A positive correlation between the E-DII and both the risk and severity of adolescent depression is underscored, emphasizing the critical role of dietary factors in the prevention and management of adolescent depression.
Abstract
The global increase in adolescent Major Depressive Disorder (MDD) has profound implications for physical and mental development, contributing to a significant societal burden. Emerging evidence suggests that low-grade chronic inflammation, commonly observed in adolescents with MDD, is associated with the severity of the disorder. This study explores the relationship among dietary inflammation, dietary nutrients and adolescent depression, utilizing data from the Energy-adjusted Dietary Inflammatory Index (E-DII) in a population from northern China.
A case-control study was conducted between March 2022 and October 2023, involving 172 treatment-naïve adolescents aged 10–23 years diagnosed with MDD and 172 age- and sex-matched healthy controls. Although the calculated minimum sample size was 174 per group, two matched pairs were excluded during data cleaning because extreme dietary reporting could have biased nutrient intake estimation. The E-DII was derived using data from a validated semi-quantitative Chinese food frequency questionnaire (FFQ). Logistic regression was employed to evaluate the association between E-DII and the risk of adolescent MDD, while restricted cubic spline (RCS) functions assessed the dose-response relationships between specific dietary nutrient intakes and MDD.
A positive association was identified between the E-DII and the risk of adolescent MDD (OR = 3.24; 95% CI: 2.32–4.51;
P
< 0.001), which persisted after adjusting for potential confounders (OR = 3.23; 95% CI: 2.22–4.69;
P
< 0.001). Although an increase in E-DII score correlated with higher HAMD scores, intra-group differences were not statistically significant (
P
= 0.159). Several dietary nutrients, including Vitamin B12, dietary fiber, zinc, polyunsaturated fatty acids (PUFA), folate, and anthocyanins, were negatively associated with the risk of MDD in adolescents, whereas carbohydrates, selenium, and alcohol intake were positively associated with MDD risk (all
P
< 0.05). RCS analysis showed nonlinear dose–response relationships for PUFA, anthocyanins, vitamin B12, and alcohol intake, whereas selenium, zinc, folate, carbohydrates, and dietary fiber showed linear associations with MDD risk.
This study underscores a positive correlation between the E-DII and both the risk and severity of adolescent depression, emphasizing the critical role of dietary factors in the prevention and management of adolescent depression. From a clinical and public health perspective, early dietary assessment and promotion of anti-inflammatory dietary patterns may provide a feasible adjunctive strategy for reducing depression risk in adolescents.
Chinese adolescents exhibit both a high clustering of unhealthy dietary behaviors and notably elevated levels of inflammation, and the clustering of unhealthy diets and inflammation levels are associated with depressive symptoms among Chinese adolescents.
Honglv Xu, Dongyue Hu, Xiaoxiao Li et al.· Nutrients· 0 citations
HEI-2020 was inversely associated with PSD, with nonlinear and race-specific patterns and DI-GM showed a significant but inconsistent indirect association, suggesting a suppressive rather than mediating role.
Can Xing, Zhenhui Lu, Xiaoming Guo et al.· BMC Psychiatry· 0 citations
Longitudinal studies have shown an association between diet quality and depression. However, reverse causality, unmeasured confounding, and selection bias remained important limitations. We aim to examine the relationship between diet quality and depression in older adults while addressing these issues and explore modification role of genetic predisposition to depression and low-grade inflammation. We emulated a target trial of dietary interventions using data from the ASPREE cohort. An ultra-processed food (UPF) index and an anti-inflammatory diet measure were extracted from a food frequency questionnaire to quantify diet quality. Depressive symptoms were assessed annually with a Center for Epidemiologic Studies-Depression 10-item score of ≥8. A polygenic score was derived using the latest Psychiatric Genomics Consortium data for major depression. Systemic inflammation was assessed using circulating high-sensitivity C-reactive protein. Inverse probability treatment weighting was applied to balance measured confounders. The effects of diet quality on depressive symptoms were estimated using generalised estimating equations. A total of 7220 participants (52.7% female), aged 70+ years, were followed for a median of 5.7 years. High UPF consumption was associated with a higher risk of depressive symptoms (RR: 1.12, 95% CI: 1.03-1.21), while an anti-inflammatory diet was associated with lower depressive symptoms (RR: 0.93, 95% CI: 0.86-1.00). Genetic predisposition or low-grade inflammation did not modify the observed associations. Higher diet quality is associated with a lower risk of depressive symptoms, independent of genetic predisposition or low-grade inflammation, which may support dietary interventions as a modifiable lifestyle strategy for mental health promotion and prevention in older adults.
B. Mengist, Najmeh Davoodian, M. Lotfaliany et al.· Molecular Psychiatry· 0 citations
Background/Objectives: The relationship between diet and mental wellbeing is bidirectional: nutritional psychiatry examines effects of diet on mental health, whereas emotional-eating research focuses on the reverse. Although dose–response links between nutrient intake and health outcomes are well studied, few have analyzed such relationships between food-group intake and stress. Using cross-sectional data from a regional observational study of Japanese adolescents and young adults (males: n = 48, age = 32.3 ± 5.23; females: n = 124, age = 29.8 ± 5.77), we estimated dose–response associations between intake frequency of various food groups and stress responses. Methods: Mental and physical health was assessed using the response values for the mental and physical stress-reaction items in the Brief Job Stress Questionnaire. Intake frequency for each food group was obtained from a food frequency questionnaire (FFQ). Although the FFQ provides ordinal frequency categories, we demonstrate that structural equation modeling allows these data to be treated as integer values representing monthly intake frequency, enabling the estimation of associations with stress responses. Results: The analysis showed that, in females, the presence or absence of intake—rather than the frequency of intake—of dark-green and yellow vegetables was associated with the magnitude of stress responses. In contrast, for bread, noodles, and starchy foods, a monotonic positive association was observed between intake frequency and fatigue. Conclusions: Although these associations do not disentangle the bidirectional causal relationship between diet and mental–physical health, they provide evidence on the linear and nonlinear associations between food-group–specific intake frequencies and stress responses in the AYA population.
Makoto Hazama, H. Kagami-Katsuyama, Naohito Ito et al.· Nutrients· 0 citations
BACKGROUND
Consumption of processed foods has been steadily increasing in modern societies, raising concerns about their potential mental health effects.
AIM
This study aimed to investigate the association between food processing levels and depressive symptoms in a nationally representative sample of Korean adults and to explore potential biological mechanisms involving systemic inflammation.
METHODS
We analyzed data from 18,213 Korean adults (≥19 years) from the 2014-2020 KNHANES. Dietary intake, assessed via 24-hour recall and categorized by the NOVA classification, was used to estimate minimally processed food (MPF) and ultra-processed food (UPF) intake as percentages of total food and energy. Depressive symptoms were measured with the PHQ-9. Associations were examined using multivariable regression models, with item-level and exploratory indirect effect analyses conducted to explore symptom specificity and the role of systemic inflammation (via CRP) in a subsample.
RESULTS
In continuous models, higher MPF intake was associated with lower depressive symptoms (β = -0.040, 95% CI: -0.077 to -0.003), whereas UPF intake showed a positive association (β = 0.081, 95% CI: 0.032 to 0.130), with less consistent patterns in quartile-based analyses. Exploratory item-level analyses suggested associations with cognitive-affective symptoms that did not survive correction for multiple comparisons, while systemic inflammation statistically accounted for approximately 11.7% of the UPF-depressive symptom association.
CONCLUSIONS
In this nationally representative study, higher UPF intake was associated with greater depressive symptoms, while MPF intake showed an inverse relationship. These modest, exploratory findings warrant prospective and interventional studies examining the role of dietary modification in mental health.
Lita Kim, Jieun Noh, Eung Ju Park et al.· Psychiatry Research· 0 citations
Evidence linking overall dietary patterns with psychological health in older adults remains inconsistent, particularly in urban China. We derived dietary patterns among community-dwelling older adults in Shanghai and examined their associations with multiple psychological outcomes.
We analyzed cross-sectional baseline data from adults aged ≥60 years recruited at two community health service centers in Shanghai. Previous-month diet was assessed using a modified quantitative 25-item food-frequency questionnaire. Parallel analysis guided principal component analysis of 21 non-alcohol food groups; bootstrap resampling assessed pattern stability. The prespecified primary outcome was continuous K10 psychological distress; secondary outcomes were K10 ≥16 and the WHOQOL-BREF psychological-domain score. A reconstructed depressive-symptom composite and CD-RISC-10 were exploratory. Associations per 1-SD were estimated with HC3 linear or modified Poisson regression. Model 2, selected as the main parsimonious model in the revised analysis, adjusted for age, sex, district, and education. FDR correction was applied within four-pattern outcome families and globally across 12 main-model comparisons spanning primary and secondary outcomes.
Among 246 respondents, 233 were included in pattern derivation and the main regression analyses. Four components explained 45.28% of total variance; the fourth, characterized by sugar-sweetened beverages, showed limited bootstrap reproducibility and was treated as exploratory. No dietary pattern was associated with continuous K10 (all within-family FDR-adjusted
P
≥0.208) or K10 ≥16 (all within-family FDR-adjusted
P
≥0.459). In a secondary, hypothesis-generating analysis, each 1-SD higher sweet–fried–processed pattern score was associated with a 0.392-point lower WHOQOL psychological-domain score (β = −0.392, 95% CI −0.671 to −0.113; within-WHOQOL-family FDR-adjusted
P
= 0.024; global FDR-adjusted
P
= 0.073). No exploratory association with the depressive-symptom composite or CD-RISC-10 survived within-outcome-family FDR correction. The first three patterns and the secondary WHOQOL association were similar in three-component varimax and four-component promax analyses.
The analysis of the prespecified primary outcome, continuous K10 psychological distress, was null. The association between the sweet–fried–processed pattern and poorer psychological quality of life was secondary and hypothesis-generating. Given the cross-sectional design, small sample, and data-driven dietary assessment, prospective replication using validated dietary measures and external pattern validation is required.
Hao-Nan Shi, Zuo-Wei Wang, Jia Zhu et al.· Frontiers in Nutrition· 0 citations