Effect Modification of The Association Between Dietary Patterns and Depression by Diabetes Among Adults in Qatar: A Populationbased Study

Abstract

Background: Diabetes is a major public health problem in Qatar and significantly increases the risk of depression. Dietary patterns are related to the incidence of depression among patients with diabetes. However, no study has been conducted in Qatar on the relationship between dietary patterns and depression symptoms in adults. Aim: To assess the association between dietary patterns and depressive symptoms severity among adults with or without diabetes in Qatar. Methods: 1000 adults were selected from the Qatar Biobank (QBB). Each person with diabetes was matched with one person without diabetes based on age and sex in this cross-sectional study. Food intake was assessed based on a computer-administered food frequency questionnaire (FFQ). Factor analysis was used to identify dietary patterns. Patient Health Questionnaire-9 (PHQ-9) was used to assess depression symptoms. Results: Moderate to severe depression symptoms were present in 13.5% of the sample. Two dietary patterns were identified: “unhealthy” (high consumption of fast food, biryani, mixed dish (chicken/meat/fish), croissant) and “prudent” (high consumption of fresh fruit, salads/raw vegetables, canned/dried fruit, and dates). After adjusting for sociodemographic, lifestyle factors (smoking and physical activity), and chronic conditions, high intake of “unhealthy” pattern was associated with an increased prevalence of moderate to severe depression symptoms in individuals with diabetes (prevalence ratio, PR=1.41; 95% CI: 1.28, 1.56; p-value<0.001). While there was no statistically significant association between moderate to severe depression symptoms and the “prudent” dietary pattern among those with or without diabetes. Conclusion: The “unhealthy” dietary pattern was positively associated with moderate to severe depression symptoms in those with diabetes. Promoting healthy eating habits should be considered in the prevention and management of depression. Keywords Depression symptoms, Diabetes, Dietary pattern, Factor analysis