The Association Between Sugar Intake And The Risk Of Depressive In The Adults

Objective:Currently,the relationship between sugar intake and depression is not clear.The purpose of this study was to explore the association between total sugar,sugar intake from non-alcoholic beverages,sweets and functional beverages with the risk of depression,and to provide scientific dietary guidance for the prevention of depression.Methods:The participants included in this study were 20,708 adults aged 20 and above from 2007-2008,2009-2010,2011-2012,2013-2014 and 2015-2016 in the National Health and Nutrition Examination Survey(NHANES)database.The survey included questionnaires,physical examinations and laboratory examinations to collect demographic and sociological information,lifestyle characteristics,physical data,health and disease information.Dietary data were obtained through two 24-hour dietary review interviews,and depression was assessed by the Patient Health Questionnaire(PHQ-9).Continuous variables were compared by t test and categorical variables by chi-square test to compare baseline characteristics between depressed and non-depressed participants.After appropriate process of weighting of the data,univariate and multivariate logistic regression analyses were used to explore the association between total sugar,sugar from nonalcoholic beverages,sweets and functional beverages and depression,respectively.Stratified analyses were performed by age(<45 years old,45 to 64 years old and>65 years old),gender(male and female)and total energy(low,normal and high energy)to assess the above-mentioned associations.Restricted cubic spline models were used to assess the dose-response relationship between total sugar,sugar intake from nonalcoholic beverages,sweets and functional beverages and the risk of depression.Results:A total of 20708 adults aged 20 years or above were included in this study,including 1628 participants with depression,with a prevalence rate of 7.86%.Univariate logistic regression analysis of the data showed that total sugar,sugar from nonalcoholic beverages and sugar from sweets were associated with depression,the corresponding odds ratios(ORs)and 95%confidence intervals(CIs)of depression were 1.17(1.01-1.36),1.67(1.33-2.09)and 1.45(1.13-1.86),respectively.In the multivariate logistic regression model 1 adjusted for age and gender,the above correlation was still statistically significant,and the corresponding ORs(95%CI)was 1.35(1.16-1.57),1.84(1.45-2.34)and 1.54(1.20-1.99),respectively.In multivariate-adjusted models adjusting for age,sex,race,marital status,educational level,body mass index,total energy intake,smoking status,alcohol consumption,total sugar,sugar from nonalcoholic beverages and sugar from sweets were associated with the risk depression,and the corresponding ORs(95%CIs)of depression were 1.73(1.40-2.13),1.51(1.15-1.99)and 1.41(1.10-1.80).Logistic regression analysis showed that there is no significant association between sugar in energy drinks and depression,compared with the lowest intake,the corresponding OR(95%CI)of the highest intake group in the univariate,multivariate model 1 and multivariate model 2 were 1.24(0.58-2.66),1.43(0.63-3.24)and 1.19(0.52-2.72),respectively,Multivariate logistic regression model 2 was used to compare the highest dose group with the lowest dose group in different age groups(<45 years old,45?64 years old and>65 years old group)and gender(male and female)groups and energy(low,normal and high energy)group.The results showed that total sugar intake was significantly associated with increased risk of depression in groups 45?64 years old,65 or older years and female group.Increased sugar intake from non-alcoholic beverages was associated with a statistically significant increase in the risk of depression in groups under 45 years old,65 or older years,male and female groups.There was also a statistically significant association between increased sugar intake from sweets and increased risk of depression in the under 45 years old,65 or older years old and male groups.Dose-response analyses found that the risk of depressive symptoms was associated with total sugar(P for nonlinearity=0.00),sugar from nonalcoholic beverages(P for nonlinearity=0.01)and sugar from sweets(P for nonlinearity=0.00)intakes in a nonlinear manner.The risk of depression increases with total sugar intake.With the increase of sugar intake in non-alcoholic beverages,the OR of depression increased gradually.When the intake reached 43g/d,OR(95%CI)were 1.46(1.00-2.14),and the correlation began to be statistically significant.Dose-response analysis of sugar from sweets showed that when the intake was less than 20g/d,the risk of depression increased with the sugar intake.When the intake reached 22g/d,OR(95%CI)was 1.78(1.31-2.41).Then,the risk of depression decreased slowly as sugar intake from sweets increased.When the intake reached 43g/d,there was no statistically significant association between sugar intake from sweets and depression risk.Conclusions:The increased consumption of total sugar,sugar from nonalcoholic beverages and sugar from sweets may be associated with an increased risk of depression.The results of this study need to be confirmed by more prospective cohort studies and experimental studies.