Diet Intake and Patterns in Adults With and Without Depression in South Asia

Abstract

Abstract Objectives To compare dietary intake and patterns among adults with and without depression in South Asia. Methods Baseline survey data from the 2015–16 Centre for cArdiometabolic Risk Reduction in South-Asia study, representative of three urban South Asian cities (n = 13 588), were analyzed. Non-pregnant adults ≥ 20 years completed interviewer-administered surveys including a semi-quantitative Food Frequency Questionnaire (FFQ) and Patient Health Questionnaire-9 (PHQ-9) to assess depression. Participants were categorized as having moderate/severe depression (PHQ-9 = 10–27), mild depression (PHQ-9 = 5–9), and no depression (PHQ-9 = 0–4). FFQ data were transformed into daily food (g/d) and beverage (ml/d) intake. Among adults with and without depression, we compared differences in socio-demographic characteristics and daily food and nutrient intake (energy and macronutrients and their distributions) using Students t tests and chi-sq tests and determined diet patterns using exploratory factor analysis. Results Overall,16% (95% CI 14.7, 17.5) had mild depression and 6% (95% CI 5.1, 7.1) had moderate/severe depression. Compared with adults with no or mild depression, adults with moderate/severe depression had lower intake of energy (2196 ± 804 [no] vs. 2408 ± 852 [mild] vs. 2751 ± 902 [moderate/severe] kcal/d), carbohydrates (284 ± 102 vs. 318 ± 117 vs. 366 ± 125 g/d)), protein (77 ± 35 vs. 81 ± 36 vs. 87 ± 33g/d)), fat (81 ± 36 vs. 88 ± 37 vs. 101 ± 39 g/d), and all food groups except meat (41 ± 83 vs. 41 ± 97 vs. 28 ± 73 g/d) and poultry (132 ± 146 vs. 107 ± 143 vs. 76 ± 113 g/d). Across groups, diets comprised 51–53% carbohydrates, 12–14% protein, and 32–33% fat. Four distinct diet patterns were seen among adults without depression (traditional, modern, non-vegetarian, vegetarian), with mild depression (traditional, western, vegetarian, non-vegetarian), and with moderate/severe depression (traditional, energy-dense, western, non-vegetarian). Conclusions Diets of South Asian adults with depression were poorer in quality and quantity than those without depression. Efforts are needed to better study the direction of these associations and ways to improve diets of South Asians. Funding Sources NHLBHI, NIH, Oxford Health Alliance Vision 2020 of the UnitedHealth Group, Fogarty International Center and the Eunice Kennedy Shriver NIDDK, NIH and the Emory Global Health Institute.