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Association of dietary patterns with depressive symptoms in Chinese postmenopausal women

  • Kuan Liao (a1), Yeqing Gu (a1), Mingyue Liu (a1), Jingzhu Fu (a1), Xiaotong Wang (a1), Guanlin Yang (a1), Qing Zhang (a2), Li Liu (a2), Ge Meng (a1), Zhanxin Yao (a3), Hongmei Wu (a1), Yang Xia (a1), Xue Bao (a1), Shunming Zhang (a1), Shaomei Sun (a2), Xing Wang (a2), Ming Zhou (a2), Huanli Jiao (a2), Qiyu Jia (a2), Kun Song (a2), Yuntang Wu (a1) and Kaijun Niu (a1) (a2) (a4) (a5)...


Many components in diet have regulated oxidative stress, inflammatory reaction and even balance oestrogen levels. Because these factors are closely associated with depressive symptoms in postmenopausal women, it is considered that dietary factors are able to prevent and control depressive symptoms. On the other hand, a dietary pattern that considers the correlations and synergies between foods and nutrients is expected to have a greater impact on disease risk. The aim of the present study is to evaluate whether dietary patterns are associated with depressive symptoms in Chinese postmenopausal women. A cross-sectional study of 2051 postmenopausal women (mean age: 58·8 (sd 7·4) years) was conducted in Tianjin, China. Dietary consumption was assessed by a valid self-administered FFQ. Principal component analysis was used to derive three major dietary patterns: ‘healthy’, ‘sweets’ and ‘traditional Tianjin’ from eighty-eight food items. Depressive symptoms were assessed using the Zung Self-Rating Depression Scale, and cut-off point of 48 indicating serious depressive symptoms. The association between quartile of dietary patterns and depressive symptoms was assessed using multiple logistic regression analysis. The multivariable-adjusted OR of having depressive symptoms for increasing quartile of dietary patterns were as follows: healthy, 1·00, 0·79 (95 % CI 0·49, 1·28), 0·62 (95 % CI 0·37, 1·04) and 0·57 (95 % CI 0·33, 0·97); sweets, 1·00, 0·75 (95 % CI 0·42, 1·3), 1·08 (95 % CI 0·64, 1·81) and 1·66 (95 % CI 1·03, 2·71); and traditional Tianjin, 1·00, 1·02 (95 % CI 0·58, 1·79), 0·96 (95 % CI 0·54, 1·71) and 2·53 (95 % CI 1·58, 4·16), respectively. The present study demonstrated that a healthy dietary pattern was inversely associated with depressive symptoms. On the contrary, greater adherence to sweets and traditional Tianjin dietary patterns was associated with a higher prevalence of depressive symptoms.


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*Corresponding author: K. Niu, emails,


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These authors are co-first authors and contributed equally to this work.



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1. World Health Organization (2016) Depression fact sheet.
2. Ferrari, AJ, Charlson, FJ, Norman, RE, et al. (2013) Burden of depressive disorders by country, sex, age, and year: findings from the global burden of disease study 2010. PLoS Med 10, e1001547.
3. Chen, Y, Bennett, D, Clarke, R, et al. (2017) Patterns and correlates of major depression in Chinese adults: a cross-sectional study of 0.5 million men and women. Psychol Med 47, 958970.
4. Seow, LS, Subramaniam, M, Abdin, E, et al. (2016) Sleep disturbance among people with major depressive disorders (MDD) in Singapore. J Ment Health 25, 492499.
5. Phillips, MR, Zhang, J, Shi, Q, et al. (2009) Prevalence, treatment, and associated disability of mental disorders in four provinces in China during 2001-05: an epidemiological survey. Lancet 373, 20412053.
6. Kessler, RC, McGonagle, KA, Swartz, M, et al. (1993) Sex and depression in the National Comorbidity Survey. I: lifetime prevalence, chronicity and recurrence. J Affect Disord 29, 8596.
7. Sassarini, DJ (2016) Depression in midlife women. Maturitas 94, 149154.
8. Liu, S, Manson, JE, Buring, JE, et al. (2002) Relation between a diet with a high glycemic load and plasma concentrations of high-sensitivity C-reactive protein in middle-aged women. Am J Clin Nutr 75, 492498.
9. Black, CN, Penninx, BW, Bot, M, et al. (2016) Oxidative stress, anti-oxidants and the cross-sectional and longitudinal association with depressive symptoms: results from the CARDIA study. Transl Psychiatry 6, e743.
10. Murakami, K & Sasaki, S (2010) Dietary intake and depressive symptoms: a systematic review of observational studies. Mol Nutr Food Res 54, 471488.
11. Georgakis, MK, Thomopoulos, TP, Diamantaras, AA, et al. (2016) Association of age at menopause and duration of reproductive period with depression after menopause: a systematic review and meta-analysis. JAMA Psychiatry 73, 139149.
12. Low, YL, Dunning, AM, Dowsett, M, et al. (2007) Phytoestrogen exposure is associated with circulating sex hormone levels in postmenopausal women and interact with ESR1 and NR1I2 gene variants. Cancer Epidemiol Biomarkers Prev 16, 10091016.
13. Hodge, A & Bassett, J (2016) What can we learn from dietary pattern analysis? Public Health Nutr 19, 191194.
14. Hu, FB (2002) Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol 13, 39.
15. Mihrshahi, S, Dobson, AJ & Mishra, GD (2015) Fruit and vegetable consumption and prevalence and incidence of depressive symptoms in mid-age women: results from the Australian longitudinal study on women’s health. Eur J Clin Nutr 69, 585591.
16. Rienks, J, Dobson, AJ & Mishra, GD (2013) Mediterranean dietary pattern and prevalence and incidence of depressive symptoms in mid-aged women: results from a large community-based prospective study. Eur J Clin Nutr 67, 7582.
17. Liu, ZM, Ho, SC, Xie, YJ, et al. (2016) Associations between dietary patterns and psychological factors: a cross-sectional study among Chinese postmenopausal women. Menopause 23, 12941302.
18. Song, F & Cho, MS (2017) Geography of food consumption patterns between South and North China. Foods 6, 34.
19. Song, K, Du, H, Zhang, Q, et al. (2014) Serum immunoglobulin M concentration is positively related to metabolic syndrome in an adult population: Tianjin Chronic Low-Grade Systemic Inflammation and Health (TCLSIH) Cohort Study. PLOS ONE 9, e88701.
20. Sun, S, Wu, H, Zhang, Q, et al. (2014) Subnormal peripheral blood leukocyte counts are related to the lowest prevalence and incidence of metabolic syndrome: Tianjin Chronic Low-grade Systemic Inflammation and Health Cohort Study. Mediators Inflamm 2014, 412386.
21. Gregory, RJ (2006) The Zung Self-rating Depression Scale as a potential screening tool for use with Eskimos. Psychiatric Services 45, 573575.
22. Su, Q, Yu, B, He, H, et al. (2016) Nut consumption is associated with depressive symptoms among Chinese adults. Depress Anxiety 33, 10651072.
23. Aoki, A, Nagate, M, Utsumi, K, et al. (2012) Can we determine depressive conditions on the basis of somatic symptoms? A cross-sectional study of depressive conditions among Japanese patients at a university hospital general medicine clinic. Intern Med 51, 13351340.
24. Alberti, KG, Eckel, RH, Grundy, SM et al. (2009) Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 120, 16401645.
25. Craig, CL, Marshall, AL, Sjostrom, M et al. (2003) International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 35, 13811395.
26. Martinez-Gonzalez, MA & Sanchez-Villegas, A (2016) Food patterns and the prevention of depression. Proc Nutr Soc 75, 139146.
27. Beydoun, MA, Beydoun, HA, Boueiz, A et al. (2013) Antioxidant status and its association with elevated depressive symptoms among US adults: National Health and Nutrition Examination Surveys 2005-6. Br J Nutr 109, 17141729.
28. Akbaraly, TN, Brunner, EJ, Ferrie, JE et al. (2009) Dietary pattern and depressive symptoms in middle age. Br J Psychiatry 195, 408413.
29. Bottiglieri, T (2005) Homocysteine and folate metabolism in depression. Prog Neuropsychopharmacol Biol Psychiatry 29, 11031112.
30. Mei, J, Yeung, SS & Kung, AW (2001) High dietary phytoestrogen intake is associated with higher bone mineral density in postmenopausal but not premenopausal women. J Clin Endocrinol Metab 86, 52175221.
31. Lipovac, M, Chedraui, P, Gruenhut, C et al. (2010) Improvement of postmenopausal depressive and anxiety symptoms after treatment with isoflavones derived from red clover extracts. Maturitas 65, 258261.
32. Craig, MC & Murphy, DG (2007) Estrogen: effects on normal brain function and neuropsychiatric disorders. Climacteric 10 Suppl 2, 97104.
33. Murakami, K, Sasaki, S, Takahashi, Y et al. (2008) Dietary glycemic index is associated with decreased premenstrual symptoms in young Japanese women. Nutrition 24, 554561.
34. Berk, M, Williams, LJ, Jacka, FN et al. (2013) So depression is an inflammatory disease, but where does the inflammation come from? BMC Med 11, 200.
35. Miller, AH, Maletic, V & Raison, CL (2009) Inflammation and its discontents: the role of cytokines in the pathophysiology of major depression. Biol Psychiatry 65, 732741.
36. Schachter, J, Martel, J, Lin, CS et al. (2018) Effects of obesity on depression: a role for inflammation and the gut microbiota. Brain Behav Immun 69, 18.
37. Yu, B, Shao, J, Yu, F et al. (2017) Consumption of preserved egg, a high-lead-containing food, is strongly associated with depressive symptoms in Chinese adults. Br J Nutr 118, 737742.
38. Xia, Y, Wang, N, Yu, B et al. (2017) Dietary patterns are associated with depressive symptoms among Chinese adults: a case-control study with propensity score matching. Eur J Nutr 56, 25772587.
39. Zung, WW (1965) A self-rating depression scale. Arch Gen Psychiatry 12, 6370.


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Association of dietary patterns with depressive symptoms in Chinese postmenopausal women

  • Kuan Liao (a1), Yeqing Gu (a1), Mingyue Liu (a1), Jingzhu Fu (a1), Xiaotong Wang (a1), Guanlin Yang (a1), Qing Zhang (a2), Li Liu (a2), Ge Meng (a1), Zhanxin Yao (a3), Hongmei Wu (a1), Yang Xia (a1), Xue Bao (a1), Shunming Zhang (a1), Shaomei Sun (a2), Xing Wang (a2), Ming Zhou (a2), Huanli Jiao (a2), Qiyu Jia (a2), Kun Song (a2), Yuntang Wu (a1) and Kaijun Niu (a1) (a2) (a4) (a5)...


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