Diet-Related Inflammation is Associated with Major Depressive Disorder in Bahraini Adults: Results of a Case-Control Study Using the Dietary Inflammatory Index

Abstract

Purpose

This case-control study aimed to examine the association between the inflammation potential of the diet and depression.

Patients and Methods

Ninety-six patients with major depression disorder were matched with 96 age- and sex-matched healthy controls. Energy-adjusted DII (E-DII^TM) scores were calculated based on the participants’ responses to a detailed nutritional assessment using a quantitative food frequency questionnaire. Descriptive results were reported. Logistic regression was used to estimate odds ratios and 95% confidence intervals associated with E-DII scores and depression adjusting for covariates including age, sex, body mass index, comorbidities, level of education, and employment.

Results

The mean E-DII score of participants in the study was 1.32±1.08, indicating a generally pro-inflammatory diet. Patients with depression had elevated E-DII scores compared to age- and sex-matched controls with E-DII scores of 1.72± 1.09 vs 0.90±0.90, respectively (P=0.001). Results of logistic regression analysis revealed that patients with depression were nearly three times more likely to be in the extreme ends of pro-inflammatory diet (OR 2.75; 95% CI 1.82–4.15).

Conclusion

Adult Bahraini patients with depression have higher dietary inflammation potential compared to the general population controls. Further research is needed to confirm these results and provide effective interventions to reduce the burden of this dietary inflammation.

Keywords:

• inflammation
• depression
• case-control study
• mental health
• Arabian population groups

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

Dr. James R. Hébert owns controlling interest in Connecting Health Innovations LLC (CHI), a company that has licensed the right to his invention of the dietary inflammatory index (DII^®) from the University of South Carolina in order to develop computer and smart phone applications for patient counseling and dietary intervention in clinical settings. Dr. Nitin Shivappa is an employee of CHI and also reports non-financial support from Connecting Health Innovations. The subject matter of this paper will not have any direct bearing on that work, nor has that activity exerted any influence on this project. The authors report no other conflicts of interest in this work.