Antioxidant status and its association with elevated depressive symptoms among US adults: National Health and Nutrition Examination Surveys 2005-6 - PubMed (original) (raw)

Antioxidant status and its association with elevated depressive symptoms among US adults: National Health and Nutrition Examination Surveys 2005-6

May A Beydoun et al. Br J Nutr. 2013 May.

Abstract

We examined the relationship of elevated depressive symptoms with antioxidant status. Cross-sectional data from the National Health and Nutrition Examination Surveys 2005–6 on US adults aged 20–85 years were analysed. Depressive symptoms were measured using the Patient Health Questionnaire with a score cut-off point of 10 to define ‘elevated depressive symptoms’. Serum antioxidant status was measured by serum levels of carotenoids, retinol (free and retinyl esters), vitamin C and vitamin E. The main analyses consisted of multiple logistic and zero-inflated Poisson regression models, taking into account sampling design complexity. The final sample consisted of 1798 US adults with complete data. A higher total serum carotenoid level was associated with a lower likelihood of elevated depressive symptoms with a reduction in the odds by 37 % overall with each sd increase in exposure, and by 34 % among women (P< 0·05). A dose–response relationship was observed when total serum carotenoids were expressed as quartiles (Q4 (1·62–10·1 μmol/l) v. Q1 (0·06–0·86 μmol/l): OR 0·41; 95 % CI 0·23, 0·76, P< 0·001; P for trend = 0·035), though no significant associations were found with the other antioxidant levels. Among carotenoids, β-carotene (men and women combined) and lutein+zeaxanthins (women only, after control for dietary lutein+zeaxanthin intake and supplement use) had an independent inverse association with elevated depressive symptoms among US adults. None of the other serum antioxidants had a significant association with depressive symptoms, independently of total carotenoids and other covariates. In conclusion, total carotenoids (mainly β-carotene and lutein+zeaxanthins) in serum were associated with reduced levels of depressive symptoms among community-dwelling US adults.

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Conflict of interest statement

Conflict of interest statement: None declared.

Figures

FIGURE 1

Adjusted odds ratios (with 95% CI) of major serum antioxidant level (expressed as quartiles, Q2, Q3, Q4 vs. Q1) and elevated depressive symptoms among US adults, uncontrolled for dietary antioxidant intakes or supplement use; NHANES 2005–06 Notes: CI=Confidence Interval. Ranges for each antioxidant quartile is as follows in μmol/L: Retinol+retinyl esters (Q1: 0.07–1.7; Q2: 1.7–2.1; Q3: 2.1–2.5; Q4: 2.5–8.9); Total carotenoids (Q1: 0.06–0.86; Q2: 0.86–1.18; Q3: 1.18–1.62; Q4: 1.62–10.1); Vitamin E (Q1: 0.2–26.7; Q2: 21.7–27.3; Q3: 27.4–35.9; Q4: 35.9–303.8); Vitamin C (Q1: 0.6–34.6; Q2: 35.2–54.5; Q3: 55.1–70.4; Q4: 71.0–274.2). Analyses were based on multiple logistic regression models that included all antioxidant exposures simultaneously adjusted for socio-demographic factors: Lifestyle and health-related factors (smoking status, BMI, physical activity: Mets.hr.wk−1, recoded as “0–<5”; “5–10”; “>10”, history of selected chronic conditions (i.e. type 2 diabetes, CVD and cancer)), anti-depressant use and dietary intakes (total energy intake, alcohol, _n_-3 PUFA), serum levels folate, total homocysteine, vitamin B-12, 25-hydroxyvitamin D and serum total cholesterol, anti-depressant use, and the inverse mills ratio, 2-stage Heckman selection model. *P<0.05; ┼P<0.001 for null hypothesis that Loge(OR)=0.

FIGURE 2

Adjusted odds ratios (with 95% CI) of major serum antioxidant level (expressed as quartiles, Q2, Q3, Q4 vs. Q1) and elevated depressive symptoms among US adults, controlled for dietary antioxidant intakes and supplement use; NHANES 2005–06 Notes: CI=Confidence Interval. Ranges for each antioxidant quartile is as follows in μmol/L: Retinol+retinyl esters (Q1: 0.07–1.7; Q2: 1.7–2.1; Q3: 2.1–2.5; Q4: 2.5–8.9); Total carotenoids (Q1: 0.06–0.86; Q2: 0.86–1.18; Q3: 1.18–1.62; Q4: 1.62–10.1); Vitamin E (Q1: 0.2–26.7; Q2: 21.7–27.3; Q3: 27.4–35.9; Q4: 35.9–303.8); Vitamin C (Q1: 0.6–34.6; Q2: 35.2–54.5; Q3: 55.1–70.4; Q4: 71.0–274.2). Analyses were based on multiple logistic regression models that included all antioxidant exposures simultaneously adjusted for socio-demographic factors: age, sex, race/ethnicity, marital status, educational level and poverty income ratio, and other potential confounders: Lifestyle and health-related factors (smoking status, BMI, physical activity: Mets.hr.wk−1, recoded as “0–<5”; “5–10”; “>10”, history of selected chronic conditions (i.e. type 2 diabetes, CVD and cancer)) and dietary intakes (total energy intake, alcohol, dietary antioxidant (or group of antioxidants), _n_-3 PUFA, dietary supplement use), serum levels folate, total homocysteine, vitamin B-12, 25-hydroxyvitamin D and serum total cholesterol, anti-depressant use, and the inverse mills ratio, 2-stage Heckman selection model. *P<0.05 ┼P<0.001 for null hypothesis that Loge(OR)=0.

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Antioxidant status and its association with elevated depressive symptoms among US adults: National Health and Nutrition Examination Surveys 2005-6 - PubMed (original) (raw)