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- Title
Interaction of Depression and Unhealthy Diets on the Risk of Cardiovascular Diseases and All-Cause Mortality in the Chinese Population: A PURE Cohort Substudy.
- Authors
Lang, Xinyue; Liu, Zhiguang; Islam, Shofiqul; Han, Guoliang; Rangarajan, Sumathy; Tse, Lap Ah; Mushtaha, Maha; Wang, Junying; Hu, Lihua; Qiang, Deren; Zhu, Yingxuan; Yusuf, Salim; Lin, Yang; Hu, Bo
- Abstract
This study aimed to identify the interaction of depression and diets on cardiovascular diseases (CVD) incident and death in China and key subpopulations. We included 40,925 participants from the Prospective Urban Rural Epidemiology (PURE)-China cohort which recruited participants aged 35–70 years from 45 urban and 70 rural communities. Depression was measured by the adapted Short-Form (CIDI-SF). The unhealthy diet was considered when the score of Alternative Healthy Eating Index was below the lowest tertile. The primary outcome was a composite outcome of incident CVD and all-cause mortality. Cox frailty models were used to examine the associations. During a median follow-up of 11.9 years (IQR: 9.6–12.6 years), depression significantly increased the risk of the composite outcome (HR = 2.00; 95% CI, 1.16–3.27), major CVD (HR = 1.82; 95% CI, 1.48–2.23), and all-cause mortality (HR = 2.21; 95% CI, 1.51–3.24) for the unhealthy diet group, but not for the healthy diet group. The interaction between depression and diet for the composite outcome was statistically significant (RERI = 1.19; 95% CI, 0.66–1.72; AP = 0.42, 95% CI, 0.27–0.61; SI = 3.30, 95% CI, 1.42–7.66; multiplicative-scale = 1.74 95% CI, 1.27–2.39), even in the subgroup and sensitivity analyses. In addition, the intake of vegetable and polyunsaturated fatty acids contributed most to the interaction of diets and depression. Depressive participants should focus on healthy diets, especially vegetables and polyunsaturated fatty acids, to avoid premature death and CVD.
- Subjects
CHINA; CARDIOVASCULAR diseases risk factors; CAUSES of death; PATIENT aftercare; UNSATURATED fatty acids; CONFIDENCE intervals; VEGETABLES; RURAL conditions; DIET; RISK assessment; MENTAL depression; DESCRIPTIVE statistics; METROPOLITAN areas; SENSITIVITY &; specificity (Statistics); NATURAL foods; LONGITUDINAL method; PROPORTIONAL hazards models; COMORBIDITY
- Publication
Nutrients, 2022, Vol 14, Issue 23, p5172
- ISSN
2072-6643
- Publication type
Article
- DOI
10.3390/nu14235172