Elsevier

Nutrition

Volume 54, October 2018, Pages 48-53
Nutrition

Applied nutritional investigation
Exploration of the association between dietary fiber intake and depressive symptoms in adults

https://doi.org/10.1016/j.nut.2018.03.009Get rights and content

Highlights

  • The association of dietary fiber intake with depressive symptoms is controversial.

  • Total, vegetable, and fruit fiber were inversely associated with depressive symptoms.

  • A nonlinear association was found between total fiber intake and depressive symptoms.

Abstract

Objective

Current evidence on the association between dietary fiber intake and the risk of depressive symptoms is inconsistent. Thus, the purpose of the present study was to explore their association.

Methods

Data from the National Health and Nutrition Examination Survey 2007 to 2014 were used in this cross-sectional study. Dietary data were obtained through two 24-h dietary recall interviews. Depressive symptoms were assessed using Patient Health Questionnaire. Logistic regression models and restricted cubic spline models were applied to evaluate the associations among dietary intakes of total, cereal, vegetable, and fruit fiber and depressive symptoms.

Results

A total of 16 807 adults ages 20 y or older were included in this study. Dietary intakes of total, cereal, vegetable, and fruit fiber were inversely associated with depressive symptoms in unadjusted model and multivariate-adjusted model 1. In multivariate-adjusted model 2, the odds ratios (95% confidence intervals) of depressive symptoms were 0.59 (0.44–0.79), 0.90 (0.69–1.19), 0.58 (0.45–0.76), and 0.64 (0.45–0.92) for the highest versus lowest quartile of total, cereal, vegetable, and fruit fiber intakes, respectively. Dose-response analyses found that the risk of depressive symptoms was associated with total fiber intake in a nonlinear manner, whereas the relationships were linear with cereal, vegetable, and fruit fiber intakes.

Conclusions

Our study suggested that intakes of total fiber, vegetable fiber, and fruit fiber were inversely associated with depressive symptoms. Further larger prospective studies are needed to confirm our findings.

Introduction

Depression is a common mental disorder worldwide. In 2015, more than 300 million people of all ages suffered from depression, equivalent to 4.4% of the world's population [1]. Depression has been ranked by the World Health Organization as the single largest contributor to global disability and the major contributor to suicide deaths [1], [2]. Epidemiologic studies have suggested that depression increased the risks of all-cause mortality and cardiovascular-related mortality [3], [4]. Moreover, depression was often comorbid with chronic diseases, which incrementally worsened the health state of people [5], [6], [7], [8]. Therefore, it is necessary to identify the potentially modifiable risk factors to reduce the risk of depression.

Epidemiologic evidence has revealed the associations between depression and dietary factors, such as fish [9], fruit [10], vegetables [10], and some nutrients (folate [11] and zinc and iron [12]). Dietary fiber is a group of food components derived mainly from cereals, vegetables, and fruit. Previous studies have suggested that dietary fiber may have protective effects on several diseases, such as endometrial cancer [13], type 2 diabetes [14], and inflammatory bowel disease [15]. Some epidemiologic studies have also reported that dietary fiber intake could alter the profile of intestinal microbiota [16], and the intestinal microbiota might modulate the function of brain-gut axis, a bidirectional communication system between the central nervous system and gastrointestinal tract [17]. Thus, dietary fiber intake may be associated with a reduced risk of depression.

To date, some studies [18], [19], [20], [21], [22], [23] have explored the relationship between dietary fiber intake and depressive symptoms. A cohort study [21] indicated that higher consumption of dietary fiber was associated with a decreased risk of depressive symptoms among American postmenopausal women. A case-control study [20] performed among Korean adolescent girls and a cross-sectional study [23] performed among an elderly Chinese population also suggested such a significantly inverse association. However, two cross-sectional studies [19], [22] reported no statistically significant association in older Australian and Japanese population. Meanwhile, one cross-sectional study performed in Japanese employees [18] suggested that the risk of depressive symptoms was significantly associated with vegetable and fruit fiber intake but not with total, cereal, soluble, and insoluble fiber intakes. Previous studies on the association of dietary fiber intake with depressive symptoms were conducted among specific population, and the results are controversial. Thus, the purpose of the present study was to evaluate the associations among dietary intakes of total, cereal, vegetable, and fruit fiber and depressive symptoms in US adults using data from the National Health and Nutrition Examination Survey (NHANES) 2007 to 2014.

Section snippets

Study population

NHANES is designed to assess the health and nutritional status of US population, with a complex, multistage probability sampling design to select a representative sample of the civilian non-institutionalized US population [24]. NHANES participants were first interviewed in their homes and then completed the health examination in a mobile examination center (MEC). Survey data are released in 2-y cycles. Data from four cycles of NHANES (2007–2008, 2009–2010, 2011–2012, and 2013–2014) were used in

Results

Baseline characteristics for analyzed sample by depressive symptoms are present in Table 1. There were 16 807 participants included in the present study. The prevalence of depressive symptoms was 9.41%. Compared with participants without depressive symptoms, those with depressive symptoms were more likely to be female, younger, obese, and single or living alone and have higher prevalence of hypertension, diabetes, and smoking at least 100 cigarettes in life. The educational level, household

Discussion

In this large, nationally representative database, we found that intakes of total, vegetable, and fruit fiber were inversely associated with depressive symptoms among US adults, even after adjustment for a wide variety of potential confounders. In stratified analyses by age and sex, the inverse association between total fiber intake and depressive symptoms was statistically significant in the age group younger than 45 y and the 45 to 64 y group, for both men and women.

In the present study, we

Conclusions

Our study suggested that intakes of total fiber, vegetable fiber, and fruit fiber were inversely associated with depressive symptoms in US adults. Further large-scale prospective studies are needed to confirm our findings.

Acknowledgments

The authors thank all the authors of the included papers. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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