Food access and dietary indicators associated with depression in women of reproductive age in rural Bangladesh
01 September 2017 (online)
Depression is common among women of reproductive age, especially in low- and middle-income countries. Increased nutritional needs during pregnancy and lactation may deplete nutrients essential to neurotransmission and increase the risk of depression. Depression may conversely lead to poor self- and child care and reduce household food access and dietary diversity. We aim to examine the association between depressive symptoms and several indicators of food access and nutritional status in women in rural Bangladesh.
The Food and Agricultural Approaches to Reducing Malnutrition (FAARM) cluster-randomized trial evaluates the impact of a homestead food production program on undernutrition, including around 2600 young women in 96 villages in rural Sylhet. We used cross-sectional FAARM baseline data from 2015 to study the association of food access and nutritional status with depression using multivariable logistic regression. The Edinburgh Postpartum Depression Scale for Bangladesh was used to screen for depression.
Of 2599 women, 1018 were pregnant or one year postpartum. Of these, 18% screened positive for major depression (EPDS ≥12) and 22% of the non-perinatal women. Both household-level moderate or severe food insecurity and poor or borderline household diets were associated with double to triple the odds of depression in the fully adjusted models. Inadequate dietary diversity was associated with double the odds of depression, and consumption of several nutrient groups (dairy, eggs, fish, vitamin A-rich foods and vitamin C-rich foods) was associated with less depression. Anemia was not associated with depression. Chronic energy deficiency (BMI < 18.5) was associated with a 38% higher odds of depression.
We identified a strong association of several indicators of food access and nutrition with depression in young women in Bangladesh, but longitudinal studies are needed to clarify the causal direction of the association.