ASSOCIATION OF 24-HOUR ENERGY INTAKE BEHAVIOR WITH DEPRESSIVE SYMPTOMS: FINDINGS FROM THE NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY

This study examined the association between energy intake rhythmicity and depressive symptoms, motivated by the observation that appetite changes are a key clinical feature of depression and that circadian rhythm disruption plays an important role in its pathophysiology, while the specific contribution of eating rhythms remains unclear. Using data from 34,974 non-institutionalized participants in the National Health and Nutrition Examination Survey, covariate-adjusted, sample-weighted regression models were applied to evaluate the relationship between 24-hour energy intake patterns and depressive symptoms, including the proportion of energy intake from non-meals, meal timing, the distribution of energy intake across meals, and energy intake during different time periods of the day (morning, midday, afternoon, evening, night, and overnight). A higher proportion of energy intake from non-meals was associated with increased depressive symptoms (adjusted odds ratio [OR] = 1.11, 95% confidence interval [CI]: 1.08–1.15). The proportion of breakfast energy intake relative to total daily energy intake showed a nonlinear association with depressive symptoms; among individuals whose breakfast energy intake accounted for less than 20% of daily energy, each 10% increase in this proportion was associated with a 15% lower prevalence of depressive symptoms (adjusted OR = 0.85, 95% CI: 0.75–0.96). Overall, these findings suggest that, among U.S. adults, a higher proportion of energy consumed from non-meals is associated with greater depressive symptoms, whereas adequate breakfast energy intake is linked to fewer depressive symptoms, providing potential evidence to inform future dietary rhythm–based interventions for depression.