Cong Xiao, Tracy Melissa, Edmunds Lynn S, Hosler Akiko S, Appleton Allison A
Department of Epidemiology and Biostatistics, School of Public Health, State University of New York at Albany, 1 University Place, Rensselaer, NY 12144, United States.
Division of Nutrition, New York State Department of Health, USA.
Brain Behav Immun Health. 2020 Feb;2:100017. doi: 10.1016/j.bbih.2019.100017.
Inflammation may be a hidden process in the relationship between dietary intake and depression, but no study has evaluated the role of diet and inflammation jointly in explaining depression risk in early life. The current study aims to investigate the relationship between inflammatory dietary pattern (IDP) in childhood and depression in early adulthood.
This study used data prospectively collected over 10 years from the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort (n = 6939) free from depression at baseline (age 8.5 years). An IDP score was empirically derived via reduced rank regression and stepwise linear regression based on dietary intake data from the food frequency questionnaire at 8.5 years and levels of inflammatory biomarkers, C-reactive protein and interleukin-6, at 9.5 years. At age 18 years, depression cases were identified via the International Statistical Classification of Diseases, 10th Revision (ICD-10) diagnosis and the Clinical Interview Schedule-Revised (CIS-R) depression score. Logistic regression models were constructed to examine the relationship between the IDP score and risk of depression adjusted for potential confounders. Analyses stratified by weight status were also conducted. Multiple imputations were utilized to minimize bias due to loss-to-follow-up.
Participants in the highest tertile of IDP score had 1.34 times odds to develop depression compared to those in the lowest tertile (95% CI, 1.08-1.66; -trend<0.01), after dietary misreporting status and energy intake were adjusted. After all covariates were adjusted, the relationship between IDP tertiles and depression was attenuated (highest tertile vs. lowest tertile: OR = 1.21; 95% CI, 0.96-1.51); in addition, the relationship was marginally significant among participants who were not overweight or obese (p < 0.10) but not significant among participants who were overweight or obese.
Higher IDP in childhood seems to be associated with higher depression risk in early adulthood. The study provides preliminary evidence that chronic inflammation may underlie the relationship between diet and depression even for children, especially those who are not overweight or obese.
炎症可能是饮食摄入与抑郁症之间的一个隐藏过程，但尚无研究评估饮食和炎症在解释早期生活中抑郁症风险方面的联合作用。本研究旨在调查儿童期炎症性饮食模式（IDP）与成年早期抑郁症之间的关系。
本研究使用了从埃文亲子纵向研究（ALSPAC）队列中前瞻性收集的10年数据（n = 6939），这些参与者在基线时（8.5岁）无抑郁症。IDP得分是根据8.5岁时食物频率问卷中的饮食摄入数据以及9.5岁时炎症生物标志物C反应蛋白和白细胞介素-6的水平，通过降秩回归和逐步线性回归经验性得出的。在18岁时，通过国际疾病分类第10版（ICD-10）诊断和修订后的临床访谈时间表（CIS-R）抑郁症评分来确定抑郁症病例。构建逻辑回归模型以检验IDP得分与经潜在混杂因素调整后的抑郁症风险之间的关系。还进行了按体重状况分层的分析。采用多重插补法以尽量减少失访导致的偏差。
在调整了饮食误报状况和能量摄入后，IDP得分处于最高三分位数的参与者患抑郁症的几率是最低三分位数参与者的1.34倍（95%可信区间，1.08 - 1.66；趋势p<0.01）。在调整了所有协变量后，IDP三分位数与抑郁症之间的关系减弱（最高三分位数与最低三分位数相比：比值比 = 1.21；95%可信区间，0.96 - 1.51）；此外，这种关系在非超重或肥胖的参与者中具有边缘显著性（p<0.10），但在超重或肥胖的参与者中不显著。
儿童期较高的IDP似乎与成年早期较高的抑郁症风险相关。该研究提供了初步证据，表明慢性炎症可能是饮食与抑郁症之间关系的基础，即使对于儿童也是如此，尤其是那些非超重或肥胖的儿童。
