The Association of Energy Distribution Between Dinner and Breakfast With Depressive Symptoms in Early Pregnancy.

AIM: To examine the association between the distribution of energy and macronutrients between dinner and breakfast and depressive symptoms in early pregnancy. METHODS: This study used baseline data from a maternity cohort conducted in Wuhan, China. Dietary intake was assessed via a 24-h recall, and depressive symptoms were defined as EPDS ≥ 10. The differences in energy and macronutrient intake between dinner and breakfast (Δ = dinner-breakfast) were categorized into tertiles. Logistic regression models were developed to assess the associations between Δ and depressive symptoms. Isocaloric substitution models were used to evaluate the effect of shifting energy or macronutrients from dinner to breakfast. RESULTS: Two hundred two individuals (41.74%) met the criteria for depressive symptoms. The highest tertile was associated with a significantly increased risk of depressive symptoms compared with the lowest tertile after multivariable adjustment (ΔEnergy: OR = 1.97, 95% CI: 1.21-3.19; ΔCarbohydrate: OR = 1.89, 95% CI: 1.17-3.06; ΔFat: OR = 1.65, 95% CI: 1.03-2.64). Isocalorically replacing 5% of total energy at dinner with breakfast was associated with a 7% (OR = 0.93, 95% CI: 0.86-0.99) lower risk of depressive symptoms, while macronutrient substitution between meals showed no significant effect. CONCLUSIONS: Higher energy and macronutrient intake at dinner relative to breakfast was associated with a higher risk of depressive symptoms, highlighting the potential importance of daily energy distribution for mental health in early pregnancy.