Association between depression and fruit and vegetable consumption among adults in South Asia

Background: In recent years there has been a growing research interest regarding the impact of dietary behaviour on mental health outcomes. The present study aimed to investigate the association between fruit and vegetable (F&V) consumption and depression in three south Asian countries-Bangladesh, India and Nepal. Methods: Cross-sectional data were obtained from World Health Survey of WHO conducted during 2002-04. In total 14,133 adult subjects (Bangladesh 3262, India 7594, Nepal 3277) aged 18 years and above were included in the study. Outcome variables were Self-Reported Depression (SRD) during last 30 days and 12 months. Multivariable regression methods were used to explore the association between F&V consumption and depression. Results: Prevalence of Self-Reported Depression during past 12 months were respectively 39%, 17.7%, and 49.9% for Bangladesh, India and Nepal. In India, those who consumed less than five servings of vegetables were respectively 41% [AOR = 1.41; 95% CI = 0.60-3.33] and 57% [AOR = 1.57; 95% CI = 0.93-2.64] more likely to report severe-extreme and mild-moderate depression during past 30 days compared to those who consumed five servings a day. Regarding fruit consumption, compared to those who consumed five servings a day, the odds of severe-extreme and mild-moderate SRD were respectively 3.5 times [AOR = 3.48; 95% CI = 1.216-10.01] and 45% [AOR = 1.44; 95% CI = 0.89-2. 32] higher in Bangladesh, and 2.9 times [AOR = 2.92; 95% CI = 1.12-7.64] and 42% higher [AOR = 1.41; 95% CI = 0.89-2.24] in Nepal compared to those who consumed less than five servings a day during last 30 days. Conclusion: Daily intake of less than five servings of F&V was associated with higher odds of depression. Nutrition programs aimed at promoting F&V consumption might prove beneficial to reduce the prevalence of depression in south Asian population. Further studies are required to understand the factors limiting the adequate consumption of F&V.