Nutritional Epidemiology of Type 2 Diabetes and Depressive Symptoms

In Japan, the prevalences of type 2 diabetes and depression are increasing, but evidence linking these diseases to diet is limited. The present study reviewed the association of type 2 diabetes with intakes of rice, fish/seafood, and soy product and isoflavone, and the association of depressive symptoms with folate, vitamin D, and dietary pattern, in the Japanese population. The analysis of type 2 diabetes comprised around 55 000 men and women aged 45 to 75 years who completed a questionnaire for the Japan Public Health Center-based Prospective Study and were free of type 2 diabetes at baseline. The odds ratio of self-reported physician-diagnosed type 2 diabetes during the subsequent 5 years increased with rice intake among women and among physically inactive men but decreased with total fish/seafood intake among men. In addition, risk tended to decrease with soy product and isoflavone intake among overweight and postmenopausal women. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. The participants were approximately 530 workers aged 21 to 67 years who participated in a health survey at the time of a periodic health check. A cross-sectional and prospective inverse association between serum folate and depressive symptoms was observed. Serum 25-hydroxyvitamin D level was suggestively associated with decreased prevalence of depressive symptoms in late autumn. In addition, a healthy Japanese pattern characterized by high intakes of vegetables, fruit, mushrooms, and soy products was inversely associated with depressive symptoms. The findings suggest that diet has a role in the development of type 2 diabetes and depression in Japanese.