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Chegini M, Shirani P, Omidvar N, Eini-Zinab H, Pour-Ebrahim F, Rezazadeh A. Relationship between diet quality and depression among Iranian older adults in Tehran. BMC Geriatr 2022; 22:708. [PMID: 36028815 PMCID: PMC9419352 DOI: 10.1186/s12877-022-03380-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 08/12/2022] [Indexed: 11/26/2022] Open
Abstract
Background Depression is one of the prevalent mental disorders that is common in older ages. Evidence suggests that dietary intake status may potentially be associated with depression. However, this association has not been well studied in older adults, and the nature of the association remains unclear. This study aimed to investigate the association between diet quality and depression in free-living older adults living in Tehran city. Methods This cross-sectional study was conducted on 583 older adults (279 men and 304 women) aged 60 to 80 years living in Tehran city, selected by the systematic cluster sampling method. Individuals' dietary intake was determined by two non-consecutive 24-h dietary recalls, and diet quality was assessed calculating score of Healthy Eating Index-2015 (HEI-2015). The validated short form of the Geriatric Depression Scale (GDS-11) was used to assess depression status. A logistic regression model was used to assess the chance of depression across tertiles of HEI-2015 score. Results The point prevalence of depression was 22.5%, which was significantly higher in women (91 (69.5%) women vs. 40 (30.5%) men). A higher percentage of seniors at the higher tertile of HEI score were women, belonged to Fars ethnicity and had a higher score of activity of daily living (ADL). After adjustment for all potential confounders, the trend of depression chance was significantly decreased in those with higher HEI-2015 scores (p-for trend < 0.05). Conclusion Higher quality of diet was associated with a lower possibility of depression in the studied participants. Further studies are required to investigate the possible causal relationship. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03380-1.
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Affiliation(s)
- Maedeh Chegini
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, School of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Pedram Shirani
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, School of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, School of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hassan Eini-Zinab
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, School of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Pour-Ebrahim
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, School of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arezoo Rezazadeh
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, School of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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2
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Beydoun MA, Shaked D, Hossain S, Beydoun HA, Katzel LI, Davatzikos C, Gullapalli RP, Seliger SL, Erus G, Evans MK, Zonderman AB, Waldstein SR. Corrigendum: Vitamin D, Folate, and Cobalamin Serum Concentrations Are Related to Brain Volume and White Matter Integrity in Urban Adults. Front Aging Neurosci 2021; 13:660049. [PMID: 33953664 PMCID: PMC8092045 DOI: 10.3389/fnagi.2021.660049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 02/02/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- May A Beydoun
- Laboratory of Epidemiology and Population Sciences, The National Institute on Aging (NIA) the Intramural Research Program (IRP), The National Institutes of Health (NIH), Baltimore, MD, United States
| | - Danielle Shaked
- Laboratory of Epidemiology and Population Sciences, The National Institute on Aging (NIA) the Intramural Research Program (IRP), The National Institutes of Health (NIH), Baltimore, MD, United States.,Department of Psychology, University of Maryland, Baltimore County, MD, United States
| | - Sharmin Hossain
- Laboratory of Epidemiology and Population Sciences, The National Institute on Aging (NIA) the Intramural Research Program (IRP), The National Institutes of Health (NIH), Baltimore, MD, United States
| | - Hind A Beydoun
- Department of Research Programs, Fort Belvoir Community Hospital, Fort Belvoir, VA, United States
| | - Leslie I Katzel
- Geriatric Research Education and Clinical Center, Baltimore VA Medical Center, Baltimore, MD, United States.,Division of Gerontology & Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Christos Davatzikos
- Section for Biomedical Image Analysis, Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States
| | - Rao P Gullapalli
- Department of Diagnostic Radiology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Stephen L Seliger
- Division of Nephrology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Guray Erus
- Section for Biomedical Image Analysis, Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States
| | - Michele K Evans
- Laboratory of Epidemiology and Population Sciences, The National Institute on Aging (NIA) the Intramural Research Program (IRP), The National Institutes of Health (NIH), Baltimore, MD, United States
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, The National Institute on Aging (NIA) the Intramural Research Program (IRP), The National Institutes of Health (NIH), Baltimore, MD, United States
| | - Shari R Waldstein
- Department of Psychology, University of Maryland, Baltimore County, MD, United States.,Geriatric Research Education and Clinical Center, Baltimore VA Medical Center, Baltimore, MD, United States.,Division of Gerontology & Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
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3
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Beydoun MA, Shaked D, Hossain S, Beydoun HA, Katzel LI, Davatzikos C, Gullapalli RP, Seliger SL, Erus G, Evans MK, Zonderman AB, Waldstein SR. Vitamin D, Folate, and Cobalamin Serum Concentrations Are Related to Brain Volume and White Matter Integrity in Urban Adults. Front Aging Neurosci 2020; 12:140. [PMID: 32523528 PMCID: PMC7261885 DOI: 10.3389/fnagi.2020.00140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 04/27/2020] [Indexed: 11/13/2022] Open
Abstract
Background and objectives: Lower vitamin status has been linked to cognitive deficits, pending mechanistic elucidation. Serum 25-hydroxyvitamin D [25(OH)D], folate and cobalamin were explored against brain volumes and white matter integrity (WMI). Methods: Two prospective waves from Healthy Aging in Neighborhoods of Diversity Across the Life Span (HANDLS) study were primarily used [Baltimore, City, MD, 2004–2015, N = 183–240 urban adults (Agev1: 30–64 years)]. Serum vitamin 25-hydroxyvitamin D [25(OH)D], folate and cobalamin concentrations were measured at visits 1 (v1: 2004–2009), while structural and diffusion Magnetic Resonance Imaging (sMRI/dMRI) outcomes were measured at vscan: 2011–2015. Top 10 ranked adjusted associations were corrected for multiple testing using familywise Bonferroni (FWER < 0.05) and false discovery rates (FDR, q-value < 0.10). Results: We found statistically significant (FWER < 0.05; β±SE) direct associations of 25(OH)D(v1) with WM volumes [overall: +910 ± 336/males: +2,054 ± 599], occipital WM; [overall: +140 ± 40, males: +261 ± 67 and Agev1 > 50 years: +205 ± 54]; parietal WM; [overall: +251 ± 77, males: +486 ± 129 and Agev1 > 50 years: +393 ± 108] and left occipital pole volume [overall: +15.70 ± 3.83 and above poverty: 19.0 ± 4.3]. Only trends were detected for cobalamin exposures (q < 0.10), while serum folate (v1) was associated with lower mean diffusivity (MD) in the Anterior Limb of the Internal Capsule (ALIC), reflecting greater WMI, overall, while regional FA (e.g., cingulum gyrus) was associated with greater 25(OH)D concentration. Conclusions: Among urban adults, serum 25(OH)D status was consistently linked to larger occipital and parietal WM volumes and greater region-specific WMI. Pending longitudinal replication of our findings, randomized controlled trials of vitamin D supplementation should be conducted against brain marker outcomes.
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Affiliation(s)
- May A Beydoun
- Laboratory of Epidemiology and Population Sciences, The National Institute on Aging (NIA) The Intramural Research Program (IRP), The National Institutes of Health (NIH), Baltimore, MD, United States
| | - Danielle Shaked
- Laboratory of Epidemiology and Population Sciences, The National Institute on Aging (NIA) The Intramural Research Program (IRP), The National Institutes of Health (NIH), Baltimore, MD, United States.,Department of Psychology, University of Maryland, Baltimore County, MD, United States
| | - Sharmin Hossain
- Laboratory of Epidemiology and Population Sciences, The National Institute on Aging (NIA) The Intramural Research Program (IRP), The National Institutes of Health (NIH), Baltimore, MD, United States
| | - Hind A Beydoun
- Department of Research Programs, Fort Belvoir Community Hospital, Fort Belvoir, VA, United States
| | - Leslie I Katzel
- Geriatric Research Education and Clinical Center, Baltimore VA Medical Center, Baltimore, MD, United States.,Division of Gerontology & Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Christos Davatzikos
- Section for Biomedical Image Analysis, Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States
| | - Rao P Gullapalli
- Department of Diagnostic Radiology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Stephen L Seliger
- Division of Nephrology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Guray Erus
- Section for Biomedical Image Analysis, Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States
| | - Michele K Evans
- Laboratory of Epidemiology and Population Sciences, The National Institute on Aging (NIA) The Intramural Research Program (IRP), The National Institutes of Health (NIH), Baltimore, MD, United States
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, The National Institute on Aging (NIA) The Intramural Research Program (IRP), The National Institutes of Health (NIH), Baltimore, MD, United States
| | - Shari R Waldstein
- Department of Psychology, University of Maryland, Baltimore County, MD, United States.,Geriatric Research Education and Clinical Center, Baltimore VA Medical Center, Baltimore, MD, United States.,Division of Gerontology & Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
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Khosravi M, Sotoudeh G, Amini M, Raisi F, Mansoori A, Hosseinzadeh M. The relationship between dietary patterns and depression mediated by serum levels of Folate and vitamin B12. BMC Psychiatry 2020; 20:63. [PMID: 32054533 PMCID: PMC7020545 DOI: 10.1186/s12888-020-2455-2] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 01/22/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Major depressive disorder is among main worldwide causes of disability. The low medication compliance rates in depressed patients as well as the high recurrence rate of the disease can bring up the nutrition-related factors as a potential preventive or treatment agent for depression. The aim of this study was to investigate the association between dietary patterns and depression via the intermediary role of the serum folate and vitamin B12, total homocysteine, tryptophan, and tryptophan/competing amino acids ratio. METHODS This was an individually matched case-control study in which 110 patients with depression and 220 healthy individuals, who completed a semi-quantitative food frequency questionnaire were recruited. We selected the depressed patients from three districts in Tehran through non-probable convenience sampling from which healthy individuals were selected, as well. The samples selection and data collection were performed during October 2012 to June 2013. In addition, to measure the serum biomarkers 43 patients with depression and 43 healthy people were randomly selected from the study population. To diagnose depression the criteria of Diagnostic and Statistical Manual of Mental Disorders, fourth edition, were utilized. RESULTS The findings suggest that the healthy dietary pattern was significantly associated with a reduced odds of depression (OR: 0.75; 95% CI: 0.61-0.93) whereas the unhealthy dietary pattern increased it (OR: 1.382, CI: 1.116-1.71). The mediation analysis showed that the healthy dietary pattern was associated with a reduced risk of depression via increased serum levels of the folate and vitamin B12; however, the unhealthy dietary pattern was associated with increased risk of depression via decreased serum levels of folate and vitamin B12, based on tree adjusted logistic regression models. CONCLUSION Dietary patterns may be associated with depression by changing the serum levels of folate and vitamin B12. Further studies are required to confirm the mechanism.
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Affiliation(s)
- Maryam Khosravi
- grid.411583.a0000 0001 2198 6209Department of Nutrition, School of Medicine, Mashhad University of medical Sciences, Mashhad, Iran ,grid.464653.60000 0004 0459 3173Department of Public Health, North Khorasan University of medical Sciences, Bojnurd, Iran
| | - Gity Sotoudeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Hojatdoost Street, Naderi Street, Keshavarz Blvd., Tehran, Iran.
| | - Maryam Amini
- Department of Nutrition Research, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, No. 7., Hafezi St., Farahzadi Blvd., Qods Town, 19395-4741, Tehran, 1981619573, Iran.
| | - Firoozeh Raisi
- grid.411705.60000 0001 0166 0922Department of Psychiatry, Roozbeh Hospital and Psychiatry and Psychology Research Centre, Tehran University of Medical Sciences, Tehran, Iran
| | - Anahita Mansoori
- Nutrition and Metabolic Diseases Research Center, Ahvaz Junishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahdieh Hosseinzadeh
- grid.412505.70000 0004 0612 5912Department of Nutrition, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Beydoun MA, Hossain S, Beydoun HA, Shaked D, Weiss J, Evans MK, Zonderman AB. Red Cell Distribution Width Is Directly Associated with Poor Cognitive Performance among Nonanemic, Middle-Aged, Urban Adults. J Nutr 2020; 150:128-139. [PMID: 31912144 PMCID: PMC6946901 DOI: 10.1093/jn/nxz182] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 05/08/2019] [Accepted: 07/15/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Epidemiological evidence suggests that both anemia and elevated red cell distribution width (RDW) are associated with cognitive impairment. However, the interplay between these 2 predictors has been understudied. OBJECTIVES We examined sex- and anemia-specific associations between RDW and cognitive performance among urban adults in the United States. METHODS Data from the Healthy Aging in Neighborhoods of Diversity Across the Life Span Study (Baltimore, MD; participants aged 30-65 y at baseline, ∼59% African-American, 45% men) were used. Participants were selected based on the completion of 11 cognitive tasks at baseline (2004-2009) and follow-up (2009-2013) visits (mean time between visits: 4.64 ± 0.93 y) and availability of exposure and covariate data, yielding a sample of between 1526 and 1646 adults out of the initial 3720 adults recruited at baseline. Multiple linear mixed-effects regression models were conducted with RDW as the main exposure of interest and anemia/sex as the key effect modifiers. RESULTS Overall, high RDWs were linked to poorer baseline performance on the California Verbal Learning Test (CVLT) List A (per 1 unit increase in RDW %, main effect: γ01 = -0.369 ± 0.114; P = 0.001) and to slower rates of decline on the CVLT Delayed Free Recall (per 1 unit increase in RDW %, RDW × time: γ11 = +0.036 ± 0.013; P = 0.007). Among nonanemic participants, RDWs were consistently associated with poorer baseline performance on the Trailmaking Test, Part A (γ01 = +3.11 ± 0.89; P < 0.001) and on the CVLT List A (γ01 = -0.560 ± 0.158; P < 0.001). Moreover, RDWs were associated with poorer baseline performance on the Brief Test of Attention in the total population (γ01 = -0.123 ± 0.039; P = 0.001) and among men (γ01 = -0.221 ± 0.068; P = 0.001). We did not detect an association between hemoglobin (Hb) and baseline cognitive performance or changes over time. CONCLUSIONS Elevated RDW had a consistent cross-sectional association with poor cognitive performance in the domains of verbal memory and attention among the nonanemic group in a sample of middle-aged, urban adults. Anemia and Hb concentrations were not associated with cognition. More longitudinal studies are needed to replicate our findings.
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Affiliation(s)
- May A Beydoun
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, Intramural Research Program, Baltimore, MD, USA
| | - Sharmin Hossain
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, Intramural Research Program, Baltimore, MD, USA
| | - Hind A Beydoun
- Department of Research Programs, Fort Belvoir Community Hospital, Fort Belvoir, VA, USA
| | - Danielle Shaked
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, Intramural Research Program, Baltimore, MD, USA
| | - Jordan Weiss
- Population Studies Center and Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA
| | - Michele K Evans
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, Intramural Research Program, Baltimore, MD, USA
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, Intramural Research Program, Baltimore, MD, USA
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Dietary Patterns Vary by Depressive Symptom Severity in Youth With Depressive Disorders. TOP CLIN NUTR 2019. [DOI: 10.1097/tin.0000000000000186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Lassale C, Batty GD, Baghdadli A, Jacka F, Sánchez-Villegas A, Kivimäki M, Akbaraly T. Healthy dietary indices and risk of depressive outcomes: a systematic review and meta-analysis of observational studies. Mol Psychiatry 2019; 24:965-986. [PMID: 30254236 PMCID: PMC6755986 DOI: 10.1038/s41380-018-0237-8] [Citation(s) in RCA: 396] [Impact Index Per Article: 79.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 07/26/2018] [Accepted: 08/02/2018] [Indexed: 02/07/2023]
Abstract
With depression being the psychiatric disorder incurring the largest societal costs in developed countries, there is a need to gather evidence on the role of nutrition in depression, to help develop recommendations and guide future psychiatric health care. The aim of this systematic review was to synthesize the link between diet quality, measured using a range of predefined indices, and depressive outcomes. Medline, Embase and PsychInfo were searched up to 31st May 2018 for studies that examined adherence to a healthy diet in relation to depressive symptoms or clinical depression. Where possible, estimates were pooled using random effect meta-analysis with stratification by observational study design and dietary score. A total of 20 longitudinal and 21 cross-sectional studies were included. These studies utilized an array of dietary measures, including: different measures of adherence to the Mediterranean diet, the Healthy Eating Index (HEI) and Alternative HEI (AHEI), the Dietary Approaches to Stop Hypertension, and the Dietary Inflammatory Index. The most compelling evidence was found for the Mediterranean diet and incident depression, with a combined relative risk estimate of highest vs. lowest adherence category from four longitudinal studies of 0.67 (95% CI 0.55-0.82). A lower Dietary Inflammatory Index was also associated with lower depression incidence in four longitudinal studies (relative risk 0.76; 95% CI: 0.63-0.92). There were fewer longitudinal studies using other indices, but they and cross-sectional evidence also suggest an inverse association between healthy diet and depression (e.g., relative risk 0.65; 95% CI 0.50-0.84 for HEI/AHEI). To conclude, adhering to a healthy diet, in particular a traditional Mediterranean diet, or avoiding a pro-inflammatory diet appears to confer some protection against depression in observational studies. This provides a reasonable evidence base to assess the role of dietary interventions to prevent depression. This systematic review was registered in the PROSPERO International Prospective Register of Systematic Reviews under the number CRD42017080579.
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Affiliation(s)
- Camille Lassale
- Department of Epidemiology and Public Health, University College London, London, WC1E 6BT, United Kingdom.
- Department of Behavioural Science and Health, University College London, London, WC1E 6BT, United Kingdom.
| | - G David Batty
- Department of Epidemiology and Public Health, University College London, London, WC1E 6BT, United Kingdom
| | - Amaria Baghdadli
- Department of Psychiatry & Autism Resources Centre, University Hospital of Montpellier, CHRU de Montpellier, F-34000, France
- INSERM, U1018, Centre for Research in Epidemiology and Population Health, Hôpital Paul Brousse, Villejuif, France
| | - Felice Jacka
- Deakin University, Food & Mood Centre, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Almudena Sánchez-Villegas
- Nutrition Research Group, Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
- Ciber de Fisiopatología de la Obesidad y Nutrición (CIBER OBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, London, WC1E 6BT, United Kingdom
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Tasnime Akbaraly
- Department of Epidemiology and Public Health, University College London, London, WC1E 6BT, United Kingdom
- Department of Psychiatry & Autism Resources Centre, University Hospital of Montpellier, CHRU de Montpellier, F-34000, France
- MMDN, University of Montpellier, EPHE, INSERM, U1198, Montpellier, F-34095, France
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Prospective association between adherence to dietary recommendations and incident depressive symptoms in the French NutriNet-Santé cohort. Br J Nutr 2018; 120:290-300. [DOI: 10.1017/s0007114518000910] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractA posteriorihealthier dietary patterns and several nutrients have been associated with lower risks of depression in various studies; however, evidence is lacking with regard to the prospective association between adherence to nutritional recommendations (food-based and nutrient-based recommendations) and incident depression or depressive symptoms. In this study, we investigate such associations in the NutriNet Santé cohort. The study sample included 26 225 participants (aged 18–86 years) who were initially free of depressive symptoms. Adherence to nutritional recommendations was measured by four scores namely modified French Programme National Nutrition Santé-Guideline Score (mPNNS-GS), Alternative Healthy Eating Index-2010 (AHEI-2010), Probability of Adequate Nutrient Intake Dietary Score (PANDiet) and Diet Quality Index-International (DQI-I), using non-consecutive dietary record data during the first 2 years of follow-up (mean number of recording days=8,sd2). Depressive symptoms were defined by a Center for Epidemiologic Studies Depression Scale (CES-D) score ≥17 for men and ≥23 for women. We used Cox proportional hazards models to estimate hazard ratios and 95 % CI, modelling the dietary scores as standardised continuous variables and as tertiles. Over a mean follow-up of 6 years, we identified 2166 incident cases of depressive symptoms. All dietary scores with the exception of the AHEI-2010 were significantly inversely associated with incident depressive symptoms. In the fully adjusted model, an increase of 1sdin the mPNNS-GS, PANDiet and DQI-I was, respectively, associated with an 8 % (95 % CI 4, 13), 5 % (95 % CI 1, 9) and 9 % (95 % CI 5, 13) reduction in the risk of depressive symptoms. Overall, these findings suggest that diet in accordance with national or international guidelines could have beneficial effects with regard to mental health.
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Association between blood folate concentrations and depression in reproductive aged U.S. women, NHANES (2011-2012). J Affect Disord 2017; 223:209-217. [PMID: 28777954 DOI: 10.1016/j.jad.2017.07.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 07/04/2017] [Accepted: 07/08/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND Blood folate concentrations have been linked to an increased risk of depression in adults. Depression is particularly pronounced among women; however, the association between folate concentration and depression is not well-examined among women of reproductive age. The purpose of our study was to assess the association between low serum and red blood cell folate concentration and the risk of moderate to severe depression among non-pregnant women of reproductive age in the United States (U.S.). METHODS We used data from nationally representative, population-based U.S. National Health and Nutrition Examination Survey (NHANES) (2011-2012) examining non-pregnant women of reproductive age (20-44 years). We compared serum and red blood cell (RBC) folate concentrations between women with and without self-reported depression based on Patient Health Questionnaire-9 (PHQ-9) scores, and examined the association between folate concentrations and depression using linear and logistic regression analysis. RESULTS A total of 16.7% of eligible women in our study reported to have moderate to severe depression. The median serum folate concentrations for women with and without depression were 17.8ng/ml and 17.2ng/ml, respectively (P = <0.01). There was no statistical difference in median RBC folate concentrations between women with and without depression (P = 0.2). Serum folate concentration was weakly associated with an increased risk of moderate to severe depression among non-pregnant women of reproductive age, after adjusting for important demographic and life-style factors (aOR: 1.11; 95% CI: 1.01, 1.22). There was no interaction with race and ethnicity. LIMITATIONS Cross-sectional design. CONCLUSIONS Folate concentrations in the blood may partly explain the increased risk of moderate to severe depression among non-pregnant women of reproductive age in the U.S. Robust prospective studies are needed to confirm our findings.
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Bender A, Hagan KE, Kingston N. The association of folate and depression: A meta-analysis. J Psychiatr Res 2017; 95:9-18. [PMID: 28759846 DOI: 10.1016/j.jpsychires.2017.07.019] [Citation(s) in RCA: 96] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 07/20/2017] [Accepted: 07/20/2017] [Indexed: 12/23/2022]
Abstract
BACKGROUND Previous research suggested that folate levels play an important role in the etiology and course of depression. However, the literature has been inconsistent with regard to differences in folate level between individuals with and without depression. The present meta-analysis synthesized the results of previous studies to examine whether individuals with depression had lower levels of folate than individuals without depression. METHODS Meta-analytic procedures were conducted in accordance with PRISMA guidelines. Studies evaluating folate levels in individuals with and without depression via red blood cell folate, serum folate, or dietary intake of folate methods were identified via PsycINFO and PubMed. Random-effects meta-analysis was conducted using Hedge's g, and moderation analysis was used for both folate measurement method and population type. Study heterogeneity was assessed with I2 and publication bias was qualitatively assessed via funnel plot and quantitatively assessed with the trim-and-fill method and Begg's adjusted rank test. RESULTS We found a significant, small effect size, such that individuals with depression had lower folate levels than those without depression, Hedge's g = -0.24 (95% CI = -0.31, -0.16), p < 0.001. Study heterogeneity was high (I2 = 84.88%), and neither folate measurement method nor population accounted for study heterogeneity. CONCLUSIONS Individuals with depression have lower serum levels of folate and dietary folate intake than individuals without depression. Given that previous literature suggested folate supplementation improved the efficacy of traditional antidepressant medications, future research on folate supplementation in depression is warranted and clinicians may wish to consider folate supplementation for patients with depression.
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Sánchez-Villegas A, Henríquez-Sánchez P, Ruiz-Canela M, Lahortiga F, Molero P, Toledo E, Martínez-González MA. A longitudinal analysis of diet quality scores and the risk of incident depression in the SUN Project. BMC Med 2015; 13:197. [PMID: 26377327 PMCID: PMC4573281 DOI: 10.1186/s12916-015-0428-y] [Citation(s) in RCA: 100] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 07/17/2015] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Some studies have pointed out that several dietary patterns could be associated with a reduced risk of depression among adults. This association seems to be consistent across countries, cultures and populations. The objective of the study was to compare and to establish the type of relationship between three diet quality scores and depression in the SUN (Seguimiento Universidad de Navarra) Cohort study. METHODS We performed a dynamic cohort study based on Spanish university graduates free of depression at baseline. Dietary intake was repeatedly assessed at baseline and after 10 years of follow-up with a validated semi-quantitative food-frequency questionnaire. Three previously described diet quality scores: Mediterranean Diet Score (MDS), Pro-vegetarian Dietary Pattern (PDP) and Alternative Healthy Eating Index-2010 (AHEI-2010) were built. Participants were classified as having depression if they reported a new clinical diagnosis of depression by a physician or initiated the use of an antidepressant drug during follow-up. Time-dependent Cox regression models with cumulative averages of diet and restricted cubic splines were used to estimate hazard ratios of depression according to quintiles of adherence to the MDS, PDP and AHEI-2010. RESULTS One thousand and fifty one incident cases of depression were observed among 15,093 participants from the SUN Cohort after a median follow-up of 8.5 years. Inverse and significant associations were observed between the three diet quality scores and depression risk. The hazard ratios and 95 % confidence intervals for extreme quintiles (fifth versus first) of updated adherence to MDS, PDP and AHEI-2010 were 0.84 (0.69-1.02), 0.74 (0.61-0.89) and 0.60 (0.49-0.72), respectively. The dose-response analyses showed non-linear associations, suggesting that suboptimal adherence to these dietary patterns may partially be responsible for increased depression risk. CONCLUSIONS Better adherence to the MDS, PDP and AHEI-2010 was associated with a reduced risk of depression among Spanish adults. However, our data suggested a threshold effect so that although the risk of depression was reduced when comparing moderate versus lower adherence, there was not much extra benefit for the comparison between moderate and high or very high adherence.
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Affiliation(s)
- Almudena Sánchez-Villegas
- Nutrition Research Group, Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.
- Ciber de Fisiopatología de la Obesidad y Nutrición (CIBER OBN), Instituto de Salud Carlos III, Madrid, Spain.
- Department of Clinical Sciences, University of Las Palmas de Gran Canaria, P.O. Box 550, , CP. 35080, Las Palmas de Gran Canaria, Spain.
| | - Patricia Henríquez-Sánchez
- Nutrition Research Group, Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.
- Ciber de Fisiopatología de la Obesidad y Nutrición (CIBER OBN), Instituto de Salud Carlos III, Madrid, Spain.
| | - Miguel Ruiz-Canela
- Ciber de Fisiopatología de la Obesidad y Nutrición (CIBER OBN), Instituto de Salud Carlos III, Madrid, Spain.
- Department of Preventive Medicine and Public Health, University of Navarra, C/ Irunlarrea, n° 1, CP. 31008, Pamplona, Spain.
| | - Francisca Lahortiga
- Department of Psychiatry and Medical Psychology, University Clinic of Navarra, Pamplona, Spain.
| | - Patricio Molero
- Department of Psychiatry and Medical Psychology, University Clinic of Navarra, Pamplona, Spain.
| | - Estefanía Toledo
- Ciber de Fisiopatología de la Obesidad y Nutrición (CIBER OBN), Instituto de Salud Carlos III, Madrid, Spain.
- Department of Preventive Medicine and Public Health, University of Navarra, C/ Irunlarrea, n° 1, CP. 31008, Pamplona, Spain.
| | - Miguel A Martínez-González
- Ciber de Fisiopatología de la Obesidad y Nutrición (CIBER OBN), Instituto de Salud Carlos III, Madrid, Spain.
- Department of Preventive Medicine and Public Health, University of Navarra, C/ Irunlarrea, n° 1, CP. 31008, Pamplona, Spain.
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Beydoun MA, Fanelli Kuczmarski M, Kitner-Triolo MH, Beydoun HA, Kaufman JS, Mason MA, Evans MK, Zonderman AB. Dietary antioxidant intake and its association with cognitive function in an ethnically diverse sample of US adults. Psychosom Med 2015; 77:68-82. [PMID: 25478706 PMCID: PMC4597309 DOI: 10.1097/psy.0000000000000129] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Dietary antioxidants can inhibit reactions accompanying neurodegeneration and thus prevent cognitive impairment. We describe associations of dietary antioxidants with cognitive function in a large biracial population, while testing moderation by sex, race, and age and mediation by depressive symptoms. METHODS This was a cross-sectional analysis of 1274 adults (541 men and 733 women) aged 30 to 64 years at baseline (mean [standard deviation] = 47.5 [9.3]) in the Healthy Aging in Neighborhoods of Diversity Across the Lifespan Study, Baltimore city, MD. Cognitive performance in the domains of memory, language/verbal, attention, spatial, psychomotor speed, executive function, and global mental status were assessed. The 20-item Center for Epidemiologic Studies Depression Scale was used to measure depressive symptoms. Dietary intake was assessed with two 24-hour recalls, estimating daily consumption of total carotenoids and vitamins A, C, and E per 1000 kcal. RESULTS Among key findings, 1 standard deviation (∼ 2.02 mg/1000 kcal) higher vitamin E was associated with a higher score on verbal memory, immediate recall (β = +0.64 [0.19], p = .001), and better language/verbal fluency performance (β = +0.53 [0.16], p = .001), particularly among the younger age group. Women with higher vitamin E intake (β = +0.68 [0.21], p = .001) had better performance on a psychomotor speed test. The vitamin E-verbal memory association was partially mediated by depressive symptoms (proportion mediated = 13%-16%). CONCLUSIONS In sum, future cohort studies and dietary interventions should focus on associations of dietary vitamin E with cognitive decline, specifically for domains of verbal memory, verbal fluency, and psychomotor speed.
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Affiliation(s)
- M. A. Beydoun
- National Institute on Aging, NIA/NIH/IRP, Baltimore, MD
| | | | | | - H. A. Beydoun
- Graduate Program in Public Health, Eastern Virginia Medical School, Norfolk, VA
| | - J. S. Kaufman
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - M. A. Mason
- Statistical Information Systems, MedStar Research Institute, Baltimore, MD
| | - M. K. Evans
- National Institute on Aging, NIA/NIH/IRP, Baltimore, MD
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13
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Beydoun MA, Gamaldo AA, Canas JA, Beydoun HA, Shah MT, McNeely JM, Zonderman AB. Serum nutritional biomarkers and their associations with sleep among US adults in recent national surveys. PLoS One 2014; 9:e103490. [PMID: 25137304 PMCID: PMC4138077 DOI: 10.1371/journal.pone.0103490] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Accepted: 07/02/2014] [Indexed: 12/27/2022] Open
Abstract
Background The associations between nutritional biomarkers and measures of sleep quantity and quality remain unclear. Methods Cross-sectional data from the National Health and Nutrition Examination Surveys (NHANES) 2005–2006 were used. We selected 2,459 adults aged 20–85, with complete data on key variables. Five sleep measures were constructed as primary outcomes: (A) Sleep duration; (B) Sleep disorder; (C) Three factors obtained from factor analysis of 15 items and labeled as “Poor sleep-related daytime dysfunction” (Factor 1), “Sleepiness” (Factor 2) and “Sleep disturbance” (Factor 3). Main exposures were serum concentrations of key nutrients, namely retinol, retinyl esters, carotenoids (α-carotene, β-carotene, β-cryptoxanthin, lutein+zeaxanthin, lycopene), folate, vitamin B-12, total homocysteine (tHcy), vitamin C, 25-hydroxyvitamin D (25(OH)D) and vitamin E. Main analyses consisted of multiple linear, logistic and multinomial logit models. Results Among key findings, independent inverse associations were found between serum vitamin B-12 and sleep duration, 25(OH)D and sleepiness (as well as insomnia), and between folate and sleep disturbance. Serum total carotenoids concentration was linked to higher odds of short sleep duration (i.e. 5–6 h per night) compared to normal sleep duration (7–8 h per night). Conclusions A few of the selected serum nutritional biomarkers were associated with sleep quantity and quality. Longitudinal studies are needed to ascertain temporality and assess putative causal relationships.
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Affiliation(s)
- May A. Beydoun
- National Institute on Aging, NIA/NIH/IRP, Baltimore, Maryland, United States of America
- * E-mail:
| | - Alyssa A. Gamaldo
- National Institute on Aging, NIA/NIH/IRP, Baltimore, Maryland, United States of America
| | - Jose A. Canas
- Pediatric Endocrinology, Diabetes and Metabolism Nemours Children's Clinic, Jacksonville, Florida, United States of America
| | - Hind A. Beydoun
- Graduate program in Public Health, Eastern Virginia Medical School, Norfolk, Virginia, United States of America
| | - Mauli T. Shah
- National Institute on Aging, NIA/NIH/IRP, Baltimore, Maryland, United States of America
- Department of Psychology, University of Maryland, Baltimore County, Baltimore, Maryland, United States of America
| | - Jessica M. McNeely
- National Institute on Aging, NIA/NIH/IRP, Baltimore, Maryland, United States of America
- Department of Psychology, University of Maryland, Baltimore County, Baltimore, Maryland, United States of America
| | - Alan B. Zonderman
- National Institute on Aging, NIA/NIH/IRP, Baltimore, Maryland, United States of America
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Beydoun MA. The interplay of gender, mood, and stress hormones in the association between emotional eating and dietary behavior. J Nutr 2014; 144:1139-41. [PMID: 24919688 PMCID: PMC4093980 DOI: 10.3945/jn.114.196717] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Revised: 05/16/2014] [Accepted: 05/23/2014] [Indexed: 11/14/2022] Open
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Lai JS, Hiles S, Bisquera A, Hure AJ, McEvoy M, Attia J. A systematic review and meta-analysis of dietary patterns and depression in community-dwelling adults. Am J Clin Nutr 2014; 99:181-97. [PMID: 24196402 DOI: 10.3945/ajcn.113.069880] [Citation(s) in RCA: 480] [Impact Index Per Article: 48.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Studies of single nutrients on depression have produced inconsistent results, and they have failed to consider the complex interactions between nutrients. An increasing number of studies in recent years are investigating the association of overall dietary patterns and depression. OBJECTIVE This study aimed to systematically review current literature and conduct meta-analyses of studies addressing the association between dietary patterns and depression. DESIGN Six electronic databases were searched for articles published up to August 2013 that examined the association of total diet and depression among adults. Only studies considered methodologically rigorous were included. Two independent reviewers completed study selection, quality rating, and data extraction. Effect sizes of eligible studies were pooled by using random-effects models. A summary of the findings was presented for studies that could not be meta-analyzed. RESULTS A total of 21 studies were identified. Results from 13 observational studies were pooled. Two dietary patterns were identified. The healthy diet pattern was significantly associated with a reduced odds of depression (OR: 0.84; 95% CI: 0.76, 0.92; P < 0.001). No statistically significant association was observed between the Western diet and depression (OR: 1.17; 95% CI: 0.97, 1.68; P = 0.094); however, the studies were too few for a precise estimate of this effect. CONCLUSIONS The results suggest that high intakes of fruit, vegetables, fish, and whole grains may be associated with a reduced depression risk. However, more high-quality randomized controlled trials and cohort studies are needed to confirm this finding, specifically the temporal sequence of this association.
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Affiliation(s)
- Jun S Lai
- Priority Research Centre for Gender, Health and Ageing (JSL and AJH), the Priority Research Centre for Translational Neuroscience and Mental Health (SH), and the Centre for Clinical Epidemiology and Biostatistics (MM and JA), University of Newcastle, New South Wales, Australia; the Hunter Medical Research Institute, Newcastle, New South Wales, Australia (AB, AJH, and JA); and the John Hunter Hospital, Newcastle, New South Wales, Australia (JA)
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Ewies AAA. Folic acid supplementation: The new dawn for postmenopausal women with hot flushes. World J Obstet Gynecol 2013; 2:87-93. [DOI: 10.5317/wjog.v2.i4.87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2013] [Revised: 04/24/2013] [Accepted: 06/19/2013] [Indexed: 02/05/2023] Open
Abstract
Hot flushes, experienced by 75% of menopausal women, are associated with estrogen deprivation. Estrogen was shown to ameliorate hot flushes by interacting with monoamine neurotransmitters in the brain; reducing noradrenaline and increasing serotonin. Hormone replacement therapy (HRT), the first treatment option, causes concerns over possible increased risks particularly breast cancer. Folic acid is involved in the biosynthesis of serotonin and nordrenaline, which is responsible for its effects on mood and cognition, and degrees of folate inadequacy, not severe enough to produce megaloblastic anaemia, were found to be associated with depression and cognitive malfunctioning. Also, increased age was observed to relate to reduced serum and cerebrospinal fluid folic acid levels. There is emerging evidence that folic acid supplementation ameliorates hot flushes by the same mechanism as estrogen. To explore this hypothesis, a multi-centre, double-blind, placebo-controlled randomized is being set up to compare the effect of 5 mg folic acid vs placebo in reducing the frequency and severity of hot flushes in postmenopausal women, and on the blood level of serotonin and noradrenaline. If folic acid supplementation is demonstrated to be effective, this will be a turning point in the clinical practice since it represents a cheap, safe and well-tolerated alternative to HRT.
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17
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Beydoun MA, Fanelli Kuczmarski MT, Beydoun HA, Hibbeln JR, Evans MK, Zonderman AB. ω-3 fatty acid intakes are inversely related to elevated depressive symptoms among United States women. J Nutr 2013; 143:1743-52. [PMID: 24005610 PMCID: PMC3796345 DOI: 10.3945/jn.113.179119] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Evidence that depressive symptoms are inversely related to n-3 (ω-3) fatty acids is growing among United States adults. We assessed whether self-reported depressive symptoms were inversely associated with n-3 fatty acid intakes by using a cross-sectional study in 1746 adults (aged 30-65 y) in Baltimore City, MD (2004-2009). The 20-item Center for Epidemiologic Studies-Depression Scale (CES-D) was used, with a CES-D score ≥16 suggestive of elevated depressive symptoms (EDS). By using the mean of two 24-h dietary recalls, n-3 highly unsaturated fatty acids (HUFAs; ≥20 carbons), n-3 polyunsaturated fatty acids (PUFAs; ≥18 carbons), and plausible ratios with n-6 (ω6) fatty acids were estimated. EDS prevalence was 18.1% among men and 25.6% among women. In women, the uppermost tertile (tertile 3) of n-3 PUFAs (compared with tertile 1) was associated with reduced odds of EDS by 49%, with a substantial sex differential. The n-3 PUFA:n-6:PUFA ratio was inversely related to EDS among women (tertile 2 vs. tertile 1, OR: 0.74; 95% CI: 0.41, 1.32; tertile 3 vs. tertile 1, OR: 0.47; 95% CI: 0.27, 0.83). A similar pattern was noted for n-3 HUFA:n-6 HUFA among women. For CES-D subscales, n-3 PUFA (% of energy) was inversely related to somatic complaints, whereas positive affect was directly related to n-3 HUFA (% of energy; total population and among women), n-3 HUFA:n-6 HUFA (women), and n-3 HUFA:n-6 PUFA (total population and among women). In sum, among United States women, higher intakes of n-3 fatty acids [absolute (n-3) and relative to n-6 fatty acids (n-3:n-6)] were associated with lower risk of elevated depressive symptoms, specifically in domains of somatic complaints (mainly n-3 PUFAs) and positive affect (mainly n-3 HUFAs).
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Affiliation(s)
- May A. Beydoun
- National Institute on Aging, Intramural Research Program, NIH, Baltimore, MD,To whom correspondence should be addressed. E-mail:
| | | | - Hind A. Beydoun
- Graduate Program in Public Health, Eastern Virginia Medical School, Norfolk, VA; and
| | - Joseph R. Hibbeln
- Nutritional Neurosciences Section, National Institute of Alcohol Abuse and Alcoholism, Intramural Research Program, NIH, Bethesda, MD
| | - Michele K. Evans
- National Institute on Aging, Intramural Research Program, NIH, Baltimore, MD
| | - Alan B. Zonderman
- National Institute on Aging, Intramural Research Program, NIH, Baltimore, MD
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18
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Quirk SE, Williams LJ, O’Neil A, Pasco JA, Jacka FN, Housden S, Berk M, Brennan SL. The association between diet quality, dietary patterns and depression in adults: a systematic review. BMC Psychiatry 2013; 13:175. [PMID: 23802679 PMCID: PMC3706241 DOI: 10.1186/1471-244x-13-175] [Citation(s) in RCA: 249] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Accepted: 06/21/2013] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Recent evidence suggests that diet modifies key biological factors associated with the development of depression; however, associations between diet quality and depression are not fully understood. We performed a systematic review to evaluate existing evidence regarding the association between diet quality and depression. METHOD A computer-aided literature search was conducted using Medline, CINAHL, and PsycINFO, January 1965 to October 2011, and a best-evidence analysis performed. RESULTS Twenty-five studies from nine countries met eligibility criteria. Our best-evidence analyses found limited evidence to support an association between traditional diets (Mediterranean or Norwegian diets) and depression. We also observed a conflicting level of evidence for associations between (i) a traditional Japanese diet and depression, (ii) a "healthy" diet and depression, (iii) a Western diet and depression, and (iv) individuals with depression and the likelihood of eating a less healthy diet. CONCLUSION To our knowledge, this is the first review to synthesize and critically analyze evidence regarding diet quality, dietary patterns and depression. Further studies are urgently required to elucidate whether a true causal association exists.
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Affiliation(s)
- Shae E Quirk
- School of Medicine, Deakin University, Geelong, Australia
| | - Lana J Williams
- School of Medicine, Deakin University, Geelong, Australia,Department of Psychiatry, The University of Melbourne, Parkville, Australia
| | - Adrienne O’Neil
- School of Medicine, Deakin University, Geelong, Australia,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Julie A Pasco
- School of Medicine, Deakin University, Geelong, Australia,Northwest Academic Centre, Department of Medicine, The University of Melbourne, Sunshine Hospital, 176 Furlong Road, St Albans, Australia
| | - Felice N Jacka
- School of Medicine, Deakin University, Geelong, Australia,Northwest Academic Centre, Department of Medicine, The University of Melbourne, Sunshine Hospital, 176 Furlong Road, St Albans, Australia,Orygen Youth Health Research Centre, Parkville, Australia
| | | | - Michael Berk
- School of Medicine, Deakin University, Geelong, Australia,Northwest Academic Centre, Department of Medicine, The University of Melbourne, Sunshine Hospital, 176 Furlong Road, St Albans, Australia,Orygen Youth Health Research Centre, Parkville, Australia,Mental Health Research Institute, Parkville, Australia
| | - Sharon L Brennan
- School of Medicine, Deakin University, Geelong, Australia,Department of Psychiatry, The University of Melbourne, Parkville, Australia,Northwest Academic Centre, Department of Medicine, The University of Melbourne, Sunshine Hospital, 176 Furlong Road, St Albans, Australia,Australian Institute for Musculoskeletal Science, The University of Melbourne, 176 Furlong Road, St Albans, Australia
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Beydoun MA, Beydoun HA, Boueiz A, Shroff MR, Zonderman AB. Antioxidant status and its association with elevated depressive symptoms among US adults: National Health and Nutrition Examination Surveys 2005-6. Br J Nutr 2013; 109:1714-29. [PMID: 22935166 PMCID: PMC3810278 DOI: 10.1017/s0007114512003467] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We examined the relationship of elevated depressive symptoms with antioxidant status. Cross-sectional data from the National Health and Nutrition Examination Surveys 2005–6 on US adults aged 20–85 years were analysed. Depressive symptoms were measured using the Patient Health Questionnaire with a score cut-off point of 10 to define ‘elevated depressive symptoms’. Serum antioxidant status was measured by serum levels of carotenoids, retinol (free and retinyl esters), vitamin C and vitamin E. The main analyses consisted of multiple logistic and zero-inflated Poisson regression models, taking into account sampling design complexity. The final sample consisted of 1798 US adults with complete data. A higher total serum carotenoid level was associated with a lower likelihood of elevated depressive symptoms with a reduction in the odds by 37 % overall with each sd increase in exposure, and by 34 % among women (P< 0·05). A dose–response relationship was observed when total serum carotenoids were expressed as quartiles (Q4 (1·62–10·1 μmol/l) v. Q1 (0·06–0·86 μmol/l): OR 0·41; 95 % CI 0·23, 0·76, P< 0·001; P for trend = 0·035), though no significant associations were found with the other antioxidant levels. Among carotenoids, β-carotene (men and women combined) and lutein+zeaxanthins (women only, after control for dietary lutein+zeaxanthin intake and supplement use) had an independent inverse association with elevated depressive symptoms among US adults. None of the other serum antioxidants had a significant association with depressive symptoms, independently of total carotenoids and other covariates. In conclusion, total carotenoids (mainly β-carotene and lutein+zeaxanthins) in serum were associated with reduced levels of depressive symptoms among community-dwelling US adults.
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Affiliation(s)
| | - Hind A. Beydoun
- Graduate Program in Public Health, Eastern Virginia Medical School,
Norfolk, VA
| | - Adel Boueiz
- Department of Internal Medicine, Johns Hopkins University,
Baltimore, MD
| | - Monal R. Shroff
- Department of Epidemiology, University of Michigan at Ann Arbor, Ann
Arbor, MI
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Guenther PM, Casavale KO, Kirkpatrick SI, Reedy J, Hiza HA, Kuczynski KJ, Kahle LL, Krebs-Smith SM. Update of the Healthy Eating Index: HEI-2010. J Acad Nutr Diet 2013; 113:569-80. [PMID: 23415502 PMCID: PMC3810369 DOI: 10.1016/j.jand.2012.12.016] [Citation(s) in RCA: 993] [Impact Index Per Article: 90.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Accepted: 12/21/2012] [Indexed: 12/25/2022]
Abstract
The Healthy Eating Index (HEI) is a measure of diet quality in terms of conformance with federal dietary guidance. Publication of the 2010 Dietary Guidelines for Americans prompted an interagency working group to update the HEI. The HEI-2010 retains several features of the 2005 version: (a) it has 12 components, many unchanged, including nine adequacy and three moderation components; (b) it uses a density approach to set standards, eg, per 1,000 calories or as a percentage of calories; and (c) it employs least-restrictive standards; ie, those that are easiest to achieve among recommendations that vary by energy level, sex, and/or age. Changes to the index include: (a) the Greens and Beans component replaces Dark Green and Orange Vegetables and Legumes; (b) Seafood and Plant Proteins has been added to capture specific choices from the protein group; (c) Fatty Acids, a ratio of polyunsaturated and monounsaturated to saturated fatty acids, replaces Oils and Saturated Fat to acknowledge the recommendation to replace saturated fat with monounsaturated and polyunsaturated fatty acids; and (d) a moderation component, Refined Grains, replaces the adequacy component, Total Grains, to assess overconsumption. The HEI-2010 captures the key recommendations of the 2010 Dietary Guidelines and, like earlier versions, will be used to assess the diet quality of the US population and subpopulations, evaluate interventions, research dietary patterns, and evaluate various aspects of the food environment.
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Affiliation(s)
- Patricia M. Guenther
- Center for Nutrition Policy and Promotion U.S. Department of Agriculture 3101 Park Center Dr., Ste. 1034 Alexandria, VA 22302 Telephone: 703-605-0253 Fax:703-305-3300
| | - Kellie O. Casavale
- Office of Disease Prevention and Health Promotion U.S. Department of Health and Human Services 1101 Wootton Pkwy., Ste. LL100 Rockville, MD 20852 Telephone: 240-453-8252 Fax: 240-453-8281
| | - Sharon I. Kirkpatrick
- Risk Factor Monitoring and Methods Branch Applied Research Program Division of Cancer Control and Population Sciences National Cancer Institute 6130 Executive Blvd. MSC 7344 Bethesda, MD 20892-7344 Telephone: 301-435-1638 Fax: 301-465-3710
| | - Jill Reedy
- Risk Factor Monitoring and Methods Branch Applied Research Program Division of Cancer Control and Population Sciences National Cancer Institute 6130 Executive Blvd. MSC 7344 Bethesda, MD 20892-7344 Telephone: 301-496-8500 Fax: 301-465-3710
| | - Hazel A.B. Hiza
- Center for Nutrition Policy and Promotion U.S. Department of Agriculture 3101 Park Center Dr., Ste. 1034 Alexandria, VA 22302 Telephone: 703-305-2979 Fax: 703-305-3300
| | - Kevin J. Kuczynski
- Center for Nutrition Policy and Promotion U.S. Department of Agriculture 3101 Park Center Dr., Ste. 1034 Alexandria, VA 22302 Telephone: 703-305-2153 Fax: 703-305-3300
| | - Lisa L. Kahle
- Information Management Services, Inc. 3901 Calverton Blvd, Suite 200 Calverton MD 20705 Telephone: 301-680-9770 Fax: 301-680-8304
| | - Susan M. Krebs-Smith
- Applied Research Program Division of Cancer Control and Population Sciences National Cancer Institute 6130 Executive Blvd. MSC 7344 Bethesda, MD 20892-7344 Telephone: 301-496-8500 Fax: 301-465-3710
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McMartin SE, Jacka FN, Colman I. The association between fruit and vegetable consumption and mental health disorders: evidence from five waves of a national survey of Canadians. Prev Med 2013; 56:225-30. [PMID: 23295173 DOI: 10.1016/j.ypmed.2012.12.016] [Citation(s) in RCA: 142] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Revised: 12/20/2012] [Accepted: 12/21/2012] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The objective of this study was to examine the association between fruit and vegetable intake (FVI) and mental health disorders. METHOD This study used data from the Canadian Community Health Survey (CCHS), a repeated cross-sectional study of Canadians with five waves between 2000 until 2009 (n=296,121 aged 12 years or older). FVI was assessed based on frequency of consumption. The primary outcome was a major depressive episode over the previous 12 months. Logistic regression models adjusted for age, gender, household income, education, physical activity, chronic illness and smoking. RESULTS In the first wave, greater FVI was significantly associated with lower odds of depression (OR: 0.85 95% CI:0.78-0.92). A combined estimate of all 5 waves demonstrated similar results (OR: 0.72; 95% CI: 0.71-0.75). Relative to those with the lowest FVI, those with the greatest FVI also had significantly lower odds of suffering from distress (OR: 0.87 95% CI: 0.78-0.98). These results were consistent across other waves. Perceived poor mental health status and previous diagnosis of a mood disorder and anxiety disorder also demonstrated statistically significant inverse associations with FVI (all p<0.05). CONCLUSION These findings suggest a potentially important role of a healthy diet in the prevention of depression and anxiety.
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Affiliation(s)
- Seanna E McMartin
- Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada
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Jacka FN, Mykletun A, Berk M. Moving towards a population health approach to the primary prevention of common mental disorders. BMC Med 2012; 10:149. [PMID: 23186355 PMCID: PMC3534562 DOI: 10.1186/1741-7015-10-149] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Accepted: 11/27/2012] [Indexed: 12/16/2022] Open
Abstract
There is a need for the development of effective universal preventive approaches to the common mental disorders, depression and anxiety, at a population level. Poor diet, physical inactivity and smoking have long been recognized as key contributors to the high prevalence noncommunicable diseases. However, there are now an increasing number of studies suggesting that the same modifiable lifestyle behaviors are also risk factors for common mental disorders. In this paper we point to the emerging data regarding lifestyle risk factors for common mental disorders, with a particular focus on and critique of the newest evidence regarding diet quality. On the basis of this most recent evidence, we consequently argue for the inclusion of depression and anxiety in the ranks of the high prevalence noncommunicable diseases influenced by habitual lifestyle practices. We believe that it is both feasible and timely to begin to develop effective, sustainable, population-level prevention initiatives for the common mental illnesses that build on the established and developing approaches to the noncommunicable somatic diseases.
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Affiliation(s)
- Felice N Jacka
- Deakin University, School of Medicine and Barwon Health, PO Box 281, Geelong, 3220, Australia
- The University of Melbourne, Department of Psychiatry, Parkville, 3010, Australia
| | - Arnstein Mykletun
- Norwegian Institute of Public Health, Division of Mental Health, Kalfarveien 31, 5018, Bergen, Norway
- University of New South Wales, School of Psychiatry, Black Dog Institute, Building Hospital Road, Prince of Wales Hospital, Randwick, 2031, Australia
| | - Michael Berk
- Deakin University, School of Medicine and Barwon Health, PO Box 281, Geelong, 3220, Australia
- The University of Melbourne, Department of Psychiatry, Parkville, 3010, Australia
- The Florey Institute of Neuroscience and Mental Health, Genetics Lane, Royal Parade, The University of Melbourne, Parkville, 3010, Australia
- Orygen Youth Health Research Centre, 35 Poplar Road, Parkville, 3052, Australia
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Andreeva VA, Galan P, Torrès M, Julia C, Hercberg S, Kesse-Guyot E. Supplementation with B vitamins or n-3 fatty acids and depressive symptoms in cardiovascular disease survivors: ancillary findings from the SUpplementation with FOLate, vitamins B-6 and B-12 and/or OMega-3 fatty acids (SU.FOL.OM3) randomized trial. Am J Clin Nutr 2012; 96:208-14. [PMID: 22648722 DOI: 10.3945/ajcn.112.035253] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Dietary factors might affect depressive symptoms. OBJECTIVE In secondary data analyses, we examined effects of supplementation with B vitamins or n-3 (omega-3) fatty acids on depressive symptoms in cardiovascular disease survivors. DESIGN The SUpplementation with FOLate, vitamins B-6 and B-12 and/or OMega-3 fatty acids (SU.FOL.OM3) trial was a secondary prevention trial (2003-2009; n = 2501) in which individuals aged 45-80 y were randomly assigned, by using a 2 × 2 factorial design, to receive 0.56 mg 5-methyl-tetrahydrofolate and vitamins B-6 (3 mg) and B-12 (0.02 mg); EPA and DHA (600 mg) in a 2:1 ratio; B vitamins and n-3 fatty acids; or a placebo. Depressive symptoms were evaluated at years 3 and 5 with the 30-item Geriatric Depression Scale (GDS). Overall and sex-specific ORs and 95% CIs were estimated in 2000 participants by using factorial logistic regression. RESULTS After a median of 4.7 y of supplementation, there was no association between allocation to receive B vitamins and depressive symptoms. However, the allocation to receive n-3 fatty acids was positively associated with depressive symptoms (GDS >10) in men (adjusted OR: 1.28; 95% CI: 1.03, 1.61) but not in women. CONCLUSIONS We showed no beneficial effects of a long-term, low-dose supplementation with B vitamins or n-3 fatty acids on depressive symptoms in cardiovascular disease survivors. The adverse effects of n-3 fatty acids in men merit confirmation.
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Affiliation(s)
- Valentina A Andreeva
- Nutritional Epidemiology Research Unit, University of Paris 13, Bobigny, France.
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Seppälä J, Koponen H, Kautiainen H, Eriksson JG, Kampman O, Männistö S, Mäntyselkä P, Oksa H, Ovaskainen Y, Viikki M, Vanhala M. Association between folate intake and melancholic depressive symptoms. A Finnish population-based study. J Affect Disord 2012; 138:473-8. [PMID: 22353381 DOI: 10.1016/j.jad.2012.01.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Accepted: 01/04/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND An association between low blood folate levels and depressive symptoms (DS) has been reported in several epidemiological studies, but no studies have examined folate intake in melancholic or non-melancholic DS in population-based samples. METHODS The aim of the study was to evaluate folate intake in DS with or without melancholic characteristics as a part of the Finnish diabetes prevention program (FIN-D2D). Altogether, 4500 randomly selected subjects aged 45-74 years were selected from the National Population Register. The study population (N=2806, participation rate 62%) consisted of 1328 men and 1478 women. The health examinations were carried out in 2007 according to the WHO MONICA project. The assessment of DS was based on the Beck Depression Inventory (BDI, cut-off≥10 points). A summary score of melancholic items in the BDI was used in dividing the participants with DS (N=429) into melancholic (N=138) and non-melancholic DS (N=291) subgroups. Folate intake was assessed using a validated food frequency questionnaire (FFQ). RESULTS DS associated linearly with gender specific tertiles of folate intake (p for linearity=0.003). The OR for melancholic DS was 0.55 (95%CI 0.34 to 0.90) for the high tertile of folate intake versus the low (p for linearity=0.018), while the ORs for non-melancholic DS were nonsignificant. LIMITATIONS Assessment of DS was based on a self-rating scale, and the population was in advanced middle-aged. CONCLUSIONS A low folate intake was associated with DS through its effect on melancholic DS.
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Affiliation(s)
- Jussi Seppälä
- Department of Psychiatry, South-Savo Hospital District, Mikkeli, Finland.
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Zhao G, Ford ES, Li C, Greenlund KJ, Croft JB, Balluz LS. Use of folic acid and vitamin supplementation among adults with depression and anxiety: a cross-sectional, population-based survey. Nutr J 2011; 10:102. [PMID: 21962075 PMCID: PMC3200167 DOI: 10.1186/1475-2891-10-102] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Accepted: 09/30/2011] [Indexed: 01/30/2023] Open
Abstract
Background Evidence suggests that folate deficiency may be causatively linked to depressive symptoms. However, little is known on the status of use of folic acid and vitamin supplements among people with mental disorders. This study examined the prevalence and the likelihood of use of folic acid or vitamin supplements among adults with depression and anxiety in comparison to those without these conditions. Methods Using data from 46, 119 participants (aged ≥ 18 years) in the 2006 Behavioral Risk Factor Surveillance System survey, we estimated the adjusted prevalence and odds ratios with 95% confidence intervals for taking folic acid and vitamin supplements among those with ever diagnosed depression (n = 8, 019), ever diagnosed anxiety (n = 5, 546) or elevated depressive symptoms (n = 3, 978, defined as having a depression severity score of ≥ 10 on the Patient Health Questionnaire-8 diagnostic algorithm). Results Overall, women were more likely than men to take folic acid supplements 1-4 times/day (50.2% versus 38.7%, P < 0.001) and vitamin supplements (62.5% versus 49.8%, P < 0.001). After multivariate adjustment, men with ever diagnosed depression or anxiety were 42% and 83%, respectively, more likely to take folic acid supplements < 1 time/day; 44% and 39%, respectively, more likely to take folic acid supplements 1-4 times/day; and 40% and 46%, respectively, more likely to take vitamin supplements compared to men without these conditions (P < 0.05 for all comparisons). Women with ever diagnosed depression were 13% more likely to take folic acid supplements 1-4 times/day and 15% more likely to take vitamin supplements than women without this condition (P < 0.05 for both comparisons). Use of folic acid and vitamin supplements did not differ significantly by elevated depressive symptoms in either sex. Conclusion The prevalence and the likelihood of taking folic acid and vitamin supplements varied substantially by a history of diagnosed depression among both men and women and by a history of diagnosed anxiety among men, but not by presence of elevated depressive symptoms in either sex.
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Affiliation(s)
- Guixiang Zhao
- Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
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Jacka FN, Pasco JA, Mykletun A, Williams LJ, Nicholson GC, Kotowicz MA, Berk M. Diet quality in bipolar disorder in a population-based sample of women. J Affect Disord 2011; 129:332-7. [PMID: 20888648 DOI: 10.1016/j.jad.2010.09.004] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2010] [Revised: 09/06/2010] [Accepted: 09/06/2010] [Indexed: 11/29/2022]
Abstract
BACKGROUND Recent epidemiological evidence has indicated a role for diet quality in unipolar depressive illness. This study examined the association between diet quality and bipolar disorder (BD) in an epidemiological cohort of randomly selected, population-based women aged 20-93 years. METHODS An a priori diet quality score was derived from food frequency questionnaire data, a factor analysis identified habitual dietary patterns and glycemic load was assessed. Mental health was assessed using the SCID-I/NP. RESULTS BD was identified in 23 women and there were 691 participants with no history of psychopathology. Compared to those with no psychopathology, those with BD had a higher glycemic load (p=0.06) and higher scores on a 'western' dietary factor (p=0.03) and the 'modern' dietary factor (p=0.02). For each standard deviation increase in a 'western' and 'modern' dietary pattern and glycemic load, the odds ratios for BD were increased ('western' OR=1.88, 95% CI 1.33-2.65; 'modern' OR=1.72, 95% CI 1.14-2.39; GL OR=1.56, 95% CI 1.13-2.14). Conversely, a 'traditional' dietary pattern was associated with reduced odds for BD (OR=0.53 95% CI 0.32-0.89) after adjustments for overall energy intake. LIMITATIONS The small sample size did not allow for multivariate analyses and the cross-sectional study design precludes any determinations regarding the direction of the relationships between diet quality and BD. CONCLUSION These data are largely concordant with results from dietary studies in unipolar depression. However, clinical recommendations cannot be made until the direction of the relationship between diet quality and BD is determined. Longitudinal studies are warranted.
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Affiliation(s)
- Felice N Jacka
- The University of Melbourne, Department of Clinical and Biomedical Sciences: Barwon Health, Geelong, Australia.
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Abstract
OBJECTIVE To examine, in a nationally representative sample of U.S. adults, the associations of serum folate, vitamin B-12, and total homocysteine (tHcy) levels with depressive symptoms. Several nutritional and physiological factors have been linked to depression in adults, including low folate and vitamin B-12 and elevated tHcy levels. METHODS Data on U.S. adults (age, 20-85 years; n = 2524) from the National Health and Nutrition Examination Survey during the period 2005 to 2006 were used. Depressive symptoms were measured with the Patient Health Questionnaire (PHQ), and elevated symptoms were defined as a PHQ total score of ≥10. Serum folate, vitamin B-12, and tHcy were mainly expressed as tertiles. Multiple ordinary least square (OLS), logistic, and zero-inflated Poisson regression models were conducted in the main analysis. RESULTS Overall, mean PHQ score was significantly higher among women compared with men. Elevated depressive symptoms (PHQ score of ≥10) were inversely associated with folate status, particularly among women (fully adjusted odds ratio [tertiles T(3) versus T(1)] = 0.37; 95% confidence interval, 0.17-0.86), but not significantly related to tHcy or vitamin B-12. No interaction was noted between the three exposures in affecting depressive symptoms. In older adults (≥50 years) and both sexes combined, tHcy was positively associated with elevated depressive symptoms (fully adjusted odds ratio [tertiles T(2) versus T(1)] = 3.01; 95% confidence interval, 1.01-9.03), although no significant dose-response relationship was found. CONCLUSIONS Future interventions to improve mental health outcomes among U.S. adults should take into account dietary and other factors that would increase levels of serum folate.
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Skarupski KA, Tangney C, Li H, Ouyang B, Evans DA, Morris MC. Longitudinal association of vitamin B-6, folate, and vitamin B-12 with depressive symptoms among older adults over time. Am J Clin Nutr 2010; 92:330-5. [PMID: 20519557 PMCID: PMC2904034 DOI: 10.3945/ajcn.2010.29413] [Citation(s) in RCA: 136] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND B-vitamin deficiencies have been associated with depression; however, there is very little prospective evidence from population-based studies of older adults. OBJECTIVE We examined whether dietary intakes of vitamins B-6, folate, or vitamin B-12 were predictive of depressive symptoms over an average of 7.2 y in a community-based population of older adults. DESIGN The study sample consisted of 3503 adults from the Chicago Health and Aging project, an ongoing, population-based, biracial (59% African American) study in adults aged > or =65 y. Dietary assessment was made by food-frequency questionnaire. Incident depression was measured by the presence of > or =4 depressive symptoms from the 10-item version of the Center for Epidemiologic Studies Depression scale. RESULTS The logistic regression models, which used generalized estimating equations, showed that higher total intakes, which included supplementation, of vitamins B-6 and B-12 were associated with a decreased likelihood of incident depression for up to 12 y of follow-up, after adjustment for age, sex, race, education, income, and antidepressant medication use. For example, each 10 additional milligrams of vitamin B-6 and 10 additional micrograms of vitamin B-12 were associated with 2% lower odds of depressive symptoms per year. There was no association between depressive symptoms and food intakes of these vitamins or folate. These associations remained after adjustment for smoking, alcohol use, widowhood, caregiving status, cognitive function, physical disability, and medical conditions. CONCLUSION Our results support the hypotheses that high total intakes of vitamins B-6 and B-12 are protective of depressive symptoms over time in community-residing older adults.
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Affiliation(s)
- Kimberly A Skarupski
- Section of Nutrition and Nutritional Epidemiology, Rush University Medical Center, Chicago, IL 60304, USA.
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