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January 21, 2021
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More dietary fiber may decrease depression risk among premenopausal women

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Editor's Note: On Jan. 22, the headline was changed to indicate that more dietary fiber may decrease depression risk among premenopausal women. We regret the error. 

Dietary fiber intake was inversely associated with depression among premenopausal, but not postmenopausal, women, according to findings published in Menopause.

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“Regarding dietary modifications, the consumption of several foods such as fruits, vegetables, fish, whole grains, olive oil and low-fat dairy products is inversely correlated with depressive symptoms,” Yunsun Kim, MD, of the department of family medicine at Chung-ang University Hospital in Seoul, South Korea, and colleagues wrote in the study background. “Previous studies suggested that dietary fiber intake has a significant negative association with depression. Thus, dietary fiber intake from fruits and vegetables was proposed to play a modulatory role in the gut microbiota that is mainly explained by the ‘gut-brain axis,’ and it was also proposed that changes in the gut microbiota composition affect neurotransmission and various neuropsychiatric phenomena.”

Kim and colleagues analyzed data from 5,807 women using data from the Korea National Health and Nutrition Examination Survey data for 2014, 2016 and 2018 (mean age, 47 years; 2,949 premenopausal). Researchers calculated dietary fiber intake according to the 24-hour recall method and used Patient Health Questionnaire-9 scores to assess depression. A t test based on the general linear model was used to compare mean dietary fiber intake according to the presence of depression by menopause status. Logistic regression analysis was used to estimate ORs for depression.

Among all women, dietary fiber intake was higher among those without depression vs. those with depression (mean, 14.07 g/1,000 kcal/day vs. 12.67 g /1,000 kcal/day; P = .003). The relationship remained significant when stratified by menopausal status for premenopausal women (mean, 12.45 g/1,000 kcal/day vs. 10.3 g/1,000 kcal/day; P < .001). There were no differences observed among postmenopausal women.

Researchers observed an inverse relationship between a change in daily dietary fiber intake, calculated as 1 g/1,000 kcal, and the prevalence of depression among premenopausal women in a model adjusted for age, BMI, education level, marital status, income and other factors, with an OR of 0.949 (95% CI, 0.906-0.993).

“We believe that our findings are clinically significant because when we converted the scale of daily dietary fiber intake as 3 g/1,000 kcal, ie, 3 g increase for every 1,000 kcal of daily energy intake, it was equivalent to a 15% decrease in the prevalence of depression, and dietary fiber intake would be modifiable for the general population,” the researchers wrote. “Moreover, the effect size of our study was not markedly smaller than that of the previous study that reported an OR of 0.67 (95% CI, 0.503-0.806) for depression and fruit and vegetable consumption as quartiles. The gap in energy-adjusted dietary fiber intake between the lowest and the highest quartile was 3 g to 4 g/1,000 kcal.”