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Fast food may contribute to teen depression
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Analyzing the Article
Target audience:
Parents of preteens and teens in general,
Parents of preteens and teens with mental health problems
Teens
Fast food industry
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What does the article say?
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-Depression among middle schoolers is on the rise
-Rate of major depressive episodes among kids 12-17 increased by 52% from 2005 to 2017
-Rate of depression, psychological distress and suicidal thoughts among older teens and young adults was even higher: 63%.
-One reason is a high fast-food, low plant-based diet
What does the article say?
Initial reaction: Not sure what to make of it. When you hear of teenage depression, diet is not one of the things discussed as a risk factor unless it is depression associated with a eating disorder. Risk factors for depression are usually family history, long term bullying, victim of abuse, chronic pain from physical illness.
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Recommendations: Include more potassium-rich foods in diet, which can lead to a better sense of well-being and improved mental health
Potential impact of study: If true, reduction in fast food consumption among teens and decrease in depressive symptoms among teens
Initial reaction: Not sure if I agree or disagree
What does the literature say?
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Introduction
Diet is understudied risk factor for depression
In adolescents, studies linked unhealthy diet with depressive symptoms; did not establish diet as risk factor for development of depressive symptoms .
Study: utilizes urinary sodium and potassium excretions as markers of unhealthy diet
Focused on urban African American youth who are higher risk for both poor diet and depression
Diet is understudied risk factor for depression.
In adolescents, a number of cross-sectional studies linked unhealthy diet with depressive symptoms but they didn’t convincingly establish diet as a risk factor for the development of depressive symptoms.
-a few longitudinal studies examined these associations over time, but their results were mixed.
-a significant limitation of the literature on diet and depression is the reliance of self-reports of dietary consumption which are known to be biased
-this study addresses this limitation by utilizing urinary sodium and potassium excretions as markers of unhealthy diet
-urinary sodium excretion has been established as a reliable marker of sodium consumption and may reflect consumption of processed, unhealthy foods which are high in sodium
-urinary potassium excretion has been established as a marker of overall diet quality, with higher potassium excretion positively correlated with greater intake of vegetables, fruits, whole grains, fish, and poultry and negatively correlated with intake of fast food and red meat
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Methods
-Study included 84 adolescents. They invited 240 students, 129 provided their contact information and 84 of those completed the wave 1 interview.
The average age was 13.36 years. 50% male, 95% African American, 4% Caucasian, and 1% Hispanic.
-They came from low income families with average annual salary of 20k-25k. Average Parental education was some college but no degree.
-Adolescents were recruited from 4 public middle schools (grades 6-9). Across the 4 schools, 83% to 87% of students were eligible for free or reduced price lunch.
-after the wave 1 interview, a week later, one overnight urine sample was collected.
-1.5 years later, 76 of the families participated in wave 2.
-symptoms of depression in the last last 2 weeks were measured at Wave 1 and Wave 2 with adolescent report on the center for epidemiological studies depression 10. The 10 items were rated on a 4-point scale (1- less than 1 day a week to 4-5-7 days a week)
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-84 adolescents- 13.36 years, 50% male, 95% African American, 4% Caucasian, 1% Hispanic
--low income families
-4 public middle schools in Birmingham, AL
-after 1st interview, looked for symptoms of depression over previous 2 weeks
-1 week later, 12-h urine sample collected
-1.5 years later, reassessment of depression symptoms and urine sample
Results and Discussion
Greater sodium excretion was associated with more depressive symptoms at follow up but not at baseline. This suggests that the effects of sodium on mood may accumulate over time.
Potassium excretion was positively associated with sodium excretion, but not with depressive symptoms at either time point.
-The combination of high sodium and low potassium intake is most predictive of increased adolescent depression. This is seen through multiple mechanisms, including direct effects on NTs and neural function.
-Recent reviews of experimental animal studies demonstrated western diet, high in sodium, saturated fat, added sugars has negative effects on behavior and cognition through impairments in frontal, limbic, and hippocampal areas of the brain.
-Highly processed foods affect the gut microbiome which is known to affect brain function.
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Greater sodium excretion was associated with more depressive symptoms after 1.5 year follow up
Potassium excretion was positively associated with sodium excretion, but not with depressive symptoms at either time point.
High sodium and low potassium= most predictive of increased adolescent depression.
Limitations
-Small sample size
-Single assessment of urinary biomarkers
-Did not obtain self-reports of dietary intake, could not examine the association between self-reported intake of specific nutrients and depressive symptoms
-Incorporate other indicators of dietary intake such as sugars and nitrogen
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Conclusion
Reducing consumption of sodium-rich foods and increasing consumption of potassium rich fruits may help reduce the prevalence of depression in adolescents.
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Discussion Questions
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-Do you believe diet affects mental health? Did this research study change your belief?
As an RD, would you recommend increased consumption of potassium rich foods and decreased consumption of sodium rich foods to help with depressive symptoms?
References
LaMotte S. Fast Food May Contribute to Teen Depression, Study Says. CNN Web site. https://www.cnn.com/2019/08/29/health/fast-food-teen-depression-wellness/index.html?no-st=1570413451. Published August 29, 2019. Accessed October 3, 2019.
Mrug S, Orihuela C, Mrug M, Sanders PW. Sodium and potassium excretion predict increased depression in urban adolescents. Physiol Rep. 2019;7(16):e14213.
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