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Association between healthy eating and depression symptoms among Chinese older adults: A cross-sectional study based on the Chinese Longitudinal Healthy Longevity survey.
Published on: May 29, 2024
Original author: Xinyue Zhang, et al. (2024) (DOI: 10.1016/j.pmedr.2024.102616)
This study aimed to assess the relationship between the healthy eating index (HEI) and depression symptoms in an older adult population using the Chinese Longevity Health Survey. Global aging is accelerating, with the elderly population expected to reach two billion by 2050. China has the world's largest aging population, projected to reach 28% of its total population by 2040. Depression is a prevalent mental health issue among older adults, significantly affecting their well-being. Despite its impact, many elderly individuals do not receive treatment for depression. Dietary patterns have been linked to depression, with studies showing varying results across different populations. Notable dietary patterns like the Mediterranean diet and the Dietary Approaches to Stop Hypertension (DASH) are associated with lower depression risks, although findings are inconsistent. Cultural and socioeconomic factors influence dietary habits, leading to differences in dietary impacts on mental health between the western and Asian populations. Research on the Chinese population's dietary patterns, which emphasize plant-based foods and tea, could provide insights into how diet affects depression in older adults. A study using the Chinese Longitudinal Healthy Longevity Survey (CLHLS) aims to explore this relationship by developing a healthy eating index (HEI) tailored to Chinese dietary habits. Methodology: The study analyzed data from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS) to investigate the relationship between dietary patterns and depression symptoms in older Chinese adults. The final sample included 12,078 participants aged 60 years and older. Diet quality was assessed using a Healthy Eating Index (HEI) based on self-reported intake of 13 food items, scored to a maximum of 50 points. Depression symptoms were measured using the CESD-10 scale, with a score of ≥10 indicating depressive symptoms. Covariates included age, gender, marital status, smoking and drinking habits, exercise, and economic and physical status. Logistic regression models and restricted cubic spline analysis evaluated associations between HEI and depression, while subgroup analyses assessed consistency across different demographic and lifestyle factors. Missing data were imputed using the KNN algorithm, and all statistical analyses were performed using SPSS and R software. Results: The main finding of this large population-based cross-sectional study was that a higher Healthy Eating Index (HEI) was associated with a lower risk of depression symptoms in older Chinese adults, for both men and women. After adjusting for sociodemographic and lifestyle covariates, each standard deviation (7.1) increase in the HEI corresponded to a 14% lower risk of depression symptoms (OR = 0.86; 95% CI: 0.82 to 0.90). Compared with the lowest quartile, the risk of depression was lower by 7% (OR = 0.93; 95% CI: 0.83 to 1.03) in the second quartile, 16% (OR = 0.84; 95% CI: 0.75 to 0.95) in the third quartile, and 31% (OR = 0.69; 95% CI: 0.62 to 0.77) in the highest quartile. These results indicate that healthier dietary patterns are linked to reduced depression risk in older Chinese adults. In contrast, the dietary habits of the elderly in western countries, typified by the Mediterranean diet, emphasize olive oil, plant foods, daily dairy, regular fish, eggs, white meat, and moderate wine consumption, highlighting cultural dietary differences. Conclusion: The study highlights the significant impact of diet on mental health in older adults, specifically demonstrating that adherence to healthier dietary patterns can substantially reduce the risk of depression symptoms in the elderly population in China. This finding underscores the importance of promoting healthy eating habits as part of public health strategies aimed at improving mental health among older adults. Additionally, the study contributes to the growing body of evidence linking diet quality with mental health, suggesting that dietary interventions could be an effective approach to mitigating depression in aging populations. Given the rapid aging of the global population, these insights are particularly relevant for shaping dietary guidelines and public health policies to support healthy aging and mental well-being. In contrast with the western dietary patterns also suggests potential cultural adaptations for diet-based mental health interventions in different regions.
Social connectedness, functional capacity, and longevity: A focus on positive relations with others.
Published on: February 21, 2024
Original author: Elliot Friedman, et al. (2024) (DOI: 10.1016/j.socscimed.2023.116419)
The study aims to investigate the impact of positive relations with others on aging-related health outcomes, particularly longevity and functional capacity. Building on Aristotle's notion of humans as inherently social beings, the research seeks to expand current understandings of social connection by examining the distinct contribution of cultivating warm, trusting relationships. Drawing on Holt-Lunstad's conceptual framework, the study distinguishes between structural (social integration) and functional (social support) aspects of social connectedness, with a focus on the unique role of positive relations in promoting health. Existing literature suggests that positive relations with others may play a crucial role in better health outcomes, including fewer functional limitations and increased longevity. However, few studies have specifically examined this aspect of social connection in relation to physical health. The study hypothesizes that greater positive relations with others was associated with enhanced longevity and improved functional capacity over time, independent of social integration and social support. The research aims to fill the gap by analyzing longitudinal data on aging adults, assessing mobility limitations as indicators of functional capacity. By considering the influence of positive relations with others alongside social integration and social support, the study seeks to provide insights into the unique contribution of warm, trusting relationships to health and well-being in later part of life. Methodology: The study draws on data from the Mid-life in the United States (MIDUS) longitudinal survey, utilizing information from its first and third waves along with mortality data from the National Death Index up to 2022. Functional limitations, assessed through self-reports on mobility-related tasks, and mortality outcomes are the focus. Logistic and linear regression models were employed to analyze the onset and changes in limitations over time, as well as mortality risk. Social relationships were assessed through measures of positive relations with others, social integration, and social support, with adjustments for potential confounders. Statistical analyses aimed to determine the independent contribution of positive relations to health outcomes, with clustered sandwich estimators used to address familial and genetic influences. Results were interpreted in terms of average marginal effects for logistic regression models, with Stata 16 utilized for analysis. Results: The study's results revealed significant associations between positive relations with others and various health outcomes among participants from the MIDUS longitudinal survey. Higher scores on the positive relations scale were linked to fewer functional limitations and reduced mortality risk over time. Linear regression models showed that greater positive relations were associated with less decline in functional limitations and lower odds of developing new limitations over the study period. Logistic regression models also indicated a lower probability of mortality among those with higher scores on positive relations. These associations remained significant even after adjusting for demographic factors, social support, and social integration. Additional analyses did not find significant interactions by gender or age. Overall, the findings underscore the importance of positive social relationships for promoting health and well-being in later life. Conclusion: The study benefits from a large, national sample and well-established measures of social connectedness, shedding light on the role of positive relations in promoting health and longevity beyond traditional measures of social integration and support. This underscores the importance of fostering meaningful connections for overall well-being in later life. Impact of research: The impact of this study lies in its contribution to understanding the nuanced relationship between social connections and health outcomes, particularly in the context of positive relations with others. By highlighting the distinct role of positive relationships in promoting health and longevity, the study enriches existing literature on social connectedness and well-being. This emphasis on the quality of social relationships underscores the importance of fostering meaningful connections, beyond mere structural or functional aspects, for overall health in later life.
