A Study on the Association between Depressive Disorder and Dietary Intake in Middle-aged Women and Meta-Analysis
저자
발행사항
인천 : 가천대학교 대학원, 2022
학위논문사항
학위논문(박사)-- 가천대학교 대학원 : 융합의과학과 뇌과학전공 2022. 8
발행연도
2022
작성언어
영어
주제어
발행국(도시)
인천
형태사항
; 26 cm
일반주기명
지도교수: 이해정
UCI식별코드
I804:23001-200000641915
소장기관
The prevalence of depressive disorders among Korean women is increasing. Recently, a number of dietary-related studies have been reported for alleviating or preventing depressive disorders. And due to the development of neuroimaging technology, research on depressive disorders is also being conducted from a structural and functional perspective. However, so far, studies examining the association of dietary intake, depressive disorder, and brain gray matter volume in middle-aged women have rarely been conducted in Korea. Therefore, this study was conducted to investigate the association between depressive disorder and dietary intake in 2,201 middle-aged women aged 45 to 69 living in South Korea. Of the total subjects, 130 (85 in the depressive disorder group and 45 in the control group) were selected and the association between brain white matter volume and biomarkers and the association between gray matter volume and dietary intake were analyzed through imaging analysis taken with brain functional magnetic resonance imaging (fMRI).
An analysis of the association between BDI depression scores and nutrient intake found that higher intakes of calcium, potassium, vitamin A, and vitamin C were associated with a lower prevalence of depressive disorder, respectively. In addition, the higher intakes of polyunsaturated fatty acids, omega-3 fatty acids, eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA) were associated with the lower prevalence of depression. Among the food groups, the higher intake frequencies of greenish-yellow vegetables, mushrooms, fruits, blue-backed fish, and anchovies, were more significantly associated with the prevalence of depressive disorder.
Dietary patterns were identified using factor analysis based on 34 food groups. We identified two major dietary patterns: A ‘healthy’ dietary pattern was characterized by a high intake of multigrain rice, beans, nuts, kimchi, green vegetables, and fruits. An ‘unhealthy’ dietary pattern was characterized by a high intake of white rice, noodles, dumplings, meat, and soda. A higher score for a healthy diet pattern was associated with a lower prevalence of depression, and a higher score for an unhealthy diet pattern was associated with a higher prevalence of depression.
Brain fMRI scans were used to analyze the amount of white matter and gray matter in 130 participants. Participants were divided into quartiles based on their homocysteine and cortisol levels. The gray matter volume and the levels of homocysteine and cortisol showed an inverse correlation. The gray matter volume of the right lingual gyrus showed a positive correlation with the intake of DPA and DHA and a negative correlation with the CES-D score, and the gray matter volume of the right middle temporal gyrus showed a positive correlation with the intake of DPA and a negative correlation with the CES-D score.
Our results suggest that high intakes of omega-3 fatty acids have been associated with a lower risk of depressive disorder in middle-aged women. Also, the right lingual and right middle temporal gyrus were specific regions of the brain that were found to be associated with depression scores and fatty acid intake.
In conclusion, calcium, potassium, vitamin A, vitamin C, omega-3 fatty acids, green and yellow vegetables, mushrooms, fruits, blue-backed fish, and healthy dietary patterns are associated with decreased risk of depressive disorder in middle-aged Korean women. Therefore, in order to prevent depressive disorder among middle-aged Korean women, we believe it is important to consume a balanced diet, especially one rich in omega-3 fatty acids.
There are many studies on the association between omega-3 fatty acid intake and depression, but the results are not consistent. This study sought to find previous research articles on the association between omega-3 fatty acid intake and depression and to investigate the effect of omega-3 fatty acid intake on reducing depression through a systematic review and meta-analysis. Data from PubMed, Medline, and EMBASE were searched for systematic review and meta-analysis up to March 2022.
Among the articles that studied the association between omega-3 fatty acids and depression in the database, a total of 11 RCTs for women were selected for systematic review and meta-analysis. In terms of the distribution of 11 articles by country, there were 4 from the United States, 3 from Iran, and 1 each from Canada, Australia, Italy, and Taiwan, respectively. As a result of investigating the risk of bias, the quality of the articles was mostly good. A total of 8 articles were found to have a significant effect on depression reduction, and 3 articles were found it to be insignificant.
A meta-analysis was conducted on the entire set of 11 articles. Meta-analysis was also conducted on subgroups of middle-aged women who were 40 years old or older and subgroups of women who were younger than 40.
The total number of subjects for 11 RCTs was 917: the experimental group was 459, and the control group was 458. As a result of the meta-analysis, the average effect size of omega-3 fatty acids on depression was -0.63 (95% CI: [-1.21; -0.05]), showing the median effect size.
The total number of subjects for middle-aged women over the age of 40 was 246, the experimental group was 125 and the control group was 121. As a result of meta-analysis, the average effect size of omega-3 fatty acids on depression was -0.64 (95% CI: [-1.03; -0.24]), showing the median effect size.
The total number of subjects for women under the age of 40 was 144, the experimental group was 79, and the control group was 65. The meta-analysis results showed that the average effect size of omega-3 fatty acids on depression was -0.69 (95% CI: [-1.36; -0.02]), showing the median effect size.
The results of the systematic literature review and meta-analysis showed that the intake of omega-3 fatty acids is inversely associated with the risk of depressive disorder in women, which is in line with the results of a study conducted on middle-aged women in Korea in Part I.
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