Associations of dietary habits, inflammatory dietary index, and lifestyle factors with depressive symptoms: A cross-sectional study of 53,539 individuals with thyroid nodules

Lijun Li; Ying Li; Hui Li; Yi Zhou; Xue He; Pingting Yang; Xingxing Wang; Jiayi Zhu; Yinglong Duan; Jianfei Xie; Andy S K Cheng

doi:10.1016/j.jad.2025.119735

Associations of dietary habits, inflammatory dietary index, and lifestyle factors with depressive symptoms: A cross-sectional study of 53,539 individuals with thyroid nodules

J Affect Disord. 2025 Jun 20:388:119735. doi: 10.1016/j.jad.2025.119735. Online ahead of print.

Authors

Lijun Li¹, Ying Li², Hui Li³, Yi Zhou³, Xue He², Pingting Yang², Xingxing Wang⁴, Jiayi Zhu⁴, Yinglong Duan⁵, Jianfei Xie⁶, Andy S K Cheng⁷

Affiliations

¹ Health Management Medicine Center, the Third Xiangya Hospital, Central South University, Changsha 410013, China; School of Psychological Sciences, Monash University, Melbourne 3800, Australia.
² Health Management Medicine Center, the Third Xiangya Hospital, Central South University, Changsha 410013, China.
³ Nursing department, The Third Xiangya Hospital, Central South University, Changsha 410013, China.
⁴ Xiangya School of Nursing, Central South University, Changsha 410013, China.
⁵ Nursing department, The Third Xiangya Hospital, Central South University, Changsha 410013, China. Electronic address: yinglongduan@outlook.com.
⁶ Nursing department, The Third Xiangya Hospital, Central South University, Changsha 410013, China; Clinical Nursing Safety Management Research Center, Central South University, Changsha 410013, China. Electronic address: xiejianfei@csu.edu.cn.
⁷ School of Health Sciences, Western Sydney University, Sydney, Australia.

PMID: 40544881
DOI: 10.1016/j.jad.2025.119735

Abstract

Background: Depressive symptoms are closely associated with thyroid nodules (TNs). Lifestyle and dietary factors have been linked to depressive symptoms. Therefore, this study aimed to investigate the associations between dietary patterns-including dietary diversity, protein-enriched dietary, inflammatory dietary patterns, dietary habits and depressive symptoms in individuals with TNs.

Methods: This cross-sectional study included 53,539 participants who underwent physical examinations between January 2017 and March 2024. Participants completed self-reported questionnaires on demographic characteristics, physical health, activity levels, dietary index scores, dietary habits, and depressive symptoms.

Results: Participants were female (OR: 1.38, 95 % CI: 1.30-1.46), divorced or widowed (OR: 1.56, 95 % CI: 1.31-1.85), had a higher waist-hip ratio, and (OR: 2.22; 95 % CI: 1.43-3.43) and engaged in prolonged sedentary time (OR: 1.51; 95 % CI: 1.41-1.62) were more likely to report depressive symptoms. Regarding dietary factors, an anti-inflammatory dietary (OR: 0.79; 95 % CI: 0.75-0.83) and a protein-enriched dietary (OR: 0.87; 95 % CI: 0.83-0.92) were associated with a lower risk of depressive symptoms. However, irregular eating (OR: 2.00, 95 % CI: 1.81-2.21), overeating frequently (OR: 1.87; 95 % CI: 1.70-2.05), and being a former drinker (OR: 1.43, 95 % CI: 1.19-1.71) were associated with a higher risk of depressive symptoms in individuals with TNs.

Conclusions: Unhealthy eating behaviors and prolonged sedentary time were associated with a higher risk of depressive symptoms in individuals with TNs, while anti-inflammatory and protein-rich diets were associated with lower odds. These findings suggest potential links between dietary and lifestyle factors and depressive symptoms, which may warrant further investigation in prospective or interventional studies.

Keywords: Anti-inflammatory; Depressive symptoms; Dietary; Thyroid nodules.