Dietary inflammatory index (DII®) and the risk of depression symptoms in adults

• Published in: Clinical nutrition (Edinburgh, Scotland) Scotland), 2021-05, Vol.40 (5), p.3631-3642
• Main Authors: Shakya, Prem Raj, Melaku, Yohannes Adama, Shivappa, Nitin, Hébert, James R., Adams, Robert J., Page, Amanda J., Gill, Tiffany K.
• Format: Article
• Language: English
• Subjects: CES-D; Depressive symptoms; Dietary inflammatory index; E-DII; Inflammation; Meta-analysis
• ISSN: 0261-5614; 1532-1983
• DOI: 10.1016/j.clnu.2020.12.031

Findings from observational studies investigating the association between Dietary Inflammatory Index (DII®) scores and depression symptoms (DepS) are inconsistent. This study aims to assess the association between energy-adjusted DII (E-DII™) and DepS using the North West Adelaide Health Study (NWAHS) cohort as well as update a previous meta-analysis. A total of 1743 (mean ± SD age: 56.6 ± 13.6 years, 51% female) study participants from NWAHS were included in the cross-sectional study and 859 (mean ± SD age: 58.4 ± 12.1 years, 52.6% female) in the longitudinal analyses. The Center for Epidemiological Studies Depression Scale (CES-D) was used for the measurement of DepS. E-DII scores were calculated from the dietary data collected using a validated food frequency questionnaire (FFQ). Data from two stages [Stage 3 (2008–10) and North West 15 (NW15) (2015)] were used. Log- and negative binomial regression were used to assess the association between quartiles of E-DII and DepS. A recent meta-analysis was updated by including 12 publications (six cross-sectional and six cohort studies) on the association between DII and DepS. In the cross-sectional analysis, a higher E-DII score (i.e., more pro-inflammatory diet) was associated with a 79% increase in odds of reporting DepS [ORQuartile4vs1: 1.79; 95% CI: 1.14–2.81; p = 0.01; p for trend (ptrend) = 0.03]. Males with higher E-DII had a more than two-fold higher odds of DepS (ORQuartile4vs1: 2.27; 95% CI: 1.02–5.06; p = 0.045; ptrend = 0.09). Females with higher E-DII had an 81% increase in odds of DepS (ORQuartile4vs1: 1.81; 95% CI: 1.01–3.26; p = 0.046; ptrend = 0.07). These associations were consistent in the longitudinal analysis. Comparing highest to lowest quintiles of E-DII, the updated meta-analysis showed that a pro-inflammatory diet is associated with a 45% increase in odds of having DepS (OR: 1.45; 95% CI: 1.20–1.74; p