Abstract
BackgroundDepression imposes immense public health burden, demonstrating an urgent need of the identification of modifiable risk factors. Only a few cohort studies have analyzed the association between Mediterranean dietary pattern (MDP) and depression but with mixed results. We examined the impact of MDP on clinically ascertained depression in a large population-based dataset.MethodsIn 1991/92, detailed information on diet, using a food frequency questionnaire, and potential confounding factors (body weight, height, educational attainment, smoking, previous diabetes and hypertension, and physical activity) was collected, in a random sample of 49,261 Swedish women aged 29-49. Adherence to MDP was calculated. Clinical depression was extracted from the National Patient Register. Study participants were followed up through 2012.ResultsDuring an average follow-up of 20.4 years, 1677 incident cases of depression were diagnosed. We observed a lower risk of depression for medium (score 4-5) and high (6-9) adherence to MDP, compared with low (0-3) adherence (Medium: hazard ratio (HR) = 0.90, 95% confidence interval (CI) = 0.81-1.00; High: HR = 0.82, 95%CI = 0.71-0.94). Per unit increase of adherence, the risk of depression was reduced by 5% (HR = 0.95, 95%CI = 0.92-0.98). The association became stronger when restricting to severe form of depression (HR = 0.51, 95%CI = 0.33-0.76). The HRs were higher from age 50 onward both over the first and the second 10-year follow-up period, compared with before age 50, indicating stronger association with increasing age. Results remained after extensive sensitivity analyses.ConclusionHigher adherence to a Mediterranean diet at middle age was associated with a lower risk of depression later in life among Swedish women.
Highlights
Depression imposes immense public health burden, demonstrating an urgent need of the identification of modifiable risk factors
Adherence to Mediterranean dietary pattern (MDP) At cohort entry, the study participants were asked to recall their dietary habits during the six months before enrolment, through answering an food frequency questionnaire (FFQ), which assessed the frequency and quantity of consumption of approximately 80 food items and beverages [22]
Covariates We considered a range of demographic factors, lifestyle factors, anthropometric profile, and medical history as potential confounders of the studied association, including age, calendar year of birth, body weight, height, total years of education, smoking status, previous diabetes and hypertension, as well as level of physical activity, all collected from the questionnaires at baseline
Summary
Depression imposes immense public health burden, demonstrating an urgent need of the identification of modifiable risk factors. The identification of modifiable risk factors for depression is urgently needed. Mediterranean diet is one of the classical anti-inflammatory dietary patterns [8] and has been perceived to have benefits on multiple aspects of human health, including mental and brain health [9, 10]. This dietary pattern refers to a food profile characterized by high consumption of vegetables, fruits, legumes, nuts and complex carbohydrates, and mono-unsaturated lipids
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