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Dietary pattern and depressive symptoms in middle age

  • Tasnime N. Akbaraly (a1), Eric J. Brunner (a2), Jane E Ferrie (a2), Michael G. Marmot (a2), Mika Kivimaki (a2) and Archana Singh-Manoux (a3)...
Abstract
Background

Studies of diet and depression have focused primarily on individual nutrients.

Aims

To examine the association between dietary patterns and depression using an overall diet approach.

Method

Analyses were carried on data from 3486 participants (26.2% women, mean age 55.6 years) from the Whitehall II prospective cohort, in which two dietary patterns were identified: ‘whole food’ (heavily loaded by vegetables, fruits and fish) and ‘processed food’ (heavily loaded by sweetened desserts, fried food, processed meat, refined grains and high-fat dairy products). Self-reported depression was assessed 5 years later using the Center for Epidemiologic Studies – Depression (CES–D) scale.

Results

After adjusting for potential confounders, participants in the highest tertile of the whole food pattern had lower odds of CES–D depression (OR = 0.74, 95% CI 0.56–0.99) than those in the lowest tertile. In contrast, high consumption of processed food was associated with an increased odds of CES–D depression (OR = 1.58, 95% CI 1.11–2.23).

Conclusions

In middle-aged participants, a processed food dietary pattern is a risk factor for CES–D depression 5 years later, whereas a whole food pattern is protective.

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Copyright
Corresponding author
Tasnime N. Akbaraly, Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK. Email: tasnime.akbaraly@inserm.fr
Footnotes
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T.N.A. is sponsored by the Academy of Finland (projects 117604, 124322). A.S.-M. is supported by a European Young Investigator Award from the European Science Foundation. M.G.M. is supported by a Medical Research Council (MRC) research professorship. J.E.F. is supported by the MRC (grant G8802774) and M.K. is supported by the Academy of Finland. The Whitehall II study has been supported by grants from the MRC, the British Heart Foundation, the UK Health and Safety Executive, the UK Department of Health, the US National Heart, Lung and Blood Institute (grant HL36310), the US National Institute on Aging (grant AG13196), the US Agency for Health Care Policy and Research (grant HS06516) and the John D. and Catherine T. MacArthur Foundation Research Networks on Successful Midlife Development and Socio-economic Status and Health.

Declaration of interest

None.

Footnotes
References
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6 Kamphuis, MH, Geerlings, MI, Grobbee, DE, Kromhout, D. Dietary intake of B(6-9-12) vitamins, serum homocysteine levels and their association with depressive symptoms: the Zutphen Elderly Study. Eur J Clin Nutr 2008; 62: 939–45.
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10 Marmot, M, Brunner, E. Cohort profile: the Whitehall II study. Int J Epidemiol 2005; 34: 251–6.
11 Brunner, E, Stallone, D, Juneja, M, Bingham, S, Marmot, M. Dietary assessment in Whitehall II: comparison of 7 d diet diary and food-frequency questionnaire and validity against biomarkers. Br J Nutr 2001; 86: 405–14.
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13 Bingham, SA, Gill, C, Welch, A, Cassidy, A, Runswick, SA, Oakes, S, et al. Validation of dietary assessment methods in the UK arm of EPIC using weighed records, and 24-hour urinary nitrogen and potassium and serum vitamin C and carotenoids as biomarkers. Int J Epidemiol 1997; 26 (suppl 1): S13751.
14 Akbaraly, TN, Singh-Manoux, A, Marmot, MG, Brunner, EJ. Education attenuates the association between dietary patterns and cognition. Dement Geriatr Cogn Disord 2009; 27: 147–54.
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Dietary pattern and depressive symptoms in middle age

  • Tasnime N. Akbaraly (a1), Eric J. Brunner (a2), Jane E Ferrie (a2), Michael G. Marmot (a2), Mika Kivimaki (a2) and Archana Singh-Manoux (a3)...
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eLetters

Dietary pattern can influence inflammation status and IDO activity

Dietmar Fuchs, University Professor
11 December 2009

With great interest we read the study by Akbaraly and coworkers in which an association between dietary patterns and depressive mood was described in middle-aged healthy individuals.1 A processed food dietary pattern was found as a risk factor for depression 5 years later according to the Center for Epidemiologic Studies – Depression scale(CES-D) whereas a whole food pattern was protective. Thus, results suggestthat healthy eating habits like frequent consumption of fruits, vegetablesand fish may play an important protective role, whereas processed food maypromote inflammatory processes. Especially this latter aspect may deserve special attention because of its relationship to the biochemistry of 5-hydroxytryptamine (serotonin, 5HT) which is considered as one of the crucial players in the pathogenesis of depression.2

Pro-inflammatory responses and related cytokine cascades such as the production of Th1-type cytokine interferon-gamma are well characterized for their antiproliferative activity against infected or malignant cells. One of the most important strategies thereby is the induction of tryptophan degrading enzyme indoleamine 2,3-dioxygenase (IDO). In patientswith infectious diseases and in cancer an association was observed betweenlowered tryptophan levels due to a higher degradation rate and the development of psychiatric symptoms like depression and cognitive impairment.3,4 Notably, in vitro studies showed that anti-oxidant compounds like vitamin C and E and resveratrol are to not only able to down-regulate the inflammatory responses, e.g., neopterin production, in stimulated peripheral mononuclear cells but also suppress the activity of IDO and thus counteract tryptophan degradation.5,6 No such data are available from patients but an inverse relationship was found between increased immune activation status and diminished concentrations of several antioxidant vitamins in patients with cardiovascular disease.7 With this background it will be important to investigate whether the relationship found between dietary patterns and depressive mood is associated with changes of serum/plasma tryptophan concentrations.

References

1 Akbaraly TN, Brunner EJ, Ferrie JE, Marmot MG, Kivimaki M, Singh-Manoux A. Dietary pattern and depressive symptoms in middle age. Br J Psychiatry 2009; 195: 408-13.2 Widner B, Laich A, Sperner-Unterweger B, Ledochowski M, Fuchs D. Neopterin production tryptophan degradation and mental depression: what isthe link? Brain Behav Immun 2002; 16: 590-5.3 Huang A, Fuchs D, Widner B, Glover C, Henderson DC, Allen-Mersh TG. Serum tryptophan decrease correlates with immune activation and impaired quality of life in colorectal cancer. Brit J Cancer 2002; 86: 1691-6.4 Schroecksnadel K, Sarcletti M, Winkler C, Mumelter B, Wiee G, Fuchs D, Zangerle R. Quality of life and immune activation in patients with HIV infection. Brain Behav Immun 2008; 22: 881-9.5 Winkler C, Schroecksnadel K, Schennach H, Fuchs D. Vitamin C and E suppress mitogen-stimulated peripheral blood mononuclear cells in vitro. Int Arch Allergy Immunol 2007; 142: 127-32.6 Wirleitner B, Schroecksnadel K, Winkler C, Schennach H, Fuchs D. Resveratrol suppresses interferon-gamma-induced biochemical pathways in human peripheral blood mononuclear cells in vitro. Immunol Lett 2005; 100:159-63.7 Murr C, Schroecksnadel K, Winklhofer-Roob BM, Mangge H, Böhm BO, Winkelmann BR, Maerz W, Fuchs D. Inverse association between serum concentrations of neopterin and antioxidants in patients with and without angiographic coronary artery disease. Atherosclerosis 2009; 202: 543-9.
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