Abstract
BACKGROUND: Epidemiological evidence on the relationships between intakes of different categories of vegetables and fruits and depressive symptoms is very limited and inconsistent, especially with no evidence from the general population. This study aimed to estimate their relationships among a large general population. METHODS: The cross-sectional design was based on the National Health and Nutrition Examination Survey (2007-2014) and included 16,925 adults. Dietary information was attained from two nonconsecutive 24-hr dietary recalls. Patient Health Questionnaire was applied for measuring depressive symptoms. The associations between vegetables and fruits intakes and depressive symptoms were appraised utilizing logistic regression and restricted cubic spline. RESULTS: Compared with the lowest category of intake, the most-adjusted odds ratios of depressive symptoms for the highest intake category of tomatoes and tomato mixtures were 0.81 (95% confidence interval [CI], 0.66-0.99), and 0.64 (95% CI, 0.48-0.85) for dark-green vegetables, 0.67 (95% CI, 0.53-0.84) for other vegetables, 0.48 (95% CI, 0.29-0.79) for berries, 0.67 (95% CI, 0.55-0.82) for total vegetables, and 0.70 (95% CI, 0.57-0.86) for total fruits, and for the medium categories of bananas and dried fruits were 0.62 (95% CI, 0.41-0.95) and 0.39 (95% CI, 0.19-0.81), respectively. After sensitivity analysis further excluding subjects with co-morbid health conditions, these findings remained significant, except for bananas. An L-shaped relationship was observed between depressive symptoms and intake of total vegetables, while the association was linear with total fruits intake. CONCLUSIONS: Intakes of tomatoes and tomato mixtures, dark-green vegetables, other vegetables, berries, dried fruits, total vegetables, and total fruits were inversely related to depressive symptoms among adults.