Abstract

Background: Psychological disorders such as anxiety and depression have become a public health problem due to urbanization and industrialization and associated changes in behavioural risk factors; western type diet, sleep disorders, stressful lifestyle, alcoholism, tobacco, and sedentary behaviour. Western diet appears to be a risk factor of depression because it is associated with chronic neuro-inflammation, whereas Indo-Mediterranean dietary patterns may be neuroprotective. This study aims to determine the association of Indo-Mediterranean Neuroprotective dietary (MIND) pattern with risk of depression. Study design and setting: Cross-sectional survey in a hospital. Subjects and methods: After written informed consent and approval from hospital ethic committee, all subjects (n=2002) above 25 years of age (1016 males and 986 females) were randomly selected and recruited from urban population of Moradabad, North India. Clinical data and risk factors were recorded with the help of case record form and validated questionnaires. Assessment of depression was made by the modified depression rating scale. Subjects were classified in to possible depression and depression by assessment of depressive symptoms. The association of depression with dietary factors was calculated by multivariate logistic regression analysis after adjustment of age, sex and body mass index. Results: The overall prevalence of depression was 6.84% (n=137). The prevalence was significantly lower among men, compared to women (6.10% vs 7.61%, n=62 vs 75, P<0.02), respectively, and the risk increased with increase in age in both genders. Multivariate logistic regression analysis, after adjustment of age and body mass index, showed that fruit, vegetable and nuts intake were significantly and strongly but inversely associated with depression among both men, Odds ratio and 95 % confidence interval of difference; (0.76, ((95% CI 0.70-0.86, P<0.001) as well as in women, Odds ratio and 95% confidence interval; (0.78, 95% CI 0.72-0.86, P<0.001), MIND diet score >24 was also inversely associated with depression among both men (0.89, 95% CI, 0.81-0.99, P,0.01) and women (0.87, 95% CI 0.80-0.97, P<0.01). Total western type food intake revealed positive association among both men (0.78, (95% CI 0.69-0.87, P, 0.001) and women (0.79, 95% CI 0.74-0.88, P<0.001). The intake of meat and eggs also showed modest positive association with depression, in men (0.89, (95% CI 0.76-1.01, P<0.05) but not among women. Sedentary behavior was significantly associated with depression among both men (0.88, 95% CI 0.77-1.00, P<0.05) and women (0.93, 95%CI 0.71-1.03, P<0.05). Tobacco intake showed significant modest association with depression among men 0.94, (95% CI 0.81-1.07, P<0.05) as well as in women (0.92, 95% CI 0.80-1.04, P<0.05), but alcoholism showed no such association among women showing, wider confidence interval; OD 0.90, (95% CI 0.74-1.09). Conclusion: The prevalence of possible depression and depression have become public health problems in India. The intake of prudent foods, in particular fruits, vegetables, whole grains, and nuts mustard oil showed inverse association with depression whereas increased intake of Western type foods may increase the risk of depression. It is possible that increased intake of Indo-Mediterranean type foods (MIND), and decrease in western type foods, physical activity and cessation of tobacco and alcoholism can protect against depression.

Keywords

healthy diet, functional foods, inflammation, antioxidants in the diet