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Background: Low dietary nutrient intake may be associated with depressive symptoms. However, few such studies have been conducted among postpartum women and results have been controversial.
Purpose: To investigate the association between dietary nutrient intake and depressive symptoms among Japanese one-month postpartum women.
Methods: This cross-sectional study was conducted at a university hospital in Tokyo from June 2015 to September 2016. We recruited healthy women with healthy babies at their postpartum check-up. Dietary nutrient intake was assessed using a validated, brief-type, self-administered diet history questionnaire. Depressive symptoms were defined as a score of ? 9 on the Edinburgh Postnatal Depression Scale. Multiple logistic regression analysis was performed to identify if dietary nutrient intake was associated with depressive symptoms. Variables with P-values < 0.10 in the bivariate analysis and factors identified as important, based on the literature review, were included. P < 0.05 was considered significant.
Results: Data from 246 participants were analyzed. Depressive symptom prevalence was 19.5%. Participants with an educational level above university level comprised 69.1%, and 68.3% of participants had a household income of ? 7 million Japanese yen. In the multivariate analysis, dietary nutrient intake was not significantly associated with depressive symptoms. However, higher educational level and need for emotional support as assessed by midwives or nurses were significantly associated with an increased risk of depressive symptoms.
Conclusion: Dietary nutrient intake was not significantly associated with depressive symptoms in this high socioeconomic status population. Further research is needed to identify the relationship between dietary intake and depressive symptoms among more socioeconomically diverse postpartum women. Additionally, it may be important for postpartum depression support systems to pay attention to highly-educated women and to undertake continued follow-up for women who are assessed by midwives or nurses as needing emotional support either during pregnancy or while in the hospital.
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Cox, J.L., Holden, J.M., & Sagovsky, R. (1987). Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry, 150, 782–786. https://doi.org/10.1192/bjp.150.6.782
Ellsworth-Bowers, E.R., & Corwin, E.J. (2012). Nutrition and the psychoneuroimmunology of postpartum depression. Nutrition Research Reviews, 25, 180–192. https://doi.org/10.1017/s0954422412000091
Fukuda, Y., & Hiyoshi, A. (2012). High quality nutrient intake is associated with higher household expenditures by Japanese adults. Bioscience Trends, 6, 176–182. https://doi.org/10.5582/bst.2012.v6.4.176
Hamazaki, K., Takamori, A., Tsuchida, A., Kigawa, M., Tanaka, T., Ito, M., … Katoh, T. (2018). Dietary intake of fish and n-3 polyunsaturated fatty acids and risks of perinatal depression: The Japan Environment and Children’s Study (JECS). Journal of Psychiatric Research, 98, 9–16. https://doi.org/10.1016/j.jpsychires.2017.11.013
Hamazaki, K., Matsumura, K., Tsuchida, A., Kasamatsu, H., Tanaka, T., Ito, M., … the Japan Environment and Children’s Study Group. (2020). Dietary intake of fish and n-3 polyunsaturated fatty acids and risk of postpartum depression: a nationwide longitudinal study – the Japan Environment and Children's Study (JECS). Psychological Medicine, 50, 2416–2424. https://doi.org/10.1017/s0033291719002587
Honda, Y. (2008). The Bottleneck of family education: Japanese mothers impelled to good parenting. Keisoshobo (in Japanese).
Ishikawa, H., Kawakami, N., & Kessler, R.C. (2016). Lifetime and 12-month prevalence, severity and unmet need for treatment of common mental disorders in Japan: Results from the final dataset of World Mental Health Japan Survey. Epidemiology and Psychiatric Sciences, 25, 217–229. https://doi.org/10.1017/s2045796015000566
Kobayashi, S., Honda, S., Murakami, K., Sasaki, S., Okubo, H., Hirota, N.,…Date, C. (2012). Both comprehensive and brief self-administered diet history questionnaires satisfactorily rank nutrient intakes in Japanese adults. Journal of Epidemiology, 22, 151–159. https://doi.org/10.2188/jea.je20110075
Kobayashi, S., Murakami, K., Sasaki, S., Okubo, H., Hirota, N., Notsu, A.,…Date, C. (2011). Comparison of relative validity of food group intakes estimated by comprehensive and brief-type self-administered diet history questionnaires against 16 d dietary records in Japanese adults. Public Health Nutrition, 14, 1200–1211. https://doi.org/10.1017/s1368980011000504
Letourneau, N.L., Dennis, C.L., Benzies, K., Duffett-Leger, L., Stewart, M., Tryphonopoulos, P.,…Watson, W., (2012). Postpartum depression is a family affair: Addressing the impact on mothers, fathers, and children. Issues in Mental Health Nursing, 33, 445–457. https://doi.org/10.3109/01612840.2012.673054
Liu, X., Wang, S., & Wang, G. (2022). Prevalence and Risk Factors of Postpartum Depression in Women: A Systematic Review and Meta-analysis. Journal of clinical nursing, 31(19-20), 2665–2677. https://doi.org/10.1111/jocn.16121
Matsumoto, H., Matsuzaki, M., Shiraishi, M., Haruna, M. Relationship between body image and dietary intake among women at one month postpartum. (2018). Bosei eisei, 59(2), 406–415 (in Japanese).
Matsumura, K., Hamazaki, K., Tsuchida, A., Kasamatsu, H., Inadera, H., Japan Environment and Children’s study (JECS) Group. (2019). Education level and risk of postpartum depression: results from the Japan Environment and Children's Study (JECS). BMC Psychiatry, 19, 419. https://doi.org/10.1186/s12888-019-2401-3
Ministry of Health, Labor and Welfare. (2011). Comprehensive survey of living conditions. http://www.mhlw.go.jp/toukei/saikin/hw/k-tyosa/k-tyosa10/2-4.html
Ministry of Health, Labor and Welfare. (2020). Dietary reference intakes for Japanese. Dai-ichi shuppan.
Ministry of Health, Labor and Welfare. (2010a). Specified report of vital statistics in FY 2010, Live Births. http://www.mhlw.go.jp/english/database/db-hw/FY2010/live_births.html
Ministry of Health, Labor and Welfare. (2010b). Guideline for nurturing support and home visiting services. http://www.mhlw.go.jp/bunya/kodomo/kosodate08/03.html
Miyake, Y., Sasaki, S., Tanaka, K., Yokoyama, T., Ohya, Y.,…The Osaka Maternal and Child Health Study Group. (2006). Dietary folate and vitamins B12, B6, and B2 intake and the risk of postpartum depression in Japan: The Osaka Maternal and Child Health Study. Journal of Affective Disorders, 96, 133–138. https://doi.org/10.1016/j.jad.2006.05.024
Miyake, Y., Sasaki, S., Yokoyama, T., Tanaka, K., Ohya, Y., Fukushima, W.,…The Osaka Maternal and Child Health Study group. (2006). Risk of postpartum depression in relation to dietary fish and fat intake in Japan: The Osaka Maternal and Child Health Study. Psychological Medicine, 36, 1727–1735. https://doi.org/10.1017/s0033291706008701
Miyake, Y., Tanaka, K., Sasaki, S., & Hirota, Y. (2011). Employment, income, and education and risk of postpartum depression: The Osaka Maternal and Child Health Study. Journal of Affective Disorders, 130, 133–137. https://doi.org/10.1016/j.jad.2010.10.024
Mori, T., Tsuchiya, K.J., Matsumoto, K., Matsumoto, K., Suzuki, K., Mori, N., & Takei, N. (2011). Psychosocial risk factors for postpartum depression and their relation to timing of onset: The Hamamatsu Birth Cohort (HBC) Study. Journal of Affective Disorders, 135, 341–346. https://doi.org/10.1016/j.jad.2011.07.012
Murakami, K., Hashimoto, H., Lee, J.S., Kawakubo, K., Mori, K., & Akabayashi, A. (2011). Distinct impact of education and income on habitual exercise: A cross-sectional analysis in a rural city in Japan. Social Science & Medicine, 73, 1683–1688. https://doi.org/10.1016/j.socscimed.2011.09.024
Murakami, K., Miyake, Y., Sasaki S, Tanaka, K., Yokoyama, T., Ohya, Y., Fukushima, W.,…The Osaka Maternal and Child Health Study Group. (2008). Dietary glycemic index and load and the risk of postpartum depression in Japan: The Osaka Maternal and Child Health Study. Journal of Affective Disorders, 110, 174–179. https://doi.org/10.1016/j.jad.2007.12.230
Murakami, K., Miyake, Y., Sasaki, S., Tanaka, K., & Arakawa, M. (2010). Fish and n-3 polyunsaturated fatty acid intake and depressive symptoms: Ryukyus Child Health Study. Pediatrics, 126, e623–e630. https://doi.org/10.1542/peds.2009-3277
Murakami, K., Miyake, Y., Sasaki, S., Tanaka, K., Ohya, Y., & Hirota, Y. (2009). Education, but not occupation or household income, is positively related to favorable dietary intake patterns in pregnant Japanese women: The Osaka Maternal and Child Health Study. Nutritional Research, 29, 164–172. https://doi.org/10.1016/j.nutres.2009.02.002
Nishimura, M., Takemori, K., & Yamamoto, H. (2008). Life events and lifestyle of women in their twenties and thirties: Influence of marriage, pregnancy, giving birth, and child-care. Japanese Journal of Public Health, 55, 503–510 (in Japanese).
Okano, T., Murata, M., Masuji, F., Tamaka, R., Nomura, J., & Miyaoka, H. (1996). Validation and reliability of Japanese version of the EPDS (Edinburgh Postnatal Depression Scale). Archives of Psychiatric Diagnostics and Clinical Evaluation, 7, 525–533 (in Japanese).
Okubo, H., Miyake, Y., Sasaki, S., Tanaka, K., Murakami, K., & Hirota, Y. (2011). Dietary patterns during pregnancy and the risk of postpartum depression in Japan: The Osaka Maternal and Child Health Study. British Journal of Nutrition, 105, 1251–1257. https://doi.org/10.1017/s0007114510004782
Rechenberg, K., & Humphries, D. (2013). Nutritional interventions in depression and perinatal depression. Yale Journal of Biology and Medicine, 86, 127–137.
Sakanashi, K., Katsukawa, Y., Mizuno, S., & Kato, C. (2015). Mental health and child-rearing activities of mothers with 1-month-old infants. Kanto Gakuin University Journal of Nursing, 2, 1–9 (in Japanese).
Shimada, M., Watanabe, H., Kamiya, S. Nakane, N., Toda, R., Agata, T., … Suzuki, S. (2001). A nationwide survey on mothers in a one-month postpartum period regarding newborn care & personal health concerns and their needs for support. The Journal of Child Health, 60, 671–679 (in Japanese).
Statistics Bureau, Ministry of Internal Affairs and Communications, Japan. (2010). Population census. http://www.stat.go.jp/data/kokusei/2010/users-g/qa-1.htm
The Japan Society of Obstetrics and Gynecology. (2016). The report of joint conference on maternal mental health 2015.?http://fa.kyorin.co.jp/jsog/readPDF.php?file=68/1/068010129.pdf
Tsunoda, K., Hamazaki, K., Matsumura, K., Kasamatsu, H., Tsuchida, A., Inadera, H., & Japan Environment and Children’s Study (JECS) Group (2023). Dietary Intake of Vitamin D during Pregnancy and the Risk of Postpartum Depressive Symptoms: The Japan Environment and Children's Study. Journal of nutritional science and vitaminology, 69(1), 14–20. https://doi.org/10.3177/jnsv.69.14
Willett, W.C., Howe, G.R., & Kushi, L.H. (1997). Adjustment for total energy intake in epidemiologic studies. American Journal of Clinical Nutrition, 65, 1220S–1231S. https://doi.org/10.1093/ajcn/65.4.1220s
Yonkers, K.A., Vigod, S., & Ross, L.E. (2011). Diagnosis, pathophysiology, and management of mood disorders in pregnant and postpartum women. Obstetrics & Gynecology, 117, 961–977. https://doi.org/10.1097/aog.0b013e31821187a7
Zhao, X. H., & Zhang, Z. H. (2020). Risk factors for postpartum depression: An evidence-based systematic review of systematic reviews and meta-analyses. Asian journal of psychiatry, 53, 102353. https://doi.org/10.1016/j.ajp.2020.102353