The association of diet and depression: an analysis of dietary measures in depressed, non-depressed, and healthy youth.

BACKGROUND: The association of diet quality with depression among the pediatric age group has been inconsistent. This may be due, in part, to varying dietary assessment methods. The current study sought to examine this association, and its reliability, using four dietary measures previously studied in children and adolescents. METHODS: Dietary habits among 139 children and adolescents (10-18 years, 66% female) with major depressive disorder [MDD (n = 77)], non-MDD psychiatric conditions (PSYCH; n = 31), or without psychiatric illness (healthy controls [HC]; n = 31) were examined. Using self-reported dietary intake, diet quality was characterized using the Youth Healthy Eating Index (YHEI), Dietary Questionnaire (DQ), Health Behaviour of Teenagers (HBT), and the Healthy Eating Habits Scale (HEHS). Multivariate Analysis of Covariances examined the association between depression status and dietary habits across measures controlling for participant age. RESULTS: The multivariate effect was significant by diet measures, F (16, 256) = 1.9, p = .02, partial η2 = 0.12, with significant differences across groups on consumption of healthy dietary practices and minimal variability across measures. In subgroup analyses, MDD children had decreased consumption of healthy foods compared with PSYCH and HC children on three out of four measures. There was no difference in consumption of unhealthy foods across diagnostic groups. LIMITATIONS: Cross-sectional design. CONCLUSIONS: Children with MDD consume fewer healthy foods than non-MDD children, with little variation by dietary measure. Research examining the directionality of this association and specific dietary deficits among MDD youth is needed to elucidate potential preventative targets for intervention.

Evaluation of Kawasaki disease risk-scoring systems for intravenous immunoglobulin resistance.

OBJECTIVES: To assess the performance of 3 risk scores from Japan that were developed to predict, in children with Kawasaki disease, resistance to intravenous immunoglobulin (IVIG) treatment. STUDY DESIGN: We used data from a randomized trial of pulsed steroids for primary treatment of Kawasaki disease to assess operating characteristics of the 3 risk scores, and we examined whether steroid therapy lowers the risk of coronary artery abnormalities in patients prospectively classified as IVIG resistant. RESULTS: For comparability with published cohorts, we analyzed the data of 99 patients who were not treated with steroids (16% IVIG-retreated) and identified male sex, lower albumin level, and higher aspartate aminotransferase level as independent risk factors for IVIG resistance. The Kobayashi score was similar in IVIG-resistant and -responsive patients, yielding a sensitivity of 33% and specificity of 87%. There was no interaction of high-risk versus low-risk status by treatment received (steroid versus placebo) with any of the 3 risk score algorithms. CONCLUSION: Risk-scoring systems from Japan have good specificity but low sensitivity for predicting IVIG resistance in a North American cohort. Primary steroid therapy did not improve coronary outcomes in patients prospectively classified as being at high-risk for IVIG resistance.