Knüppel, Anika;
(2020)
Free sugar, fibre intake and mood disorders: an epidemiological investigation.
Doctoral thesis (Ph.D), UCL (University College London).
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Abstract
The aim of this thesis is to investigate the role of high sugar intake from sweet food / beverages and high fibre intake as predictors of mood disorders, and as moderators of the association between financial insecurity and mood disorders. The study was based on repeat measures of diet and mood disorders in the Whitehall II cohort. Analyses used random effects models with multiple 2, 5 and 10-year follow-up cycles. Diet was measured using food frequency questionnaires and defined as sugar intake from sweet food / beverages and fibre intake. Mood disorders were defined as common mental disorder (CMD, measured with the General Health Questionnaire), depression measured using Center for Epidemiologic Studies Depression scale, and the Revised Clinical Interview Schedule. Sugar intake from sweet food / beverages was associated with increased odds of incident CMD after 5 years in men and with recurrent depression in women. Findings in men were similar when meta-analysing associations with incident antidepressant intake in Whitehall II and the EPIC-Norfolk study. There was no evidence that mood disorders are associated with a change in sugar intake from sweet food / beverages. Fibre intake was associated with reduced odds of incident CMD after 5 and 10 years. There was no strong evidence that mood disorders are associated with a change in fibre intake. Financial insecurity consistently increased odds of mood disorders, but there was no evidence for effect modification by sugar intake from sweet food / beverages or fibre intake. Findings suggest an adverse effect of sugar intake from sweet food / beverages and a protective role of a diet high in fibre in long-term psychological health. There was no evidence that free sugar or fibre intake could moderate associations between financial insecurity and psychological health. Future research needs to clarify whether associations reflect a causal relationship.
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