Journal of affective disorders · 2026
Irregular meal frequency and depressive symptoms: Moderating roles of dietary diversity and breakfast skipping.
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Tae Hyejin, Chae Jeong-Ho
Аннотация
BACKGROUND: Irregular main-meal consumption frequency may disrupt metabolic and behavioral regulation, factors increasingly linked to affective disorders. However, evidence from nationally representative populations is limited.
METHODS: We analyzed data from 21,568 adults in the 2014-2022 Korea National Health and Nutrition Examination Survey. Depressive symptoms were assessed with the PHQ-9. Multivariable logistic regression and restricted cubic spline analyses were conducted, adjusting for sociodemographic, lifestyle, and nutritional factors. Moderation and subgroup analyses examined dietary diversity, breakfast skipping, and lifestyle variables.
RESULTS: Irregular main-meal consumption frequency was associated with higher odds of depressive symptoms (adjusted OR for highest vs. lowest irregularity = 1.55, 95% CI 1.42-1.69, p < 0.001). The association was strongest in those with the lowest dietary diversity, while greater variety buffered adverse effects. Frequent breakfast skipping heightened susceptibility. No higher-order interactions were observed. Subgroup analyses showed stronger associations in men, smokers, and late-night eaters, though these require cautious interpretation.
LIMITATIONS: Cross-sectional design, self-reported diet, and unmeasured confounders (stress, medication, sleep) may limit causal inference.
CONCLUSIONS: Irregular main-meal consumption frequency was associated with depressive symptoms, moderated by dietary diversity and breakfast habits, highlighting meal pattern regularity as a modifiable nutritional target for prevention.
METHODS: We analyzed data from 21,568 adults in the 2014-2022 Korea National Health and Nutrition Examination Survey. Depressive symptoms were assessed with the PHQ-9. Multivariable logistic regression and restricted cubic spline analyses were conducted, adjusting for sociodemographic, lifestyle, and nutritional factors. Moderation and subgroup analyses examined dietary diversity, breakfast skipping, and lifestyle variables.
RESULTS: Irregular main-meal consumption frequency was associated with higher odds of depressive symptoms (adjusted OR for highest vs. lowest irregularity = 1.55, 95% CI 1.42-1.69, p < 0.001). The association was strongest in those with the lowest dietary diversity, while greater variety buffered adverse effects. Frequent breakfast skipping heightened susceptibility. No higher-order interactions were observed. Subgroup analyses showed stronger associations in men, smokers, and late-night eaters, though these require cautious interpretation.
LIMITATIONS: Cross-sectional design, self-reported diet, and unmeasured confounders (stress, medication, sleep) may limit causal inference.
CONCLUSIONS: Irregular main-meal consumption frequency was associated with depressive symptoms, moderated by dietary diversity and breakfast habits, highlighting meal pattern regularity as a modifiable nutritional target for prevention.