Aug 2026· Nutrients· Vol 18, pp. 2636· 0 citations· 100 references
Medicine
TL;DR
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.
Abstract
Background/Objectives: Studies suggest a potential link between dietary behaviors, inflammation, and depressive symptoms in adolescents, but longitudinal evidence remains scarce. This study examines the longitudinal associations among unhealthy diets, inflammatory markers, and depressive symptoms in Chinese adolescents. Methods: This prospective longitudinal study enrolled 1693 middle school students (52.3% female) from Yunnan Province, China. Participants were assessed at five waves: October 2022 (T1), June 2023 (T2), October 2023 (T3), June 2024 (T4), and October 2024 (T5). Unhealthy dietary behaviors were assessed using a Food Frequency Questionnaire, and depressive symptoms were measured with the Children’s Depression Inventory. Blood samples were collected to measure inflammatory markers. Generalized estimating equations, generalized linear models, and path analysis were applied to examine the associations and mediating pathways. Results: Prevalence of depressive symptoms increased from 26.3% to 37.3% over 2 years. Compared with Q1 (the lowest quartile), Q4 of unhealthy dietary scores was significantly associated with an increased risk of positive depression symptoms (adjusted OR = 1.20). IL-4 (β =−0.26–−0.17) and CRP (β = 0.64–1.07) were associated with depressive symptoms. However, the mediating role of inflammation in the association between unhealthy dietary scores and depressive symptoms was not statistically significant. Conclusions: Chinese adolescents exhibit both a high clustering of unhealthy dietary behaviors and notably elevated levels of inflammation. Our longitudinal study indicates that the clustering of unhealthy diets and inflammation levels are associated with depressive symptoms among Chinese adolescents.
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.
Junxiang Cheng, Ning Ma, Qia Liu et al.· BMC Psychiatry· 0 citations
Depression is one of the most prevalent mental health conditions among older adults in China, profoundly impairing quality of life and impeding healthy aging. Dietary diversity, as a comprehensive indicator of overall diet quality, has been associated with various chronic diseases and mental health outcomes. However, the association between longitudinal trajectories of the Dietary Diversity Score (DDS) and depressive symptoms among older adults remains poorly understood.
Using four waves of longitudinal data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) spanning 2008 to 2018, a total of 1,538 participants aged ≥65 years were included. Latent Class Growth Analysis (LCGA) was applied to identify distinct long-term DDS trajectories, with CESD-10 depressive scores assessed in 2018 serving as the primary outcome. Three multivariable linear regression models examined the associations between DDS trajectories and depressive scores with stepwise covariate adjustment. Binary logistic regression sensitivity analyses, subgroup analyses, and Restricted Cubic Spline (RCS) analyses were conducted to examine the association between the number of teeth and depressive scores.
LCGA identified three DDS trajectories: stable (Class 1,
n
= 946), high-decreasing (Class 2,
n
= 205), and low-increasing (Class 3,
n
= 387). In the fully adjusted model, compared with Class 1, Class 2 had lower depressive scores (
B
= −0.902, 95% CI: −1.800 to −0.005), whereas Class 3 had higher depressive scores (
B
= 0.901, 95% CI: 0.200–1.602). Sensitivity analyses confirmed that Class 3 was associated with a higher risk of depressive symptoms (OR = 1.405, 95% CI: 1.064–1.857). RCS analyses revealed a nonlinear association between the number of teeth and depressive scores (
p
< 0.001), with predicted depressive scores showing a pronounced and sustained decline when the number of teeth exceeded 20.
Long-term maintenance of higher dietary diversity was associated with lower depressive scores among Chinese older adults. A nonlinear dose–response relationship was observed between number of teeth and depressive symptoms. These findings suggest that maintaining greater dietary diversity in early aging, together with good oral health, higher health literacy, and better quality of life, may be associated with better mental health in older adults.
Jiafa Yang, Yuxia Xie, Fengting Hu et al.· Frontiers in Nutrition· 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
: Background: Sedentary behavior is associated with increased depressive symptoms, but longitudinal studies on this topic are lacking. This 3-year prospective cohort study aimed to determine whether baseline learning and screen time were associated with the risk of depressive symptoms during follow-up among Chinese college students. Methods: This study analyzed information about 1318 college students at Shenyang Normal University who were assessed at baseline in November 2017 and followed up annually from 2018 to November 2020. Sedentary behavior was evaluated using self-reported questionnaires about learning and screen time, and depressive symptoms were identified using the Zung Self-Rating Depression Scale. Associations between sedentary behavior and depressive symptoms were analyzed using logistic regression with sociodemographic and lifestyle covariates. Results: Logistic regression analysis indicated that the risk of depressive symptoms in the highest tertile (T3, >510 min/day) of learning time was lower than that in the lowest tertile (T1, ≤ 160 min/day) in the final adjusted model (Model 2: odds ratio [OR], 0.76; 95% confidence interval [CI], 0.58–1.00; p = 0.050). Conversely, students in the middle screen-time tertile (T2, 90–200 min/day) had a higher risk of depressive symptoms than those in the lowest tertile (T1, ≤ 90 min/day; Model 2: OR = 1.43, 95% CI = 1.08, 1.89, p = 0.01). Conclusions: Learning-related sedentary behavior might reduce the risk of depressive symptoms among college students, whereas screen time is positively associated with depressive symptoms. This emphasizes the importance of learning in preventing depression and highlights the need for careful consideration of the relationship between different types of sedentary behavior and the risk of depressive symptoms.
Yong Xu, Chunchun Wu, Yan Huang et al.· International Journal of Men...· 0 citations
Background Hypertension (HTN) affects 31.6% of Chinese adults and contributes to cardiovascular and cerebrovascular diseases through chronic inflammation. Pro-inflammatory diets, measured by the Dietary Inflammatory Index (DII), have been associated with increased HTN risk. However, evidence from tropical regions remains limited. As China’s only tropical province, Hainan has distinctive dietary patterns shaped by its geographic and climatic characteristics. This study aimed to examine the association between the DII and HTN among adults in Hainan to identify high-risk dietary patterns and inform targeted prevention strategies. Methods A cross-sectional study was conducted between 2020 and 2022 using a multistage sampling design to assess dietary intake among adults in Hainan. Data included demographic characteristics, height and weight, blood pressure assessments, and three-day dietary recalls. Quantile regression models were applied to evaluate the association between the DII and HTN. Subgroup analyses explored potential effect. Results A total of 826 adults were included, including 359 men (43.5%) and 467 women (56.5%). In unadjusted quantile regression, only new-onset HTN showed a significant inverse association with DII compared to normal blood pressure, confined to the median quantile (β = −0.96, 95% CI: −1.89 to −0.04; p = 0.040). However, this association was attenuated after adjustment for confounders and was no longer statistically significant (adjusted p > 0.05). Subgroup analyses revealed DII values were less likely to be at the median among female and Han Chinese with incident HTN, and among hypertensives aged 34–54 years, whereas in the 55–64 age group, those with incident HTN and no prior history were less likely to fall at the lower end of the DII distribution. No significant associations were found in males, ethnic minorities, or across occupational physical activity intensity categories. Conclusion This study suggests a potential relationship between dietary inflammatory potential and blood pressure in Hainan adults. No significant association persisted after full adjustment; however, an association between DII and new-onset HTN was observed at the median quantile in unadjusted models. Consistent trends in subgroup explorations indicate that pro-inflammatory dietary patterns may be associated with elevated blood pressure in specific populations, such as females, Han Chinese, and adults aged 34–64 years.
Yan Fu, Diyue Liu, Yinuo Cheng et al.· Frontiers in Nutrition· 0 citations
Background
Recently, the "weekend warrior" pattern, characterized by meeting recommended physical activity (PA) guidelines within one or two weekly sessions, has received increasing attention. However, its association with mental health outcomes remains unclear. This study aimed to examine the relationship between PA patterns and depressive symptoms.
Methods
This study analyzed data from 26,424 adults from the Korea National Health and Nutrition Examination Survey conducted in 2014, 2016, 2018, 2020, and 2022. PA was assessed by a self-reported questionnaire and classified according to World Health Organization guidelines for moderate-to-vigorous PA. Participants were categorized as inactive (<150 min/ wk), weekend warriors (≥150 min/wk over 1-2 days), or regularly active (≥150 min/wk over ≥3 days). Depressive symptoms were defined as a Patient Health Questionnaire-9 score ≥5. Associations were examined using multivariable logistic regression, stratified by sex and age.
Results
Prevalence of depressive symptoms among participants was 19.3%. The weekend warrior PA pattern was not significantly associated with depressive symptoms. Contrarily, the regularly active PA pattern was inversely associated with depressive symptoms (odds ratio [OR], 0.72; 95% confidence interval [CI], 0.66-0.79); this association remained significant after multivariable adjustment (OR, 0.81; 95% CI, 0.74-0.89). In stratified analyses by sex and age group, the regularly active group consistently showed an inverse association with depressive symptoms, whereas no significant association was observed for the weekend warrior PA pattern.
Conclusion
Regularity of physical activity may be more important for mental health than total activity volume alone.
Soyoung Kim, Esther Kim, Sung-il Cho· Korean Journal of Family Med...· 0 citations
