Elsevier

Journal of Affective Disorders

Volume 294, 1 November 2021, Pages 686-692
Journal of Affective Disorders

Research Paper
Mushroom intake and depression: A population-based study using data from the US National Health and Nutrition Examination Survey (NHANES), 2005–2016

https://doi.org/10.1016/j.jad.2021.07.080Get rights and content

Highlights

  • Association between mushroom intake and depression was examined using NHANES.

  • The overall prevalence of depression was 5.9%.

  • Participants with mushroom consumption had lower odds of having depression.

Abstract

Background

Mushrooms contain numerous bioactive compounds that may be associated with reduced anxiety including vitamin B12, nerve growth factor, antioxidants, and anti-inflammatory agents. We hypothesized that mushroom consumption is associated with a lower risk of depression in American adults.

Methods

Data from the National Health and Nutrition Examination Survey 2005–2016 was used. Up to two days of 24 h dietary recall were analyzed to assess mushroom intake frequency. Depression was measured using the Patient Health Questionnaire (PHQ-9, score ≥ 10). We used multivariable logistic regression models, adjusting for potential confounding factors.

Results

Among 24,699 participants (mean (SE) age: 45.5 (0.3) years), the weighted prevalence of depression was 5.9%. Mushrooms were consumed by 5.2% of participants. Compared with the lowest tertile of mushroom intake, participants in the middle tertile (median intake = 4.9 g/d, number of cases = 16) had lower odds of depression (adjusted OR = 0.31; 95% confidence interval [CI] 0.16, 0.60) while those in the highest tertile did not differ (median intake = 19.6 g/d, adjusted OR = 0.91; 95% CI: 0.47, 1.78, number of cases = 22) (P-trend = 0.42).

Limitations

Cross-sectional data and lack of information on specific types of mushrooms consumed.

Conclusion

Mushroom consumers had a lower odd of depression. However, we did not observe a dose-response relationship.

Introduction

Major depression is one of the most common mental health illnesses in the United States (US). According to the National Institute of Mental Health, approximately 17.3 million adults in the US have had at least one major depressive episode (National Institutes of Health, 2019). Mental illnesses such as depression are the third leading cause of hospitalization in the US among adults (Kessler et al., 2007; Parks et al., 2006) and those living with an acute mental illness tend to die on average 25 years earlier than healthy individuals. Depression is a significant public health problem and serious medical illness which is associated with mood disorder symptoms such as feelings of guilt or low self-esteem, and cognitive and physical symptoms such as disturbed sleep, changes in appetite or weight, and poor concentration (American Psychiatric Association, 2013; Marcus et al., 2012). It is a significant contributing factor to the global burden of disease and is also associated with increased rates of chronic diseases, suicide attempts, medical costs, disability, and impaired function (Katon, 2003; Moussavi et al., 2007; Wells et al., 1989).

Evidence from a randomized controlled trial suggested dietary improvements as an efficacious treatment strategy for treating major depressive episodes (Jacka et al., 2017). In addition, a meta-analysis study also indicated that a dietary pattern characterized by a high intake of fruits, vegetables, whole grains, and antioxidants and low intakes of animal-derived foods was associated with a lower risk of depression (Li et al., 2017).

Mushrooms are low in calories and fat, cholesterol-free, and good a sources of vitamins (e.g., B1, B2, B12, and vitamin C) and minerals (selenium and copper)(Breene, 1990; Mattila et al., 2000), and fit well with a healthy eating pattern (O'Neil et al., 2013). Even though mushrooms share some nutritional characteristics with plant-derived foods, they are biologically distinct as fungi. Importantly, mushrooms are a rich dietary source of potent antioxidants glutathione and ergothioneine. Antioxidants and B12 are thought to have anti-depressant effects. Certain species of edible mushrooms such as Hericium erinaceus (Lion's Mane) can stimulate the expression of neurotrophic factors such as nerve growth factor (NGF) synthesis, which could have a potential impact on preventing neuropsychiatric disorders including major depression (Kawagishi et al., 1996; Kawagishi et al., 1994; Ma et al., 2010). Mushrooms also contain anti-inflammatory agents (Elsayed et al., 2014). Inflammation has been linked to depression, and nonsteroidal anti-inflammatory drugs are thought to lower stress and depression (Kohler et al., 2016). White button mushroom buttons, which are the most commonly consumed mushroom variety in the US, also contain potassium, which is believed to reduce anxiety (Mrug et al., 2019).

There have been few reported epidemiological studies on the association between mushroom consumption and depression, and these have been limited to small (< 100 participants) clinical trials where intervention with the mushrooms species Hericium erinaceus was found to be effective at alleviating the symptoms of depression (Nagano et al., 2010; Okamura et al., 2015; Vigna et al., 2019). To the best of our knowledge, there have been no observational studies on mushroom consumption and depression. Thus, we aim to fill this critical gap in knowledge by investigating the association between mushroom consumption and depression in a nationally representative sample of US adults using the National Health and Nutrition Examination Survey (NHANES) (2005–2016).

Section snippets

Data source

The NHANES comprises a series of cross-sectional, stratified, multistage probability surveys conducted continually by the National Center for Health Statistics (NCHS) of the Centers for Disease Control and Prevention (CDC). The NHANES is a program of studies designed to examine the health and nutritional status of adults and children in the US. Before 1994, the NHANES was conducted periodically; starting in 1999, the survey became a continuous program, with every 2-years constituting 1 cycle

Results

Among 24,699 US adults (12,268 men and 10,304 women) included in the current analysis, the mean (SE) age was 45.5(0.3) years; about half of the study participants were men (50.2%), and more than half were non-Hispanic Whites (66.1%). The overall weighted prevalence of depression and mushroom consumers during our study period were 5.9%, (95% CI: 5.4, 6.5%) and 5.2 %, (95% CI: 4.7, 5.7), respectively. Compared with mushroom non-consumers, mushroom consumers were more likely to be females,

Discussion

In this large cross-sectional study of nationally representative of more than 24,000 US adults, we found that those with mushroom consumption had lower odds of having depression. The observed association was independent of socio-demographics, major lifestyle risk factors, self-reported diseases, medications use, and other dietary factors. We did not observe a significant dose-response relationship between greater mushroom intake and the odds of depression. Furthermore, in this study, replacing

Strengths

Our study has several strengths. Previous epidemiological studies that have examined the effects of mushrooms on depression were limited to small clinical trials with sample sizes ranged from 8 to 77 subjects (Nagano et al., 2010; Okamura et al., 2015; Vigna et al., 2019). To the best of our knowledge, this is the first large scale epidemiological study that used nationally representative US adult population data and examined the association between mushroom consumption and depression. In

Limitations

Notwithstanding, the study has some limitations that need to be addressed. First, self-reported 24 h dietary recalls using USDA foods code for recipes may have introduced misclassification bias. This includes misclassification of mushrooms as vegetables and inaccurate assessment of mushroom content in the mixed of dishes. The two 24 h recalls may not have adequately captured the within-person variation in mushroom intake. Such nondifferential measurement error may have underestimated the

Conclusion

In this nationally representative study of US adults, we found that mushroom intake was associated with lower odds of depression. However, our results should be interpreted with caution. We found that compared to the lowest tertile, the middle tertile was associated with depression but not for the highest tertile indicating that the finding could be possibly due to chance. Our findings are consistent with preclinical studies suggestive of potential health benefits from specific bioactive

Financial support

There was no external or internal funding to support this study.

Data availability

Data used for this study are available on the NHANES website: https://wwwn.cdc.gov/nchs/nhanes/.

CRediT authorship contribution statement

Djibril M. Ba: Conceptualization, Investigation, Visualization, Formal analysis, Writing – original draft, Writing – review & editing. Xiang Gao: Conceptualization, Investigation, Visualization, Writing – review & editing. Laila Al-Shaar: Conceptualization, Investigation, Visualization, Writing – review & editing. Joshua E. Muscat: Writing – review & editing. Vernon M. Chinchilli: Writing – review & editing. Robert B. Beelman: Writing – review & editing. John P. Richie: Conceptualization,

Declaration of Competing Interest

None.

Acknowledgment

None.

References (58)

  • H. Okamura et al.

    The effects of Hericium erinaceus (Amyloban® 3399) on sleep quality and subjective well-being among female undergraduate students: a pilot study

    Personal. Med. Univ.

    (2015)
  • C.D. Pandya et al.

    Antioxidants as potential therapeutics for neuropsychiatric disorders

    Prog. Neuropsychopharmacol. Biol. Psychiatr.

    (2013)
  • Y. Wang et al.

    Depression among people with type 2 diabetes mellitus, US National Health and Nutrition Examination Survey (NHANES)

    BMC Psychiatr.

    (2016)
  • R.P. Wildman et al.

    Relation of inflammation to peripheral arterial disease in the national health and nutrition examination survey

    Am. J. Cardiol.

    (2005)
  • Diagnostic and Statistical Manual of Mental Disorders,

    (2013)
  • D.M. Ba et al.

    Association of mushroom consumption with all-cause and cause-specific mortality among American adults: prospective cohort study findings from NHANES III

    Nutr. J.

    (2021)
  • D.M. Ba et al.

    Higher mushroom consumption is associated with lower risk of cancer: a systematic review and meta-analysis of observational studies

    Adv. Nutr.

    (2021)
  • R.B. Beelman et al.

    Micronutrients and bioactive compounds in mushrooms: a recipe for healthy aging?

    Nutr. Today

    (2019)
  • A.M. Bernstein et al.

    Major dietary protein sources and risk of coronary heart disease in women

    Circulation

    (2010)
  • M.A. Beydoun et al.

    Antioxidant status and its association with elevated depressive symptoms among US adults: National Health and Nutrition Examination Surveys 2005–6

    Br. Nutr.

    (2013)
  • W.M. Breene

    Nutritional and medicinal value of specialty mushrooms

    J. Food Prot.

    (1990)
  • Centers for Disease Control and Prevention, 2011. Laboratory procedures manual....
  • Centers for Disease Control and Prevention, NCHS: about National Health and Nutrition Examination Survey (NHANES)....
  • National Health and Nutrition Examination Survey Data

    (2016)
  • M. de Groot et al.

    Association of depression and diabetes complications: a meta-analysis

    Psychosom. Med.

    (2001)
  • C.L. Dikeman et al.

    Effects of stage of maturity and cooking on the chemical composition of select mushroom varieties

    J. Agric. Food Chem.

    (2005)
  • Y. Du et al.

    Trends in adherence to the physical activity guidelines for Americans for aerobic activity and time spent on sedentary behavior among US adults

    JAMA Netw. Open

    (2019)
  • E.A. Elsayed et al.

    Mushrooms: a potential natural source of anti-inflammatory compounds for medical applications

    Med. Inflamm.

    (2014)
  • J. Ey et al.

    Dietary sources and antioxidant effects of ergothioneine

    J. Agric. Food Chem.

    (2007)
  • Cited by (26)

    View all citing articles on Scopus
    View full text