Epidemiology and Public Health Programme, Hospital del Mar Medical Research Institute, PRBB, Carrer Doctor Aiguader 88, Barcelona, 08003, Spain.
Preventive Medicine and Public Health Training Unit PSMar-UPF-ASPB (Parc de Salut Mar - Pompeu Fabra University - Agència de Salut Pública de Barcelona), Barcelona, Spain.
Eur J Nutr. 2024 Dec;63(8):2885-2895. doi: 10.1007/s00394-024-03466-z. Epub 2024 Aug 24.
Our aim was to determine the association between diet quality and depression incidence in the population-based REGICOR cohort study, Catalonia, Spain.
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.
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.
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.
本研究旨在基于人群的 REGICOR 队列研究，评估饮食质量与抑郁发生率之间的关联，该研究在西班牙加泰罗尼亚进行。
本研究为前瞻性观察研究，使用参与者的基线（2003-2006 年）、随访（2007-2013 年）和临床记录数据。在基线时使用食物频率问卷（FFQ）得出五个饮食质量评分：相对地中海饮食评分（rMED）、改良地中海饮食评分（ModMDS）、得舒饮食评分（DASH）、健康植物性饮食指数（HPDI）和世界卫生组织健康饮食指标（WHO-HDI）。排除使用抗抑郁药治疗的参与者，作为基线时存在抑郁的替代指标。在随访时，使用患者健康问卷（PHQ-9）评估抑郁症状（≥10 定义为抑郁障碍）。次要结局是通过临床记录评估的抑郁诊断。使用逻辑回归和 Cox 比例风险模型进行分析。
主要分析纳入了 3046 名成年人（50.3%为女性），平均年龄为 54.7（SD=11.6）岁。随访 6 年后，共发现 184 例（6.04%）抑郁障碍病例。rMED 每增加 1SD，抑郁障碍的可能性降低 16%（OR=0.84；95%CI=0.71-0.98）。对二次结局分析（n=4789）发现，在 12 年的随访中有 261 例（5.45%）新诊断为临床抑郁症病例，WHO-HDI 与临床抑郁症风险降低 19%相关（HR=0.81；95%CI=0.70-0.93）。调整 BMI 后并未削弱研究结果。
在这项基于人群的队列研究中，发现饮食质量与抑郁发生率之间存在显著的负相关，这与社会人口统计学、健康和生活方式无关。遵循健康饮食可能是预防抑郁的一种补充干预措施。
