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      A Pro-Inflammatory Diet Is Associated With an Increased Odds of Depression Symptoms Among Iranian Female Adolescents: A Cross-Sectional Study

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          Abstract

          Background: The relation between dietary inflammation and risk of depression has not been widely explored. We examined the association between the inflammatory effect of the diet and the odds of depression among Iranian female adolescents.

          Methods: Using a stratified cluster sampling technique, 300 female adolescents aged 15–18 years were recruited from schools in Tehran between years 2014–2015. Depression was assessed using the Depression, Anxiety and Stress Scale (DASS)- a 21-point scale. The dietary inflammatory index (DII®) was used to evaluate the inflammatory potential of the diet. Dietary intake was assessed using a validated food frequency questionnaire. In addition to descriptive statistics, multivariable linear and logistic regression were used to calculate confounder-adjusted beta estimates and odds ratios.

          Results: In total, 88 females (30%) had at least a moderate level of depressive symptoms (DASS > 6). Females with the most pro-inflammatory diet had higher DASS depression score (β = 1.67; 95% CI = 0.03, 3.31) and were at 3.96 (95% CI = 1.12, 13.97) times higher odds of having at least moderate depressive symptoms, compared to females with the least anti-inflammatory diets.

          Conclusion: These data suggest that Iranian adolescent females eating a pro-inflammatory diet, as indicated by higher DII scores, had greater odds of having at least moderate depressive symptoms.

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          Most cited references48

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          Sex and depression in the National Comorbidity Survey. I: Lifetime prevalence, chronicity and recurrence.

          Basic epidemiologic prevalence data are presented on sex differences in DSM-III-R major depressive episodes (MDE). The data come from the National Comorbidity Survey (NCS), the first survey in the U.S. to administer a structured psychiatric interview to a nationally representative sample of the general population. Consistent with previous research, women are approximately 1.7 times as likely as men to report a lifetime history of MDE. Age of onset analysis shows that this sex difference begins in early adolescence and persists through the mid-50s. Women also have a much higher rate of 12-month depression than men. However, women with a history of depression do not differ from men with a history of depression in either the probability of being chronically depressed in the past year or in the probability of having an acute recurrence in the past year. This means that the higher prevalence of 12-month depression among women than men is largely due to women having a higher risk of first onset. The implications of these results for future research are discussed in a closing section of the paper.
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            Validation of a new self-report instrument for measuring physical activity.

            Development and validation of a physical activity scale for measuring physical activity in 24 h of sports, work, and leisure time on an average weekday. For development of the physical activity scale, 2500 randomly selected Danish men and women between the age of 20 and 60 were contacted by mail and asked to select frequent and relevant physical activities from a number of activities of known MET intensity. The activities were included in the physical activity scale, organized in nine different MET levels ranging from sleep/rest (0.9 METs) to high-intensity physical activities (>6 METs). Face validity of the physical activity scale was explored through interviews with 10 volunteer men and women. Concurrent validity was assessed against 4 d of accelerometry (CSA 7164) and physical activity diary in 40 volunteer men and women between 20 and 60 yr of age. The correlation between the activity scale and the diary was high (r = 0.74, P = 0.000), whereas correlation between the activity scale and accelerometer measurements was poor (r = 0.20, NS). The physical activity scale MET-time was systematically higher than average MET-time estimated from the diary, and the difference increased with increasing total MET-time. The physical activity scale appears to be a simple and valid alternative to measuring physical activity by diary in adult sedentary to moderately active Danes. The scale encompasses work, leisure time, and sports activity in one measure; it is easy to administer, and it provides detailed information on different activity levels as well as a single measure of the total amount of physical activity on an average weekday.
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              Inflammation in psychiatric disorders: what comes first?

              Neuropsychiatric disorders (i.e., mood disorders and schizophrenia) and inflammation are closely intertwined, and possibly powering each other in a bidirectional loop. Depression facilitates inflammatory reactions and inflammation promotes depression and other neuropsychiatric disorders. Patients with neuropsychiatric disorders exhibit all cardinal features of inflammation, including increased circulating levels of inflammatory inducers, activated sensors, and inflammatory mediators targeting all tissues. Inflammation may contribute to the pathophysiology and clinical progression of these disorders. Of note, proinflammatory cytokines modulate mood behavior and cognition by reducing brain monoamine levels, activating neuroendocrine responses, promoting excitotoxicity (increased glutamate levels), and impairing brain plasticity. What are the sources of this chronic inflammation? Increasing evidence indicates that changes in neuroendocrine regulation, metabolism, diet/microbiota, and negative health behaviors are important triggers of inflammation. Finally, recent data indicate that early-life stress is associated with overt inflammation prior to the development of neuropsychiatric disorders.
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                Author and article information

                Contributors
                Journal
                Front Psychiatry
                Front Psychiatry
                Front. Psychiatry
                Frontiers in Psychiatry
                Frontiers Media S.A.
                1664-0640
                29 August 2018
                2018
                : 9
                : 400
                Affiliations
                [1] 1Cancer Prevention and Control Program, University of South Carolina , Columbia, SC, United States
                [2] 2Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina , Columbia, SC, United States
                [3] 3Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute (WHO Collaborating Center), Shahid Beheshti University of Medical Sciences , Tehran, Iran
                [4] 4Nutrition and Food Sciences Department, American University of Beirut , Beirut, Lebanon
                Author notes

                Edited by: Joseph Firth, Western Sydney University, Australia

                Reviewed by: Rebekah Carney, Greater Manchester Mental Health NHS Foundation Trust, United Kingdom; Scott B. Teasdale, University of New South Wales, Australia

                This article was submitted to Mood and Anxiety Disorders, a section of the journal Frontiers in Psychiatry

                Article
                10.3389/fpsyt.2018.00400
                6124384
                30210375
                9aa7f335-455f-401d-a947-3fbe3d6a87b1
                Copyright © 2018 Shivappa, Hebert, Neshatbini Tehrani, Bayzai, Naja and Rashidkhani.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 26 May 2018
                : 09 August 2018
                Page count
                Figures: 0, Tables: 3, Equations: 0, References: 86, Pages: 8, Words: 6592
                Categories
                Psychiatry
                Original Research

                Clinical Psychology & Psychiatry
                dietary inflammatory index,diet,inflammation,depression,iran
                Clinical Psychology & Psychiatry
                dietary inflammatory index, diet, inflammation, depression, iran

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