Diet quality and depressive symptoms in older adults, assessing the effect modification by genetic predisposition and low-grade inflammation: a target trial emulation.

The relationship between dietary nutrient intake and adolescent depression based on the dietary inflammation index: a case-control study

A positive correlation between the E-DII and both the risk and severity of adolescent depression is underscored, emphasizing the critical role of dietary factors in the prevention and management of adolescent depression.

Depression as a mediator in the link between physical activity and cardiovascular disease: Insights from NHANES 2007–2018 and Mendelian randomization

Depression Symptoms and Advanced Cardiovascular-Kidney-Metabolic Syndrome in U.S. Adults: The Moderating Role of Sex.

OBJECTIVE To examine the association between depressive symptoms and advanced cardiovascular-kidney-metabolic (CKM) syndrome among U.S. adults and to determine whether this association differs by demographic, socioeconomic, and behavioral factors. METHODS This cross-sectional study used National Health and Nutrition Examination Survey data. Depressive symptoms were assessed using the Patient Health Questionnaire-9. CKM stages were defined using the American Heart Association framework and categorized as nonadvanced CKM, stages 0 to 2, versus advanced CKM, stages 3 to 4. Survey-weighted logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs) for advanced CKM. Interaction terms tested effect modification by age, sex, race and ethnicity, poverty-income ratio, education, and smoking status. RESULTS The study included 30,244 adults. Overall, 16% of adults had advanced CKM, and 8% had depressive symptoms. In fully adjusted sex-stratified models, depressive symptoms were associated with higher odds of advanced CKM among women (OR, 2.24; 95% CI, 1.74-2.88) and men (OR, 1.75; 95% CI, 1.34-2.28). Interaction estimates indicated a stronger association among women (OR, 1.58; 95% CI, 1.12-2.23; P=0.010) and a weaker association at age ≥65 versus 30-49 years (OR, 0.42; 95% CI, 0.27-0.67; P<.001). CONCLUSIONS Depressive symptoms were associated with higher odds of advanced CKM in both women and men, with a stronger association among women and a weaker association at ages ≥65 versus 30-49. These findings support integrating mental health screening into cardiometabolic and kidney disease prevention strategies, emphasizing age- and sex-specific vulnerabilities.

Associations of the Chinese healthy eating index and dietary diversity score with depressive and anxious symptoms among older adults

Depression and anxiety significantly contribute to the mental health disease burden. Although healthy dietary patterns may mitigate mental distress, evidence regarding the associations of dietary quality and dietary diversity with mental health remains limited. This study aimed to investigate the independent and joint associations of the Chinese Healthy Eating Index (CHEI) and Dietary Diversity Score (DDS) with depression, anxiety, and their co-occurrence among Chinese older adults. We utilized cross-sectional data from the 2018 Chinese Longitudinal Healthy Longevity Survey, which included a total of 9,455 participants aged 65 years and older. The CHEI and DDS were applied to evaluate dietary quality and dietary diversity, respectively. We employed logistic regression models to examine these associations. In the fully adjusted model, higher CHEI was associated with lower odds of depression (OR [odds ratio] tertile [T] 3 vs. T1= 0.63, 95% CI [confidence interval]: 0.53, 0.75), anxiety (OR T3 vs. T1= 0.61, 95% CI: 0.51, 0.74), and their co-occurrence (OR T3 vs. T1= 0.66, 95% CI: 0.51, 0.84). A 10-unit increment in CHEI was associated with 33% lower odds of depression, 32% lower odds of anxiety, and 32% lower odds of their co-occurrence. Similarly, a higher DDS was inversely associated with the odds of depression (OR T3 vs. T1= 0.59, 95% CI: 0.50, 0.70), anxiety (OR T3 vs. T1= 0.56, 95% CI: 0.47, 0.67), and their co-occurrence (OR T3 vs. T1= 0.60, 95% CI: 0.47, 0.76). Each one-unit increase in DDS was correlated with a 12% lower odds of depression, anxiety, and their co-occurrence. Moreover, compared to the group with low CHEI and low DDS, the group with high CHEI and high DDS showed significantly lower odds of depression, anxiety, and their co-occurrence. The study revealed that higher CHEI and DDS scores were inversely associated with depressive symptoms, anxious symptoms, and their co-occurrence among Chinese older adults. Additional longitudinal research is required to confirm our findings. Not applicable.

Combined Associations of Diabetes and Depressive Symptoms on Cognitive Impairment Risk in the Population Aged 60 or Older: Cross-Cohort Comparisons From NHANES and CHARLS

Objective Diabetes mellitus (DM) and cognitive impairment (CoI) are correlated, but the combined impact of depressive symptoms on CoI risk in older adults remains unclear. Methods This study included 1,200 U.S. adults aged ≥60 years (National Health and Nutrition Examination Survey, NHANES) and 1,500 Chinese adults (China Health and Retirement Longitudinal Study, CHARLS). DM was defined by laboratory measures or self-report; depressive symptoms were assessed via the Patient Health Questionnaire-9 (PHQ-9) (NHANES) and CES-D-10 (CHARLS); CoI was measured using the CERAD battery (NHANES) and situational memory/mental integrity scores (CHARLS). Multivariate logistic regression estimated associations of DM and depressive symptoms with CoI. Additive interaction was evaluated by the relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy index (S). Restricted cubic spline (RCS) analyses examined nonlinear DM–depressive symptoms interactions. Results Both DM and depressive symptoms were independently and significantly associated with CoI. After multivariate adjustment, diabetic patients exhibited significantly increased CoI risk; depressive symptoms similarly elevated CoI risk. Interaction analysis revealed an additive effect when DM co-occurred with depressive symptoms in CHARLS but not in NHANES. Mediation analyses further suggest bidirectional associations: in CHARLS, diabetes and depressive symptoms appear to mediate each other’s effects on CoI. Additionally, RCS analysis in NHANES indicated a nonlinear interaction between depressive symptom severity (PHQ-9) and DM on CoI (p<0.05). Conclusion The observed associations varied across cohorts, with a significant additive interaction between diabetes and depressive symptoms found only in the CHARLS cohort. Integrating metabolic and mental health screening and interventions may optimize cognitive outcomes in high-risk older adult populations.

The association between the Global Diet Quality Score and all-cause mortality in Black South African adults.

BACKGROUND Modifiable risk factors for cardiovascular diseases (CVD) include diet quality. The Global Diet Quality Score (GDQS) was designed to provide a comprehensive diet quality assessment, yet very few studies have assessed its relationship with CVD and all-cause mortality, particularly in an African setting. OBJECTIVE We determined the association between the baseline total GDQS, GDQS positive (GDQS+) and GDQS negative (GDQS-) and all-cause and CVD mortality after 13 years of follow-up in Black South African adults (aged 30 to 70 years). GDQS+ reflects healthy food intake, while GDQS- is reverse-scored (higher scores indicating lower intake of unhealthy foods). Across all GDQS measures, higher scores indicate better diet quality. METHODS The baseline dietary data from the PURE-NWP-SA study was used to calculate the GDQS, with mortality outcomes recorded 13 years later. Cox proportional hazards models were applied, stratified by sex, age group and observation time tertiles. Models were adjusted for lifestyle factors and health status. Hazard ratios (HRs) were calculated for baseline GDQS tertiles. RESULTS The overall GDQS was low in both survivors and non-survivors, reflecting low intake of many GDQS healthy food groups, with only whole grains and liquid oils reaching desirable levels (to give maximum points to the GDQS+). Compared with Tertile (T1), participants in T3 of the GDQS+ had a lower risk of all-cause mortality (HR = 0.69; 95% CI: 0.56-0.86), whereas those in T3 of the GDQS- had a higher risk (HR = 1.39; 95% CI: 1.12-1.73). No associations were found with CVD mortality. CONCLUSION The GDQS is a valuable tool for investigating all-causes mortality risk in African populations through its GDQS+ sub-metric. However, caution is warranted when applying the GDQS in settings of dietary monotony or food insecurity, particularly the GDQS- sub-metric which gives maximum points for low intake/avoidance of unhealthy food groups.