Dietary flavonoid intake and risk of incident depression in midlife and older women.
Dietary flavonoid intake and risk of incident depression in midlife and older women.
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DOI：
10.3945/ajcn.115.124545
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发表时间：
2016-09
期刊：
影响因子：
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通讯作者：
Okereke OI
中科院分区：
文献类型：
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作者：
Chang SC;Cassidy A;Willett WC;Rimm EB;O'Reilly EJ;Okereke OI
背景：饮食中的类黄酮摄入量对抑郁风险的影响尚不清楚。目的：我们前瞻性地研究了估计的饮食类黄酮摄入量与抑郁风险之间的关系。设计：我们从护士健康研究[(NHS)年龄53-80岁]和护士健康研究II[(NHSII)年龄36-55岁]基线跟踪了82,643名无抑郁史的女性。根据每2-4年收集的有效食物频率问卷计算总黄酮类和亚类(黄酮醇、黄酮类、黄烷酮类、花青素、黄烷醇-3-醇、多聚黄酮类和原花青素)的摄入量。抑郁症被定义为医生或临床医生诊断的抑郁症或抗抑郁药的使用，并在定期问卷调查中自我报告。用COX比例风险模型检验关联性。结果：在10年的随访中，共有10,752例偶发抑郁症病例发生。观察到黄酮醇、黄酮类和黄烷酮摄入量与抑郁风险呈负相关。当比较最高(5分位数)和最低(5分位数1)五分位数时，合并多变量调整后的HR(95%CI)分别为0.93(0.88，0.99)、0.92(0.86，0.98)和0.90(0.85，0.96)，并显示出在5分位数之间呈线性趋势(P-趋势=0.0004.0 0 8)。在富含类黄酮类食物的分析中，每天食用≥2份柑橘类水果或果汁的参与者的HR为0.82(95%CI：0.74，0.91)，而服用1份/周的参与者的HR为0.82(95%CI：0.74，0.91)。仅在英国国民健康保险制度中，摄入总黄酮类、聚合物和原花青素的患者患抑郁症的风险显著降低(9-12%)。在对老年NHS参与者(基线或随访期间65岁的≥)的分析中，我们能够将抑郁症状纳入结果定义，除黄烷-3-醇外，所有类黄酮亚类的较高摄入量与显著较低的抑郁风险相关；黄酮类和原花青素显示出最强的相关性(两者的HR：0.83；95%CI：0.77，0.90)。结论：较高的类黄酮摄入量可能与较低的抑郁风险有关，尤其是在老年女性中。需要进一步的研究来证实这些联系。
Background: The impact of dietary flavonoid intakes on risk of depression is unclear. Objective: We prospectively examined associations between estimated habitual intakes of dietary flavonoids and depression risk. Design: We followed 82,643 women without a previous history of depression at baseline from the Nurses’ Health Study [(NHS) aged 53–80 y] and the Nurses’ Health Study II [(NHSII) aged 36–55 y]. Intakes of total flavonoids and subclasses (flavonols, flavones, flavanones, anthocyanins, flavan-3-ols, polymeric flavonoids, and proanthocyanidins) were calculated from validated food-frequency questionnaires collected every 2–4 y. Depression was defined as physician- or clinician-diagnosed depression or antidepressant use and was self-reported in response to periodic questionnaires. Cox proportional hazards models were performed to examine associations. Results: A total of 10,752 incident depression cases occurred during a 10-y follow-up. Inverse associations between flavonol, flavone, and flavanone intakes and depression risk were observed. Pooled multivariable-adjusted HRs (95% CIs) were 0.93 (0.88, 0.99), 0.92 (0.86, 0.98), and 0.90 (0.85, 0.96) when comparing the highest (quintile 5) with the lowest (quintile 1) quintiles, respectively, with evidence of linear trends across quintiles (P-trend = 0.0004–0.08). In flavonoid-rich food-based analyses, the HR was 0.82 (95% CI: 0.74, 0.91) among participants who consumed ≥2 servings citrus fruit or juices/d compared with <1 serving/wk. In the NHS only, total flavonoids, polymers, and proanthocyanidin intakes showed significantly (9–12%) lower depression risks. In analyses among late-life NHS participants (aged ≥65 y at baseline or during follow-up), for whom we were able to incorporate depressive symptoms into the outcome definition, higher intakes of all flavonoid subclasses except for flavan-3-ols were associated with significantly lower depression risk; flavones and proanthocyanidins showed the strongest associations (HR for both: 0.83; 95% CI: 0.77, 0.90). Conclusions: Higher flavonoid intakes may be associated with lower depression risk, particularly among older women. Further studies are needed to confirm these associations.