DOI QR코드

DOI QR Code

Association between Depression and Dietary Inflammatory Index in Korean Postmenopausal Women: Based on the 2016-2020 Korea National Health and Nutrition Examination Survey

한국 여성의 폐경 후 우울증과 식이성 염증지수 간의 관련성 연구: 2016-2020년 국민건강영양조사 자료를 이용하여

  • Kim, Jin-A (Traditional Temple Food Institute) ;
  • Lee, Sim-Yeol (Department of Home Economics Education, Dongguk University_Seoul)
  • 김진아 (전통사찰음식연구소) ;
  • 이심열 (동국대학교_서울 가정교육과)
  • Received : 2022.09.22
  • Accepted : 2022.09.29
  • Published : 2022.09.30

Abstract

The purpose of this study was to investigate the association between depressive symptoms and dietary inflammatory index(DII) in Korean postmenopausal women. The subjects consisted of 3,947 Korean postmenopausal women from the National Health and Nutrition Examination Survey from 2016~2020. Subjects were classified into quartiles of dietary inflammatory index score. Individuals with high DII scores had poor health habits such as drinking, smoking, lack of physical activity, and skipping meals. The higher the score of the DII, the higher the PHQ-9 score and the depression odds ratio, which are depressive screening tools(p for trend <0.01). Among the anti-inflammatory items, DII, MUFA, PUFA, n-3 fatty acids, and n-6 fatty acids increased the risk of depression as the DII item score increased(p for trend <0.05). As a result of this study, it was found that the dietary inflammatory index was significantly associated with depressive symptoms. The promotion of a healthy diet with anti-inflammatory properties may help to prevent depression in postmenopausal women.

본 연구는 한국 폐경 후 여성을 대상으로 우울증과 식이성 염증지수 간의 관련성을 살펴보기 위하여 국민건강영양조사 2016~2020년의 자료를 이용하여 식이성 염증지수 수준에 따른 식행동, 항염증과 염증유발 항목의 영양소 및 식품 섭취량, 식이성 염증지수와 우울증과의 관계에 관하여 비교 분석하였다. 본 연구결과 염증성 식이군은 항염증 식이군에 비해 혼자서 거주하는 비율이 높고, 교육수준과 소득수준이 낮았다. 건강행태 요인으로 염증성 식이군은 흡연율이 높고 신체활동율과 삶의 질이 낮으며, 식행동 요인으로는 아침, 점심, 저녁 식사 결식률과 가족 동반 아침식사 비율, 영양표시 인지율이 낮았다. 식이성 염증지수 점수가 높을수록 우울증상 선별도구인 PHQ-9 점수와 우울증 교차비는 증가하였다. 식이성 염증지수의 항염증 항목 중 MUFA, PUFA, n-3계 지방산, n-6계 지방산 항목은 식이성 염증지수 점수가 증가할수록 우울증 유병위험도가 증가하였다. 따라서 본 연구는 폐경 후 여성의 우울증 관리를 위한 바람직한 식생활과 항염증성 식사 섭취 지침에 기초자료를 제시할 수 있을 것으로 기대한다.

Keywords

References

  1. Adjibade, M., Andreeva, V. A., Lemogne, C., Touvier, M., Shivappa, N., Hebert, J. R.,...Kesse-Guyot, E. (2017). The inflammatory potential of the diet is associated with depressive symptoms in different subgroups of the general population. The Journal of Nutrition, 147(5), 879-887. doi:10.3945/jn.116.245167
  2. Akbaraly, T. N., Kerleau, C., Wyart, M., Chevallier, N., Ndiaye, L., Shivappa, N.,...Kivimaki, M. (2016). Dietary inflammatory index and recurrence of depressive symptoms: Results from the Whitehall II Study. Clinical Psychological Science, 4(6), 1125-1134. https://doi.org/10.1177/2167702616645777
  3. An, J. Y., Seo, E. R., Lim, K. H., Shin, J. H., & Kim, J. B. (2013). Standardization of the Korean version of screening tool for depression (Patient Health Questionnaire-9, PHQ-9). Journal of Korean Society Biological Therapies in Psychiatry, 19(1), 47-56.
  4. Azarmanesh, D., Bertone-Johnson, E. R., Pearlman, J., & Elena T. Carbone, Z. L. (2022a). The dietary inflammatory index is inversely associated with depression, which is minimally mediated by C-reactive protein. Nutrition Research, 97, 11-21. https://doi.org/10.1016/j.nutres.2021.09.002
  5. Azarmanesh, D., Bertone-Johnson, E. R., Pearlman, J., Liu, Z., & Carbone, E. T. (2022b). Association of the dietary inflammatory index with depressive symptoms among pre- and postmenopausal women: Findings from the National Health and Nutrition Examination Survey (NHANES) 2005-2010. Nutrients, 14(9), 1980. doi:10.3390/nu14091980
  6. Cho, E., & Song, Y. (2022). The relationship between depression and cardiovascular disease risk factors among Korean adults: The Korean National Health and Nutrition Examination Survey in 2014, 2016. Journal of Health Informatics and Statistics, 47(2), 86-94. https://doi.org/10.21032/jhis.2022.47.2.86
  7. Esposito, K., Marfella, R., Ciotola, M., Palo, C. D., Giugliano, F., Giugliano, G.,...Giugliano, D. (2004). Effect of a mediterraneanstyle diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome: A randomized trial. JA MA , 292(12), 1440-1446.
  8. Felger, J. C. (2019). Role of inflammation in depression and treatment implications. Switzerland: Springer, Cham.
  9. Ferrucci, L., Cherubini, A., Bandinelli, S., Bartali, B., Corsi, A., Lauretani, F.,...Guralink, J. M. (2006). Relationship of plasma polyunsaturated fatty acids to circulating inflammatory markers. Journal of Clinical Endocrinology & Metabolism, 91(2), 439-46. https://doi.org/10.1210/jc.2005-1303
  10. Galland, L. (2010). Diet and inflammation. Nutrition in Clinical Practice, 25(6), 634-640. doi:10.1177/0884533610385703
  11. Gordon, J. L., Girdler, S. S., Meltzer-Brody, S. E., Stika, C. S., Thurston, R. C., Clark, C. T.,...Wisner, K. L. (2015). Ovarian hormone fluctuation, neurosteroids, and HPA axis dysregulation in perimenopausal depression: A novel heuristic model. American Journal of Psychiatry, 172(3), 227-236. doi:10.1176/appi.ajp.2014.14070918
  12. Graziottin, A., & Serafini, A. (2009). Depression and the menopause: Why antidepressants are not enough?. Menopause Int, 15(2), 76-81. doi:10.1258/mi.2009.009021
  13. Haji-Hosseini-Gazestani, N., Keshavarz, S. A., Hosseini-Esfahani, F., & Ataie-Jafari, A. (2020). The association of dietary inflammatory index and obesity phenotypes in women. Food & Health, 3(3), 19-24.
  14. Horikawa, C., Otsuka, R., Kato, Y., Nishita, Y., Tange, C., Rogi, T.,...Shmokata, H. (2018). Longitudinal association between n-3 long-chain polyunsaturated fatty acid intake and depressive symptoms: A population-based cohort study in Japan. Nutrients, 10(11), 1-13.
  15. Im, M. Y. (2021). The effect of depression on metabolic syndrome and its components among Korean adults. Stress, 29(4), 235-241. https://doi.org/10.17547/kjsr.2021.29.4.235
  16. Johansson-Persson, A., Ulmius, M., Cloetens, L., Karhu, T., Herzig, K.-H., & Onning, G. (2014). A high intake of dietary fiber influences C-reactive protein and fibrinogen, but not glucose and lipid metabolism, in mildly hypercholesterolemic subjects. European Journal of Nutrition, 53(1), 39-48. https://doi.org/10.1007/s00394-013-0496-8
  17. Kang, I. (2020). The effect of 12 weeks of combined exercise on the deep muscle activity and body composition in postmenopausal women. Journal of Korea Society for Wellness, 17(1), 271-275. https://doi.org/10.21097/ksw.2022.2.17.1.271
  18. Kim, C.-M. (2013). KASL clinical practive guidelines: Management of alcoholic liver disease. Clinical and Molecular Hepatology, 19(3), 216-254. doi:10.3350/cmh.2013.19.3.216
  19. Kim, J., & Hwang, B. (2022). Factors related to physical activity in midlife and old women with depression. Journal of Korean Academy of Psychiatric and Mental Health Nursing, 31(2), 254-263. https://doi.org/10.12934/jkpmhn.2022.31.2.254
  20. Kim, J.-A., & Lee, S.-Y. (2021). The study of dietary habits and health behaviors according to physical activity type in Korean adults -Based on the 2016-2018 Korea National Health and Nutrition Examination Survey-. Journal of Community Nutrition, 26(2), 122-133.
  21. Kim, S., & Park, S. (2021). Association between age at natural menopause and prevalence of obesity, hypertension, diabetes, and hypercholesterolemia. Korean Public Health Research, 47(1), 1-9. https://doi.org/10.22900/KPHR.2021.47.1.001
  22. King, D. E., Brent, M. E., & Mark, E. G. (2003). Relation of dietary fat and fiber to elevation of C-reactive protein. American Journal of Cardiology, 92(1), 1335-1339. https://doi.org/10.1016/j.amjcard.2003.08.020
  23. Korea Disease Control and Prevention Agency (2020). The eighth Korea National Health and Nutrition Examination Survey (KNHANES VIII-1), 2019. Cheongju: Author.
  24. Korea Disease Control and Prevention Agency (2022). The eighth Korea National Health and Nutrition Examination Survey (KNHANES VIII-2), 2020. Cheongju: Author.
  25. Lee, H.-S. (2022). Status of Korean healthy eating index and associated factors in elderly with a focus on health habits, mental health, and nutritional status: Data from the 2016-2018 Korea National Health and Nutrition Examination Survey. Journal of the Korean Dietetic Association, 28(2), 114-126. https://doi.org/10.14373/JKDA.2022.28.2.114
  26. Majno, G., & Joris, I. (2004). Cells, tissues, and disease: Principles of general pathology (2nd ed.). New York: Oxford University Press.
  27. Medzhitov, R. (2008). Origin and physiological roles of inflammation. Nature, 454(7203), 428-435. https://doi.org/10.1038/nature07201
  28. Ministry of Health and Welfare (2013). The physical activity guide for Koreans. Sejong: Author.
  29. National Rural Resources Development Institute (2021). Korean food composition table (10th ed.). Jeonju: Author.
  30. Park, H.-R., Youn, H.-J., & Lee, J. H. (2018). Study on the relationship between the nutrient intake and level of depressive symptoms -Using the data from the Korea National Health and Nutrition Examination Survey 2016-. Journal of the Korean Dietetic Association, 24(4), 283-297. https://doi.org/10.14373/JKDA.2018.24.4.283
  31. Phillips, C. M., Shivappa, N., Hebert, J. R., & Perry, I. J. (2017). Dietary inflammatory index and mental health: A crosssectional analysis of the relationship with depressive symptoms, anxiety and well-being in adults. Clinical Nutrition, 37(5), 1485-1491. doi:10.1016/j.clnu.2017.08.029
  32. Ruiz-Canela, M., Bes-Rastrollo, M., & Martinez-Gonzalez, M. (2016). The role of dietary inflammatory index in cardiovascular disease, metabolic syndrome and mortality. International Journal of Molecular Sciences, 17(8), 1-16.
  33. Santoro, N., Epperson, C. N., & Mathews, S. B. (2015). Menopausal symptoms and their management. Endocrinology & Metabolism Clinics of North America, 44(3), 497-515. https://doi.org/10.1016/j.ecl.2015.05.001
  34. Shakya, P. R., Melaku, Y. A., Shivappa, N., Hebert, J. R., Adams, R. J., Page, A. J., & Gill, T. K. (2021). Dietary inflammatory index (DII) and the risk of depression symptoms in adults. Clinical Nutrition, 40(5), 3631-3642. https://doi.org/10.1016/j.clnu.2020.12.031
  35. Shin, D., Shivappa, N., Hebert, J. R., & Lee, K. W. (2020). Examining regional differences of dietary inflammatory index and its association with depression and depressive symptoms in Korean adults. International Journal of Environmental Research and Public Health, 17(9), 3205. doi:10.3390/ijerph17093205
  36. Shivappa, N., Schoenaker, D. A., Hebert, J. R., & Mishra, G. D. (2016). Association between inflammatory potential of diet and risk of depression in middle aged women: The Australian longitudinal study on womens. British Journal of Nutrition, 116(6), 1077-1086. https://doi.org/10.1017/S0007114516002853
  37. Shivappa, N., Steck, S. E., Hurley, T. G., Hussey, J. R., & Hebert, J. R. (2014). Designing and developing a literature-derived, population-based dietary inflammatory index. Public Health Nutrition, 17(8), 1689-1696. https://doi.org/10.1017/S1368980013002115
  38. Sierra, S., Lara-Villoslada, F., Comalada, M., Olivares, M., & Xaus, J. (2008). Dietary eicosapentaenoic acid and docosahexaenoic acid equally incorporate as decosahexaenoic acid but differ in inflammatory effects. Nutrition, 24(3), 245-254. https://doi.org/10.1016/j.nut.2007.11.005
  39. Song, D., Kim, J., Kang, M., Park, J., Lee, H., Kim, D. Y.,...Lim, H. (2022). Association between the dietary inflammatory index and bone markers in postmenopausal women. PLOS ONE, 17(3), 1-16. doi:10.1371/journal.pone.0265630
  40. Spitzer, R. L., Kroenke, K., & Williams, J. B. W. (1999). Patient health questionnaire study group. Validity and utility of a self-report version of PRIMENG: The PHQ primary care study. JAMA, 282(18), 1737-1744. https://doi.org/10.1001/jama.282.18.1737
  41. The Korean Nutrition Society (2015). Computer aided nutritional analysis program 4.0 for professionals. Retrieved from https://www.kns.or.kr/can/fileroom.asp?BoardID=Can
  42. World Health Organization (2021). Depression. Retrieved from https://www.who.int/news-room/fact-sheets/detail/depression
  43. Zhang, R., Sun, J., Li, Y., & Zhang, D. (2020). Association of n-3, n-6 fatty acids intakes and n-6:n-3 ration with the risk of depressive symptoms: NHANES 2009-2015. Nutrients, 12(240), 1-13.