Diferentes fontes de proteína e depressão em participantes de uma coorte brasileira: Estudo CUME

Abstract

Depression is a psychiatric disorder with variable symptoms. The diagnosis is based on a set of signs and symptoms, showing brain dysfunction, changes in the hypothalamic-pituitary-adrenal (HPA) axis, the immune system and the intestine-brain axis. Several hypotheses are presented for the development of depression, including the neuroinflammatory one. Diet and nutrition play significant roles in the prevention of depression and in its clinical treatment, especially in relation to eating patterns, considering the number, type, proportion or combination of different foods in the diet and the frequency with which they are habitually consumed. Among these foods, different protein sources seem to play an important role. Proteins from animal sources contribute with all the essential amino acids, while plant proteins improve pro-inflammatory markers and mixed proteins are related to the consumption of processed and ultra-processed foods, altering the intestinal balance and the synthesis of neurotransmitters. The objective of this study was to analyze the dietary intake of adults from the CUME Cohort, according to the protein source and its association with the incidence of depression among the participants. This is an epidemiological, observational, open cohort (longitudinal) study with 2572 adult participants of the CUME Project. Food consumption was categorized by animal, vegetable and mixed sources of protein. Statistical analyzes were performed using Stata®, with a significance level of 5%. Descriptive statistics were evaluated as absolute and relative frequencies, means and standard deviation, median and interquartile range (IQR (p25 – p75)), according to the

categories of the outcome variable. Statistical differences were evaluated by Pearson's chi- square test, Student's t-test or ANOVA, applying Bonferroni correction for “p” value

adjustments. Associations between crude and multivariate models by protein sources were verified by Cox regression. Based on the results, the study showed a predominance of females (63.61%; n = 1636), with 40.47% (n = 1041) aged between 30 and 39 years old and with a rate of 32 .35/1000 participants/year of incidence of depression in the study population at a median follow-up time of 3.72 years (IQR 1.99-3.91). The average consumption of protein among the total population was 105.53g/day (SD = 30.39), with 66.24 g/day (SD = 34.45) for protein from animal sources, 23.36 g/day (SD = 9.43) of vegetable source and 15.93 g/day (SD = 8.82) for mixed source protein. The average energy consumption was 2364.70 kcal/day (SD = 928.00), with a greater contribution of fresh or minimally processed foods. There was no association between the consumption of total protein and the incidence of depression throughout the segment, however, vegetable protein proved to be a protective factor for the risk of incidence of depression in the fourth quintile (Q4) for all variables. Consumption of plant-based proteins reduced the risk of depression by 47%.