Association of dietary patterns and depressive symptoms among college students
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摘要:
目的 探讨大学生饮食模式和抑郁症状的横断面及纵向关联，为促进大学生身心健康提供依据。 方法 于2019年4—5月采用整群随机抽样方法，在安徽省合肥市和江西省上饶市2所高校选取大学生进行基线调查，并于2019年9—10月进行随访调查，共调查1 110名大学生。使用抑郁-焦虑-压力自评量表(DASS-21)中抑郁分量表调查大学生的抑郁症状，使用半定量食物频率问卷(SQFFQ)调查大学生饮食行为。运用主成分分析和探索性因子分析方法分析饮食模式，使用三分位数法将各饮食模式因子得分划为T1、T2和T3组，并采用多因素Logistic回归模型分析基线饮食模式与基线和随访调查抑郁症状的关联。 结果 基线大学生轻度、中度及以上抑郁症状检出率分别为7.03%和14.23%。主成分分析和探索性因子分析结果显示大学生饮食模式可分为含糖饮料、肉类、快餐和健康食物4种。在基线和随访调查中，含糖饮料、肉类和快餐3种饮食模式T3组中度及以上抑郁症状检出率最高(χ2值分别为21.51，32.25，22.21；23.54，13.91，19.98，P值均＜0.05)。调整协变量后，多因素Logistic回归模型结果显示，大学生肉类和快餐饮食模式T3组与基线、随访中度及以上抑郁症状均呈正相关；大学生快餐饮食模式T3组与随访轻度抑郁症状呈正相关(P值均＜0.05)。 结论 大学生肉类和快餐饮食模式可增加抑郁症状的发生风险，改善大学生饮食模式对促进大学生心理健康有积极作用。 Abstract:Objective To describe the cross-sectional and longitudinal associations of dietary patterns and depressive symptoms among college students, so as to provide a reference for improving college students' mental and physical health. Methods From April to May 2019, 1 110 college students were randomly sampled in Hefei City, Anhui Province and Shangrao City, Jiangxi Province, and a follow-up survey was conducted from September to October 2019. The depression subscale of Depression Anxiety Stress Scale-21 (DASS-21) was used to investigate depressive symptoms in college students. The Semi-Quantitative Food Frequency Questionnaire (SQFFQ) was used to investigate the eating behaviors of college students. Diet patterns were analyzed by principal component analysis and exploratory factor analysis, and the scores were classified T1, T2 and T3. Multivariate Logistic regression models were used to analyze the association of baseline dietary patterns and depressive symptoms at baseline and follow-up. Results The detection rates of mild, moderate and above depressive symptoms among baseline college students were 7.03% and 14.23%, respectively. The results of principal component analysis and exploratory factor analysis showed that the dietary patterns of college students were divided into four patterns: sugary drinks, meat, fast food and healthy food. At baseline and follow-up surveys, the detection rate of depressive symptoms in sugary drinks, meat and fast food was the highest (χ2=21.51, 32.25, 22.21; 23.54, 13.91, 19.98, P < 0.05). The results of multivariate Logistic regression model showed that the meat and fast food T3 showed positive association with baseline and moderate follow-up, and the fast food T3 showed positive association with mild depressive symptoms at follow-up (P < 0.05). Conclusion Meat and fast food diet patterns can increase the risk of depressive symptoms, suggesting that improving their eating patterns has a positive effect on promoting the mental health of college students. -
Key words:
- Food habits /
- Depression /
- Mental health /
- Regression analysis /
- Students
1) 利益冲突声明 所有作者声明无利益冲突。 -
表 1 不同人口统计学特征大学生轻度和中度及以上抑郁症状检出率比较
Table 1. Comparison of the detection rate of mild and moderate and above depressive symptoms among college students with different demographic characteristics
组别 选项 人数 抑郁症状 χ2值 P值 轻度 中度及以上 性别 男 419 30(7.2) 84(20.0) 19.02 ＜0.01 女 691 48(6.9) 74(10.7) 家庭居住地 农村 623 44(7.1) 90(14.4) 0.06 0.97 城市 487 34(7.0) 68(14.0) 独生子女 是 260 18(6.9) 40(15.4) 0.37 0.83 否 850 61(7.1) 118(13.9) 父亲文化程度 小学及以下 254 19(7.5) 50(19.7) 9.03 0.06 初中 527 34(6.5) 69(13.1) 高中及以上 329 25(7.6) 39(11.9) 母亲文化程度 小学及以下 489 39(8.0) 69(14.1) 1.45 0.84 初中 386 25(6.5) 57(14.8) 高中及以上 235 14(6.0) 34(13.6) 家庭经济分类 较差 268 19(7.1) 50(18.7) 6.03 0.20 中等 785 55(7.0) 102(13.0) 较好 57 4(7.0) 6(10.5) 学习成绩 较差 233 20(8.6) 52(22.3) 25.46 ＜0.01 中等 683 46(6.7) 94(13.8) 较好 194 12(6.2) 12(6.2) 体力活动 低 160 12(7.5) 53(33.1) 59.18 ＜0.01 中等 523 37(7.1) 48(9.2) 高 427 29(6.8) 57(13.3) 注： ()内数字为检出率/%。 
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表 2 大学生饮食模式的因子载荷矩阵
Table 2. Factor load matrix of dietary patterns for college students
食物组别 含糖饮料 肉类 快餐 健康食物 果蔬汁饮料 0.77 — — — 碳酸饮料 0.72 — — — 茶饮料 0.69 — — — 功能性饮料 0.69 — — — 乳类饮料 0.63 — — — 淡水鱼 — 0.69 — — 海鱼 — 0.66 — 牛肉或羊肉 — 0.70 — — 鸡肉、鸭肉或鹅肉 — 0.71 — — 猪肉 — 0.69 — — 外卖西式快餐 — — 0.65 — 食堂打包西式快餐 — — 0.69 — 街头小吃或快餐店食用西式快餐 — — 0.75 — 街头小吃或快餐店食用快餐便当 — — 0.68 — 水果 — — — 0.72 蔬菜 — — — 0.67 鸡蛋 — — — 0.61 牛奶 — — — 0.56 注：剔除因子载荷绝对值＜0.3。
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表 3 基线大学生4种饮食模式与基线抑郁症状的关联
Table 3. Association of four dietary patterns with baseline depressive symptoms among baseline college students
膳食模式 组别 人数 轻度抑郁症状 中度及以上抑郁症状 调整前OR值(OR值95%CI) 调整后OR值(OR值95%CI) 检出人数 检出率/% 检出人数 检出率/% 轻度抑郁症状 中度及以上抑郁症状 轻度抑郁症状 中度及以上抑郁症状 含糖饮料 T1 370 26 7.0 45 12.2 1.00 1.00 1.00 1.00 T2 370 31 8.4 36 9.7 1.18(0.68~2.03) 0.79(0.50~1.26) 1.13(0.65~1.96) 0.72(0.44~1.17) T3 370 21 5.7 77 20.8 0.89(0.49~1.62) 1.88(1.26~2.81)* 0.83(0.45~1.53) 1.52(0.99~2.35) 肉类 T1 370 23 6.2 40 10.8 1.00 1.00 1.00 1.00 T2 370 22 5.9 37 10.0 0.94(0.51~1.73) 0.91(0.57~1.47) 0.94(0.51~1.73) 0.98(0.59~1.60) T3 370 33 8.9 81 21.9 1.72(0.99~3.00) 2.43(1.61~3.67)** 1.71(0.97~3.02) 2.16(1.38~3.34)* 快餐 T1 370 19 5.1 44 11.9 1.00 1.00 1.00 1.00 T2 370 31 8.4 38 10.3 1.66(0.92~3.01) 0.88(0.56~1.40) 1.70(0.94~3.10) 0.91(0.56~1.47) T3 370 28 7.6 76 20.5 1.70(0.93~3.12) 1.99(1.33~2.99)* 1.78(0.97~3.28) 2.18(1.42~3.36)* 健康食物 T1 370 27 7.3 63 17.0 1.00 1.00 1.00 1.00 T2 370 25 6.8 58 15.7 0.90(0.51~1.60) 0.90(0.61~1.33) 0.96(0.54~1.71) 1.19(0.78~1.83) T3 370 26 7.0 37 10.0 0.88(0.50~1.54) 0.54(0.35~0.83)* 0.96(0.54~1.71) 0.73(0.45~1.16) 注：*P＜0.05，**P＜0.01；协变量为性别、父母文化程度、家庭经济情况、学习成绩和体力活动。
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表 4 基线大学生4种饮食模式与随访抑郁症状的关联
Table 4. Association of four dietary patterns and follow-up depressive symptoms among baseline college students
膳食模式 组别 人数 轻度抑郁症状 中度及以上抑郁症状 调整前OR值(OR值95%CI) 调整后OR值(OR值95%CI) 检出人数 检出率/% 检出人数 检出率/% 轻度抑郁症状 中度及以上抑郁症状 轻度抑郁症状 中度及以上抑郁症状 含糖饮料 T1 370 35 9.5 45 12.2 1.00 1.00 1.00 1.00 T2 370 22 5.9 35 9.5 0.59(0.33~1.02) 0.72(0.45~1.15) 0.57(0.32~1.10) 0.64(0.40~1.05) T3 370 20 5.4 74 20.0 0.60(0.34~1.06) 1.73(1.15~2.59)* 0.56(0.31~1.01) 1.34(0.87~2.07) 肉类 T1 370 20 5.4 41 11.1 1.00 1.00 1.00 1.00 T2 370 27 7.3 44 11.9 1.40(0.77~2.54) 1.11(0.70~1.75) 1.35(0.74~2.148) 1.19(0.74~1.90) T3 370 30 8.1 69 18.6 1.71(0.95~3.08) 1.92(1.26~2.92)* 1.58(0.87~2.90) 1.63(1.05~2.53)* 快餐 T1 370 20 5.4 41 11.1 1.00 1.00 1.00 1.00 T2 370 24 6.5 41 11.1 1.22(0.66~2.24) 1.01(0.64~1.61) 1.30(0.69~2.41) 1.11(0.69~1.79) T3 370 33 8.9 72 19.5 1.92(1.08~2.43)* 2.05(1.35~3.11)* 2.12(1.18~3.82)* 2.25(1.45~3.49)** 健康食物 T1 370 29 7.8 6 16.2 1.00 1.00 1.00 1.00 T2 370 24 6.5 45 12.2 0.77(0.44~1.36) 0.70(0.46~1.07) 0.76(0.43~1.36) 0.88(0.56~1.38) T3 370 24 6.5 49 13.2 0.78(0.45~1.38) 0.77(0.51~1.17) 0.79(0.44~1.41) 1.02(0.65~1.59) 注：*P＜0.05，**P＜0.01；协变量为性别、父母文化程度、家庭经济情况、学习成绩和体力活动。
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