The association between depressive symptoms and vegetarian diets is controversial. This study examines the cross-sectional association between depressive symptoms and vegetarian diets while controlling for potential confounders. Among 90,380 subjects from the population-based Constances cohort, depressive symptoms were defined by a score ≥19 on the Centre of Epidemiologic Studies-Depression (CES-D) scale and diet types (omnivorous, pesco-vegetarian, lacto-ovo-vegetarian and vegan) were determined with a food frequency questionnaire. Associations between depressive symptoms and diet were estimated through logistic regressions adjusting for socio-demographics, other foods, alcohol and tobacco consumption, physical activity and health-related concerns; specificity analyses considered the exclusion of any other food group. Depressive symptoms were associated with pesco-vegetarian and lacto-ovo-vegetarian diets in multivariable analyses (Odds-Ratio [95% confidence interval]: 1.43 [1.19–1.72] and 1.36 [1.09–1.70], respectively), especially in case of low legumes intake (p for interaction < 0.0001), as well as with the exclusion of any food group (e.g., 1.37 [1.24–1.52], 1.40 [1.31–1.50], 1.71 [1.49–1.97] for meat, fish and vegetables exclusion, respectively). Regardless of food type, the Odds-Ratio of depressive symptoms gradually increased with the number of excluded food groups (p for trend < 0.0001). Depressive symptoms are associated with the exclusion of any food group from the diet, including but not restricted to animal products.

Background: Obstructive sleep apnoea (OSA) is associated with increased morbidity and mortality. Although the disorder has been well studied in selected high-risk populations, few data exist on its prevalence in the general population. We aimed to assess the prevalence and determinants of OSA in France.Methods: Data from participants of the French population-based CONSTANCES cohort aged 18–69 years at inclusion and being treated for sleep apnoea or screened for OSA in 2017 using the Berlin Questionnaire were analysed. Weighted analyses were performed to provide recent and representative results in the general population.Results: Among 20 151 participants, the prevalence of treated sleep apnoea was 3.5% (95% CI 3.0–3.9%). The prevalence of untreated subjects with a positive Berlin Questionnaire was 18.1% (95% CI 17.3–19.2%) for a total weighted prevalence of treated sleep apnoea or high risk of OSA of 20.9% (95% CI 20.0–21.9%). Regarding prevalence of OSA symptoms, it was 37.2% (95% CI 36.1–38.3%) for severe snoring and 14.6% (95% CI 13.8–15.5%) for hypersomnolence. In multivariable logistic regression analysis, male sex, age, previous cardiovascular events, smoking, low educational level, low physical activity and depressive symptoms were associated with having either treated sleep apnoea or a positive Berlin Questionnaire.Conclusion: In this large French population-based cohort, one in five participants had a high likelihood of OSA, whereas only 3.5% were treated for the disorder, suggesting major underdiagnosis in the general population. OSA diagnosis should be considered more often in people with risk factors such as depressive symptoms as well as unhealthy behaviours and socioeconomic conditions.

The health correlates of the metabolically healthy obese (MHO) phenotype, particularly in relation to depressive symptoms remains unclear. Accordingly, we examined the risk of depressive symptoms in this phenotype using a 16-year follow-up prospective study. A sample of 14 475 participants (75% men), aged 44–59 years in 1996, was drawn from the Gazel cohort. Obesity was defined as body mass index (BMI) ≥ 30 kg/m² and metabolic health as having none of the self-reported following cardiovascular risk factors: hypertension, type 2 diabetes and dyslipidemia. Depressive symptoms were assessed by the Center for Epidemiologic Studies Depression (CES-D) scale in 1996, 1999, 2002, 2005, 2008 and 2012. Generalized Estimating Equations (GEE) were used to estimate the risk of depressive symptoms during a follow-up of 16 years. In multivariate analyses, metabolically unhealthy normal weight [Odds Ratio (OR) = 1.37; 95% Confidence Interval (CI): 1.25–1.51], overweight [1.44 (1.31–1.59)] and obese [1.30 (1.10–1.54)] but not MHO participants [1.04 (0.81–1.32)] had higher risk of depressive symptoms at the start of follow-up compared to metabolically healthy normal weight individuals. Depressive symptoms decreased over time in metabolically healthy normal weight individuals [0.52 (0.50–0.55)], this decrease was less marked only in metabolically unhealthy obese participants [1.22 (1.07–1.40)]. Compared to MHO participants, metabolically unhealthy obese individuals were at increased risk of depression at the start of follow-up, but with a similar reduction of this risk over time. Poor metabolic health, irrespective of BMI was associated with greater depressive symptoms at the start of follow-up, whereas a poorer course of depressive symptoms over time was observed only in those with both obesity and poor metabolic health.