Abstract
BACKGROUND AND OBJECTIVES: This cross-sectional study explored the association between dietary patterns and depressive symptoms in middle-aged and older individuals in China. METHODS AND STUDY DESIGN: A total of 2,956 individuals aged 45-74 years were included in the current data analysis, based on a community-based cross-sectional study from Qingdao, China. Data for this study were derived from field surveys conducted from August 2009 to November 2010. Their mean age was 57.2 ± 8.46 years, and 62.4% were women. Dietary intake was assessed using a validated semi-quantitative food frequency questionnaire (SQFFQ). Dietary patterns were derived using principal component analysis. Depressive symptoms were assessed using the validated Zung Self-Rating Depression Scale. Logistic regression and restricted cubic spline analyses were conducted to examine the association between dietary patterns and depressive symptoms. RESULTS: Of the participants, 12.4% had depressive symptoms. These participants were younger, were more likely to be smokers, had a higher body mass index, and had lower income and education levels compared with individuals without depressive symptoms. Four dietary patterns were identified: Balanced, Animal-Pickled vegetables, High sugar-Alcohol, and Animal-Seafood-Egg dietary patterns. The Balanced (odds ratio = 0.53, p < 0.01) and Animal-Seafood-Egg (odds ratio = 0.74, p < 0.01) dietary patterns were negatively associated with depressive symptoms, whereas the Animal-Pickled vegetables dietary pattern was positively associated with depressive symptoms. No significant association was observed for the High sugar-Alcohol dietary pattern. Subgroup analysis revealed stronger inverse effects of Balanced and Animal-Seafood-Egg dietary patterns in women younger than 60 years, nonsmokers, and urban residents compared with in their counterparts. Sensitivity analysis confirmed stability across the continuous and quartile-based variables. CONCLUSIONS: The Balanced and Animal-Seafood-Egg dietary patterns were associated with lower odds of depressive symptoms, whereas the Animal-Pickled vegetables dietary pattern was associated with higher odds of depressive symptoms.