Vagal Afferent Research Group, University of Adelaide, Adelaide, SA 5005, Australia; Nutrition, Diabetes and Gut Health, Lifelong Health, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA 5001, Australia.
Adelaide Medical School, University of Adelaide, Adelaide, SA 5005, Australia; Flinders Health and Medical Research Institute- Sleep Health, College of Medicine and Public Health, Flinders University, Bedford Park, SA 5042, Australia.
Clin Nutr. 2021 May;40(5):3631-3642. doi: 10.1016/j.clnu.2020.12.031. Epub 2020 Dec 29.
BACKGROUND & AIMS: Findings from observational studies investigating the association between Dietary Inflammatory Index (DII®) scores and depression symptoms (DepS) are inconsistent. This study aims to assess the association between energy-adjusted DII (E-DII™) and DepS using the North West Adelaide Health Study (NWAHS) cohort as well as update a previous meta-analysis.
A total of 1743 (mean ± SD age: 56.6 ± 13.6 years, 51% female) study participants from NWAHS were included in the cross-sectional study and 859 (mean ± SD age: 58.4 ± 12.1 years, 52.6% female) in the longitudinal analyses. The Center for Epidemiological Studies Depression Scale (CES-D) was used for the measurement of DepS. E-DII scores were calculated from the dietary data collected using a validated food frequency questionnaire (FFQ). Data from two stages [Stage 3 (2008-10) and North West 15 (NW15) (2015)] were used. Log- and negative binomial regression were used to assess the association between quartiles of E-DII and DepS. A recent meta-analysis was updated by including 12 publications (six cross-sectional and six cohort studies) on the association between DII and DepS.
In the cross-sectional analysis, a higher E-DII score (i.e., more pro-inflammatory diet) was associated with a 79% increase in odds of reporting DepS [OR: 1.79; 95% CI: 1.14-2.81; p = 0.01; p for trend (p) = 0.03]. Males with higher E-DII had a more than two-fold higher odds of DepS (OR: 2.27; 95% CI: 1.02-5.06; p = 0.045; p = 0.09). Females with higher E-DII had an 81% increase in odds of DepS (OR: 1.81; 95% CI: 1.01-3.26; p = 0.046; p = 0.07). These associations were consistent in the longitudinal analysis. Comparing highest to lowest quintiles of E-DII, the updated meta-analysis showed that a pro-inflammatory diet is associated with a 45% increase in odds of having DepS (OR: 1.45; 95% CI: 1.20-1.74; p < 0.01) with higher odds in females (OR: 1.53; 95% CI: 1.16-2.01; p = 0.01) compared to their male counterparts (OR: 1.29; 95% CI: 0.98-1.69; p = 0.15).
The data from the NWAHS and the updated meta-analysis of observational studies provide further evidence that a pro-inflammatory diet is positively associated with increased risk of DepS. These findings support the current recommendation on consuming a less inflammatory diet to improve DepS.
观察性研究调查饮食炎症指数（DII®）评分与抑郁症状（DepS）之间关联的结果不一致。本研究旨在使用西北阿德莱德健康研究（NWAHS）队列评估能量调整的 DII（E-DII™）与 DepS 之间的关联，并更新之前的荟萃分析。
共有 1743 名（平均年龄±标准差：56.6±13.6 岁，51%为女性）来自 NWAHS 的研究参与者被纳入横断面研究，859 名（平均年龄±标准差：58.4±12.1 岁，52.6%为女性）被纳入纵向分析。使用流行病学研究抑郁量表（CES-D）来测量 DepS。E-DII 评分是从使用经过验证的食物频率问卷（FFQ）收集的饮食数据中计算得出的。使用来自两个阶段[第 3 阶段（2008-10 年）和西北 15 期（NW15）（2015 年）]的数据。使用对数和负二项回归来评估 E-DII 四分位数与 DepS 之间的关联。通过纳入 12 项关于 DII 与 DepS 关联的出版物（6 项横断面研究和 6 项队列研究），更新了最近的荟萃分析。
在横断面分析中，较高的 E-DII 评分（即更促炎饮食）与报告 DepS 的几率增加 79%相关[比值比：1.79；95%置信区间：1.14-2.81；p=0.01；趋势检验的 p 值（p）=0.03]。男性中 E-DII 较高者出现 DepS 的几率高出两倍以上（比值比：2.27；95%置信区间：1.02-5.06；p=0.045；p=0.09）。女性中 E-DII 较高者出现 DepS 的几率增加 81%（比值比：1.81；95%置信区间：1.01-3.26；p=0.046；p=0.07）。这些关联在纵向分析中是一致的。与 E-DII 的最高五分位数相比，更新的荟萃分析显示，促炎饮食与出现 DepS 的几率增加 45%相关（比值比：1.45；95%置信区间：1.20-1.74；p<0.01），女性出现 DepS 的几率更高（比值比：1.53；95%置信区间：1.16-2.01；p=0.01），而男性出现 DepS 的几率较低（比值比：1.29；95%置信区间：0.98-1.69；p=0.15）。
来自 NWAHS 的数据和观察性研究的荟萃分析更新进一步表明，促炎饮食与增加 DepS 风险呈正相关。这些发现支持目前关于摄入较少促炎饮食以改善 DepS 的建议。
