Diet and Depression: A Secondary Analysis from NHANES 1999-2002

This Ph.D. dissertation presents results that shed light on whether there is an association between dietary intake and depressive disorder, feelings of sadness, or thoughts of death. This question is investigated in the context of a secondary data analysis using cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) 1999-2002. Subjects in this study were identified as a subpopulation of the NHANES survey that completed the Composite International Diagnostic Interview questionnaire for major depression. The presence of depression may lead to a decline in dietary intake and nutritional status. Conversely, poor dietary intake may have a role in the etiology of depression. Specifically, depression is associated with lower plasma, erythrocyte, phospholipid, and adipose tissue omega-3 fatty acids. Little is known about the comprehensive dietary intake of those with depression or depressive symptoms. Initially, comparisons of the dietary profile between those with and without depression or depressive symptoms were investigated. Secondly, analysis was done to determine the relationship between dietary omega-3 fatty acids and depression or depressive symptoms. Lastly, to clarify the relationship between diet and depression, misreporting of dietary energy intake was evaluated.No significant differences in the dietary profile or nutritional biochemistries were found between the altered mood and normal mood groups. No significant differences were found in dietary omega-3 fatty acids between the depressed and non-depressed groups, even after adjusting for confounding variables. Misreporting of energy intake was not significantly associated with altered mood status and remained non-significant after adjusting for confounding variables. In both groups, a significant decreasing trend in the ratio of energy intake to estimated basal metabolic rate (EI:BMRest) was found as body mass index increased.Based on dietary intake alone, the relationship between depression and specific nutrients may not be apparent. Dietary intake among those with depression and depressive symptoms appears to be adequate, but adequacy may not be sufficient as a route for prevention or management of depression. Further investigation of diet and depression ought to measure diet, including nutrition supplements, and biochemical levels of nutrients from a broader age range of adults and children and those with comorbid illnesses