Food-Group Intakes and Depression in Tangerang, Indonesia: An Exploratory Case-Control Study

Background: Diet may be associated with depression, but evidence on locally consumed food groups in Indonesia is limited. Objectives: To compare food-group intake between people with and without a formal diagnosis of depression in Tangerang, Indonesia, and to explore whether BMI modifies any association. Methods: In this case-control study, cases were psychiatric outpatients with a formal diagnosis of depression. Controls had no formal diagnosis and were recruited through university and community networks. Daily intake of ten food groups was estimated with a semi-quantitative food frequency questionnaire. Intakes were compared with independent-samples t-tests (Welch's test when variances were unequal), overall and stratified by BMI group. Logistic regression estimated the odds of depression per 100 g/day of sweetened beverage intake, adjusted for BMI group, sex, and age, with a sweetened beverage and BMI group interaction term. Results: There were 257 participants: 104 cases and 153 controls. Sweetened beverages were the only food group whose intake differed significantly between groups (approximately 214 vs. 153 g/day; mean difference 61 g/day; 95% CI 18-103; p=0.005). Each additional 100 g/day was associated with higher odds of depression after adjustment (OR 1.29; 95% CI 1.09-1.52). The association appeared stronger in underweight/normal-weight participants (ratio of ORs for overweight/obese vs. underweight/normal 0.70; 95% CI 0.49-0.99; p for interaction=0.046). Conclusions: Higher sweetened beverage intake was associated with depression in this sample, and there was modest evidence that the association differed by BMI group. Because the study is cross-sectional in timing, the case-control samples were selected differently, and many comparisons were made, these findings are exploratory. They do not establish causality.