ω-3 Fatty Acid Intakes Are Inversely Related to Elevated Depressive Symptoms among United States Women

Evidence that depressive symptoms are inversely related to n–3 (ω-3) fatty acids is growing among United States adults. We assessed whether self-reported depressive symptoms were inversely associated with n–3 fatty acid intakes by using a cross-sectional study in 1746 adults (aged 30–65 y) in Baltimore City, MD (2004–2009). The 20-item Center for Epidemiologic Studies–Depression Scale (CES-D) was used, with a CES-D score ≥16 suggestive of elevated depressive symptoms (EDS). By using the mean of two 24-h dietary recalls, n–3 highly unsaturated fatty acids (HUFAs; ≥20 carbons), n–3 polyunsaturated fatty acids (PUFAs; ≥18 carbons), and plausible ratios with n–6 (ω6) fatty acids were estimated. EDS prevalence was 18.1% among men and 25.6% among women. In women, the uppermost tertile (tertile 3) of n–3 PUFAs (compared with tertile 1) was associated with reduced odds of EDS by 49%, with a substantial sex differential. The n–3 PUFA:n–6:PUFA ratio was inversely related to EDS among women (tertile 2 vs. tertile 1, OR: 0.74; 95% CI: 0.41, 1.32; tertile 3 vs. tertile 1, OR: 0.47; 95% CI: 0.27, 0.83). A similar pattern was noted for n–3 HUFA:n–6 HUFA among women. For CES-D subscales, n–3 PUFA (% of energy) was inversely related to somatic complaints, whereas positive affect was directly related to n–3 HUFA (% of energy; total population and among women), n–3 HUFA:n–6 HUFA (women), and n–3 HUFA:n–6 PUFA (total population and among women). In sum, among United States women, higher intakes of n–3 fatty acids [absolute (n–3) and relative to n–6 fatty acids (n–3:n–6)] were associated with lower risk of elevated depressive symptoms, specifically in domains of somatic complaints (mainly n–3 PUFAs) and positive affect (mainly n–3 HUFAs).