The relationship between dietary patterns and depression mediated by serum levels of Folate and vitamin B12

Abstract

Background: Major depressive disorder is among main worldwide causes of disability. The low medication compliance rates in depressed patients as well as the high recurrence rate of the disease can bring up the nutrition-related factors as a potential preventive or treatment agent for depression. The aim of this study was to investigate the association between dietary patterns and depression via the intermediary role of the serum folate and vitamin B12, total homocysteine, tryptophan, and tryptophan/competing amino acids ratio. Methods: This was an individually matched case-control study in which 110 patients with depression and 220 healthy individuals, who completed a semi-quantitative food frequency questionnaire were recruited. We selected the depressed patients from three districts in Tehran through non-probable convenience sampling from which healthy individuals were selected, as well. The samples selection and data collection were performed during October 2012 to June 2013. In addition, to measure the serum biomarkers 43 patients with depression and 43 healthy people were randomly selected from the study population. To diagnose depression the criteria of Diagnostic and Statistical Manual of Mental Disorders, fourth edition, were utilized. Results: The findings suggest that the healthy dietary pattern was significantly associated with a reduced odds of depression (OR: 0.75; 95% CI: 0.61-0.93) whereas the unhealthy dietary pattern increased it (OR: 1.382, CI: 1.116-1.71). The mediation analysis showed that the healthy dietary pattern was associated with a reduced risk of depression via increased serum levels of the folate and vitamin B12; however, the unhealthy dietary pattern was associated with increased risk of depression via decreased serum levels of folate and vitamin B12, based on tree adjusted logistic regression models. Conclusion: Dietary patterns may be associated with depression by changing the serum levels of folate and vitamin B12. Further studies are required to confirm the mechanism.

The Effect of Omega-3 Fatty Acids on Thromboxane, Brain-Derived Neurotrophic Factor, Homocysteine, and Vitamin D in Depressive Children and Adolescents: Randomized Controlled Trial

“…Homocysteine (HCy) is a non-proteinogenic sulfurated amino acid [47]. No differences in HCy levels in depressed adult patients and healthy individuals [47][48][49][50] or an association between HCy and DD were observed [47]. The increased risk of depression was reported only in older adults with a high HCy level [30].…”

Diet, Stress and Mental Health

“…Supplementation of antidepressants with folate and/or vitamin B12 in one study reduced the risk of relapse after successful remission [ 172 ]. Not all studies, however, have found an association between homocysteine and depression [ 174 , 175 , 176 , 177 , 178 , 179 ]. The population-based Rotterdam Study found an association between depression and homocysteine; however, the association was reduced after controlling for cardiovascular disease and functional disability [ 152 ].…”

Dietary Phytochemical Index and Psychological Disorders in a large sample of Iranian adults: a population-based study

“…healthy " dietary pattern characterized by high intakes of phytochemical rich foods including fruits, vegetables, medium fat dairy, nuts, legumes and sh was protectively associated with depression and anxiety (22,25). In addition, some other studies con rmed the health bene t effects of DPI on abdominal obesity, lipid pro le and insulin resistant (13,14).…”

“…Fruits and vegetable are main sources of folate. Results of some studies shown that there are association between serum folate and dietary intake of this vitamin and depression (25,32,33). It can be effect on mental health via methylation in the nervous system (32).…”