Adverse childhood experiences and depressive symptoms: Protective effects of dietary flavonoids

Objectives: Adverse childhood experiences (ACEs) are associated with increased inflammation, stress, and depression. Diet patterns rich in flavonoids may buffer the effects of ACEs on depression through neuroprotective mechanisms. No studies have examined the protective effects of dietary flavonoids on depressive symptoms after ACEs. We examine the relationships among ACEs, perceived stress, depressive symptoms, and flavonoid intake in older adults. Methods: In this longitudinal cohort study, flavonoid intake was provided by 6404 Seventh-day Adventist adults in North America who, as part of the Adventist Health Study-2, completed a validated food frequency questionnaire in 2002–6. ACEs, perceived stress, and depressive symptoms were assessed in the Biopsychosocial Religion and Health Study in 2006–7 and 2010–11. Bootstrapping models predicting depression were tested after controls. Results: ACEs were associated with adult depressive symptoms and perceived stress mediated this relationship. A moderated mediation model indicates that flavonoid intake buffers the association between perceived stress and depressive symptoms after ACEs. Flavonoid consumption was negatively associated with depressive symptoms (β = −0.034, p = .03). As ACEs increased by one standard deviation, depressive symptoms increased through the interaction of perceived stress and flavonoids when flavonoids were consumed a standard deviation below the mean (effect = 0.040 SD, BC 95% CI [0.030, 0.052]). Depressive symptoms were lower for those that consumed flavonoids a standard deviation above the mean (effect =. 035 SD, BC 95% CI [0.025, 0.046]). Conclusion: A varied diet rich in flavonoids may reduce depressive symptoms associated with perceived stress following ACEs exposure.