Pham Khue M, Pham Linh V, Phan Dung T, Tran Tien V, Nguyen Hoang C, Nguyen Minh H, Nguyen Huu C, Ha Tung H, Dao Hung K, Nguyen Phuoc B, Trinh Manh V, Do Thinh V, Nguyen Hung Q, Nguyen Thao T P, Nguyen Nhan P T, Tran Cuong Q, Tran Khanh V, Duong Trang T, Nguyen Lam V, Do Thao T, Vo Tam T, Do Binh N, Duong Thai H, Pham Thu T M, Le Thuy T, Do Ngoc T, Nguyen Hoai T T, Mai Thuy T T, Ha Dung T, Ngo Huong T M, Nguyen Kien T, Yang Shwu-Huey, Chao Jane C-J, Duong Tuyen Van
Faculty of Public Health, Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam.
President Office, Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam.
Front Nutr. 2020 Nov 16;7:581043. doi: 10.3389/fnut.2020.581043. eCollection 2020.
The COVID-19 pandemic causes a huge burden for affected countries. Several public health interventions were applied to contain the infection. However, the pandemic itself and the lockdown measure negatively influence people's lifestyles and psychological health. To explore determinants of healthy dietary intake and depression, and examine the interaction between healthy dietary intake and COVID-19 lockdown on depression. A cross-sectional study was conducted at 18 hospitals and health centers from February 14 to May 31, 2020. Data of 8,291 outpatients were collected including patients' characteristics, clinical parameters, health literacy, healthy dietary intake (using the healthy eating score, HES), other health-related behaviors, and depression (using the patient health questionnaire, PHQ). Depression was defined as PHQ score ≥ 10. Protective factors of healthy dietary intake and depression were higher education, better medication payment ability, higher social status, more physical activity, and higher health literacy, whereas older age, ever married, own business or other types of occupation, lockdown, suspected COVID-19 symptoms, and comorbidity were associated with lower HES scores and a higher depression likelihood. Besides, overweight/obesity and alcohol drinking were associated with lower HES scores. As compared with patients not under lockdown and with lowest HES score, those who were under lockdown and with lowest HES score had 10.6 times higher depression likelihood (odds ratio, OR, 10.60; 95% CI 6.88, 16.32; < 0.001), whereas people with higher HES score had 15% lower depression likelihood (OR 0.85; 95% CI 0.82, 0.89; < 0.001). Healthy dietary intake and depression were determined by several sociodemographic, clinical, and behavioral factors. Lockdown measure affects people's dietary intake behavior and depression. Importantly, healthy dietary intake potentially modifies the negative effect of lockdown on depression.
新冠疫情给受影响国家带来了巨大负担。为控制感染，采取了多项公共卫生干预措施。然而，疫情本身及封锁措施对人们的生活方式和心理健康产生了负面影响。为探究健康饮食摄入和抑郁的决定因素，并考察健康饮食摄入与新冠疫情封锁对抑郁的相互作用。于2020年2月14日至5月31日在18家医院和健康中心开展了一项横断面研究。收集了8291名门诊患者的数据，包括患者特征、临床参数、健康素养、健康饮食摄入（采用健康饮食评分，HES）、其他与健康相关的行为以及抑郁情况（采用患者健康问卷，PHQ）。抑郁定义为PHQ评分≥10分。健康饮食摄入和抑郁的保护因素包括高等教育、更好的药物支付能力、较高的社会地位、更多的体育活动以及较高的健康素养，而年龄较大、已婚、自营企业或其他职业类型、封锁、疑似新冠症状以及合并症与较低的HES评分和较高的抑郁可能性相关。此外，超重/肥胖和饮酒与较低的HES评分相关。与未处于封锁状态且HES评分最低的患者相比，处于封锁状态且HES评分最低的患者抑郁可能性高10.6倍（比值比，OR，10.60；95%置信区间6.88，16.32；P<0.001），而HES评分较高的人群抑郁可能性低15%（OR 0.85；95%置信区间0.82，0.89；P<0.001）。健康饮食摄入和抑郁由多种社会人口学、临床和行为因素决定。封锁措施影响人们的饮食摄入行为和抑郁。重要的是，健康饮食摄入可能会减轻封锁对抑郁的负面影响。
