Depressive Symptoms and Vegetarian Diets: Results from the Constances Cohort

Abstract

The association between depressive symptoms and vegetarian diets is controversial. This study examines the cross-sectional association between depressive symptoms and vegetarian diets while controlling for potential confounders. Among 90,380 subjects from the population-based Constances cohort, depressive symptoms were defined by a score ≥19 on the Centre of Epidemiologic Studies-Depression (CES-D) scale and diet types (omnivorous, pesco-vegetarian, lacto-ovo-vegetarian and vegan) were determined with a food frequency questionnaire. Associations between depressive symptoms and diet were estimated through logistic regressions adjusting for socio-demographics, other foods, alcohol and tobacco consumption, physical activity and health-related concerns; specificity analyses considered the exclusion of any other food group. Depressive symptoms were associated with pesco-vegetarian and lacto-ovo-vegetarian diets in multivariable analyses (Odds-Ratio [95% confidence interval]: 1.43 [1.19–1.72] and 1.36 [1.09–1.70], respectively), especially in case of low legumes intake (p for interaction < 0.0001), as well as with the exclusion of any food group (e.g., 1.37 [1.24–1.52], 1.40 [1.31–1.50], 1.71 [1.49–1.97] for meat, fish and vegetables exclusion, respectively). Regardless of food type, the Odds-Ratio of depressive symptoms gradually increased with the number of excluded food groups (p for trend < 0.0001). Depressive symptoms are associated with the exclusion of any food group from the diet, including but not restricted to animal products.

Lower intake of animal-based products links to improved weight status, independent of depressive symptoms and personality in the general population

“…In contrast to previous large cross-sectional studies 16,17 and a prospective study in patients with inflammatory bowel disease 58 , frequency of animal-derived product consumption did not explain variance in depression symptom scores in the current sample.…”

“…An additional score represents the number of restricted food items (adapted from 17 by counting all (almost) never items of 33 items FFQ (excluding drinks and light products) (score min. 0 to max.…”

“…Further, individuals showing restrictive eating patterns, i.e. excluding animal-derived food, may be more or less prone to develop mood disturbances compared to those with omnivorous eating styles: large epidemiological studies (n = 6,422-90,380) showed higher depressive symptoms in vegetarians and vegans 15–17 and in those with orthorexic behaviour 18 . Yet other (smaller) cross-sectional (n = 620) and interventional (n = 39-291) studies proposed a positive effect of plant-based diets on well-being and subclinical depression scores 19–22 .…”

“…Yet other (smaller) cross-sectional (n = 620) and interventional (n = 39-291) studies proposed a positive effect of plant-based diets on well-being and subclinical depression scores 19–22 . Recently, it has been suggested that not meat-restriction per se, but the number of excluded food groups predicts higher depressive scores 17 .…”

Should dietary guidelines recommend low red meat intake?

“…The latter reports commonly refer to failure to thrive, hyperparathyroidism, macrocytic anemia, optic and other neuropathies, lethargy, degeneration of the spinal cord, cerebral atrophy, and other serious conditions. Although the direction of causality is not clear, meat avoidance is statistically associated with eating disorders and depression (Zhang et al, 2017;Barthels et al, 2018;Hibbeln et al, 2018;Matta et al, 2018;Nezlek et al, 2018) and may mirror neurological problems (Kapoor et al, 2017).…”