Association between Breakfast Consumption and Depressive Symptoms among Chinese College Students: A Cross-Sectional and Prospective Cohort Study

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Abstract

Skipping breakfast has been suggested to increase the risk of depressive symptoms, but there is no information regarding young adults. We aimed to investigate the relationship between the frequency of breakfast consumption and the risk of depressive symptoms among Chinese college students. We investigated a cross-sectional ( n = 1060) and one-year prospective ( n = 757) relationship between the frequency of breakfast consumption and the risk of depressive symptoms. The frequency of breakfast consumption was categorized into “≤1 time/week”, “2–5 times/week”, or “≥6 times/week”. Depressive symptoms were assessed using the 20-item Zung self-rating depression scale (SDS) with an SDS score of ≥50 to indicate moderate to severe depressive symptoms. In the cross-sectional analysis, the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of depressive symptoms related with the breakfast consumption categories were 1.00 (reference) for ≥6 times/week, 1.761 (95% CI: 1.131, 2.742) for 2–5 times/week, and 3.780 (95% CI: 1.719, 8.311) for ≤1 time/week ( p for trend: <0.001) after adjusting for these potential confounders. Similarly, in the one-year prospective analysis, we found that 10.2% of participants was classified as having moderate to severe depressive symptoms. Multivariate logistic regressions analysis revealed a significant negative relationship between the frequency of breakfast consumption and the risk of depressive symptoms. The ORs (95% CI) for depressive symptoms with decreasing breakfast consumption frequency were 1.00 (reference) for ≥6 times/week, 2.045 (1.198, 3.491) for 2–5 times/week, and 2.722 (0.941, 7.872) for ≤1 time/week ( p for trend: 0.005). This one-year prospective cohort study showed that skipping breakfast is related to increased risk of depressive symptoms among Chinese college students. Future research using interventional or experimental studies is required to explore the causal relationship between the effects of breakfast consumption and depressive symptoms.

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Most cited references 42

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Breakfast skipping and health-compromising behaviors in adolescents and adults.

M Virkkunen, A Keski-Rahkonen, A. Rissanen … (2003)

To investigate which sociodemographic factors and behaviors are associated with breakfast skipping in adolescents and adults. Five birth cohorts of adolescent twins and their parents received an extensive behavioral and medical self-report questionnaire that also assessed breakfast-eating frequency. Finland, 1991-1995. A population sample of 16-y-old girls and boys (n=5448) and their parents (n=4660). Parental breakfast eating was the statistically most significant factor associated with adolescent breakfast eating. Smoking, infrequent exercise, a low education level at 16, female sex, frequent alcohol use, behavioral disinhibition, and high body mass index (BMI) were significantly associated with adolescent breakfast skipping. In adults, smoking, infrequent exercise, low education level, male sex, higher BMI, and more frequent alcohol use were associated with breakfast skipping. In the adult sample, older individuals had breakfast more often than younger ones. Both adults and adolescents who frequently skipped breakfast were much more likely to exercise very little compared to those who skipped breakfast infrequently. Breakfast skipping was associated with low family socioeconomic status in adults and adolescent boys, but not in girls. Breakfast skipping clustered moderately with smoking, alcohol use, and sedentary lifestyle in both adults and adolescents. Breakfast skipping is associated with health-compromising behaviors in adults and adolescents. Individuals and families who skip breakfast may benefit from preventive efforts that also address risk behaviors other than eating patterns. National Institute of Alcohol Abuse and Alcoholism (AA08315), Academy of Finland (44069), European Union Fifth Framework Program (QLRT-1999-00916), Yrjö Jahnsson Foundation, and Jalmari and Rauha Ahokas Foundation.

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Role of serotonin in the pathophysiology of depression: focus on the serotonin transporter.

M. Owens, C Nemeroff (1994)

Considerable evidence has accrued in the last two decades to support the hypothesis that alterations in serotonergic neuronal function in the central nervous system occur in patients with major depression. These findings include the following: (a) reduced cerebrospinal fluid (CSF) concentrations of 5-hydroxyindoleacetic acid (5-HIAA), the major metabolite of serotonin (5-HT) in drug-free depressed patients; (b) reduced concentrations of 5-HT and 5-HIAA in postmortem brain tissue of depressed and (or) suicidal patients; (c) decreased plasma tryptophan concentrations in depressed patients and a profound relapse in remitted depressed patients who have responded to a serotonergic antidepressant when brain tryptophan availability is reduced; (d) in general, all clinically efficacious antidepressants augment 5-HT neurotransmission following chronic treatment; (e) clinically efficacious antidepressant action by all inhibitors of 5-HT uptake; (f) increases in the density of 5-HT2 binding sites in postmortem brain tissue of depressed patients and suicide victims, as well as in platelets of drug-free depressed patients; (g) decreased number of 5-HT transporter (determined with [3H]imipramine or [3H]paroxetine) binding sites in postmortem brain tissue of suicide victims and depressed patients and in platelets of drug-free depressed patients. In our studies, this reduction in platelet 5-HT transporter binding is not due to prior antidepressant treatment of hypercortisolemia and is not observed in mania, Alzheimer disease, schizophrenia, panic disorder, fibromyalgia, or atypical depression. In a pilot study, this deficit predicted treatment response to an experimental antidepressant. These findings support the hypothesis that alterations in 5-HT neurons play a role in the pathophysiology of depression.

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Is low folate a risk factor for depression? A meta-analysis and exploration of heterogeneity.

Trevor Sheldon, Tracy Lightfoot, Simon Gilbody (2007)

Low folate has been causatively linked to depression, but research is contradictory. An association may arise due to chance, bias, confounding or reverse causality. A systematic review of observational studies which examined the association between depression and folate was conducted. 11 relevant studies (15 315 participants; three case-control studies, seven population surveys and one cohort study) examining the risk of depression in the presence of low folate were found. Pooling showed a significant relationship between folate status and depression (odds ratio (OR)(pooled unadjusted) = 1.55; 95% CI 1.26 to 1.91). This relationship remained after adjustment for potential confounding (OR)(pooled adjusted) = 1.42; 95% CI 1.10 to 1.83). Folate levels were also lower in depression. There is accumulating evidence that low folate status is associated with depression. Much of this evidence comes from case-control and cross-sectional studies. Cohort studies and definitive randomised-controlled trials to test the therapeutic benefit of folate are required to confirm or refute a causal relationship.

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Author and article information

Journal

Journal ID (nlm-ta): Int J Environ Res Public Health

Journal ID (iso-abbrev): Int J Environ Res Public Health

Journal ID (publisher-id): ijerph

Title: International Journal of Environmental Research and Public Health

Publisher: MDPI

ISSN (Print): 1661-7827

ISSN (Electronic): 1660-4601

Publication date (Electronic): 29 February 2020

Publication date (Print): March 2020

Volume: 17

Issue: 5

Electronic Location Identifier: 1571

Affiliations

[1 ]College of Physical Education, Key Laboratory of Physical Fitness Evaluation and Motor Function Monitoring, General Administration of Sport of China, Institute of Sports Science, Southwest University, Chongqing 400715, China; renzhongyu@ 123456swu.edu.cn (Z.R.); caojianhua2019@ 123456hotmail.com (J.C.); guoliya2019@ 123456sina.com (L.G.)

[2 ]College of Physical Education, Chongqing Nursing Vocational College, Chongqing 402763, China; chengpeng777@ 123456hotmail.com

[3 ]Department of Physical Education, Xinhua College of Sun Yat-Sen University, Guangzhou 510520, China; shidongzhe0210@ 123456hotmail.com

[4 ]Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing 400715, China; bingcao@ 123456swu.edu.cn

[5 ]School of Physical Education, Chinese Center of Exercise Epidemiology, Northeast Normal University, Changchun 130024, China; yangguang1978611@ 123456hotmail.com (G.Y.); liangsy427@ 123456nenu.edu.cn (S.L.); duf513@ 123456nenu.edu.cn (F.D.); s843505543@ 123456outlook.com (N.S.); yumiao0130@ 123456outlook.com (M.Y.); zhangcw1207@ 123456outlook.com (C.Z.); wangyr1118@ 123456outlook.com (Y.W.); Liangr0612@ 123456outlook.com (R.L.)

Author notes

[* ]Correspondence: pengli2019@ 123456sina.com

[†]

These authors have contributed equally to this work as co-first authors.

Article

Publisher ID: ijerph-17-01571

DOI: 10.3390/ijerph17051571

PMC ID: 7084814

PubMed ID: 32121348

SO-VID: 53831ac9-4254-498a-8e1b-f95a0d87e9f5

License:

Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

Association between Breakfast Consumption and Depressive Symptoms among Chinese College Students: A Cross-Sectional and Prospective Cohort Study

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25th European Students' Conference

Most cited references 42

Breakfast skipping and health-compromising behaviors in adolescents and adults.

Role of serotonin in the pathophysiology of depression: focus on the serotonin transporter.

Is low folate a risk factor for depression? A meta-analysis and exploration of heterogeneity.

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