Intake of Nutrients Among Individuals at Risk for Suicide Enrolled in the Better Resiliency Among Veterans and Non‐Veterans with Omega‐3's (BRAVO) Clinical Trial
Authors: Johnson Kristen B. , Marriott Bernadette P. , Newman Jill C. , Team BRAVO 
Published: June 2021

The relationship between diet quality and chronic conditions such as cardiovascular disease and cancer has been well‐studied, but less is known about the relationship between diet quality and mental health. Specifically, cross disciplinary scientific coalitions have identified suicide risk as a key area for nutrition research. The objective of this study was to assess intake of those nutrients of national concern for deficiency in the 2010 Dietary Guidelines (DG) for persons identified at high risk of suicide. The study sample included 111 adults in the BRAVO randomized trial who had recently attempted suicide or had high levels of diagnosed suicide ideation(Mean Beck Suicide Scale score 9.5 ± 6.6). Baseline diet was assessed by two 24‐hour recalls and one 30‐day food frequency questionnaire. We present the intake data from the initial in‐person 24‐hour recall using the Automated Multiple Pass Method compared to the Dietary Reference Intakes (DRI). Chi‐square or Fisher's exact tests were used to determine differences by demographic and clinical measures. Mean intakes for the DG key nutrients were: calcium: 1047.2 ± 596.4 mg;, potassium: 2605.8 ± 1083.2 mg, vitamin D: 5.5 ± 4.6 μg, and dietary fiber: 15.0 ± 8.7 g.

Sample Population Dietary Intake Related to the Dietary Reference Intakes for Key Nutrients

Calcium (mg)
Potassium (mg)
Vitamin D (μg)
Dietary Fiber (g)

% Did not meet DRI
p‐value
% Did not meet DRI
p‐value
% Did not meet DRI
p‐value
% Did not meet DRI
p‐value

Gender

0.0179

0.6469

0.0765

0.7327

Female
58.1

97.7

95.4

90.7

Male
33.8

94.1

83.8

92.6

Age

0.1912

0.3172

0.4211

0.3022

18–30
25.0

95.0

80.0

95.0

31–50
47.1

100

91.2

97.1

51+
47.4

93.0

89.5

87.7

BSS*

0.5179

0.0112

0.7939

0.3832

Suicidal ideation
45.3

100

87.5

93.7

No suicidal ideation
39.1

89.1

89.1

89.1

BDI Depression**

0.1533

0.0874

0.8332

0.0270

Normal
35.0

85.0

85.0

80.0

Mild/borderline
39.3

100

85.7

96.4

Moderate
55.6

95.6

88.9

97.8

Severe/extreme
27.8

100

94.4

83.3

Beck Suicide Scale
Beck Depression Inventory

These data indicate that of the DG 2010 nutrients identified as at risk of deficiency for the nation, a significantly higher percentage of persons who have the highest scores on the standard measure of suicidality (BSS) do not meet the DRI for potassium while significantly more individuals with documented depression did not meet the DRI recommendations for fiber. These results indicate that individuals at risk for suicide have poor diet quality and may benefit from education on increasing diet quality as an important step in supporting mental health.Support or Funding InformationThe BRAVO study is sponsored by award #W81XH‐13‐2‐0015 from the Department of Defense (DoD), U.S. Army Medical Research and Materiel Command (USARMC), Congressionally Directed Medical Research Programs (CDMRP) through the U.S. Army Medical Research Acquisition authority (USAMRAA).