The relation of Red and white meat intake with mental disorders in Iranian adults

Authors
Ammar Hassanzadeh Keshteli 1
Parvane Saneei 2
Shiva Kazemi 3
Peyman Adibi 1
1 Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
2 2-Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran 3-Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
3 3-Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran 4-Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
Abstract
Introduction

The relationship between meat consumption and mental disorders is less investigated. We examined the association of meat consumption with the odds of depression, anxiety, and psychological distress in Iranian adults.

Materials and Methods

This cross-sectional study was conducted on 3362 subjects with18-55 years. Usual dietary intakes were assessed through the use of a dish-based 106-item semi-quantitative food frequency questionnaire (FFQ). Hospital Anxiety and Depression Scale(HADS), and General Health Questionnaire(GHQ), all validated in the Iranian population, were applied to collect data on anxiety, depression, and psychological distress, respectively.

Results

In the current study, 28.6, 13.6 and 22.6%, of participants suffered from depression, anxiety, and psychological distress, respectively. Individuals in the top quartile of red meat intake had a 43% increased risk of depression (OR=1.43; 95%CI:1.09-1.89), compared to those in the first quartile, after adjustment for potential confounders. The highest vs. lowest red meat intake was related to a 92% greater risk of depression (OR=1.92;95%CI:1.17-3.15) in males. In overweight or obese individuals, despite the lack of any association between red meat intake and mental disorders, high intake of white meat was associated with a lower odd of psychological distress (OR=0.64;95%CI:0.42-0.99) and depression (OR=0.68;95%CI:0.45-1.00). In normal-weight participants, the highest vs. lowest red meat intake was related to 66% greater odds for depression than those (OR=1.66; 95%CI:1.14-2.42).

Conclusion

Red meat consumption was associated with an increased risk of depression, especially in men and normal-weight participants. In overweight or obese subjects, white meat intake was inversely associated with psychological distress.
Keywords
Meat intake
Diet
Depression
Anxiety
Psychological distress
Mental disorder
1. Prince M, Patel V, Saxena S, Maj M, Maselko J, Phillips MR, et al. No health without mental health. The lancet. 2007;370(9590):859-77.
2. Compton WM, Conway KP, Stinson FS, Grant BF. Changes in the prevalence of major depression and comorbid substance use disorders in the United States between 1991–1992 and 2001–2002. American Journal of Psychiatry. 2006;163(12):2141-7.
3. Solem S, Hagen R, Wang CE, Hjemdal O, Waterloo K, Eisemann M, et al. Metacognitions and Mindful Attention Awareness in Depression: A Comparison Of Currently Depressed, Previously Depressed and Never Depressed Individuals. Clinical psychology & psychotherapy. 2017;24(1):94-102.
4. Valizadeh R, Sarokhani D, Sarokhani M, Sayehmiri K, Ostovar R, Angh P, et al. A study of prevalence of anxiety in Iran: Systematic review and meta-analysis. Der Pharma Chemica. 2016; 8(21):48-57.
5. Sarokhani D, Parvareh M, Dehkordi AH, Sayehmiri K, Moghimbeigi A. Prevalence of depression among Iranian elderly: Systematic review and meta-analysis. Iranian journal of psychiatry. 2018;13(1):55.
6. Mohamadi M, Kamal SHM, Vameghi M, Rafiey H, Sajjadi ASFH. A meta-analysis of studies related prevalence of depression in Iran. J Research Health. 2017; 7(1): 581- 593.
7. Daskalopoulou M, George J, Walters K, Osborn DP, Batty GD, Stogiannis D, et al. Depression as a risk factor for the initial presentation of twelve cardiac, cerebrovascular, and peripheral arterial diseases: data linkage study of 1.9 million women and men. PLoS One. 2016;11(4):e0153838.
8. Duivis HE, Vogelzangs N, Kupper N, de Jonge P, Penninx BW. Differential association of somatic and cognitive symptoms of depression and anxiety with inflammation: findings from the Netherlands Study of Depression and Anxiety (NESDA). Psychoneuroendocrinology. 2013;38(9):1573-85.
9. Blanchard EB, Scharff L, Schwarz SP, Suls JM, Barlow DH. The role of anxiety and depression in the irritable bowel syndrome. Behaviour research and therapy. 1990;28(5):401-5.
10. Katon W, Ciechanowski P. Impact of major depression on chronic medical illness. Journal of psychosomatic research. 2002;53(4):859-63.
11. Greenberg PE, Kessler RC, Birnbaum HG, Leong SA, Lowe SW, Berglund PA, et al. The economic burden of depression in the United States: how did it change between 1990 and 2000? Journal of clinical psychiatry. 2003;64(12):1465-75.
12. Sobocki P, Jönsson B, Angst J, Rehnberg C. Cost of depression in Europe. Journal of Mental Health Policy and Economics. 2006; 9(2), 87–98.
13. Sarris J, O’Neil A, Coulson CE, Schweitzer I, Berk M. Lifestyle medicine for depression. BMC psychiatry. 2014;14(1):107.
14. Jacka FN, Pasco JA, Mykletun A, Williams LJ, Hodge AM, O'Reilly SL, et al. Association of Western and traditional diets with depression and anxiety in women. American Journal of Psychiatry. 2010;167(3):305-11.
15. Opie R, Itsiopoulos C, Parletta N, Sanchez-Villegas A, Akbaraly TN, Ruusunen A, et al. Dietary recommendations for the prevention of depression. Nutritional neuroscience. 2017;20(3):161-71.
16. Ahmadi A, Mohammadi-Sartang M, Nooraliee P, Veisi M, Rasouli J. Prevalence of anxiety and it's relationship with consumption of snacks in high school students in Shiraz. Journal of Shahrekord Uuniversity of Medical Sciences. 2013; 15(1): 83-90
17. Zhang Y, Yang Y, Xie M-s, Ding X, Li H, Liu Z-c, et al. Is meat consumption associated with depression? A meta-analysis of observational studies. BMC psychiatry. 2017;17(1):409.
18. Chen R, Wei L, Hu Z, Qin X, Copeland JR, Hemingway H. Depression in older people in rural China. Archives of internal medicine. 2005;165(17):2019-25.
19. Miyake Y, Tanaka K, Okubo H, Sasaki S, Arakawa M. Fish and fat intake and prevalence of depressive symptoms during pregnancy in Japan: baseline data from the Kyushu Okinawa Maternal and Child Health Study. Journal of psychiatric research. 2013;47(5):572-8.
20. Zhou X, Bi B, Zheng L, Li Z, Yang H, Song H, et al. The prevalence and risk factors for depression symptoms in a rural Chinese sample population. PloS one. 2014;9(6):e99692.
21. Park Y, Kim M, Baek D, Kim S-H. Erythrocyte n–3 polyunsaturated fatty acid and seafood intake decrease the risk of depression: case-control study in Korea. Annals of Nutrition and Metabolism. 2012;61(1):25-31.
22. Kim JL, Cho J, Park S, Park E-C. Depression symptom and professional mental health service use. BMC psychiatry. 2015;15(1):261.
23. Rienks J, Dobson AJ, Mishra GD. Mediterranean dietary pattern and prevalence and incidence of depressive symptoms in mid-aged women: results from a large community-based prospective study. European journal of clinical nutrition. 2013;67(1):75-82.
24. Sánchez-Villegas A, Delgado-Rodríguez M, Alonso A, Schlatter J, Lahortiga F, Majem LS, et al. Association of the Mediterranean dietary pattern with the incidence of depression: the Seguimiento Universidad de Navarra/University of Navarra follow-up (SUN) cohort. Archives of general psychiatry. 2009;66(10):1090-8.
25. Tsai AC, Chang T-L, Chi S-H. Frequent consumption of vegetables predicts lower risk of depression in older Taiwanese–results of a prospective population-based study. Public Health Nutrition. 2012;15(6):1087-92.
26. Adibi P, Keshteli AH, Esmaillzadeh A, Afshar H, Roohafza H, Bagherian-Sararoudi R, Daghaghzadeh H, Soltanian N, Feinle-Bisset C, Boyce P, Talley NJ. The study on the epidemiology of psychological, alimentary health and nutrition (SEPAHAN): overview of methodology. Journal of Research in Medical Sciences. 2012 Mar 1;17.
27. Keshteli A, Esmaillzadeh A, Rajaie S, Askari G, Feinle-Bisset C, Adibi P. A Dish-based Semi-quantitative Food Frequency Questionnaire for Assessment of Dietary Intakes in Epidemiologic Studies in Iran: Design and Development. International journal of preventive medicine. 2014;5(1):29-36.
28. Montazeri A, Vahdaninia M, Ebrahimi M, Jarvandi S. The Hospital Anxiety and Depression Scale (HADS): translation and validation study of the Iranian version. Health and quality of life outcomes. 2003;1(1):14.
29. Montazeri A, Harirchi AM, Shariati M, Garmaroudi G, Ebadi M, Fateh A. The 12-item General Health Questionnaire (GHQ-12): translation and validation study of the Iranian version. Health and quality of life outcomes. 2003;1(1):66.
30. Aminianfar S, Saneei P, Nouri M, Shafiei R, Hassanzadeh-Keshteli A, Esmaillzadeh A, et al. Validation study of self-reported anthropometric indices among the staff of the Isfahan University of Medical Sciences, Isfahan, Iran. Journal of Isfahan Medical School. 2015;33(346):1318-27.
31. NICE. Promoting and Creating Built or Natural Environments that Encourage and Support Physcial Activity: Scope. London: National Institute for Health and Clinical Excellence (2006).
32. Rienks J, Dobson A, Mishra G. Mediterranean dietary pattern and prevalence and incidence of depressive symptoms in mid-aged women: results from a large community-based prospective study. European journal of clinical nutrition. 2013;67(1):75.
33. Akbaraly TN, Brunner EJ, Ferrie JE, Marmot MG, Kivimaki M, Singh-Manoux A. Dietary pattern and depressive symptoms in middle age. The British Journal of Psychiatry. 2009;195(5):408-13.
34. Beezhold BL, Johnston CS. Restriction of meat, fish, and poultry in omnivores improves mood: a pilot randomized controlled trial. Nutrition journal. 2012;11(1):9.
35. Chen R, Wei L, Hu Z, Qin X, Copeland JR, Hemingway H. Depression in older people in rural China. Archives of internal medicine. 2005;165(17):2019-25.
36. Onder G, Penninx BW, Cesari M, Bandinelli S, Lauretani F, Bartali B, et al. Anemia is associated with depression in older adults: results from the InCHIANTI study. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 2005;60(9):1168-72.
37. Seeman MV. Psychopathology in women and men: focus on female hormones. American Journal of Psychiatry. 1997;154(12):1641-7.
38. Varì R, Scazzocchio B, D'Amore A, Giovannini C, Gessani S, Masella R. Gender-related differences in lifestyle may affect health status. Annali dell'Istituto superiore di sanita. 2016;52(2):158-66.
39. Pereira-Miranda E, Costa PR, Queiroz VA, Pereira-Santos M, Santana ML. Overweight and obesity associated with higher depression prevalence in adults: a systematic review and meta-analysis. Journal of the American College of Nutrition. 2017;36(3):223-33.
40. Howren MB, Lamkin DM, Suls J. Associations of depression with C-reactive protein, IL-1, and IL-6: a meta-analysis. Psychosomatic medicine. 2009;71(2):171-86.
41. Bremmer M, Beekman A, Deeg D, Penninx B, Dik M, Hack C, et al. Inflammatory markers in late-life depression: results from a population-based study. Journal of affective disorders. 2008;106(3):249-55.
42. Gimeno D, Kivimäki M, Brunner EJ, Elovainio M, De Vogli R, Steptoe A, et al. Associations of C-reactive protein and interleukin-6 with cognitive symptoms of depression: 12-year follow-up of the Whitehall II study. Psychological medicine. 2009;39(3):413-23.
43. Kim Y-K, Jeon SW. Neuroinflammation and the immune-kynurenine pathway in anxiety disorders. Current neuropharmacology. 2018;16(5):574-82.
44. Kohler O, Krogh J, Mors O, Benros ME. Inflammation in Depression and the Potential for Anti-Inflammatory Treatment. Current neuropharmacology. 2016;14(7):732-42.
45. Schwedhelm C, Pischon T, Rohrmann S, Himmerich H, Linseisen J, Nimptsch K. Plasma Inflammation Markers of the Tumor Necrosis Factor Pathway but Not C-Reactive Protein Are Associated with Processed Meat and Unprocessed Red Meat Consumption in Bavarian Adults. The Journal of nutrition. 2017;147(1):78-85.
46. Sánchez-Villegas A, Verberne L, De Irala J, Ruiz-Canela M, Toledo E, Serra-Majem L, et al. Dietary fat intake and the risk of depression: the SUN Project. PloS one. 2011;6(1):e16268.
47. Liu T, Zhong S, Liao X, Chen J, He T, Lai S, et al. A meta-analysis of oxidative stress markers in depression. PloS one. 2015;10(10):e0138904.
48. Pawels E, Volterrani D. Fatty acid facts, Part I. Essential fatty acids as treatment for depression, or food for mood? Drug news & perspectives. 2008;21(8):446-51.
49. Bilici M, Efe H, Köroğlu MA, Uydu HA, Bekaroğlu M, Değer O. Antioxidative enzyme activities and lipid peroxidation in major depression: alterations by antidepressant treatments. Journal of affective disorders. 2001;64(1):43-51.
50. Hayley S, Poulter M, Merali Z, Anisman H. The pathogenesis of clinical depression: stressor-and cytokine-induced alterations of neuroplasticity. Neuroscience. 2005;135(3):659-78.
51. Anisman H. Cascading effects of stressors and inflammatory immune system activation: implications for major depressive disorder. Journal of psychiatry & neuroscience. 2009; 34(1), 4–20.
52. Zhang JC, Yao W, Hashimoto K. Brain-derived Neurotrophic Factor (BDNF)-TrkB Signaling in Inflammation-related Depression and Potential Therapeutic Targets. Current neuropharmacology. 2016;14(7):721-31.
53. Karege F, Vaudan G, Schwald M, Perroud N, La Harpe R. Neurotrophin levels in postmortem brains of suicide victims and the effects of antemortem diagnosis and psychotropic drugs. Molecular Brain Research. 2005;136(1-2):29-37.
54. Uauy R, Aro A, Clarke R, L'abbé M, Mozaffarian D, Skeaff C, et al. WHO Scientific Update on trans fatty acids: summary and conclusions. European journal of clinical nutrition. 2009;63(S2):S68.
55. Calder PC. n− 3 polyunsaturated fatty acids, inflammation, and inflammatory diseases. The American journal of clinical nutrition. 2006;83(6):1505S-19S.
56. Sánchez-Villegas A, Toledo E, De Irala J, Ruiz-Canela M, Pla-Vidal J, Martínez-González MA. Fast-food and commercial baked goods consumption and the risk of depression. Public health nutrition. 2012;15(3):424-32.
57. Fernstrom JD, Wurtman RJ. Brain serotonin content: physiological regulation by plasma neutral amino acids. Science. 1972;178(4059):414-6.
58. Wurtman RJ, Wurtman JJ, Regan MM, McDermott JM, Tsay RH, Breu JJ. Effects of normal meals rich in carbohydrates or proteins on plasma tryptophan and tyrosine ratios. The American journal of clinical nutrition. 2003;77(1):128-32.
59. Anglin RE, Samaan Z, Walter SD, McDonald SD. Vitamin D deficiency and depression in adults: systematic review and meta-analysis. The British journal of psychiatry. 2013;202(2):100-7.
60. Skarupski KA, Tangney C, Li H, Ouyang B, Evans DA, Morris MC. Longitudinal association of vitamin B-6, folate, and vitamin B-12 with depressive symptoms among older adults over time. The American journal of clinical nutrition. 2010;92(2):330-5.
61. Jacka FN, Maes M, Pasco JA, Williams LJ, Berk M. Nutrient intakes and the common mental disorders in women. Journal of affective disorders. 2012;141(1):79-85.
62. Khanna P, Chattu VK, Aeri BT. Nutritional aspects of depression in adolescents-A systematic review. International journal of preventive medicine. 2019;10.