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ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutrition, Psychology and Brain Health
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1567436
This article is part of the Research Topic The Role of Nutrition in Mitigating Depression: Mechanisms, Interventions, and Outcomes View all 4 articles
Association between Plant-based Diets and Depression in Older Adults with Heart Disease: The Mediating Role of Sleep Disturbances
Provisionally accepted
Zhiyun Gong *
Yaqun Yu Yueying Cheng Qitao Xu Yawen Wang Huiqiong Li Nan Cheng Wei Zhou Jie Zhang Chao Yan - Department of Cardiac Vascular Surgery, The First Medical Center of the People's Liberation Army General Hospital, Beijing, China
Background: Depression is not uncommon among older adults with heart diseases and is related to poor prognosis at clinical setting. We aim to explore the association between plant-based diets and depression in older adults with heart disease and further investigate the mediating role of sleep disturbances in this relationship.: A cross-sectional sample of 2039 older adults with heart diseases were recruited from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). Each individual completed assessments on dietary frequency, depression, sleep quality and duration. Plant-based diet index (PDI), healthy plant-based diet index (hPDI) and unhealthy plant-based diet index (uPDI) were calculated. Logistic regression models and restricted cubic spline curves (RCS) were employed to explore the relationship between plant-based diets and depression in older adults with heart disease. Meanwhile, mediation analysis was used to investigate the mediating roles of sleep quality and sleep duration.Results: The higher the PDI (OR: 0.56, 95% CI: 0.36-0.88) and the hPDI (OR: 0.39, 95% CI: 0.24-0.62), the lower the risk of depression in older adults with heart disease.Conversely, the higher the uPDI, the higher the risk of depression (OR: 1.76, 95% CI:1.07-2.92). RCS further confirmed a negative linear dose-response relationship between PDI, hPDI and depression in older adults with heart disease, and a positive trend was found between uPDI and depression. Notably, sleep quality (Indirect effect: -0.031, mediated proportion: 61%) partially mediated the relationship between PDI and depression. In the sex-based subgroup analysis, uPDI was only associated with a higher risk of depression in females.This is the first study to suggest a significant negative relationship between plant-based diets and depression in older adults with heart disease. Sleep quality plays a mediating role in the association between plant-based diets and depression. Optimizing the dietary structure and improve sleep quality may help reduce the risk of depression in older adults with heart disease.
Keywords: Heart disease, Depression, Plant-based diets, Cross-sectional study, Sleep, older adults
Received: 27 Jan 2025; Accepted: 26 Mar 2025.
Copyright: © 2025 Gong, Yu, Cheng, Xu, Wang, Li, Cheng, Zhou, Zhang and Yan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Zhiyun Gong, Department of Cardiac Vascular Surgery, The First Medical Center of the People's Liberation Army General Hospital, Beijing, China
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