ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutrition, Psychology and Brain Health
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1668654
This article is part of the Research TopicFrom Adolescence to Adulthood: The Role of Diet in Preventing Metabolic and Mental Health DisordersView all 5 articles
Dietary Inflammation and Socioeconomic Status Mediate Depression-Constipation Link: A Cross-Sectional Analysis of NHANES 2005-2010
Provisionally accepted
- 1Department of Nursing, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medicine University, Hangzhou, China
- 2Department of Clinical psychology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medicine University, Hangzhou, China
- 3Department of Nursing School, Anhui University of Chinese Medicine, Hefei, China
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Background: This study investigated the relationship between depression and constipation and examined potential mediating roles of dietary inflammatory index (DII) and socioeconomic status using data from NHANES 2005-2010. Methods: We analyzed 12,854 adults with complete data on depression (PHQ-9), constipation (self-report/Bristol Stool Scale), DII (27 nutrients), and poverty-income ratio (PIR). Statistical analyses included multivariable logistic regression with appropriate reference categories, restricted cubic splines, mediation analysis, and subgroup assessments. Results: Constipated individuals exhibited significantly higher depression severity (mean PHQ-9: 4.25 vs. 3.00), higher DII (2.00 vs. 1.37), and lower PIR (all p<0.0001). After adjustments, PHQ-9 scores was independently associated with constipation risk (OR: 1.04, 95% CI: 1.03-1.06), with a non-linear relationship showing an inflection point at PHQ-9=10 (scores <10: OR=1.08; scores ≥10: OR=0.98). Statistical mediation analysis revealed DII mediated 6.03% and PIR mediated 12.46% of the depression-constipation association. Subgroup analyses demonstrated consistent associations across all demographic and clinical subgroups (OR range: 1.04-1.14). Conclusion: This cross-sectional study demonstrates a significant non-linear relationship between depression and constipation, partially mediated by dietary inflammation and socioeconomic status. Longitudinal studies are needed to establish causality and directionality between these variables.
Keywords: Depression, Constipation, NHANES, Mediation analysis, DiI, PIR
Received: 18 Jul 2025; Accepted: 27 Aug 2025.
Copyright: © 2025 Huang, Zhou, Yang, Meng and Wang. 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:
Qiulu Huang, Department of Nursing, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medicine University, Hangzhou, China
Lina Wang, Department of Nursing School, Anhui University of Chinese Medicine, Hefei, China
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