Abstract
BackgroundDiet has been associated with better mental health in general populations, but less is known on this association in patients with a history of coronary heart disease.The objective of this study is to examine the cross-sectional associations between dietary patterns and mental health in elderly patients with a history of myocardial infarction.MethodsData were drawn from the final assessment of the Alpha Omega cohort that monitored patients with a history of myocardial infarction (age range 60–80 years). 2171 patients with complete data for diet and mental health were included in this study. Diet was assessed with the 203-item Food Frequency Questionnaire, and subsequently categorized into two scores: the Dutch Healthy Nutrient and Food Score (DHNaFS) and the Dutch Undesirable Nutrient and Food Score (DUNaFS). Depressive symptoms, assessed with the Geriatric Depression Scale (GDS-15), and dispositional optimism, assessed with the 4-item questionnaire (4Q), were cross-sectionally analyzed in relation to dietary patterns using linear regression analysis.ResultsPatients were on average 72.2 years old and 79.5% were male. The DHNaFS score was associated with less depressive symptoms and higher dispositional optimism (β = -0.108; P<0.001; and β = 0.074; P<0.001), whereas no associations were found with the DUNaFS score. Particularly, consumption of vegetables, fruits, whole grains, fish, and low fat-dairy were associated with less depressive symptoms and higher optimism. Similar associations were found when analyzing the association between average DHNaFS score over the preceding 41 months with depression β = -0.085; P<0.001) and higher dispositional optimism (β = 0.084; P<0.001).ConclusionsA healthy dietary pattern, in particular a higher consumption of vegetables, fruit, whole grains, fish and low-fat dairy, was associated with less depressive symptoms and higher optimism. However, given the cross-sectional nature of our analyses, our findings may also be explained by more optimistic participants making healthier food choices. Therefore, future prospective or interventions studies are needed to establish the direction of causality of this association.Trial registrationClinicalTrials.gov NCT03192410.
Highlights
Depression is a highly prevalent mental disorder among patients with a history of myocardial infarction (MI) [1, 2] and is associated with a decreased quality of life and high costs in healthcare use [3]
Diet has been associated with better mental health in general populations, but less is known on this association in patients with a history of coronary heart disease
The objective of this study is to examine the cross-sectional associations between dietary patterns and mental health in elderly patients with a history of myocardial infarction
Summary
Depression is a highly prevalent mental disorder among patients with a history of myocardial infarction (MI) [1, 2] and is associated with a decreased quality of life and high costs in healthcare use [3]. Systematic reviews in general populations have shown a beneficial effect of healthy dietary patterns that include high consumption of fruits, vegetables, fish, olive oil, nuts, and legumes, and an adverse effect of unhealthy dietary patterns that include high consumption of processed food, sugar and fat [10,11,12,13] In line with these reviews, later observational studies have reported an inverse association between healthy dietary patterns and depressive symptoms [14,15,16,17]. A large randomized trial (the PREDIMED study) showed that a low fat, Mediterranean diet decreased the incidence of depression in a population at high cardiovascular risk [18] Their results suggested an association between a dietary pattern enriched with extra-virgin olive oil and mixed nuts, but only in a sensitivity analysis among the participants with diabetes mellitus type 2. The objective of this study is to examine the cross-sectional associations between dietary patterns and mental health in elderly patients with a history of myocardial infarction
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