Bakian · Translational psychiatry 2020 · cross-sectional study · n=22,692

Dietary creatine intake and depression risk among U.S. adults.

Cited 90 times in the scientific literature.

Level 4 - case-series / case-control

Cross-sectional population survey (NHANES)

PubMed 32066709 · doi:10.1038/s41398-020-0741-x · record verified 2026-08-26

What was done

Researchers analyzed cross-sectional data from 22,692 US adults aged 20 years and older from the 2005–2012 National Health and Nutrition Examination Survey (NHANES). They evaluated dietary creatine intake, depression status via the Patient Health Questionnaire (PHQ), and calculated depression prevalence across quartiles of dietary creatine. Multivariable logistic regression models were adjusted for age, sex, race/ethnicity, income-to-poverty ratio, education level, body mass index, healthcare access, smoking status, physical activity, and antidepressant/anxiolytic medication use, with stratified models by sex, age group, and medication use.

What was found

Depression prevalence was 10.23 per 100 persons (95% CI: 8.64–11.83) in the lowest quartile of dietary creatine intake versus 5.98 per 100 persons (95% CI: 4.97–6.98) in the highest quartile (p < 0.001). Dietary creatine was inversely associated with depression in fully adjusted models (adjusted odds ratio [AOR] = 0.68, 95% CI: 0.52–0.88). The negative association was strongest among females (AOR = 0.62, 95% CI: 0.40–0.98), participants aged 20–39 years (AOR = 0.52, 95% CI: 0.34–0.79), and those not taking antidepressant/anxiolytic medication (AOR = 0.58, 95% CI: 0.43–0.77).

Why it matters

This study provides large-scale epidemiological evidence linking higher dietary creatine consumption with lower depression prevalence, supporting further interventional trials of creatine for mood disorders.

Limits

The cross-sectional design cannot establish causality or temporal sequence, meaning reverse causation (e.g., depression leading to reduced food/meat intake) cannot be ruled out. Dietary intake was self-reported, and residual confounding from total protein intake or broader dietary quality was not fully accounted for in the abstract.

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