Department of Epidemiology and Health Statistics, the College of Public Health of Qingdao University, 308 Ningxia Road, Qingdao, Shandong 266071, People's Republic of China.
School of Mathematics and Statistics, Qingdao University, Qingdao 266071, PR China.
Food Funct. 2023 Oct 16;14(20):9204-9211. doi: 10.1039/d3fo00642e.
The impact of dietary diversity on depressive symptoms remains one-sided. We aim to explore the associations between all aspects of dietary diversity and the risk of depressive symptoms in US adults and their dose-response relationships. We selected 16 820 adults from the National Health and Nutrition Examination Survey (NHANES) from 2013 to 2018. Depressive symptoms were assessed using patient health questionnaire-9 (PHQ-9). Dietary diversity contains four indexes: count (dietary diversity score, DDS), evenness (Healthy Food Diversity Index, HFDI), dissimilarity (Jaccard distance, JD), and quality (Healthy Eating Index, HEI). Binary logistic regression was conducted to assess relationships between the four aspects of dietary diversity and depressive symptoms in whole and subgrouped populations. A restricted cubic spline was performed to explore the dose-response relationships. We revealed that DDS [0.20 (0.05, 0.73)], HFDI [0.51 (0.28, 0.94)], and HEI [0.46 (0.26, 0.80)] were inversely associated with the risk of depressive symptoms for the highest VS lowest quintile, especially in females and elders. Analysis of dose-response relationships determined linear relationships of DDS, HEI and depressive symptoms, while an "L" shaped relationship of HFDI and depressive symptoms. Adequate dietary diversity showed a significant effect on decreasing the risk of depressive symptoms at a score of 4 in DDS, 0.3 in HFDI, and a score of 51 in HEI. In conclusion, this study found that higher levels of dietary diversity, including count, evenness, and quality, might be protective factors against depressive symptoms, especially in females and elders. The DDS, HFDI, and HEI scores are recommended as 4, 0.3, and 51, respectively. Further investigation is needed to validate our results.
饮食多样性对抑郁症状的影响仍然是片面的。我们旨在探讨美国成年人饮食多样性的各个方面与抑郁症状风险之间的关联及其剂量反应关系。我们从 2013 年至 2018 年的国家健康和营养检查调查（NHANES）中选择了 16820 名成年人。使用患者健康问卷-9（PHQ-9）评估抑郁症状。饮食多样性包含四个指标：计数（饮食多样性评分，DDS）、均匀度（健康食品多样性指数，HFDI）、差异度（杰卡德距离，JD）和质量（健康饮食指数，HEI）。使用二元逻辑回归评估四个方面的饮食多样性与全人群和亚组人群中抑郁症状之间的关系。使用限制性立方样条探索剂量反应关系。我们发现，DDS[0.20（0.05，0.73）]、HFDI[0.51（0.28，0.94）]和 HEI[0.46（0.26，0.80）]与最高五分位数与最低五分位数相比，与抑郁症状风险呈负相关，尤其是在女性和老年人中。剂量反应关系分析确定了 DDS、HEI 和抑郁症状之间的线性关系，而 HFDI 和抑郁症状之间呈“L”形关系。适当的饮食多样性在 DDS 得分为 4、HFDI 得分为 0.3 和 HEI 得分为 51 时，对降低抑郁症状风险有显著影响。总之，本研究发现，较高水平的饮食多样性，包括计数、均匀度和质量，可能是预防抑郁症状的保护因素，尤其是在女性和老年人中。建议 DDS、HFDI 和 HEI 得分分别为 4、0.3 和 51。需要进一步的研究来验证我们的结果。
