ARTICLE INFO | ABSTRACT | |
ORIGINAL ARTICLE | Background: In recent years, the prevalence of depression has grown dramatically in the world. According to WHO reports, about 350 million people suffer from depression. In addition to the side effects of antidepressants, many patients are resistant to treatment with these drugs. One of the most important effective factors in the pathology of depression is the role of nutrition in controlling and preventing this disease. Therefore, the aim of this study was to investigate the macronutrient and micronutrient status in depressed patients and compare them with healthy people. Methods: In this case-control study, 110 depressed patients were matched with 220 healthy controls based on their age, gender, and area of residence. Patients were selected by simple sampling method. In the case group, unipolar major depressive disorder was diagnosed by a psychiatrist using the DSM-IV criteria. Food intakes of all participants were obtained using reliable semi-quantitative food frequency questionnaires and analyzed with Nutritionist4 software. Anthropometric measurements including height, weight, and waist circumference were calculated for all participants. Results: The participants included 260 women and 71 men. The two groups had a statistically significant difference in terms of occupation, history of depression, childhood traumatic experiences, and family history of depression (P < 0.05). Regarding the macronutrients and micronutrients, a significant difference was observed between the case and control groups in terms of vitamin C, vitamin K, and dietary fiber intake, which were lower in depressed patients. Conclusion: The results of this study indicated that intake of some micronutrients such as vitamins C, K, and dietary fiber may be associated with an increased risk of depression. Consumption of some micronutrients, mainly fruits and vegetables may be effective to control or prevent the risk of depression. Keywords: Depression; Micronutrient; Macronutrient; Nutrition. |
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Article history: Received: 17 Feb 2018 Revised: 18 Apr 2018 Accepted: 14 Jul 2018 |
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*Corresponding author gsotodeh@tums.ac.ir Hojatdost Street, Naderi Street, Keshavarz Blv, Tehran, Iran. Postal code: 1468995764 Tel: +98- 9123906617 |
Table 1. Comparison of mean of quantitative independent variables between case and control groups | ||||
P-valuea | Control group | Case group | N | Quantitative variables |
0.8 | 53.96 ± 0.72 | 35.85 ± 1.04b | 327 | Age (year) |
0.4 | 2.9 ± 0.12 | 3.70 ± 0.19 | 330 | Birth order |
0.6 | 3.8 ± 0.08 | 3.7 ± 0.15 | 331 | Number of family members |
0.07 | 21.2 ± 0.3 | 11.2 ± 0.42 | 327 | Number of education years |
0.8 | 7.1 ± 0.96 | 96.7 ± 1.3 | 329 | Weight (kg) |
0.5 | 361.4 ± 0.59 | 261.8 ± 0.79 | 327 | Height (cm) |
0.9 | 62.4 ± 0.37 | 62.4 ± 0.49 | 321 | Body mass index (kg/m2) |
0.5 | 88.2 ± 0.92 | 98.1 ± 1.24 | 327 | Waist circumference (cm) |
0.007 | 38.6 ± 0.33 | 36.9 ± 0.52 | 325 | Physical activity (METhr/d) |
a:t-test for normal covariates & Mann-Whitney for without normal covariates ; b: Mean ± SE |
Table 2. Comparison of qualitative independent variables between case and control groups | |||
P-valuea | Control N (%) |
Case N (%) |
Qualitative variables |
0.03 |
99 (45.2) 42 (19.2) 8 (3.7) 32 (14.6) 38 (17.4) |
66 (60.6) 12 (11.0) 6 (5.5) 16 (14.7) 9 (8.3) |
Job Housewife Clerk Self-employed Retired Student |
0.001 |
199 (90.0) 22 (10.0) |
77 (70.0) 33 (30.0) |
Depression history No Yes |
< 0.001 | 171 (77.0) 39 (36.0) |
70 (64.0) 50 (23.0) |
Childhood traumatic experiences No Yes |
0.001 |
196 (89.0) 25 (11.0) |
80 (73.0) 30 (27.0) |
Family predisposition to depression No Yes |
0.04 |
88 (39.8) 44 (19.9) 60 (27.2) 29 (13.1) |
40 (36.4) 23 (20.9) 20 (18.2) 27 (24.5) |
Number of children 0 1 2 3< |
a: χ2 test |
Table 3. Comparison of the mean (±SE) of daily intake of macronutrients and some of their components | ||||||
Adjusted model | P-valueb | P-valuea | Groups | Variables | ||
OR(95%CI) | P-valuec | Control | Case | |||
1.07 (0.72-1.6) | 0.70 | 0.04 | - | 2634 ± 69 | 2887 ± 112 | Energy (Kcal) |
1.0 (0.9- 1.0) | 0.40 | 0.10 | - | 402 ± 10 | 439 ± 19 | Carbohydrate(g) |
0.99 (0.96-1.0) | 0.80 | - | 0.06 | 61.6 ± 0.5 | 60.6 ± 0.7 | Energy from carbohydrate(%) |
1 (0.9-1.0) | 0.70 | 0.09 | - | 94 ± 3 | 101 ± 4 | Protein (g) |
0.9 (0.9-1.0) | 0.90 | - | 0.60 | 14.6 ± 0.4 | 14.8 ± 0.2 | Energy from protein (%) |
0.9 (0.9-1.0) | 0.70 | 0.10 | - | 79 ± 3 | 86 ± 4 | Fat (g) |
0.9 (0.9-1.0) | 0.60 | - | 0.30 | 62 ±0.5 | 62 ±0.7 | Energy from fat (%) |
0.6 (0.4-0.9) | 0.04 | 0.03 | - | 29 ± 1 | 26 ± 1 | Fiber (g) |
1.2 (0.6-2.2) | 0.49 | - | 0.08 | 845 ± 75 | 821 ± 32 | Tryptophan (g) |
1.0 (0.9-1.0) | 0.60 | 0.05 | - | 22 ± 0.8 | 26 ± 1 | SFA (g) |
1.0 (0.9-1.0) | 0.80 | 0.03 | - | 24 ± 0.9 | 28 ± 1 | MUFA (g) |
0.9 (0.9-1.0) | 0.40 | 0.10 | - | 20 ± 1 | 21 ± 1 | PUFA (g) |
a: Mann Whitney test; b: Independent t-test for logarithm or to the power 2 or cube root of variables; c : Multiple logistic regression to adjust for the effects of confounding variables including education level, occupation, physical activity, body mass index, and dietary patterns |
Table 4. Comparison of the mean (±SE) daily intake of vitamins as micronutrients | |||||
Adjusted model | P-valuea | Groups | Variables | ||
OR(95%CI) | P-valueb | Control | Case | ||
1.06 (0.87-1.28) | 0.50 | 0.60 | 2.45 ± 0.09 | 2.77 ± 0.11 | B1 (mg)d |
0.89 (0.65-1.22) | 0.49 | 0.60 | 2.61 ± 0.06 | 2.31 ± 0.08 | B2 (mg) d |
1.00 (0.98-1.03) | 0.60 | 0.02 | 52.8 ± 0.9 | 82.6 ± 1.2 | B3 (mg) d |
1.03 (0.93-1.13) | 0.50 | 0.60 | 7.17 ± 0.2 | 8.10 ± 0.33 | B5 (mg) d |
0.92 (0.75-1.13) | 0.40 | 0.60 | 2.5 ± 0.1 | 2.24 ± 0.09 | B6 (mg) d |
1.1 (0.60-1.93) | 0.70 | 0.90 | 614.9 ± 17.3 | 623.8 ± 27.5 | Folate(mcg) d |
0.99 (0.97-1.01 | 0.40 | 0.70 | 5.37 ± 1.6 | 4.86 ± 0.44 | B12 (mcg) d |
0.5 (0.26-0.97) | 0.04 | 0.001 | 246.7 ± 10.3 | 212.4 ± 13.9 | C (mg) d |
0.99 (0.99-0.99) | 0.01 | 0.002 | 259.0 ± 2.9 | 178.4 ± 10.0 | K (mcg) d |
1.15 (0.61-2.15) | 0.60 | 0.19 | 1848 ± 96 | 1669 ± 118 | A (RE) d |
0.80 (0.48-1.36) | 0.40 | 0.30 | 2.51 ± 0.74 | 1.73 ± 0.14 | D (mcg) e |
0.98 (0.96-1.01) | 0.30 | 0.70 | 15.4 ± 0.8 | 14.9 ± 1.0 | E (mg) f |
a: Mann Whitney test; b: Independent t-test for logarithm or to the power 2 or cube root of variables; c: Multiple logistic regression to adjust for the effects of confounding variables including education level, occupation, physical activity, body mass index, and dietary patterns; d: More than the Recommended Dietary Allowances (RDA) for men and women; e: The RDA for vitamin D for men and women is 15 mcg; f: The RDA for vitamin E for men and women is 15 mcg. |
Table 5. Comparison of the mean (±SE) daily intake of minerals as micronutrients | ||||||
Adjusted model | P- valueb | P-valuea | Groups | Variables | ||
OR(95%CI) | P-valuec | Control | Case | |||
0.99 (0.95-1.04) | 0.9 | 0.16 | - | 12.9 ± 0.43 | 13.6 ± 0.52 | Zn (mg/day) d |
0.99 (0.99-1.00) | 0.3 | 0.90 | - | 459.1 ± 17.7 | 449.4 ± 17.4 | Mg (mg/day) d |
1.29 (0.74-2.28) | 0.3 | 0.68 | - | 1125 ± 29 | 1158 ± 46 | Ca (mg/day) e |
0.87 (0.57-1.33) | 0.5 | 0.10 | - | 4820 ± 141 | 4455 ± 167 | Potassium (mg/day)f |
1.07 (0.59-1.92) | 0.8 | 0.27 | - | 1701 ± 0.53 | 1759 ± 65 | P (mg/day) d |
0.98 (0.95-1.01) | 0.2 | 0.89 | - | 21.3 ± 0.8 | 21.27 ± 0.9 | Fe (mg/day) d |
0.80 (0.62-1.10) | 0.2 | 0.80 | - | 2.2 ± 0.07 | 2.2 ± 0.09 | Cu(mg/day) d |
0.52 (0.12-2.29) | 0.3 | - | 0.001 | 0.149 ± 0.03 | 0.124 ± 0.00 | Se (mg/day) d |
a: Mann Whitney test; b: Independent t-test for logarithm or to the power 2 or cube root of variables; c: Multiple logistic regression to adjust for the effects of confounding variables including education level, occupation, physical activity, body mass index, and dietary patterns; d: More than the Recommended Dietary Allowances (RDA) for men and women; e: The RDA for calcium is 1000-1200 g/d for women and 1000 g/d for men; f: The RDA for potassium for men and women is 4.7 g/day.
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