Skipping Breakfast and Lunch, as Well as Reducing Milk and Dairy Intake, Is Associated with Depressive Symptoms in Pregnant Adolescents

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Abstract
Background and objective: Depression is the most common mental health problem in women during pregnancy, associated with psychological, social, and medical factors characteristic of this stage. However, a lack of knowledge and limited attention to this condition can aggravate its consequences and restrict access to appropriate treatment. This research seeks to fill a gap in the scientific literature by exploring the association between eating habits and dietary diversity with depressive symptomatology in a group with high psychosocial vulnerability: pregnant adolescents. Material and methods: A cross-sectional analytical study was conducted with a sample of 344 pregnant adolescents attending prenatal care at the National Institute of Perinatology (INPer), a tertiary care center. Non-probabilistic sampling was used for recruitment. Relevant information was collected using a pre-validated structured questionnaire administered via interview. Depressive symptomatology was assessed using the Edinburgh Postnatal Depression Scale (EPDS), with a score of ≥12 considered indicative of a higher risk of depression. Eating habits were evaluated based on meal omission, activities performed during meals, and dietary diversity, comparing them with national recommendations. Food group consumption was assessed using a semi-quantitative Food Frequency Questionnaire (FFQ). Robust variance Poisson regression models were employed to evaluate the independent association between undesirable eating habits, inadequate food group intake, and the presence of depressive symptomatology. Results: A significant association was observed between the presence of depressive symptoms (EPDS ≥ 12) and the omission of main meals. Specifically, skipping breakfast was associated with a higher prevalence of EPDS scores ≥ 12 (aPR = 1.55; 95% CI: 1.10–2.19; p = 0.013). Similarly, adolescents who skipped lunch showed a higher prevalence of depressive symptomatology compared to those who did not (aPR = 2.02; 95% CI: 1.11–3.68; p = 0.022). Regarding food groups, only insufficient intake of milk and dairy products was significantly associated with the presence of depressive symptoms (aPR: 1.78; 95% CI: 1.16–2.73; p = 0.008). Conclusions: This cross-sectional study found a significant association between breakfast skipping, distraction while eating, and inadequate dairy intake with a higher prevalence of depressive symptoms in socially vulnerable pregnant adolescents treated at a tertiary care center. However, due to the study’s design, causality or the direction of the relationship cannot be established (it could be bidirectional), and it cannot be affirmed that modifying the diet will necessarily reduce depression. Furthermore, the results are not generalizable to all pregnant adolescents, and future research (longitudinal or interventional) is needed to better understand these associations before developing specific dietary interventions.
Funding Information
  • Secretariat of Education, Science, Technology and Innovation of Mexico City (SECTEI) 2024 (SECTEI/147/2024)

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