title: The association between dietary patterns, diabetes and depression.
abstract: BACKGROUND
  Type 2 diabetes and depression are commonly comorbid high-prevalence chronic disorders. Diet is a key diabetes risk factor and recent research has highlighted the relevance of diet as a possible risk for factor common mental disorders. This study aimed to investigate the interrelationship among dietary patterns, diabetes and depression.
  
  
  METHODS
  Data were integrated from the National Health and Nutrition Examination Study (2009-2010) for adults aged 18+ (n=4588, Mean age=43yr). Depressive symptoms were measured by the Patient Health Questionnaire-9 and diabetes status determined via self-report, usage of diabetic medication and/or fasting glucose levels ≥126mg/dL and a glycated hemoglobin level ≥6.5% (48mmol/mol). A 24-h dietary recall interview was given to determine intakes. Multiple logistic regression was employed, with depression the outcome, and dietary patterns and diabetes the predictors. Covariates included gender, age, marital status, education, race, adult food insecurity level, ratio of family income to poverty, and serum C-reactive protein.
  
  
  RESULTS
  Exploratory factor analysis revealed five dietary patterns (healthy; unhealthy; sweets; 'Mexican' style; breakfast) explaining 39.8% of the total variance. The healthy dietary pattern was associated with reduced odds of depression for those with diabetes (OR 0.68, 95% CI [0.52, 0.88], p=0.006) and those without diabetes (OR 0.79, 95% CI [0.64, 0.97], p=0.029) (interaction p=0.048). The relationship between the sweets dietary pattern and depression was fully explained by diabetes status.
  
  
  CONCLUSIONS
  In this study, a healthy dietary pattern was associated with a reduced likelihood of depressive symptoms, especially for those with Type 2 diabetes.
authors.affiliation: IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia; Department of Statistics, Data Science and Epidemiology, Swinburne University of Technology, Hawthorn, VIC, Australia. Electronic address: jdipnall@deakin.edu.au.
authors.forename: Joanna F
authors.initials: JF
authors.lastname: Dipnall
authors.affiliation: IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia; NorthWest Academic Centre, Department of Medicine, The University of Melbourne, Melbourne, VIC, Australia. Electronic address: juliep@barwonhealth.org.au.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Pasco
authors.affiliation: Department of Statistics, Data Science and Epidemiology, Swinburne University of Technology, Hawthorn, VIC, Australia. Electronic address: dmeyer@swin.edu.au.
authors.forename: Denny
authors.initials: D
authors.lastname: Meyer
authors.affiliation: IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia; Department of Psychiatry, The University of Melbourne, Melbourne, Australia; Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia. Electronic address: mikebe@barwonhealth.org.au.
authors.forename: Michael
authors.initials: M
authors.lastname: Berk
authors.affiliation: IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia. Electronic address: lanaw@barwonhealth.org.au.
authors.forename: Lana J
authors.initials: LJ
authors.lastname: Williams
authors.affiliation: IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia; Department of Psychiatry, The University of Melbourne, Melbourne, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia. Electronic address: seetald@barwonhealth.org.au.
authors.forename: Seetal
authors.initials: S
authors.lastname: Dodd
authors.affiliation: IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia; Department of Psychiatry, The University of Melbourne, Melbourne, Australia; Centre for Adolescent Health, Murdoch Children׳s Research Institute, Melbourne, VIC, Australia; Black Dog Institute, Sydney, NSW, Australia. Electronic address: f.jacka@deakin.edu.au.
authors.forename: Felice N
authors.initials: FN
authors.lastname: Jacka
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications* / Q000523:psychology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000523:psychology*; D005163:Factor Analysis, Statistical; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D057566:Self Report; D055815:Young Adult
keywords: Depression; Diabetes; Diet; Dietary patterns; Nutrition; Psychiatry