Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain. Center for Networked Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.
Department of Epidemiology and Public Health, University College London, London, UK.
Mol Psychiatry. 2023 Aug;28(8):3475-3483. doi: 10.1038/s41380-023-02125-9. Epub 2023 Jun 23.
The Southern European Atlantic diet (SEAD) is the traditional dietary pattern of north-western Spain and northern Portugal, but it may resemble that of other European countries. The SEAD has been found associated with lower risk for myocardial infarction and mortality. Since dietary patterns may also influence mental health, we examined the association between the SEAD and depression risk in southern, central, eastern, and western European populations. We conducted a prospective analysis of five cohorts (13,297 participants aged 45-92 years, free of depression at baseline): Seniors-ENRICA-1 and Seniors-ENRICA-2 (Spain), HAPIEE (Czechia and Poland), and Whitehall-II (United Kingdom). The SEAD comprised cod, other fresh fish, red meat and pork products, dairy, legumes and vegetables, vegetable soup, potatoes, whole-grain bread, and moderate wine consumption. Depression at follow-up was defined according to presence of depressive symptoms (based on available scales), use of prescribed antidepressants, inpatient admissions, or self-reported diagnosis. Associations were adjusted for sociodemographic, lifestyle, and dietary variables. During a median follow-up of 3.9 years (interquartile range 3.4-4.9), there were 1437 new depression cases. Higher adherence to the SEAD was associated with lower depression risk in the pooled sample. Individual food groups showed a similar tendency, albeit non-significant. The fully adjusted odds ratio (95% confidence interval) per 1-standard deviation increment in the SEAD was 0.91 (0.86, 0.96). This association was rather consistent across countries [Spain = 0.86 (0.75, 0.99), Czechia = 0.86 (0.75, 0.99), Poland = 0.97 (0.89, 1.06), United Kingdom = 0.85 (0.75, 0.97); p for interaction = 0.24], and was of similar magnitude as that found for existing healthy dietary patterns. In conclusion, the SEAD was associated with lower depression risk across European populations. This may support the development of mood disorder guidelines for Southern European Atlantic regions based on their traditional diet, and for central, eastern, and western European populations based on the SEAD food groups that are culturally rooted in these places.
南欧大西洋饮食（SEAD）是西班牙西北部和葡萄牙北部的传统饮食模式，但它可能与其他欧洲国家的饮食模式相似。SEAD 与心肌梗死和死亡率降低风险有关。由于饮食模式也可能影响心理健康，我们研究了 SEAD 与南欧、中欧、东欧和西欧人群抑郁风险之间的关系。我们对五个队列（13297 名年龄在 45-92 岁、基线时无抑郁的参与者）进行了前瞻性分析：Seniors-ENRICA-1 和 Seniors-ENRICA-2（西班牙）、HAPIEE（捷克和波兰）和 Whitehall-II（英国）。SEAD 包括鳕鱼、其他新鲜鱼类、红肉和猪肉制品、乳制品、豆类和蔬菜、蔬菜汤、土豆、全麦面包和适量的葡萄酒。随访时的抑郁是根据存在的抑郁症状（基于现有量表）、使用处方抗抑郁药、住院或自我报告的诊断来定义的。调整了社会人口统计学、生活方式和饮食变量。在中位随访 3.9 年（四分位间距 3.4-4.9）期间，有 1437 例新的抑郁病例。在汇总样本中，SEAD 摄入量较高与较低的抑郁风险相关。个别食物组也显示出类似的趋势，但无统计学意义。SEAD 每增加 1 个标准差，完全调整后的比值比（95%置信区间）为 0.91（0.86，0.96）。这种关联在不同国家之间相当一致[西班牙=0.86（0.75，0.99），捷克=0.86（0.75，0.99），波兰=0.97（0.89，1.06），英国=0.85（0.75，0.97）；交互作用的 p 值=0.24]，与现有的健康饮食模式的关联程度相当。总之，SEAD 与欧洲人群的较低抑郁风险相关。这可能支持基于南欧大西洋地区传统饮食为该地区制定情绪障碍指南，以及基于在这些地区具有文化根源的 SEAD 食物组为中欧、东欧和西欧人群制定指南。
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