Dietary Pattern, Nutrition Status, and Depression among Medical Students in a University in Bangkok

Authors

  • Suphakorn Ruksawong M.Sc. (Public Health) Program in Nutrition, Faculty of Public Health, Mahidol University, Thailand
  • Patcharanee Pavadgul Department of Nutrition, Faculty of Public Health, Mahidol University
  • Sukhontha Siri Department of Epidemiology, Faculty of Public Health, Mahidol University
  • Kitikan Thana-Udom Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University

Keywords:

Dietary Pattern, Nutritional status, Depression, Medical students

Abstract

Depression is a common psychiatric problem that can lead to suicide. Medical students are at high risk for this issue, and studies have shown that diet and nutrition are also related to depression. This cross-sectional study examines the proportion and association between dietary patterns, nutritional status, and depression among medical students at a university in Bangkok. Data was collected from first to sixth-year medical students through self-administered online questionnaires, consisting of personal information, the Patient Health Questionnaire (PHQ-9) for depression assessment, a semi-quantitative food frequency questionnaire adapted for dietary patterns, and nutritional status information. Data was analyzed using Chi-square statistics for factor analysis related to depression, and logistic regression analysis for factors associated with depression. The study found that 26% of the medical students had depression. Positive aspects related to depression included the consumption of butter (OR = 7.071, 95% CI=1.570 - 31.859, P= 0.006) and iced coffee/cocoa/tea (with cream, milk, sugar) more than three times a week (OR = 5.486, 95% CI = 1.298 - 23.184, P= 0.037) compared to those who consumed them three times or less per week. Nutritional status and other factors showed no significant association with depression. However, this study has limitations due to the small sample size and the sensitive nature of psychiatric data collection. Additionally, the heavy academic and clinical workload of medical students may have resulted in incomplete data collection as initially planned, which prevents the findings from being generalized to the entire population.

References

องค์การอนามัยโลก. รายงานจากองค์การอนามัยโลก แผนกสุขภาพจิตและสารเสพติด [อินเทอร์เน็ต]. 2017 [เข้าถึงเมื่อ 4 ก.ย. 2021]. เข้าถึงได้จาก:https://apps.who.int/iris/bitstream/handle/10665/43286/9241562943-tha.pdf

World Health Organization. Mental Health Atlas 2017 [Internet]. 2020 [cited 2020 Apr 17]. Available from: https://apps.who.int/iris/bitstream/handle/10665/272735/9789241514019-eng.pdf?ua=1

World Health Organization. Depression [Internet]. 2020 [cited 2021 Jan 20]. Available from: https://www.who.int/news-room/fact-sheets/detail/depression

Kolkijkovin V, Phutathum S, Chatromyen P, Jantratikul A, Pattrayutawat M, Surinrat T, et al. A study of prevalence and associated factors of stress in the third-year medical students at Faculty of Medicine Vajira Hospital, Navamindradhiraj University. Vajira Med J. 2017;61(1):9-20.

Kuladee S, Boonvisudhi T. Association between internet addiction and depression in medical students, faculty of medicine in Thailand. European Psychiatry. 2017;41(S1):S310-S. DOI: https://doi.org/10.1016/j.eurpsy.2017.02.211

Puthran R, Zhang MW, Tam WW, Ho RC. Prevalence of depression amongst medical students: A meta‐analysis. Med Eedu. 2016;50(4):456-68. DOI: https://doi.org/10.1111/medu.12962

Limsricharoen K, Handee N, Chulakdabba S. Prevalence and associated factors of depression in second to sixth years medical students, Faculty of Medicine in Thailand. J Psychiatr Assoc Thailand. 2014;59(1):29-40.

Dyrbye LN, Thomas MR, Shanafelt TD. Systematic review of depression, anxiety, and other indicators of psychological distress among US and Canadian medical students. Acad Med. 2006;81(4):354-73. DOI: 10.1097/00001888-200604000-00009.

Kaewpila W, Thaipisuttikul P, Awirutworakul T, Jumroonrojana K, Pitidhammabhorn U, Stevens F. Depressive disorders in Thai medical students: an exploratory study of institutional, cultural, and individual factors. Int J Med Educ. 2020;11:252-60. DOI: 10.5116/ijme.5fbe.4ce5

Jongsukvarakul N. Mental health of first-year residency training at Faculty of Medicine, Siriraj Hospital (dissertation) [dissertation]. Bangkok: Mahidol University; 2008.

Voltmer E, Kötter T, Spahn C. Perceived medical school stress and the development of behavior and experience patterns in German medical students. Med Teach. 2012;34(10):840-7. DOI: 10.3109/0142159X.2012.706339

Li Y, Lv M-R, Wei Y-J, Sun L, Zhang J-X, Zhang H-G, et al. Dietary patterns and depression risk: a meta-analysis. Psychiatry Res. 2017;253:373-82. DOI: https://doi.org/10.1016/j.psychres.2017.04.020

Kim T-H, Choi J-y, Lee H-H, Park Y. Associations between dietary pattern and depression in Korean adolescent girls. J. Pediatr. Adolesc. Gynecol. 2015;28(6):533-7. DOI: https://doi.org/10.1016/j.jpag.2015.04.005

Feizi E, Naghizadeh Baghi A, Rahimi A, Nemati S. The relationship between body mass index and depression in female students of Ardabil University of Medical Sciences. Journal of Ardabil University of Medical Sciences (JAUMS). 2012;12(2):213-20. I. FEIZI, DOI: https://sid.ir/paper/60067/en

Milaneschi Y, Simmons WK, van Rossum EFC, Penninx BWJH. Depression and obesity: evidence of shared biological mechanisms. Mol Psychiatry. 2019;24(1):18-33. DOI: 10.1038/s41380-018-0017-5

Zhao G, Ford ES, Li C, Tsai J, Dhingra S, Balluz LS. Waist circumference, abdominal obesity, and depression among overweight and obese U.S. adults: National Health and Nutrition Examination Survey 2005-2006. BMC Psychiatry. 2011;11:130. DOI: 10.1186/1471-244X-11-130

Tashakori A, Riahi F, Mohammadpour A. The Relationship between body mass index and depression among high school girls in Ahvaz. Adv Med. 2016;2016:3645493. DOI: 10.1155/2016/3645493

Tashakori A, Riahi F, Mohammadpour A. The relationship between body mass index and depression among high school girls in Ahvaz. Adv Med. 2016:2016:3645493. DOI: 10.1155/2016/3645493

สุคนธ์ บุบผา. การเปรียบเทียบความถูกต้องของแบบสอบถามความถี่อาหารบริโภคกึ่งปริมาณกับการสัมภาษณ์อาหารบริโภคย้อนหลัง 24 ชั่วโมงเป็นเวลา 3 วัน ในการประเมินสารอาหารที่ได้รับของผู้สูงอายุในจังหวัดตรัง (วิทยานิพนธ์วิทยาศาตรมหาบัณฑิต (สาธารณสุขศาสตร์) สาขาวิชาโภชนวิทยา). กรุงเทพมหานคร: บัณฑิตวิทยาลัย มหาวิทยาลัยมหิดล; 2541.

Maneesopa S, Chupanit P, Muktabhant B. Relationship of energy and nutrient intakes in middle age adults based on semi-quantitative food frequency questionnaire and 24-hour dietary recall. Srinagarind Med J. 2014;29(5):435-41.

Willett WC, Sampson L, Stampfer MJ, Rosner B, Bain C, Witschi J, et al. Reproducibility and validity of a semiquantitative food frequency questionnaire. Am J Epidemiol. 1985 Jul;122(1):51-65. DOI: 10.1093/oxfordjournals.aje.a114086.

Limsirisawt K, Khongthanarat K, Wongmat N, Kuntolbut T, Sinchaipanit P, Tangpontirak A, et al. Food consumption behaviors of third-year to fifth-year medical students at the Faculty of Medicine Vajira Hospital. Vajira Medical Journal: Journal of Urban Medicine. 2020;64(2):133-44.

Martin-Rodriguez E, Guillen-Grima F, Aubá E, Martí A, Brugos-Larumbe A. Relationship between body mass index and depression in women: a 7-year prospective cohort study. The APNA study. European psychiatry. 2016;32:55-60. DOI: https://doi.org/10.1016/j.eurpsy.2015.11.003

Felger JC, Lotrich FE. Inflammatory cytokines in depression: neurobiological mechanisms and therapeutic implications. Neuroscience. 2013;29:246:199-229. DOI: 10.1016/j.neuroscience.2013.04.060

Raison CL, Capuron L, Miller AH. Cytokines sing the blues: inflammation and the pathogenesis of depression. Trends Immunol. 2006;27(1):24-31. DOI: 10.1016/j.it.2005.11.006

Koo JW, Duman RS. IL-1beta is an essential mediator of the antineurogenic and anhedonic effects of stress. Proc Natl Acad Sci U S A. 2008;105(2):751-6. DOI: 10.1073/pnas.0708092105

Li Z, Li B, Song X, Zhang D. Dietary zinc and iron intake and risk of depression: A meta-analysis. Psychiatry Res. 2017;251:41-47. DOI: 10.1016/j.psychres.2017.02.006

Oddy WH, Allen KL, Trapp GS, Ambrosini GL, Black LJ, Huang R-C, et al. Dietary patterns, body mass index and inflammation: pathways to depression and mental health problems in adolescents. Brain Behav Immun. 2018;69:428-39. DOI: 10.1016/j.bbi.2018.01.002

Melo HM, Santos LE, Ferreira ST. Diet-Derived Fatty Acids, Brain Inflammation, and Mental Health. Front Neurosci. 2019;26;13:265. DOI: 10.3389/fnins.2019.00265

Cai W, Xue C, Sakaguchi M, Konishi M, Shirazian A, Ferris HA, et al. Insulin regulates astrocyte gliotransmission and modulates behavior. J Clin Invest. 2018;128(7):2914-2926. DOI: 10.1172/JCI99366

Li Y, Cheng Y, Zhou Y, Du H, Zhang C, Zhao Z, et al. High fat diet-induced obesity leads to depressive and anxiety-like behaviors in mice via AMPK/mTOR-mediated autophagy. Exp Neurol. 2022;348:113949. DOI: 10.1016/j.expneurol.2021.113949

Richards G, Smith A. Caffeine consumption and self-assessed stress, anxiety, and depression in secondary school children. J Psychopharmacol. 2015;29(12):1236-47. DOI: 10.1177/0269881115612404

Lucas M, Mirzaei F, Pan A, Okereke OI, Willett WC, O'Reilly É J, et al. Coffee, caffeine, and risk of depression among women. Arch Intern Med. 2011;171(17):1571-8. DOI: 10.1001/archinternmed.2011.393

Grosso G, Micek A, Godos J, Sciacca S, Pajak A, Martínez-González MA, et al. Coffee consumption and risk of all-cause, cardiovascular, and cancer mortality in smokers and non-smokers: a dose-response meta-analysis. Eur J Epidemiol. 2016;31(12):1191-205. DOI: 10.1007/s10654-016-0202-2

Li P, Yin F, Zhao Y, Liu Y, Zhang R, Wang J, et al. Total sugar intake is associated with higher prevalence of depressive symptoms in obese adults. Front Public Health. 2022;10:1069162. DOI: 10.3389/fpubh.2022.1069162

Zhang L, Sun H, Liu Z, Yang J, Liu Y. Association between dietary sugar intake and depression in US adults: a cross-sectional study using data from the National Health and Nutrition Examination Survey 2011-2018. BMC Psychiatry. 2024;24(1):110. DOI: 10.1186/s12888-024-05531-7

Jacques A, Chaaya N, Beecher K, Ali SA, Belmer A, Bartlett S. The impact of sugar consumption on stress driven, emotional and addictive behaviors. Neurosci Biobehav Rev. 2019;103:178-99. DOI: 10.1016/j.neubiorev.2019.05.021

Downloads

Published

2025-01-23

How to Cite

Ruksawong, S., Pavadgul, P., Siri, S., & Thana-Udom, K. (2025). Dietary Pattern, Nutrition Status, and Depression among Medical Students in a University in Bangkok . Journal of Nutrition Association of Thailand (Online), 60(1), 1–13. retrieved from https://he01.tci-thaijo.org/index.php/JNAT/article/view/276218

Issue

Section

Research article