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Epidemiology

Dietary pattern derived by reduced rank regression and depressive symptoms in a multi-ethnic population: the HELIUS study

European Journal of Clinical Nutrition volume 71, pages 987–994 (2017)Cite this article

Subjects

Abstract

Background/Objectives:

To investigate the association of dietary patterns derived by reduced rank regression (RRR) with depressive symptoms in a multi-ethnic population.

Subjects/Methods:

Cross-sectional data from the HELIUS study were used. In total, 4967 men and women (18–70 years) of Dutch, South-Asian Surinamese, African Surinamese, Turkish and Moroccan origin living in the Netherlands were included. Diet was measured using ethnic-specific food frequency questionnaires. Depressive symptoms were measured with the nine-item patient health questionnaire.

Results:

By performing RRR in the whole population and per ethnic group, comparable dietary patterns were identified and therefore the dietary pattern for the whole population was used for subsequent analyses. We identified a dietary pattern that was strongly related to eicosapentaenoic acid+docosahexaenoic acid, folate, magnesium and zinc (response variables) and which was characterized by milk products, cheese, whole grains, vegetables, legumes, nuts, potatoes and red meat. After adjustment for confounders, a statistically significant inverse association was observed in the whole population (B: −0.03, 95% CI: −0.06, −0.00, P=0.046) and among Moroccan (B: −0.09, 95% CI: −0.13, −0.04, P=0.027) and South-Asian Surinamese participants (B: −0.05, 95% CI: −0.09, −0.01, P=<0.001), whereas no statistically significant association was found in the remaining ethnic groups. No statistically significant associations were found between the dietary pattern and significant depressed mood in any of the ethnic groups.

Conclusions:

No consistent evidence was found that consumption of a dietary pattern, high in nutrients that are hypothesized to protect against depression, was associated with lower depressive symptoms across different ethnic groups.

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References

  1. Murray CJ, Lopez AD . Evidence-based health policy—lessons from the Global Burden of Disease Study. Science 1996; 274: 740–743.

    Article  CAS  Google Scholar 

  2. Stronks K, Snijder MB, Peters RJ, Prins M, Schene AH, Zwinderman AH . Unravelling the impact of ethnicity on health in Europe: the HELIUS study. BMC Public Health 2013; 13: 402.

    Article  Google Scholar 

  3. Verweij MH-vH G, Depressiviteit en antidepressiva in Nederland (in Dutch) (Depression and anti-depression medication in the Netherlands) Centraal Bureau voor de Statistiek (accessed December 2013).

  4. Belmaker RH, Agam G . Major depressive disorder. N Engl J Med 2008; 358: 55–68.

    Article  CAS  Google Scholar 

  5. Martinez-Gonzalez MA, Sanchez-Villegas A . Food patterns and the prevention of depression. Proc Nutr Soc 2016; 75: 139–146.

    Article  Google Scholar 

  6. Lai JS, Hiles S, Bisquera A, Hure AJ, McEvoy M, Attia J . A systematic review and meta-analysis of dietary patterns and depression in community-dwelling adults. Am J Clin Nutr 2014; 99: 181–197.

    Article  CAS  Google Scholar 

  7. Sanchez-Villegas A, Martinez-Gonzalez MA . Diet, a new target to prevent depression? BMC Med 2013; 11: 3.

    Article  Google Scholar 

  8. Sarris J, Logan AC, Akbaraly TN, Amminger GP, Balanza-Martinez V, Freeman MP et al. Nutritional medicine as mainstream in psychiatry. Lancet Psychiatry 2015; 2: 271–274.

    Article  Google Scholar 

  9. Liu YHR, Mak A . Interleukin (IL)-6, tumour necrosis factor alpha (TNF-α) and soluble interleukin-2 receptors (sIL-2R) are elevated in patients with major depressive disorder: a meta-analysis and meta-regression. J Affect Disord 2012; 139: 230–239.

    Article  CAS  Google Scholar 

  10. Vavakova M, Durackova Z, Trebaticka J . Markers of oxidative stress and neuroprogression in depression disorder. Oxid Med Cell Longev 2015; 2015: 898393.

    Article  Google Scholar 

  11. Howren MB, Lamkin DM, Suls J . Associations of depression with C-reactive protein, IL-1, and IL-6: a meta-analysis. Psychosom Med 2009; 71: 171–186.

    Article  CAS  Google Scholar 

  12. Grosso G, Pajak A, Marventano S, Castellano S, Galvano F, Bucolo C et al. Role of omega-3 fatty acids in the treatment of depressive disorders: a comprehensive meta-analysis of randomized clinical trials. PLoS ONE 2014; 9: e96905.

    Article  Google Scholar 

  13. Bloch MH, Hannestad J . Omega-3 fatty acids for the treatment of depression: systematic review and meta-analysis. Mol Psychiatry 2012; 17: 1272–1282.

    Article  CAS  Google Scholar 

  14. Sanchez-Villegas A, Doreste J, Schlatter J, Pla J, Bes-Rastrollo M, Martinez-Gonzalez MA . Association between folate, vitamin B(6) and vitamin B(12) intake and depression in the SUN cohort study. J Hum Nutr Diet 2009; 22: 122–133.

    Article  CAS  Google Scholar 

  15. Petridou ET, Kousoulis AA, Michelakos T, Papathoma P, Dessypris N, Papadopoulos FC et al. Folate and B12 serum levels in association with depression in the aged: a systematic review and meta-analysis. Aging Ment Health 2015; 20: 965–973.

    Article  Google Scholar 

  16. Murakami K, Mizoue T, Sasaki S, Ohta M, Sato M, Matsushita Y et al. Dietary intake of folate, other B vitamins, and omega-3 polyunsaturated fatty acids in relation to depressive symptoms in Japanese adults. Nutrition 2008; 24: 140–147.

    Article  CAS  Google Scholar 

  17. Derom ML, Sayon-Orea C, Martinez-Ortega JM, Martinez-Gonzalez MA . Magnesium and depression: a systematic review. Nutr Neurosci 2013; 16: 191–206.

    Article  CAS  Google Scholar 

  18. Tarleton EK, Littenberg B . Magnesium intake and depression in adults. J Am Board Fam Med 2015; 28: 249–256.

    Article  Google Scholar 

  19. Vashum KP, McEvoy M, Milton AH, McElduff P, Hure A, Byles J et al. Dietary zinc is associated with a lower incidence of depression: findings from two Australian cohorts. J Affect Disord 2014; 166: 249–257.

    Article  CAS  Google Scholar 

  20. Lang UE, Beglinger C, Schweinfurth N, Walter M, Borgwardt S . Nutritional aspects of depression. Cell Physiol Biochem 2015; 37: 1029–1043.

    Article  CAS  Google Scholar 

  21. Moeller SM, Reedy J, Millen AE, Dixon LB, Newby PK, Tucker KL et al. Dietary patterns: challenges and opportunities in dietary patterns research an Experimental Biology workshop, April 1, 2006. J Am Diet Assoc 2007; 107: 1233–1239.

    Article  Google Scholar 

  22. Hu FB . Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol 2002; 13: 3–9.

    Article  CAS  Google Scholar 

  23. Akbaraly TN, Sabia S, Shipley MJ, Batty GD, Kivimaki M . Adherence to healthy dietary guidelines and future depressive symptoms: evidence for sex differentials in the Whitehall II study. Am J Clin Nutr 2013; 97: 419–427.

    Article  CAS  Google Scholar 

  24. Sanchez-Villegas A, Delgado-Rodriguez M, Alonso A, Schlatter J, Lahortiga F, Serra Majem L et al. Association of the Mediterranean dietary pattern with the incidence of depression: the Seguimiento Universidad de Navarra/University of Navarra follow-up (SUN) cohort. Arch Gen Psychiatry 2009; 66: 1090–1098.

    Article  Google Scholar 

  25. Dowlati Y, Herrmann N, Swardfager W, Liu H, Sham L, Reim EK et al. A meta-analysis of cytokines in major depression. Biol Psychiatry 2010; 67: 446–457.

    Article  CAS  Google Scholar 

  26. Sanchez-Villegas A, Henriquez-Sanchez P, Ruiz-Canela M, Lahortiga F, Molero P, Toledo E et al. A longitudinal analysis of diet quality scores and the risk of incident depression in the SUN Project. BMC Med 2015; 13: 197.

    Article  Google Scholar 

  27. Jacka FN, Mykletun A, Berk M, Bjelland I, Tell GS . The association between habitual diet quality and the common mental disorders in community-dwelling adults: the Hordaland Health study. Psychosom Med 2011; 73: 483–490.

    Article  Google Scholar 

  28. Akbaraly TN, Brunner EJ, Ferrie JE, Marmot MG, Kivimaki M, Singh-Manoux A . Dietary pattern and depressive symptoms in middle age. Br J Psychiatry 2009; 195: 408–413.

    Article  Google Scholar 

  29. Rienks J, Dobson AJ, Mishra GD . Mediterranean dietary pattern and prevalence and incidence of depressive symptoms in mid-aged women: results from a large community-based prospective study. Eur J Clin Nutr 2013; 67: 75–82.

    Article  CAS  Google Scholar 

  30. Hoffmann K, Schulze MB, Schienkiewitz A, Nothlings U, Boeing H . Application of a new statistical method to derive dietary patterns in nutritional epidemiology. Am J Epidemiol 2004; 159: 935–944.

    Article  Google Scholar 

  31. Weikert C, Schulze MB . Evaluating dietary patterns: the role of reduced rank regression. Curr Opin Clin Nutr Metab Care 2016; 19: 341–346.

    Article  CAS  Google Scholar 

  32. Miki T, Kochi T, Kuwahara K, Eguchi M, Kurotani K, Tsuruoka H et al. Dietary patterns derived by reduced rank regression (RRR) and depressive symptoms in Japanese employees: the Furukawa nutrition and health study. Psychiatry Res 2015; 229: 214–219.

    Article  Google Scholar 

  33. Vermeulen ESK, Visser M, Brouwer IA, Schene AH, Mocking RJ, Colpo M et al. The association between dietary patterns derived by reduced rank regression and depressive symptoms over time: the Invecchiare in Chianti (InCHIANTI) study. Br J Nutr 2016; 115: 2145–2153.

    Article  CAS  Google Scholar 

  34. Brussaard JH, van Erp-Baart MA, Brants HA, Hulshof KF, Löwik MR . Nutrition and health among migrants in the Netherlands. Public Health Nutr 2001; 4: 659–664.

    Article  CAS  Google Scholar 

  35. Dijkshoorn HNV, Nicolaou M . Risk groups for overweight and obesity among Turkish and Moroccan migrants in the Netherlands. Public Health 2008; 122: 625–630.

    Article  CAS  Google Scholar 

  36. de Boer EJ BH, Beukers M, Ocke MC, Dekker L, Nicolaou M, Snijder M, Voeding van MarokkaanseTurkse, Surinaamse en autochtone Nederlanders in Amsterdam. Rijksinstituut voor Volksgezondheid en Milieu; Contract No.: Rapport 2015-0099.

  37. Stronks K, Kulu-Glasgow I, Agyemang C . The utility of 'country of birth' for the classification of ethnic groups in health research: the Dutch experience. Ethn Health 2009; 14: 255–269.

    Article  Google Scholar 

  38. Dekker LH, Snijder MB, Beukers MH, de Vries JH, Brants HA, de Boer EJ et al. A prospective cohort study of dietary patterns of non-western migrants in the Netherlands in relation to risk factors for cardiovascular diseases: HELIUS-dietary patterns. BMC Public Health 2011; 11: 441.

    Article  Google Scholar 

  39. Kroenke K, Spitzer RL, Williams JB . The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001; 16: 606–613.

    Article  CAS  Google Scholar 

  40. Ikram UZ, Snijder MB, Fassaert TJ, Schene AH, Kunst AE, Stronks K . Discrimination and depression in ethnic minority groups. Ned Tijdschr Geneeskd 2015; 159: A8828.

    Google Scholar 

  41. Wittkampf KA1 NL, Schene AH, Huyser J, van Weert HC . Diagnostic accuracy of the mood module of the patient health questionnaire: a systematic review. Gen Hosp Psychiatry 2007; 29: 388–395.

    Article  Google Scholar 

  42. Manea LGS, McMillan D . A diagnostic meta-analysis of the patient health questionnaire-9 (PHQ-9) algorithm scoring method as a screen for depression. Gen Hosp Psychiatry 2015; 37: 67–75.

    Article  Google Scholar 

  43. Beukers MH, Dekker LH, de Boer EJ, Perenboom CW, Meijboom S, Nicolaou M et al. Development of the HELIUS food frequency questionnaires: ethnic-specific questionnaires to assess the diet of a multiethnic population in the Netherlands. Eur J Clin Nutr 2015; 69: 579–584.

    Article  CAS  Google Scholar 

  44. Dutch Food Composition Table 2011 National Institute for Public Health and the Netherlands Nutrition Centre: The Hague, The Netherlands, 2011.

  45. Schulze MB, Hoffmann K . Methodological approaches to study dietary patterns in relation to risk of coronary heart disease and stroke. Br J Nutr 2006; 95: 860–869.

    Article  CAS  Google Scholar 

  46. Ambrosini GL EP, Northstone K, Howe LD, Tilling K, Jebb SA . Identification of a dietary pattern prospectively associated with increased adiposity during childhood and adolescence. Int J Obes (Lond) 2012; 36: 12995–305.

    Article  Google Scholar 

  47. Willett WC . Nutritional Epidemiology. Oxford University Press, 2013.

    Google Scholar 

  48. Chocano-Bedoya PO, O'Reilly EJ, Lucas M, Mirzaei F, Okereke OI, Fung TT et al. Prospective study on long-term dietary patterns and incident depression in middle-aged and older women. Am J Clin Nutr 2013; 98: 813–820.

    Article  CAS  Google Scholar 

  49. Chan RCD, Woo J . A prospective cohort study to examine the association between dietary patterns and depressive symptoms in older Chinese people in Hong Kong. PLoS One 2014; 9: e105760.

    Article  Google Scholar 

  50. Le Port A, Gueguen A, Kesse-Guyot E, Melchior M, Lemogne C, Nabi H et al. Association between dietary patterns and depressive symptoms over time: a 10-year follow-up study of the GAZEL cohort. PLoS One 2012; 7: e51593.

    Article  CAS  Google Scholar 

  51. Stoeldraijer LGJ, Prognose van de bevolking naar herkomst, 2010-2060 (in Dutch) (Population forecast by ethnic background 2010-2060). Centraal Bureau voor de Statistiek; 2011. Contract No.: 59.

  52. Jacka FN, Cherbuin N, Anstey KJ, Butterworth P . Does reverse causality explain the relationship between diet and depression? J Affect Disord 2015; 175: 248–250.

    Article  Google Scholar 

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Acknowledgements

We are most grateful to the participants and the research team who have taken part in providing and gathering the data of the HELIUS study. The HELIUS study is conducted by the AMC Amsterdam and the Public Health Service of Amsterdam. Both organizations provided core support for HELIUS. The HELIUS study is also funded by the Dutch Heart Foundation, Organization for Health Research and Development (ZonMw), and the European Union (FP7). The current study was supported by an additional grant from the EU FP7 MooDFOOD Project ‘Multi-country cOllaborative project on the rOle of Diet, FOod-related behaviour, and Obesity in the prevention of Depression’, Grant agreement no. 613598.

Author information

Authors and Affiliations

  1. Department of Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands

    E Vermeulen, K Stronks, M B Snijder & M Nicolaou

  2. Department of Health Sciences and the EMGO Institute, VU University Amsterdam, Amsterdam, The Netherlands

    M Visser & I A Brouwer

  3. Department of Nutrition and Dietetics, Internal Medicine, VU University Medical Centre, Amsterdam, The Netherlands

    M Visser

  4. Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands

    M B Snijder

  5. Department of Psychiatry, Program for Mood Disorders, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands

    R J T Mocking

  6. Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands

    E M Derks & A H Schene

  7. Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands

    A H Schene

  8. Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands

    A H Schene

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  1. E Vermeulen
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Correspondence to E Vermeulen.

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Vermeulen, E., Stronks, K., Visser, M. et al. Dietary pattern derived by reduced rank regression and depressive symptoms in a multi-ethnic population: the HELIUS study. Eur J Clin Nutr 71, 987–994 (2017). https://doi.org/10.1038/ejcn.2017.61

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