Dietary Fiber Intake and Depression in Heart Failure Patients: A Cross-Sectional Study From NHANES Database

Objective Psychiatric disorders are prevalent among heart failure (HF) patients and depression is a common psychiatric disorder. The benefit effect of dietary fiber on depression has been reported. We aimed to assess the association between dietary fiber intake and depressive symptoms. Method A cross-sectional analysis was conducted of NHANES data collected 2005-2018 from adults ≥18 years with physician-diagnosed HF. Total and source-specific dietary fiber intake (g/day) was calculated from the average of two 24-hour dietary recalls using USDA’s AMPM protocol. Age, sex, race, education, smoking status, diabetes, hypertension, renal function, and medication use were adjusted in analyses. Survey-weighted logistic regression models examined associations between fiber intake and depression (PHQ-9 ≥10), with adjustment for confounding variables. Sensitivity analyses examined modification by BMI categories (<25, 25-29.9, ≥30 kg/m 2 ) and HF duration (≤5 vs >5 years). Results A total of 1041 participants were included, of which 188 (18.06%) with depression symptoms. High total dietary fiber intake (OR = 0.50, 95% CI: 0.29-0.86) and vegetable fiber intake (OR = 0.49, 95% CI: 0.25-0.97) were associated with the lower odds of depression in HF patients. Conclusion Depression is associated with vegetable fiber, but not with fiber from grains or fruits. Depression is less common in patients with HF who consume high levels of total dietary fiber and vegetable fiber.