Fan Yaohua, Zhao Lijun, Deng Zhiyuan, Li Mengzhu, Huang Zifeng, Zhu Meiling, Xu Wenhua
Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine, Guangzhou University of Chinese Medicine, Shenzhen, China.
Gaozhou Hospital of Traditional Chinese Medicine, Gaozhou, China.
Front Psychiatry. 2022 Jul 15;13:936283. doi: 10.3389/fpsyt.2022.936283. eCollection 2022.
The Mediterranean diet (MED), a dietary pattern rich in fruits and vegetables, whole grains, legumes, nuts, fish, and olive oil, has anti-oxidative and anti-inflammatory effects. Although some data suggest that MED adherence is associated with decreased manifestation of depressive symptoms, it remains necessary to further analyze this apparent non-linear association as well as the influence of different factors on the relationship between MED and depression. Here, we investigated associations between the alternate MED (aMED) score and depressive symptom multivariate logistic regression, weighted generalized additive (GAM) and two-step linear regression models, analyzing data from the 2005-2018 National Health and Nutrition Examination Survey (NHANES). The most important factor relevant to aMED score that contributed to the prevalence of depressive symptom was assessed using random forest. Furthermore, we examined whether the relationship between aMED score and depressive symptom differs by age, race, sex, socioeconomic variables, lifestyle- and health-related variables, and chronic medical conditions, subgroup analyses. A total of 19,477 participants (20-80 years of age) were included in this cross-sectional study. In crude and adjusted (1-5) multivariate logistic regression models, increased aMED score was noted to associate with non-depressive status, as defined using the Patient Health Questionnaire-9 ( < 0.05). Data analyses GAM and two-piecewise linear regression revealed a non-linear association between aMED and depressive symptom, which had an inflection point of 3. Random forest results revealed that vegetable score contributes greatest to the relationship between aMED and depressive symptom. Subgroup analyses revealed that aMED score is significantly negatively related with depressive symptom in most different populations ( < 0.05) with the exception of high annual income, diabetes, borderline blood glucose level and Parkinson's disease (PD) ( > 0.05). In conclusion, we observed a non-linear association between aMED score and depressive symptom. Further studies are needed to validate our results.
地中海饮食（MED）是一种富含水果、蔬菜、全谷物、豆类、坚果、鱼类和橄榄油的饮食模式，具有抗氧化和抗炎作用。尽管一些数据表明，坚持地中海饮食与抑郁症状表现的减少有关，但仍有必要进一步分析这种明显的非线性关联以及不同因素对地中海饮食与抑郁症关系的影响。在此，我们使用多变量逻辑回归、加权广义相加模型（GAM）和两步线性回归模型，分析了2005 - 2018年美国国家健康与营养检查调查（NHANES）的数据，以研究替代地中海饮食（aMED）评分与抑郁症状之间的关联。使用随机森林评估了与aMED评分相关的、导致抑郁症状患病率的最重要因素。此外，我们通过亚组分析，研究了aMED评分与抑郁症状之间的关系是否因年龄、种族、性别、社会经济变量、生活方式和健康相关变量以及慢性疾病状况而有所不同。这项横断面研究共纳入了19477名参与者（年龄在20 - 80岁之间）。在粗模型和调整后的（1 - 5）多变量逻辑回归模型中，发现aMED评分升高与非抑郁状态相关，这是根据患者健康问卷 - 9定义的（<0.05）。数据分析采用GAM和两段式线性回归显示，aMED与抑郁症状之间存在非线性关联，其拐点为3。随机森林结果显示，蔬菜评分对aMED与抑郁症状之间的关系贡献最大。亚组分析显示，除了高年收入、糖尿病、血糖临界水平和帕金森病（PD）（>0.05）外，aMED评分在大多数不同人群中与抑郁症状显著负相关（<0.05）。总之，我们观察到aMED评分与抑郁症状之间存在非线性关联。需要进一步的研究来验证我们的结果。
