Association of the Mediterranean Dietary Pattern With the Incidence of Depression: The Seguimiento Universidad De Navarra/University of Navarra Follow-Up (SUN) Cohort

Arch Gen Psychiatry. 2009 Oct;66(10):1090-8. doi: 10.1001/archgenpsychiatry.2009.129.

Abstract

Context: Adherence to the Mediterranean dietary pattern (MDP) is thought to reduce inflammatory, vascular, and metabolic processes that may be involved in the risk of clinical depression.

Objective: To assess the association between adherence to the MDP and the incidence of clinical depression.

Design: Prospective study that uses a validated 136-item food frequency questionnaire to assess adherence to the MDP. The MDP score positively weighted the consumption of vegetables, fruit and nuts, cereal, legumes, and fish; the monounsaturated- to saturated-fatty-acids ratio; and moderate alcohol consumption, whereas meat or meat products and whole-fat dairy were negatively weighted.

Setting: A dynamic cohort of university graduates (Seguimiento Universidad de Navarra/University of Navarra Follow-up [SUN] Project).

Participants: A total of 10 094 initially healthy Spanish participants from the SUN Project participated in the study. Recruitment began on December 21, 1999, and is ongoing.

Main outcome measure: Participants were classified as having incident depression if they were free of depression and antidepressant medication at baseline and reported a physician-made diagnosis of clinical depression and/or antidepressant medication use during follow-up.

Results: After a median follow-up of 4.4 years, 480 new cases of depression were identified. The multiple adjusted hazard ratios (95% confidence intervals) of depression for the 4 upper successive categories of adherence to the MDP (taking the category of lowest adherence as reference) were 0.74 (0.57-0.98), 0.66 (0.50-0.86), 0.49 (0.36-0.67), and 0.58 (0.44-0.77) (P for trend <.001). Inverse dose-response relationships were found for fruit and nuts, the monounsaturated- to saturated-fatty-acids ratio, and legumes.

Conclusions: Our results suggest a potential protective role of the MDP with regard to the prevention of depressive disorders; additional longitudinal studies and trials are needed to confirm these findings.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cohort Studies
  • Depressive Disorder / diet therapy
  • Depressive Disorder / epidemiology
  • Depressive Disorder / prevention & control*
  • Diet, Mediterranean*
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Longitudinal Studies
  • Male
  • Outcome Assessment, Health Care
  • Patient Compliance
  • Prospective Studies
  • Risk Factors
  • Spain / epidemiology
  • Surveys and Questionnaires