Original Study
Associations between Dietary Pattern and Depression in Korean Adolescent Girls

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Abstract

Study Objective

Dietary patterns are important for the physical and psychological development of adolescent girls. The purpose of the present study was to evaluate the relationship between dietary patterns and depression in this population.

Design, Setting, and Population

We conducted a case-control study in a tertiary university hospital of 849 girls aged 12 to 18 years.

Methods

The study was conducted from April 2011 to December 2012. Participants were identified as having depression if they had scores greater than 16 on the Korean version of the Beck Depression Inventory. Data were obtained using validated Korean-language questionnaires.

Main Outcome Measures

The subjects' usual dietary patterns during the past 12 months were assessed using the Food Frequency Questionnaire published by the Korean Health and Nutrition Examination Survey.

Results

Among the 849 enrolled volunteers, 116 were identified as having depressive symptoms. The mean age of the participants was 15.0 ± 1.5 years. The prevalence of girls diagnosed with depression was 13.6%. Multivariate adjusted regression analysis demonstrated that the risk of depression was significantly positively associated with the consumption of instant and processed foods and negatively associated with the intake of green vegetables and 1 to 3 servings/day of fruits, after adjusting for energy intake and menstrual regularity. Additionally, depression was negatively associated with intake of fiber, β-carotene, vitamin B6, vitamin E, vitamin C, potassium, zinc, folate, iron, and copper after adjusting for confounding variables.

Conclusion

Consumption of fast foods including ramen noodles, hamburger, pizza, fried food, and other processed foods was associated with increased risk of depression in adolescent girls. Thus, caution is required regarding dietary choices in this population.

Introduction

Adolescence is a sensitive period during which one experiences physical, social, and psychological changes caused by increases in pubertal hormones.1 Mental health issues became important for adolescents, as the vulnerability to mental illness increases during times of transition from childhood to adolescence and then to adulthood.2 Around 50% of all lifetime mental disorders start by the age of 14,3 although most are undiagnosed and are detected later in life.4 When psychiatric disorders are not treated with care at an early stage, social problems may result; one such disorder, depression, is associated with suicide.5, 6 Suicide in the leading cause of death in Korean teenagers, and the rate of death by suicide has steadily increased over the last decade.7 Although both boys and girls display a similar risk of depression prior to adolescence, the prevalence of depression disorders in girls is greater than that in boys after puberty,4, 8 possibly due to alterations in ovarian hormones.9

The importance of the adolescent diet has been the focus of previous studies examining the association between nutrient intake and mental health in adolescence.10, 11 Consumption of processed foods, take-out and fast foods, vegetables, and fruits was associated with the risk of depression in Australian10 and Chinese11 adolescents. However, Brook et al12 reported that a healthy diet was associated with reduced risk of depression in adolescent girls, but not boys, although the study did not define a healthy diet. Another study in American adolescent girls showed no significant association between depressive symptoms and intake of snacks, fast foods, vegetables, and fruits.13 Thus, in an effort to reconcile these inconsistent findings, the purpose of the present study was to evaluate correlations between dietary patterns and depression in adolescent girls.

Section snippets

Materials and Methods

This study was a case-control study performed in the physical examination center for adolescents at our university. Adolescent girls 12 to 18 years of age were recruited from January 2011 to December 2012 during visits to the center for annual routine health examinations. The study was approved by the Institutional Review Board of University Hospital, and written informed consent was obtained from all participants and their parents.

During the physical examination, height and weight were

Results

Characteristics of the depression group and nondepression are shown in Table 1. There were no significant differences between the groups in age, weight, height, BMI, and menstrual history, including the age at menarche and use of analgesics, except for menstrual regularity. Regarding the presence of menstruation, 3 girls in the control group reported only 1 or 2 episodes of vaginal spotting; consequently, these 3 girls could not say whether they had experienced true menstruation. Regarding

Discussion

In the present study, consumption of instant foods including ramen, hamburger, pizza, fried foods, and processed foods such as ham, fish paste, and snacks was associated with increased depression and was positively correlated to K-BDI scores in adolescent girls after adjusting for menstrual regularity and energy intake. By contrast, consumption of green vegetables and 1 to 3 servings/day of fruits were associated with decreased risk of depression. The present study is the first report to

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  • Cited by (0)

    This research was supported by the Soonchunhyang University Research Fund (Soonchunhyang University Support Fund Project No. 20130618) and by the Dalim Biotec. The authors indicate no conflicts of interest.

    Tae-Hee Kim and Ji-young Choi contributed equally to this work.

    Hae-Hyeog Lee and Yongsoon Park are supervisors and co-corresponding authors in the field of clinic and nutrition field. Both Lee and Park are in charge of the whole process from the research plan to the submission.

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