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. 2023 Feb 9:10:1042522.
doi: 10.3389/fnut.2023.1042522. eCollection 2023.

Association between dietary calcium and depression among American adults: National health and nutrition examination survey

Xia Shen  1 , Xue Gu  1 , Yuan-Yuan Liu  1 , Long Yang  2 , Meng Zheng  3 , Lei Jiang  4
Affiliations

Association between dietary calcium and depression among American adults: National health and nutrition examination survey

Xia Shen et al. Front Nutr. .

Abstract

Background: There is only limited evidence for an association between calcium (Ca) and depression, and the relationship was inconsistent. Therefore, the aim of this study was to assess the relationship between dietary Ca and the risk of depressive symptoms in individuals over the age of 18 in the US.

Methods: We extracted 14,971 participants from the US National Health and Nutrition Examination Survey (NHANES) 2007-2016 to probe their associations. Dietary Ca intake was measured through 24 h dietary recall method. Patients with the Patient Health Questionnaire-9 (PHQ-9) ≥ 10 scores were believed to have depressive symptoms. The association between dietary Ca and depressive symptoms was investigated using multivariate logistic regression, sensitivity analysis, and restricted cubic spline regression.

Results: In this study, 7.6% (1,144/14,971) of them had depressive symptoms. After adjusting for sex, age, race, poverty to income ratio (PIR), marital status, education, body mass index (BMI), caffeine intake, carbohydrates intake, total energy intake, smoking status, alcohol consumption, physical activity, diabetes, hypertension, severe cardiovascular disease (CVD), cancer, serum vitamin D, serum Ca, and Ca supplement, the adjusted ORs value [95% confidence interval (CI)] of depression for the lowest category (Q1 ≤ 534 mg/day) vs. Q2-Q4 of Ca intake were 0.83 (0.69-0.99), 0.97 (0.65-0.95), and 0.80 (0.63-0.98) with the p for trend (p = 0.014). The relationship between dietary Ca intake and depressive symptoms was linear (non-linear p = 0.148). None of the interactions were significant except among races (p for interaction = 0.001).

Conclusion: Association between dietary Ca and the prevalence of depressive symptoms in US adults. And Ca intake was negatively associated with the risk of depressive symptoms. As Ca intake increased, the prevalence of depressive symptoms decreased.

Keywords: National Health and Nutrition Examination Survey (NHANES); adults; calcium; depression; dietary calcium.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
The flow chart of inclusion and exclusion of the participants in the study.
FIGURE 2
FIGURE 2
The dose-response relationship between dietary calcium (Ca) intake and the risk of depressive symptoms. Adjusted for: Age + sex + hypertension + diabetes + CVD + cancer/malignancy + race/ethnicity + education + marital status + poverty to income ratio (PIR) + body mass index (BMI) + smoking status + drinking status + activity + carbohydrates intake + caffeine intake + total energy intake + serum Ca + serum vitamins D + Ca supplement.
FIGURE 3
FIGURE 3
The association between dietary calcium (Ca) intake and depressive symptoms in different subgroups.
See this image and copyright information in PMC

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