ArticleCureus2026
Macronutrient Composition and Depressive Symptoms Among Working-Age Participants in a US National Health Survey: An Isocaloric Substitution Analysis.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDepressive symptoms are common among working-age adults, and diet may be a modifiable correlate. Macronutrient composition has been linked to depressive symptoms, but usually one macronutrient at a time, and the few analyses of exchanges between them were confined to restricted populations. Protein, fat, and carbohydrate together account for almost all dietary energy, so a higher share of one implies a lower share of another. This study aimed to identify which exchange of energy between protein, fat, and carbohydrate, if any, is associated with depressive symptoms in working-age adults.
methodsIn a cross-sectional analysis of the National Health and Nutrition Examination Survey from August 2021 to August 2023, we analysed 2,125 participants aged 20-64 years with two complete 24-hour dietary recalls. Depressive symptoms were defined as a Patient Health Questionnaire-9 score of 10 or higher. Protein, fat, and carbohydrate were expressed as percentages of macronutrient-derived energy, summing to 100%. Logistic regression estimated odds ratios (ORs) across quartiles, and leave-one-out models estimated isocaloric substitution of 5% of macronutrient energy, adjusted for demographic, socioeconomic, and lifestyle factors and body mass index. Models were repeated by sex and employment status. Unweighted analyses were primary.
resultsDepressive symptoms were present in 277 participants (13.0%). The OR for the highest versus lowest quartile was 0.42 (95% CI: 0.28-0.63; P for trend < 0.001) for protein and 1.81 (1.24-2.65) for carbohydrate; fat showed no association. Replacing 5% of macronutrient energy from carbohydrate with protein was associated with lower odds (OR: 0.70, 0.59-0.84; survey-weighted: 0.76, 0.61-0.95), as was the same exchange from fat to protein (0.74, 0.60-0.90; survey-weighted: 0.78, 0.58-1.05), whereas exchanging carbohydrate for fat was not. Substitution estimates were similar by sex and among participants who were currently working (0.73, 0.58-0.92) and those who were not.
conclusionsAmong working-age adults, replacing carbohydrate or fat with protein was associated with lower odds of depressive symptoms. The design is cross-sectional, and prospective confirmation is needed.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.