Association between depressive symptoms and dietary intake in patients with type 1 diabetes

Aims: Depressive mood negatively affects self-care practices, and thereby increases the risk of long-term complications. Not much is known about the association between depressive symptoms and dietary intake in patients with type 1 diabetes, a population with high risk of cardiovascular disease. Methods: Subjects (n = 976, 41% men, age 48 +/- 14 years) were participants in the Finnish Diabetic Nephropathy Study. Depressive symptomatology was assessed with the Beck Depression Inventory (BDI). Dietary patterns were derived from food frequency questionnaire-entries by exploratory factor analysis. Energy and macronutrient intakes were calculated from food records. In the same record, participants also reported the results of their daily blood glucose monitoring. Associations between BDI score and selfcare variables were analysed using generalized linear regression. For macronutrients, a substitution model was applied. Results: TWo dietary patterns ("Fish and vegetables", and "Traditional") negatively associated with the BDI score. Instead, an increase in the "Sweet" pattern score was positively associated with depressive symptomatology. Of the macronutrients, favouring protein over carbohydrates or fats associated with lower depression scores. Higher blood glucose selfmonitoring frequency and higher variability of the measurements were positively associated with the BDI score. However, no association was observed between depressive symptoms and the mean of the blood glucose measurements. Conclusions: Depressive symptoms are reflected in the dietary intake and the selfmonitoring of blood glucose, in type 1 diabetes. Whether depression, via compromised self-care practices, negatively affect long-term outcomes in this patient group has to be the subject of future studies. (C) 2018 Elsevier B.V. All rights reserved.Peer reviewe