Adherence to Mediterranean Diet and Depressive Symptomatology Among Boston Area Puerto Ricans

J Gerontol A Biol Sci Med Sci. 2023 Feb 24;78(2):258-266. doi: 10.1093/gerona/glac057.


Background: Higher Mediterranean diet (MeD) adherence has been linked with lower depressive symptomatology, but research examining this association is limited, especially among Latinos, including mainland U.S. Puerto Ricans. Hence, we examined cross-sectional and longitudinal associations between MeD adherence and self-reported depressive symptomatology in Boston area Puerto Rican adults.

Methods: The Center for Epidemiologic Studies Depression Scale (CES-D) was used to evaluate depressive symptoms. Adherence to MeD was assessed at all 3 visits. We used multivariable linear regression for baseline cross-sectional analysis, and linear mixed effects modeling over 3 waves of follow-up for longitudinal analysis. We also assessed whether baseline MeD adherence affected 5y CES-D trajectory. We conducted sensitivity analyses among participants without diabetes, and among participants with complete MeD and CES-D measures at all visits.

Results: MeD adherence was significantly associated with CES-D score at baseline (β = -2.0, 95% confidence interval [CI] -4.0, -0.04 for highest vs lowest tertile, p trend = .04) and across 3 waves (β = -1.9, 95% CI = -3.0, -0.8 for highest vs lowest tertile, p trend = .0005). Results were similar in analyses restricted to participants without diabetes, as well as among participants with complete CES-D and MeD scores at all visits.

Conclusions: While CES-D score was consistently lower in those with higher MeD adherence over 5 years of follow up, no relationship between baseline MeD adherence and 5y CES-D trajectory was observed.

Keywords: CES-D; Mediterranean diet; depression; dietary pattern; minority; nutrition.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Boston / epidemiology
  • Cross-Sectional Studies
  • Depression* / diagnosis
  • Depression* / epidemiology
  • Diet, Mediterranean*
  • Hispanic or Latino
  • Humans
  • Patient Compliance