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European journal of nutrition
Dec, 2024;63 (8): 2885-2895.

Association between different diet quality scores and depression risk: the REGICOR population-based cohort study.

Gabriela Lugon, Álvaro Hernáez, Felice N Jacka, Jaume Marrugat, Rafael Ramos, Josep Garre-Olmo, Roberto Elosua, Camille Lassale
Author Information
  1. Gabriela Lugon: Epidemiology and Public Health Programme, Hospital del Mar Medical Research Institute, PRBB, Carrer Doctor Aiguader 88, Barcelona, 08003, Spain. gabrielamaria.lugon.ceruti@psmar.cat. ORCID
  2. Álvaro Hernáez: Epidemiology and Public Health Programme, Hospital del Mar Medical Research Institute, PRBB, Carrer Doctor Aiguader 88, Barcelona, 08003, Spain. ORCID
  3. Felice N Jacka: School of Medicine, Food & Mood Centre, IMPACT Strategic Research Centre, Deakin University, Melbourne, VIC, Australia. ORCID
  4. Jaume Marrugat: Epidemiology and Public Health Programme, Hospital del Mar Medical Research Institute, PRBB, Carrer Doctor Aiguader 88, Barcelona, 08003, Spain. ORCID
  5. Rafael Ramos: Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Girona, Spain.
  6. Josep Garre-Olmo: Girona Biomedical Research Institute (IdIBGi), Dr. Josep Trueta University Hospital, Girona, Spain. ORCID
  7. Roberto Elosua: Epidemiology and Public Health Programme, Hospital del Mar Medical Research Institute, PRBB, Carrer Doctor Aiguader 88, Barcelona, 08003, Spain. ORCID
  8. Camille Lassale: Epidemiology and Public Health Programme, Hospital del Mar Medical Research Institute, PRBB, Carrer Doctor Aiguader 88, Barcelona, 08003, Spain. camille.lassale@isglobal.org. ORCID
PMID: 39180556 DOI: 10.1007/s00394-024-03466-z

Abstract

BACKGROUND: Our aim was to determine the association between diet quality and depression incidence in the population-based REGICOR cohort study, Catalonia, Spain.
METHODS: Prospective observational study using participants' baseline (2003-2006), follow-up (2007-2013) and clinical records data. Five diet quality scores were derived from a food frequency questionnaire (FFQ) at baseline: the relative Mediterranean Diet Score (rMED), the Modified Mediterranean Diet Score (ModMDS), a Dietary Approaches to Stop Hypertension (DASH) score, a Healthful Plant-based Diet Index (HPDI) and the World Health Organization Healthy Diet Indicator (WHO-HDI). Participants using pharmacological antidepressant treatment were excluded as a proxy for presence of depression at baseline. At follow-up, the Patient Health Questionnaire (PHQ-9) was applied to assess depressive symptoms (≥ 10 defining depressive disorder). A secondary outcome was depression diagnosis assessed through clinical records. Logistic regression and Cox proportional hazards models were used.
RESULTS: Main analysis included 3046 adults (50.3% women) with a mean age of 54.7 (SD = 11.6) years. After 6-years follow-up, 184 (6.04%) cases of depressive disorder were identified. There was 16% lower odds of depressive disorder per 1SD increase of rMED (OR = 0.84; 95%CI = 0.71-0.98). Secondary outcome analysis (n = 4789) identified 261 (5.45%) incident cases of clinical depression diagnosis over 12 years follow-up, and 19% lower risk of clinical depression was observed with the WHO-HDI (HR = 0.81; 95%CI = 0.70-0.93). Adjusting for BMI did not attenuate the findings.
CONCLUSIONS: A significant inverse association between diet quality and depression incidence was found in this population-based cohort study, independent of sociodemographic, health and lifestyle. Adherence to a healthy diet could be a complementary intervention for the prevention of depression.

Keywords

Depression Dietary score Nutritional psychiatry Prevention

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Grants

  1. 100010434/'la Caixa' Foundation
  2. PERIS SLT002/16/00088, PERIS STL006/17/00234, 2017SGR222/Agència de Gestió d'Ajuts Universitaris i de Recerca

MeSH Term

Humans
Female
Male
Middle Aged
Prospective Studies
Spain
Depression
Diet, Mediterranean
Cohort Studies
Incidence
Risk Factors
Diet
Follow-Up Studies
Adult
Aged
Diet, Healthy
Surveys and Questionnaires
Dietary Approaches To Stop Hypertension
Journal Article Observational Study
Article has an altmetric score of 125

Word Cloud

Created with Highcharts 10.0.0depressiondietqualitystudyfollow-upclinicalDietdepressivepopulation-basedcohortdisorderassociationincidenceREGICORusingbaselinerecordsscoresMediterraneanScorerMEDDietaryscoreHealthWHO-HDIoutcomediagnosisanalysis6yearscasesidentifiedlower95%CI = 0BACKGROUND:aimdetermineCataloniaSpainMETHODS:Prospectiveobservationalparticipants'2003-20062007-2013dataFivederivedfoodfrequencyquestionnaireFFQbaseline:relativeModifiedModMDSApproachesStopHypertensionDASHHealthfulPlant-basedIndexHPDIWorldOrganizationHealthyIndicatorParticipantspharmacologicalantidepressanttreatmentexcludedproxypresencePatientQuestionnairePHQ-9appliedassesssymptoms≥ 10definingsecondaryassessedLogisticregressionCoxproportionalhazardsmodelsusedRESULTS:Mainincluded3046adults503%womenmeanage547SD = 116-years18404%16%oddsper1SDincreaseOR = 08471-098Secondaryn = 4789261545%incident1219%riskobservedHR = 08170-093AdjustingBMIattenuatefindingsCONCLUSIONS:significantinversefoundindependentsociodemographichealthlifestyleAdherencehealthycomplementaryinterventionpreventionAssociationdifferentrisk:DepressionNutritionalpsychiatryPrevention

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