Relationship between Dietary Inflammatory Index and Postpartum Depression in Exclusively Breastfeeding Women

Abstract

(1) Background: Research has shown that chronic inflammation can increase the risk of depression. The dietary inflammatory index (DII) is a novel measure of dietary inflammation, which has been used to investigate the relationship between diet and mental disorders in adults. However, little research has been conducted to establish an association between dietary inflammation (as measured by DII) and postpartum depression (PPD) in exclusively breastfeeding women. (2) Methods: In this cross-sectional study, 293 women who were exclusively breastfeeding for 6 months or less were enrolled. The DII scores were evaluated using semi-quantitative Food Frequency Questionnaires (FFQ), and the Edinburgh Postpartum Depression Scale (EPDS) was used to measure depression levels of breastfeeding mothers during the six months following delivery. The participants were classified by tertiles, and the possibility of DII being associated with PPD was assessed by binary regression analysis. (3) Results: The average DII score was 2.32 ± 1.08, which ranged from −1.66 to 4.19. The rate of depression was 60.1%. Adjusted for potential risk factors such as age, educational level, occupational level, number of babies, number of caregivers, social support level, and sleep quality, the results showed that the lowest DII score was associated with a lower risk of PPD than the highest score (OR tertile Q1 vs. 3 = 0.47, 95% CI: 0.24, 0.93, p = 0.030). (4) Conclusions: In exclusive breastfeeding women, the inflammatory potential of dietary intake seems to be related to depression. Interventions to improve diet quality might consider including a dietary component that aims to lower chronic systemic inflammation to prevent PPD. However, the relationship between DII and PPD among Chinese women remains to be demonstrated in a larger population.

Dietary Inflammatory Index, Sleep Duration, and Sleep Quality: A Systematic Review

“…Seven of these studies were conducted in healthy adults across the lifespan [ 19 , 20 , 23 , 24 , 26 , 30 , 33 ]. Studies that have been conducted mainly in young adults found null associations between sleep quality and the DII [ 19 , 26 , 30 , 33 ].…”

“…Seven of these studies were conducted in healthy adults across the lifespan [ 19 , 20 , 23 , 24 , 26 , 30 , 33 ]. Studies that have been conducted mainly in young adults found null associations between sleep quality and the DII [ 19 , 26 , 30 , 33 ]. However, in middle-aged adults, Wirth, Fekedulegn, et al (2022) [ 24 ] showed that more pro-inflammatory diets were correlated with higher improved subjective sleep quality.…”

“…In terms of sleep quality, small-scale ( n < 430) cross-sectional studies in healthy adults did not show an association between sleep quality and DII [ 19 , 30 , 33 ] (apart from Wirth, Fekedulegn, et al, 2022 [ 24 ]). However, it is important to note that, in the Wirth, Fekedulegn, et al, 2022 study [ 24 ], participants (i.e., police officers) were exposed to several stressors that can affect sleep, including working night and evening shifts, shift changes, and higher depression and anxiety levels (which is in line with previous work showing health disparities in this population [ 38 ]).…”

Maternal Sleeping Problems Before and After Childbirth - A Systematic Review

“… EPDS SEES BRUMS Correlations between: - PPD and BMI at 6 month postpartum (r = 0.468, p = 0.021) - PPD and household income at 6 months (r = −0.391, p = 0.065) and at 12 months (r = −0.154, p = 0.556) - PPD and SEES at six months: (r = 0.642, p < 0.001); 12 months (r = 0.679, p = 0.003) - PPD and BRUMS at six months: (r = 0.701, p < 0.001); 12 months postpartum: (r = 0.680, p = 0.004) - PPD and PSQI at 12 month postpartum: (r = 0.752, p < 0.001) Regression analysis identified factors such as household income and fatigue as the strongest predictors of PPD at six months postpartum. Hanshuang Zou 32 China Age (years): - <25 (14.3%) - 26–35 (78.8%) - 36–45 (6.9%) Sample size: 293 Cross-sectional study Two divisions: - Two groups: - PPD - Non-PPD - Three groups - Low dietary inflammatory index (Q1, DII<33.3%) - Intermediate DII (Q2, 33.3%<DII<66.7) - High DII (Q3, DII>66.7%) Evaluation of the dietary quality by assessing the DII (dietary inflammatory index) scores, exploring whether exclusive breastfeeding mothers’ diet contributes to an inflammatory environment in the body, which consequently affected the occurrence of depression EPDS Occupation level: - Employed: Non-PPD 36.1%, PPD 63.9%; - Unemployed: Non-PPD 47.1%, PPD 52.9%; p=0.069 (Chi-square test) Education levels: - Junior high school and below: Non-PPD 10%, PPD 90%; - Specialized degree: Non-PPD 33.3%, PPD 66.7%; - Bachelor’s degree: Non-PPD 46.0%, PPD 54.0%; - Postgraduate and above: Non-PPD 51.6%, PPD 48.4%; p=0.021 Number of children: - 1 child: Non-PPD 35.6%, PPD 64.4%; - 2 or more children: Non-PPD 46.9%; PPD 53.1%; p=0.054 When comparing sociodemographic factors between groups with and without postpartum depression it was found that women with a junior high school education or less, who had their first child, were the sole caregiver for the infant, and had low levels of social support, were more likely to suffer from PPD. Unemployed women and woman with better sleep quality, on the contrary, were less likely to suffer from depression.…”

Maternal and Neonatal Factors Modulating Breast Milk Cytokines in the First Month of Lactation

“…These results support the idea that the degree of inflammation in the maternal diet could have an influence on her BM cytokine levels. The importance of mDII on maternal health is evidenced in a study in Chinese breastfeeding women showing that a shift from a pro-inflammatory to an anti-inflammatory diet lowered the risk of postpartum depression [70].…”