Abstract
OBJECTIVES: To investigate relationships of self-reported frequency of adding salt to foods (FASF) with the risk of depression and anxiety, as well as to explore the potential effects of biological aging (BA) on these associations.</p>
METHODS: Using data from the UK Biobank, we constructed a prospective cohort study that included 439,412 participants. Additionally, we developed two BA indicators using the Klemera and Doubal method (KDM-BA) and the PhenoAge algorithm. We also calculated the accelerated KDM-BA and PhenoAge scores.</p>
RESULTS: During a median follow-up of 12.7 years, we identified 18,678 incident cases of depression and 22,017 incident cases of anxiety, respectively. We observed that subjects with higher FASF had an increased risk of depression and anxiety. Compared to individuals who "never/rarely" adding salt to foods, the hazard ratios (HRs) and (95 % confidence intervals [CI]) of depression were 1.08 (1.05-1.12), 1.16 (1.10-1.21), and 1.37 (1.29-1.45) for the group of "sometimes", "usually", and "always" respectively; and the HRs (95 % CI) of anxiety were 1.05 (1.01-1.08), 1.05 (1.01-1.10), and 1.27 (1.20-1.34), respectively. In addition, we observed that higher FASF was positively related to accelerated BA, which in turn was significantly associated with a higher risk of depression and anxiety. Mediation analyses showed that accelerated KDM-BA or accelerated PhenoAge mediated the associations of FASF with depression and anxiety.</p>
CONCLUSIONS: Our study demonstrates a positive relationship of FASF with incidence of anxiety and depression. Moreover, BA can modify and mediate the above associations and may serve as a potential mechanism.</p>