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Association of habitual intake of fruits and vegetables with depressive symptoms: the AusDiab study

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Abstract

Purpose

To investigate the relationship of habitual FV intake, different types of FV, and vegetable diversity with depressive symptoms.

Methods

Australian men and women (n = 4105) aged > 25 years from the Australian Diabetes, Obesity and Lifestyle Study were included. Dietary intake was assessed using a Food Frequency Questionnaire at baseline, 5 and 12 years. Depressive symptoms were assessed using the validated 10-item Centre for Epidemiology Studies Short Depression Scale at 12 years. Multiple logistic regression models were used to investigate the association between the exposures of interest and depressive symptoms using odds ratios (OR) and 95% confidence intervals (CI) across quartiles of FV intake and vegetable diversity. Analyses were multivariable-adjusted for confounding factors.

Results

At 12 years, 425 (10.4%) participants had “any depressive symptoms”. Habitual FV intake was inversely associated with depressive symptoms at 12 years. After adjustment, participants in quartile 2 of FV intake (Q2; median 317 g/day) had a 20% lower odds of having any depressive symptoms (OR [95% CI] 0.80 [0.69, 0.95]) in comparison to those in the lowest quartile of FV intake (Q1; median 223 g/day). Yellow/orange/red and leafy green vegetables were the key vegetable types driving this association. Higher vegetable diversity (4–6 different vegetables/day) was associated with a 24–42% lower odds of having depressive symptoms when compared to < 3 different vegetables/day. The associations remained similar after further adjusting for diet quality.

Conclusion

A FV-rich diet, consisting of a diverse range of vegetables, particularly yellow/orange/red and leafy green vegetables may help to lower depressive symptoms. Promoting such a diet, particularly in men and women with a low FV intake, may have a significant public health impact.

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Data availability

The data that support the findings of this study were available from the Baker Heart and Diabetes Institute, under a license agreement. Data will be available from the Principal Investigator of AusDiab upon reasonable request and approval of the AusDiab Steering Committee.

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Acknowledgements

The AusDiab study, initiated and coordinated by the International Diabetes Institute, and subsequently coordinated by the Baker Heart and Diabetes Institute, gratefully acknowledges the support and assistance given by: A Allman, B Atkins, S Bennett, S Chadban, S Colagiuri, M de Courten, M Dalton, M D’Emden, T Dwyer, D Jolley, I Kemp, P Magnus, J Mathews, D McCarty, A Meehan, K O’Dea, P Phillips, P Popplewell, C Reid, A Stewart, R Tapp, H Taylor, T Welborn, F Wilson and P Zimmet. Also, for funding or logistical support, we are grateful to: The Commonwealth Dept of Health and Aged Care, Abbott Australasia Pty Ltd, Alphapharm Pty Ltd, AstraZeneca, Aventis Pharmaceutical, Bristol-Myers Squibb Pharmaceuticals, Eli Lilly (Aust) Pty Ltd, GlaxoSmithKline, Janssen-Cilag (Aust) Pty Ltd, Merck Lipha s.a., Merck Sharp & Dohme (Aust), Novartis Pharmaceutical (Aust) Pty Ltd., Novo Nordisk Pharmaceutical Pty Ltd, Pharmacia and Upjohn Pty Ltd, Pfizer Pty Ltd, Roche Diagnostics, Sanofi Synthelabo (Aust) Pty Ltd., Servier Laboratories (Aust) Pty Ltd, BioRad Laboratories Pty Ltd, HITECH Pathology Pty Ltd, the Australian Kidney Foundation, Diabetes Australia, Diabetes Australia (Northern Territory), Queensland Health, South Australian Department of Human Services, Tasmanian Department of Health and Human Services, Territory Health Services, Victorian Department of Human Services, the Victorian OIS program and Health Department of Western Australia. RA is supported by an Australian Government Research Training Program Scholarship (International).

Funding

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. The salary of LCB is supported by a National Health and Medical Research Council (NHMRC) of Australia Emerging Leadership Investigator Grant (ID: 1172987) and a National Heart Foundation of Australia Post-Doctoral Research Fellowship (ID: 102498). The salary of JRL is supported by a National Heart Foundation of Australia Future Leader Fellowship (ID: 102817). The salary of JMH is supported by a National Health and Medical Research Council of Australia Senior Research Fellowship (ID: 1116973). JES is supported by an NHMRC Investigator Grant (ID: 1173952). None of the funding agencies had any role in the conduct of the study; collection, management, analysis, or interpretation of the data; or preparation, review, or approval of the manuscript.

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Author notes

  1. Simone Radavelli-Bagatini, Reindolf Anokye, Joshua R. Lewis and Lauren C. Blekkenhorst have contributed equally.

Authors and Affiliations

  1. Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia

    Simone Radavelli-Bagatini, Reindolf Anokye, Nicola P. Bondonno, Marc Sim, Catherine P. Bondonno, Jonathan M. Hodgson, Joshua R. Lewis & Lauren C. Blekkenhorst

  2. Medical School, The University of Western Australia, Perth, WA, Australia

    Nicola P. Bondonno, Marc Sim, Catherine P. Bondonno, Jonathan M. Hodgson, Joshua R. Lewis & Lauren C. Blekkenhorst

  3. School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia

    Mandy J. Stanley

  4. School of Arts and Humanities, Psychology and Criminology, Edith Cowan University, Perth, WA, Australia

    Craig Harms

  5. Flinders Centre for Epidemiology and Biostatistics, Flinders University, Adelaide, SA, Australia

    Richard Woodman

  6. Diabetes and Population Health, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia

    Dianna J. Magliano

  7. Clinical Diabetes and Epidemiology, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia

    Jonathan E. Shaw

  8. School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia

    Dianna J. Magliano & Jonathan E. Shaw

  9. Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Melbourne, VIC, Australia

    Robin M. Daly

  10. Centre for Kidney Research, Children’s Hospital at Westmead, School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia

    Joshua R. Lewis

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  1. Simone Radavelli-Bagatini
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Contributions

SRB, RA, LCB, JRL and JMH designed the statistical analysis of the study, planned the statistical analysis, interpreted the results and extensively reviewed the manuscript. SRB and NPB analysed the data. RW assisted with the statistical analyses. SRB and RA reviewed the literature and prepared the manuscript. NPB, MS, CPB, CH assisted with the methodology and interpretation of the results. SRB, RA, NPB, MS, CPB, MJS, CH, RW, DJM, JES, RMD, JMH, JRL, LCB had significant input and critically reviewed and approved the final manuscript.

Corresponding author

Correspondence to Simone Radavelli-Bagatini.

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Conflict of interest

DJM and JES report grants from Abbott Australasia Pty Ltd, Alphapharm Pty Ltd, AstraZeneca, Bristol-Myers Squibb, Eli Lilly Australia, GlaxoSmithKline, Janssen-Cilag, Merck Sharp & Dohme, Novartis Pharmaceuticals, Novo Nordisk Pharmaceuticals, Roche Diagnostics Australia, Sanofi Aventis and Sanofi-synthelabo, during the conduct of the study. RMD received a Primary Growth Partnership grant via the Ministry of Primary Industries in New Zealand with Fonterra Co-operative Group Ltd, outside the submitted work. All other authors have no potential conflicts of interest to report. JMH reports grants from FruitWest, grants from Department of Agriculture and Food WA, outside the submitted work.

Ethical approval

The study was approved by The Human Research Ethics Committees of the International Diabetes Institute, and the Alfred Hospital (Melbourne, Australia).

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Radavelli-Bagatini, S., Anokye, R., Bondonno, N.P. et al. Association of habitual intake of fruits and vegetables with depressive symptoms: the AusDiab study. Eur J Nutr 60, 3743–3755 (2021). https://doi.org/10.1007/s00394-021-02532-0

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