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Article

Prospective Associations of Maternal Dietary Patterns and Postpartum Mental Health in a Multi-Ethnic Asian Cohort: The Growing up in Singapore towards Healthy Outcomes (GUSTO) Study

by
Cherlyen Teo
1,
Ai-Ru Chia
2,
Marjorelee T. Colega
1,
Ling-Wei Chen
3,4,
Doris Fok
2,
Wei Wei Pang
2,
Keith M. Godfrey
5,
Kok Hian Tan
6,7,
Fabian Yap
6,8,9,
Lynette Pei-Chi Shek
1,3,
Yap-Seng Chong
1,2,
Michael Meaney
1,10,
Helen Chen
6,11 and
Mary Foong-Fong Chong
1,12,*
1
Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore 117609, Singapore
2
Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore 119228, Singapore
3
Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
4
School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin 4, Ireland
5
Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton SO16 6YD, UK
6
Duke-National University of Singapore Graduate Medical School, Singapore 169857, Singapore
7
Department of Maternal Fetal Medicine, KK Women’s and Children’s Hospital, Singapore 229899, Singapore
8
Department of Paediatric Endocrinology, KK Women’s and Children’s Hospital, Singapore 229899, Singapore
9
Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
10
Douglas Mental Health University Institute, McGill University, Montreal, QC H4H 1R3, Canada
11
Department of Psychological Medicine, KK Women’s & Children’s Hospital, Singapore 229899, Singapore
12
Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore
 
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Author to whom correspondence should be addressed.
Nutrients 2018, 10(3), 299; https://doi.org/10.3390/nu10030299
Submission received: 31 December 2017 / Revised: 9 February 2018 / Accepted: 28 February 2018 / Published: 2 March 2018
(This article belongs to the Special Issue Dietary Patterns, Diet Quality and Human Health)
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Abstract

Diet in the first month postpartum, otherwise known as “the confinement diet” in Asia, has unique characteristics that are influenced by traditions, cultures, and beliefs. We aimed to characterize dietary patterns during confinement period in a multi-ethnic Asian cohort and examined their associations with postpartum depression (PPD) and anxiety (PPA). Dietary intakes of 490 women were ascertained in the first month postpartum using 3-day food diaries and dietary patterns were derived by factor analysis. Participants completed the Edinburgh Postnatal Depression Scale (EPDS) and State-Trait Anxiety Inventory (STAI) at three months’ postpartum; higher scores are indicative of more depressive and anxiety symptoms, respectively. Four dietary patterns were identified: Traditional-Chinese-Confinement diet, Traditional-Indian-Confinement diet, Eat-Out diet and Soup-Vegetables-Fruits diet. The Traditional-Indian-Confinement diet was associated with less PPD symptoms [β (95% CI) −0.62 (−1.16, −0.09) EPDS score per SD increase in diet score] and a non-significant trend with reduced probable PPD (EPDS scores ≥ 13) [OR (95% CI) 0.56 (0.31, 1.01)]. The Soup-Vegetables-Fruits diet was associated with less PPA symptoms [β (95% CI) −1.49 (−2.56, −0.42) STAI-state score]. No associations were observed for other dietary patterns. Independent of ethnicity, adherence to the Traditional-Indian-Confinement diet that is characterized by intake of herbs and legumes, and Soup-Vegetables-Fruits diet high in fruits, vegetables and fish during the postpartum period were associated with less PPD and PPA symptoms, respectively.
Keywords: postpartum depression; postpartum anxiety; maternal diet; confinement diet; dietary patterns postpartum depression; postpartum anxiety; maternal diet; confinement diet; dietary patterns

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MDPI and ACS Style

Teo, C.; Chia, A.-R.; Colega, M.T.; Chen, L.-W.; Fok, D.; Pang, W.W.; Godfrey, K.M.; Tan, K.H.; Yap, F.; Shek, L.P.-C.; et al. Prospective Associations of Maternal Dietary Patterns and Postpartum Mental Health in a Multi-Ethnic Asian Cohort: The Growing up in Singapore towards Healthy Outcomes (GUSTO) Study. Nutrients 2018, 10, 299. https://doi.org/10.3390/nu10030299

AMA Style

Teo C, Chia A-R, Colega MT, Chen L-W, Fok D, Pang WW, Godfrey KM, Tan KH, Yap F, Shek LP-C, et al. Prospective Associations of Maternal Dietary Patterns and Postpartum Mental Health in a Multi-Ethnic Asian Cohort: The Growing up in Singapore towards Healthy Outcomes (GUSTO) Study. Nutrients. 2018; 10(3):299. https://doi.org/10.3390/nu10030299

Chicago/Turabian Style

Teo, Cherlyen, Ai-Ru Chia, Marjorelee T. Colega, Ling-Wei Chen, Doris Fok, Wei Wei Pang, Keith M. Godfrey, Kok Hian Tan, Fabian Yap, Lynette Pei-Chi Shek, and et al. 2018. "Prospective Associations of Maternal Dietary Patterns and Postpartum Mental Health in a Multi-Ethnic Asian Cohort: The Growing up in Singapore towards Healthy Outcomes (GUSTO) Study" Nutrients 10, no. 3: 299. https://doi.org/10.3390/nu10030299

APA Style

Teo, C., Chia, A.-R., Colega, M. T., Chen, L.-W., Fok, D., Pang, W. W., Godfrey, K. M., Tan, K. H., Yap, F., Shek, L. P.-C., Chong, Y.-S., Meaney, M., Chen, H., & Chong, M. F.-F. (2018). Prospective Associations of Maternal Dietary Patterns and Postpartum Mental Health in a Multi-Ethnic Asian Cohort: The Growing up in Singapore towards Healthy Outcomes (GUSTO) Study. Nutrients, 10(3), 299. https://doi.org/10.3390/nu10030299

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