression incidence.

LIMITATIONS

Our ability to detect confounders was only limited.

CONCLUSION

There is evidence that a higher quality of a diet is associated with a lower risk for the onset of depressive symptoms, but not all available results are consistent with the hypothesis that diet influences depression risk. Prospective studies that control for relevant confounders such as obesity incidence and randomized controlled prevention trials are needed to increase the validity of findings in this field.

The interventional relationship between frequent fish consumption and depression symptoms in aging adults: a randomized controlled trial

OBJECTIVE

The present investigation was intended to test the hypothesis that the elderly provided with the frequent consumption of fishes marinated in essential oil of Perilla frutescens (EOPF) or not would experience fewer depressive symptoms after 6 months.

METHODS

A total of 180 participants were recruited from Sina Hospital, Mashhad, Iran, who were diagnosed with depression based on Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision and Beck Depression Inventory. Participants (n = 180) were randomly assigned in a 1:1:1 ratio to Groups A, B, and C. The last two were provided with an instruction to consume Caspian white fish marinated in the presence or absence of EOPF (434 g each week or four meals per week). Group A served as the control with the common diet. The outcome measures were performed using the Beck Depression Inventory and the General Health Questionnaire.

RESULTS

There were no statistically significant differences in depressive symptom scores between groups with frequent fish consumption as compared with the control (p > 0.05). Yet adjustment for covariates showed that there was a significant reduction in depression among them (p < 0.05). Moreover, consumption of fish and EOPF was associated with more considerable improvements than Groups A and B (p < 0.05).

CONCLUSIONS

It could be concluded that high intakes of unsaturated fatty acids can afford to diminish likelihood of late-life depression. Copyright © 2017 John Wiley & Sons, Ltd.

DHA mediates the protective effect of fish consumption on new episodes of depression among women

In a longitudinal cohort study of young Australian adults, we reported that for women higher baseline levels of fish consumption were associated with reduced incidence of new depressive episodes during the 5-year follow-up. Fish are high in bothn-3 fatty acids and tyrosine. In this study, we seek to determine whethern-3 fatty acids or tyrosine explain the observed association. During 2004–2006, a FFQ (nine fish items) was used to estimate weekly fish consumption among 546 women aged 26–36 years. A fasting blood sample was taken and high-throughput NMR spectroscopy was used to measure 233 metabolites, including serumn-3 fatty acids and tyrosine. During 2009–2011, new episodes of depression since baseline were identified using the lifetime version of the Composite International Diagnostic Interview. Relative risks were calculated using log-binomial regression and indirect effects estimated using the STATA binary_mediation command. Potential mediators were added to separate models, and mediation was quantified as the proportion of the total effect due to the mediator. Then-3 DHA mediated 25·3 % of the association between fish consumption and depression when fish consumption was analysed as a continuous variable and 16·6 % when dichotomised (reference group: <2 serves/week). Tyrosine did not mediate the association (<0·1 %). Components in fish other thann-3 fatty acids and tyrosine might be beneficial for women’s mental health.

Omega-6 to omega-3 polyunsaturated fatty acid ratio and subsequent mood disorders in young people with at-risk mental states: a 7-year longitudinal study

While cross-sectional studies suggest that patients with mood disorders have a higher ratio of omega-6 to omega-3 polyunsaturated fatty acids (PUFAs) and lower levels of omega-3 PUFAs, it is unknown if a high n-6/3 ratio indicates vulnerability for depression. We tested this hypothesis in a 7-year follow-up study of young individuals with an ultra-high risk (UHR) phenotype. We conducted a secondary analysis of the Vienna omega-3 study, a longitudinal study of omega-3 PUFAs in individuals at UHR for psychosis (n=69). Levels of n-6 and n-3 PUFAs were measured in the phosphatidylethanolamine fraction of erythrocyte membranes at intake into the study. Mood disorder diagnosis was ascertained with the Structured Clinical Interview for DSM-IV-TR and confirmed by review of medical records and interviews of caregivers. A higher n-6/3 PUFA ratio at baseline predicted mood disorders in UHR individuals over a 7-year (median) follow-up (odds ratio=1.89, 95% CI=1.075-3.338, P=0.03). This association remained significant after adjustment for age, gender, smoking, severity of depressive symptoms at baseline and n-3 supplementation. Consistent results were obtained for individual PUFAs, including lower levels of eicosapentaenoic acid and docosahexaenoic acid. The predictive capacity of these findings was specific to mood disorders as no associations were found for any other psychiatric disorder. To our knowledge, our data provide the first prospective evidence that the n-6/3 PUFA ratio is associated with an increased risk for mood disorders in young people exhibiting an UHR phenotype. These findings may have important implications for treatment and risk stratification beyond clinical characteristics.

Sex Differences in the Relationship between Sleep Behavior, Fish Consumption, and Depressive Symptoms in the General Population of South Korea

Sleep, fish consumption, and depression have a close relationship; however, the role of sex differences in sleep, fish consumption, and depression research is not yet well-established. This study aimed to examine whether the impact of bedtime, sleep-onset latency, sleep duration, sleep quality, and fish consumption on depressive symptoms differed in women and men. An online survey was conducted in South Korea with a stratified random sample of 600 participants between the ages of 20 and 69, whose gender and age were proportional to estimates of Korea's general population. The 20-item Center for Epidemiologic Studies Depression Scale was used to measure depressive symptoms with a cut-off score of 16. The Pittsburgh Sleep Quality Index (PSQI) was applied to evaluate sleep timing, sleep-onset latency, sleep duration, and sleep quality. Our results indicated that late bedtime and short sleep duration were independently associated with depressive symptoms in women. Sleep-onset latency and poor sleep quality were independently associated with increased prevalence of depressive symptoms in both men and women. Higher fish consumption was significantly associated with decreased prevalence of depressive symptoms in men only. Our findings suggested the importance of a different approach for men and women in terms of promoting healthy sleep habits. In addition, higher fish consumption may be beneficial in the primary prevention of depression in Korean men. Further research is needed to confirm the findings from this cross-sectional study.

The Role of Lipid Biomarkers in Major Depression

In the UK, the lifetime-documented prevalence of major depressive disorder (MDD) is currently 10%. Despite its increasing prevalence and devastating impact on quality of life, the pathophysiological mechanisms underpinning MDD remain to be fully elucidated. Current theories of neurobiological components remain incomplete and protein-centric, rendering pharmacological treatment options suboptimal. In this review, we highlight the pivotal role of lipids in intra- and inter-neuronal functioning, emphasising the potential use of lipids as biomarkers for MDD. The latter has significant implications for improving our understanding of MDD at the cellular and circuit level. There is particular focus on cholesterol (high and low density lipoprotein), omega-3, and omega-6 polyunsaturated fatty acids due to established evidence in the literature of a link between atherosclerotic disease and major depression. We argue that there is significant potential scope for the use of such peripheral biomarkers in the diagnosis, stratification and treatment of MDD.

Do sex hormones or hormone therapy modify the relation of n-3 fatty acids with incident depressive symptoms in postmenopausal women? The MESA Study

INTRODUCTION

Considering that estradiol (E2) and n-3 polyunsaturated fatty acids (PUFAs) have roles in neurogenesis and in neurotransmission, we examined whether the association of PUFAs with incident depressive symptoms in postmenopausal women is modified by hormone therapy (HT) use or estrogen status.

METHODS

Women (N=1616) free of depressive symptoms at baseline (2000-2002) in the Multi-Ethnic Study of Atherosclerosis were classified by HT usage and quartiles of dietary eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and the sum EPA+DHA. Women with serum E2 ≤0.073 nmol/L (sample median), were classified low on E2. Poisson regression was used to model incident depressive symptoms at examination 3 (2004-05), defined by the Center for Epidemiological Studies Depression Scale ≥16 or taking an antidepressant, first as a function of HT use and n-3 PUFA quartiles, and second, as a function of low E2 status and n-3 PUFA quartiles.

RESULTS

Among HT non- users, positive, graded relationships (p-trends≤0.003) were found between PUFAs and incident depressive symptoms. Compared to the lowest quartile, the adjusted risk ratios (RRs) for the highest were 2.10, 2.39, and 2.04 for EPA, DHA, and EPA+DHA, respectively. For HT users, no associations were seen. When analyses were run for E2 status, the RRs over quartiles of the PUFAs were positive and graded for low E2 women, but were null for High E2 women.

CONCLUSIONS

Higher intakes of DHA and EPA were associated with higher risk of depressive symptoms in nonusers of HT, contrary to hypothesis.

Bi-directional associations between healthy lifestyles and mood disorders in young adults: The Childhood Determinants of Adult Health Study

BACKGROUND

Healthy lifestyles prevent cardiovascular disease and are increasingly recognized in relation to mental health but longitudinal studies are limited. We examined bi-directional associations between mood disorders and healthy lifestyles in a cohort followed for 5 years.

METHOD

Participants were aged 26-36 years at baseline (2004-2006) and 31-41 years at follow-up (2009-2011). At follow-up, lifetime mood disorders (depression or dysthymia) were retrospectively diagnosed with the Composite International Diagnostic Interview. A five-item lifestyle score (comprising body mass index, non-smoking, alcohol consumption, leisure time physical activity and healthy diet) was measured at both time points. Linear and log multinomial regression determined if mood disorder before baseline predicted changes in lifestyle (n = 1041). Log binomial regression estimated whether lifestyle at baseline predicted new episodes of mood disorder (n = 1233). Covariates included age, sex, socio-economic position, parental and marital status, social support, major life events, cardiovascular disease history, and self-rated physical and mental health.

RESULTS

A history of mood disorder before baseline predicted unfavourable trajectories of lifestyle over follow-up, including somewhat lower risk of improvement [relative risk (RR) 0.76, 95% confidence interval (CI) 0.56-1.03] and greater risk of worsening (RR 1.46, 95% CI 0.99-2.15) of lifestyle independent of confounding factors. Higher lifestyle scores at baseline were associated with a 22% (RR 0.76, 95% CI 0.61-0.95) reduced risk of first episodes of mood disorder, independent of confounding factors.

CONCLUSIONS

Healthy lifestyles and mood disorders are closely related. Our results suggest that healthy lifestyles may not only reduce cardiovascular disease but also promote mental health.

Fish Consumption and Premenstrual Syndrome and Dysphoric Disorder in Japanese Collegiate Athletes

STUDY OBJECTIVE

To determine the specific characteristics of premenstrual syndrome (PMS)/premenstrual dysphoric disorder (PMDD) in Japanese collegiate athletes, with a focus on their fish consumption.

DESIGN

Cross-sectional study.

SETTING

A university in Osaka, the largest city in western Japan.

PARTICIPANTS AND INTERVENTIONS

The participants were 312 female collegiate students. The study group was composed of 200 students who were members of sport clubs, and the control (nonathletes) group was composed of 112 members of cultural clubs.

MAIN OUTCOME MEASURES

Premenstrual symptoms and social activities.

RESULTS

The prevalence of moderate to severe PMS and PMDD in the study group was the same as in nonathletes. The prominent feature of premenstrual symptoms in athletes was that the severities of 'physical symptoms' and 'performance in training or competition' were much greater than those of nonathletes (P = .003 and P = .002, Mann-Whitney U test). There was a greater effect of PMS and PMDD on athletes, affecting their physical symptoms and performance compared with nonathletes. In terms of dietary habits, 'fish or dried fish' consumption was associated with a decreased risk of poor performance in athletes (odds ratio, 0.61; 95% confidence interval, 0.40-0.92).

CONCLUSION

The results from this study indicate that fish consumption might be positively associated with the relief of PMS/PMDD-induced athletic disturbance.

Association between Fish Intake and Depressive Symptoms among Community-living Older Chinese Adults in Singapore: A Cross-sectional Study

OBJECTIVE

Our aim of this study was to investigate the association between fish consumption and depressive symptoms in senior ethnic Chinese residents of Singapore.

DESIGN

A population-based cross-sectional study.

SETTING

The Singapore Longitudinal Aging Studies (SLAS).

PARTICIPANT

The study consisted of 2,034 participants from the Singapore Longitudinal Aging Studies (SLAS) project who were at least 55 years old.

MEASUREMENTS

The presence of depressive symptoms was compared between those who self-reported eating fish at least three times a week versus those who ate fish less often. A score of 5 or greater on the 15-item Geriatric Depression Scale (GDS-15) was the cutoff for being designated as having depressive symptoms.

RESULTS

Fish intake was associated with a lower prevalence of depressive symptoms ([odds ratio] OR = 0.60, 95% [confidence interval] CI 0.40-0.90; P = .015) after controlling for age, sex, marital status, housing, smoking, alcohol consumption, physical exercise, social and productive activities, self-rated health, hypertension, diabetes, heart failure or attack, stroke, fruit and vegetable intake, and Mini-Mental State Examination (MMSE) scores.

CONCLUSION

Our results suggest that eating fish at least three times a week is associated with a lower odds of having depressive symptoms among Chinese adults over 55 years old living in Singapore.

Higher Adherence to the Australian Dietary Guidelines Is Associated with Better Mental Health Status among Australian Adult First-Time Mothers

BACKGROUND

Mental health disorders are a leading cause of disability worldwide, including in first-time mothers. Understanding the associations between diet and depressive symptoms could assist in improving mental health status in this group.

OBJECTIVE

Our aim was to determine the association between diet quality, fruit, vegetable, and fish consumption and depressive symptoms in first-time mothers aged 19 to 45 years.

DESIGN

We analyzed cross-sectional, baseline data (3 months postpartum) from the Melbourne InFANT (Infant Feeding, Activity, and Nutrition Trial) Extend Program.

PARTICIPANTS/SETTING

Participants were first-time Australian mothers aged 19 to 45 years from the Geelong and Melbourne regions of Victoria, Australia (n=457).

MAIN OUTCOME MEASURES

A self-administered, 137-item food frequency questionnaire assessed dietary intake over the past year. Adherence to the 2013 Australian Dietary Guidelines was assessed using the Dietary Guideline Index as a measure of diet quality. Depressive symptoms were determined using the Center for Epidemiologic Studies Depression Scale.

STATISTICAL ANALYSIS PERFORMED

Relationships between diet quality, fruit, vegetable, and fish intake and depressive symptoms were investigated using linear regression adjusted for relevant covariates (age, smoking status, sleep quality, education, physical activity status, and body mass index).

RESULTS

Better diet quality, as indicated by a higher score on the Dietary Guideline Index, was associated with lower depressive symptoms after adjusting for relevant covariates (β=-.034; 95% CI -.056 to -0.012). There were no other associations between dietary intake and depressive symptoms.

CONCLUSIONS

Adherence to the Australian Dietary Guidelines was associated with better mental health status among first-time mothers. Further research, including longitudinal and intervention studies, are required to determine causality between dietary intake and depressive symptoms, which might help inform future public health nutrition programs for this target group.

A comparison of the dietary patterns derived by principal component analysis and cluster analysis in older Australians

BACKGROUND

Despite increased use of dietary pattern methods in nutritional epidemiology, there have been few direct comparisons of methods. Older adults are a particularly understudied population in the dietary pattern literature. This study aimed to compare dietary patterns derived by principal component analysis (PCA) and cluster analysis (CA) in older adults and to examine their associations with socio-demographic and health behaviours.

METHODS

Men (n = 1888) and women (n = 2071) aged 55-65 years completed a 111-item food frequency questionnaire in 2010. Food items were collapsed into 52 food groups and dietary patterns were determined by PCA and CA. Associations between dietary patterns and participant characteristics were examined using Chi-square analysis. The standardised PCA-derived dietary patterns were compared across the clusters using one-way ANOVA.

RESULTS

PCA identified four dietary patterns in men and two dietary patterns in women. CA identified three dietary patterns in both men and women. Men in cluster 1 (fruit, vegetables, wholegrains, fish and poultry) scored higher on PCA factor 1 (vegetable dishes, fruit, fish and poultry) and factor 4 (vegetables) compared to factor 2 (spreads, biscuits, cakes and confectionery) and factor 3 (red meat, processed meat, white-bread and hot chips) (mean, 95% CI; 0.92, 0.82-1.02 vs. 0.74, 0.63-0.84 vs. -0.43, -0.50- -0.35 vs. 0.60 0.46-0.74, respectively). Women in cluster 1 (fruit, vegetables and fish) scored highest on PCA factor 1 (fruit, vegetables and fish) compared to factor 2 (processed meat, hot chips cakes and confectionery) (1.05, 0.97-1.14 vs. -0.14, -0.21- -0.07, respectively). Cluster 3 (small eaters) in both men and women had negative factor scores for all the identified PCA dietary patterns. Those with dietary patterns characterised by higher consumption of red and processed meat and refined grains were more likely to be Australian-born, have a lower level of education, a higher BMI, smoke and did not meet physical activity recommendations (all P < 0.05).

CONCLUSIONS

PCA and CA identified comparable dietary patterns within older Australians. However, PCA may provide some advantages compared to CA with respect to interpretability of the resulting dietary patterns. Older adults with poor dietary patterns also displayed other negative lifestyle behaviours. Food-based dietary pattern methods may inform dietary advice that is understood by the community.

Fish consumption and depressive symptoms in undergraduate students: A cross-sectional analysis

BACKGROUND

Emerging evidence suggests that fish consumption may have beneficial effects on mood disorders. However, no study has been reported on this issue in young adults to date. The aim of this study was to investigate the relationship between fish consumption and depressive symptoms in Japanese undergraduate students.

METHODS

The 20-item Center for Epidemiologic Studies Depression Scale was used to measure depressive symptoms with a cut-off score of 16. A total of 4190 completed questionnaires (from 2124 men and 2066 women) were received for analysis.

RESULTS

Multivariate logistic analysis showed that fish intake was inversely associated with risk of depressive symptoms in undergraduate students. After adjustment for possible confounders, the odds-ratios (95% confidence intervals) for fish intake 1-2 times/month, 1-2 times/week, 3-4 times/week, and almost every day (compared with "almost never") were 0.78 (0.62-0.99), 0.70 (0.56-0.87), 0.67 (0.53-0.85) and 0.65 (0.46-0.92), respectively. This association tended to be stronger in women than in men.

CONCLUSIONS

Frequent fish consumption in undergraduate students seems to moderate depressive symptoms. Further research is warranted to clarify the causality.

Fatty acid metabolism and its longitudinal relationship with the hypothalamic-pituitary-adrenal axis in major depression: Associations with prospective antidepressant response

BACKGROUND

Metabolism of dietary fatty acids (FAs), and its relationship with the hypothalamic-pituitary-adrenal (HPA)-axis, have been found to be altered in major depressive disorder (MDD). Moreover, indications exist that these factors are associated with antidepressant-response. If we better understand these associations, we might identify novel targets for add-on therapy to increase antidepressant-response, and/or early indicators to improve response prediction.

OBJECTIVE

To determine whether alterations in FA-metabolism, and their relationship with the HPA-axis, are associated with prospective response to the antidepressant paroxetine in MDD.

DESIGN

We first compared 70 initially unmedicated MDD-patients with 51 age- and gender-matched controls at study-entry, regarding salivary cortisol and erythrocyte membrane FAs [omega-3 docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA), FA-chain length, -unsaturation and -peroxidizability]. Subsequently, we treated patients with 6 weeks 20mg/day selective serotonin reuptake inhibitor paroxetine. After 6 weeks, we continued this treatment in responders (i.e. showing ≥50% decrease in Hamilton depression rating scale-score), and randomized non-responders to a 6-week, double-blind, placebo-controlled dose-escalation up to 50mg/day. We repeated cortisol and FA-measures in patients after 6 and 12 weeks.

RESULTS

Compared to controls, patients showed higher FA-chain length, FA-unsaturation and FA-peroxidation, and more negative relationships of FA-unsaturation and FA-peroxidation with cortisol. Moreover, these negative relationships were associated with paroxetine nonresponse. Nonresponse was also associated with low DHA, which was related to low fatty fish intake. Furthermore, early responders showed initial low FA-chain length, FA-peroxidation and EPA that increased during the study, while non-responders exhibited opposite patterns.

CONCLUSIONS

FA-metabolism alterations, and their relationship with cortisol, are associated with prospective paroxetine response in MDD, and may therefore form an early indicator of treatment effectiveness. Moreover, dietary fatty fish intake may improve antidepressant response through an effect on FA-metabolism.