Refined Carbohydrates Linked to Increased Risk of Depression in Postmenopausal Women

A diet high in refined carbohydrates may lead to an increased risk for new-onset depression in postmenopausal women, according to a study published in The American Journal of Clinical Nutrition.

The study by James Gangwisch, PhD and colleagues in the department of psychiatry at Columbia University Medical Center (CUMC) looked at the dietary glycemic index, glycemic load, types of carbohydrates consumed, and depression in data from more than 70,000 postmenopausal women who participated in the National Institutes of Health’s Women’s Health Initiative Observational Study between 1994 and 1998.

This shows a lady with her head in her hands, sitting on a sofa.
Refined foods such as white bread, white rice, and soda trigger a hormonal response in the body to reduce blood sugar levels. This response also may cause or exacerbate mood changes, fatigue, and other symptoms of depression. The image is for illustrative purposes only. Image credit: Irais Esparza.

Consumption of carbohydrates increases blood sugar levels to varying degrees, depending on the type of food ingested. The more highly refined the carbohydrate, the higher its score on the glycemic index (GI) scale. The GI scale, which goes from 0-100, measures the amount of sugar found in the blood after eating. Refined foods such as white bread, white rice, and soda trigger a hormonal response in the body to reduce blood sugar levels. This response may also cause or exacerbate mood changes, fatigue and other symptoms of depression.

The investigators found that progressively higher dietary GI scores and consumption of added sugars and refined grains were associated with increased risk of new-onset depression in post-menopausal women. Greater consumption of dietary fiber, whole grains, vegetables and non-juice fruits was associated with decreased risk. This suggests that dietary interventions could serve as treatments and preventive measures for depression. Further study is needed to examine the potential of this novel option for treatment and prevention, and to see if similar results are found in the broader population.

About this psychology research

Columbia University, College of Physicians and Surgeons, Department of Psychiatry (JEG); Stony Brook University, Stony Brook Medicine, Program of Public Health and Department of Preventive Medicine (LH); University of California-Davis, School of Medicine, Department of Public Health Sciences (LG); New York University Langone Medical Center, Department of Psychiatry (DM, MGO); Duke University Medical Center, Department of Psychiatry and Behavioral Sciences, Center for the Study of Aging and Human Development (MEP); Health Partners Institute for Education and Research and the University of Minnesota Medical School, Department of Psychiatry (RCR); Stony Brook University, Stony Brook Medicine, Department of Preventive Medicine (DL)

The authors have declared no conflicts of interest.

Funding: The WHI program is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services through contracts N01WH22110, 24152, 32100-2, 32105-6, 32108-9, 32111-13, 32115, 32118-32119,38 32122, 42107-26, 42129-32, and 44221. Dr. Payne is supported by an NIH Building Interdisciplinary Research Careers in Women’s Health (BIRCWH) K12 grant (#HD043446).

Source: Columbia University Medical Center
Image Credit: The image is credited to Irais Esparza and is licensed CC BY-SA 4.0
Original Research: Abstract for “High Glycemic Index Diet as a Risk Factor for Depression: Analyses from the Women’s Health Initiative” by James E. Gangwisch, Lauren Hale, Lorena Garcia, Dolores Malaspina, Mark G. Opler, Martha E. Payne, Rebecca C. Rossom, and Dorothy Lane in American Journal of Clinical Nutrition. Published online June 24 2015 doi:10.3945/​ajcn.114.103846


Abstract

High Glycemic Index Diet as a Risk Factor for Depression: Analyses from the Women’s Health Initiative

Background: The consumption of sweetened beverages, refined foods, and pastries has been shown to be associated with an increased risk of depression in longitudinal studies. However, any influence that refined carbohydrates has on mood could be commensurate with their proportion in the overall diet; studies are therefore needed that measure overall intakes of carbohydrate and sugar, glycemic index (GI), and glycemic load.

Objective: We hypothesized that higher dietary GI and glycemic load would be associated with greater odds of the prevalence and incidence of depression.

Design: This was a prospective cohort study to investigate the relations between dietary GI, glycemic load, and other carbohydrate measures (added sugars, total sugars, glucose, sucrose, lactose, fructose, starch, carbohydrate) and depression in postmenopausal women who participated in the Women’s Health Initiative Observational Study at baseline between 1994 and 1998 (n = 87,618) and at the 3-y follow-up (n = 69,954).

Results: We found a progressively higher dietary GI to be associated with increasing odds of incident depression in fully adjusted models (OR for the fifth vs. first quintile: 1.22; 95% CI: 1.09, 1.37), with the trend being statistically significant (P = 0.0032). Progressively higher consumption of dietary added sugars was also associated with increasing odds of incident depression (OR for the fifth vs. first quintile: 1.23; 95% CI: 1.07, 1.41; P-trend = 0.0029). Higher consumption of lactose, fiber, nonjuice fruit, and vegetables was significantly associated with lower odds of incident depression, and nonwhole/refined grain consumption was associated with increased odds of depression.

Conclusions: The results from this study suggest that high-GI diets could be a risk factor for depression in postmenopausal women. Randomized trials should be undertaken to examine the question of whether diets rich in low-GI foods could serve as treatments and primary preventive measures for depression in postmenopausal women. The Women’s Health Initiative is registered at clinicaltrials.gov as NCT00000611.

“High Glycemic Index Diet as a Risk Factor for Depression: Analyses from the Women’s Health Initiative” by James E. Gangwisch, Lauren Hale, Lorena Garcia, Dolores Malaspina, Mark G. Opler, Martha E. Payne, Rebecca C. Rossom, and Dorothy Lane in American Journal of Clinical Nutrition. Published online June 24 2015 doi:10.3945/​ajcn.114.103846

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