U-shaped association between daily eating frequency and nighttime fasting duration and depression in NHANES 2005-2018

Existing studies display certain limitations and inconsistencies regarding the association between daily eating frequency (DEF) and nighttime fasting duration (NFD) and depression. We examines the relationships between DEF, NFD, and depression.

Among the 29,035 subjects in the National Health and Nutrition Examination Survey (NHANES) 2005-2018, depression is defined by a total Patient Health Questionnaire-9 (PHQ-9) score of at least 10. DEF is quantified through the number of eating instances, and NFD is evaluated by examining the day's first and last meals. Weighted logistic regression models, restricted cubic spline (RCS), and mediation analysis are performed.

In comparison to DEF between 3.6 and 4.0 times, subjects with DEF ≤ 3 times (OR 1.28, 95 % CI 1.11-1.49) and DEF ≥ 4.6 times (OR 1.17, 95 % CI 1.01-1.34) have a greater risk of depression. Relative to NFD ranging from 12.1 to 13.3 h, those with NFD ≤ 10.8 h (OR 1.32, 95 % CI 1.14-1.52) and NFD ≥ 14.9 h (OR 1.37, 95 % CI 1.19-1.59) are at increased risk of depression. The U-shaped smoothing curves for the association further validate the findings. Blood urea nitrogen (BUN) and globulin (Glo) play a mediating role in the association. Among subjects having a lower daily energy intake, the impact of DEF and NFD on depression is more significant (P_interaction < 0.05).

DEF ≤ 3 or ≥ 4.6 times and NFD ≤ 10.8 or ≥ 14.9 h are independently related to increased depression risk.