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      Exploring Singapore’s consumption of local fish, vegetables and fruits, meat and problematic alcohol use as risk factors of depression and subsyndromal depression in older adults

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          Depression is a chronic mental disorder that severely impacts the older adult population globally. Nutritional psychiatry is an approach that has gained traction over the years. Exploring locally relevant consumption of common types of fish, vegetables and fruits (V&F), meat and problematic alcohol use (PAU) as risk factors associated with depression and subsyndromal depression (SSD) could reveal modifiable factors that could be targeted in the local older adult population in Singapore.


          Data collected from the Well-being of the Singapore Elderly (WiSE) study, a cross-sectional population-based epidemiological study of Singapore’s older adult population was analysed for the purposes of this study. Two thousand five hundred sixty-five participants were recruited and comprised of Singapore citizens and permanent residents aged ≥60 years. Data on fish, meat, and V&F consumption were collected using the sociodemographic and risk factor questionnaire. The CAGE (Cut, Annoyed, Guilt, and Eye-opener) questionnaire was used to determine PAU. The Geriatric Mental State-Automated Geriatric Examination for Computer Assisted Taxonomy (GMS-AGECAT) was used to obtain participants’ diagnosis of depression or SSD. A multinomial logistic regression was used to explore the relationship between depression and dietary factors.


          Consumption of V&F in the last 3 days was less likely to be associated with depression and SSD. Frequent consumption of specific species of fish was associated with depression and SSD. PAU and the frequent consumption of Himantura gerrardi (stingray) were more likely to be associated with SSD. Finally, meat consumption was more likely to be associated with depression and SSD.


          The preliminary findings of the study support a need for healthy eating for the older adult population in Singapore. Further directions include a more thorough health and nutrition survey to capture accurate diets among the older adults in Singapore.

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          Most cited references 32

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          Fish consumption and major depression.

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            Vitamin B12, folic acid, and the nervous system.

            There are many reasons for reviewing the neurology of vitamin-B12 and folic-acid deficiencies together, including the intimate relation between the metabolism of the two vitamins, their morphologically indistinguishable megaloblastic anaemias, and their overlapping neuropsychiatric syndromes and neuropathology, including their related inborn errors of metabolism. Folates and vitamin B12 have fundamental roles in CNS function at all ages, especially the methionine-synthase mediated conversion of homocysteine to methionine, which is essential for nucleotide synthesis and genomic and non-genomic methylation. Folic acid and vitamin B12 may have roles in the prevention of disorders of CNS development, mood disorders, and dementias, including Alzheimer's disease and vascular dementia in elderly people.
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              A recent perspective on alcohol, immunity, and host defense.

              Multiple line of clinical and experimental evidence demonstrates that both acute, moderate, and chronic, excessive alcohol use result in various abnormalities in the functions of the immune system. Medline and PubMed databases were used to identify published reports with particular interest in the period of 2000-2008 in the subject of alcohol use, infection, inflammation, innate, and adaptive immunity. This review article summarizes recent findings relevant to acute or chronic alcohol use-induced immunomodulation and its consequences on host defense against microbial pathogens and tissue injury. Studies with in vivo and in vitro alcohol administration are both discussed. The effects of alcohol on lung infections, trauma and burn injury, liver, pancreas, and cardiovascular diseases are evaluated with respect to the role of immune cells. Specific changes in innate immune response and abnormalities in adaptive immunity caused by alcohol intake are detailed. Altered inflammatory cell and adaptive immune responses after alcohol consumption result in increased incidence and poor outcome of infections and other organ-specific immune-mediated effects.

                Author and article information

                65-6389-2521 , JANRIUS_CM_GOH@IMH.COM.SG ,
                BMC Geriatr
                BMC Geriatr
                BMC Geriatrics
                BioMed Central (London )
                10 June 2019
                10 June 2019
                : 19
                Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

                Funded by: Ministry of Health -Singapore (SG)
                Funded by: The Singapore Millennium Foundation of the Temasek Trust
                Research Article
                Custom metadata
                © The Author(s) 2019

                Geriatric medicine

                alcohol, fruits, vegetables, fish, older adult, diet, singapore, risk factors, depression


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