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Meta-Analysis
. 2020 Aug;50(11):1872-1883.
doi: 10.1017/S0033291719001958. Epub 2019 Aug 14.

Association of a priori dietary patterns with depressive symptoms: a harmonised meta-analysis of observational studies

Mary Nicolaou  1 , Marco Colpo  2 , Esther Vermeulen  1 , Liset E M Elstgeest  3 , Mieke Cabout  3 , Deborah Gibson-Smith  4 , Anika Knuppel  5 , Giovana Sini  2 , Danielle A J M Schoenaker  6   7 , Gita D Mishra  6 , Anja Lok  8 , Brenda W J H Penninx  4 , Stefania Bandinelli  2 , Eric J Brunner  5 , Aiko H Zwinderman  9 , Ingeborg A Brouwer  3 , Marjolein Visser  3
Affiliations
Meta-Analysis

Association of a priori dietary patterns with depressive symptoms: a harmonised meta-analysis of observational studies

Mary Nicolaou et al. Psychol Med. 2020 Aug.

Abstract

Background: Review findings on the role of dietary patterns in preventing depression are inconsistent, possibly due to variation in assessment of dietary exposure and depression. We studied the association between dietary patterns and depressive symptoms in six population-based cohorts and meta-analysed the findings using a standardised approach that defined dietary exposure, depression assessment and covariates.

Methods: Included were cross-sectional data from 23 026 participants in six cohorts: InCHIANTI (Italy), LASA, NESDA, HELIUS (the Netherlands), ALSWH (Australia) and Whitehall II (UK). Analysis of incidence was based on three cohorts with repeated measures of depressive symptoms at 5-6 years of follow-up in 10 721 participants: Whitehall II, InCHIANTI, ALSWH. Three a priori dietary patterns, Mediterranean diet score (MDS), Alternative Healthy Eating Index (AHEI-2010), and the Dietary Approaches to Stop Hypertension (DASH) diet were investigated in relation to depressive symptoms. Analyses at the cohort-level adjusted for a fixed set of confounders, meta-analysis used a random-effects model.

Results: Cross-sectional and prospective analyses showed statistically significant inverse associations of the three dietary patterns with depressive symptoms (continuous and dichotomous). In cross-sectional analysis, the association of diet with depressive symptoms using a cut-off yielded an adjusted OR of 0.87 (95% confidence interval 0.84-0.91) for MDS, 0.93 (0.88-0.98) for AHEI-2010, and 0.94 (0.87-1.01) for DASH. Similar associations were observed prospectively: 0.88 (0.80-0.96) for MDS; 0.95 (0.84-1.06) for AHEI-2010; 0.90 (0.84-0.97) for DASH.

Conclusion: Population-scale observational evidence indicates that adults following a healthy dietary pattern have fewer depressive symptoms and lower risk of developing depressive symptoms.

Keywords: AHEI-2010; DASH; Mediterranean diet; MooDFOOD project; depression; diet; meta-analysis.

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Figures

Fig. 1.
Fig. 1.
Cross-sectional association between dietary patterns and continuous ‘depressive symptoms’.
Fig. 2.
Fig. 2.
Cross-sectional association between dietary patterns and ‘high depressive symptoms’.
Fig. 3.
Fig. 3.
Cross-sectional association between dietary patterns and ‘high depressive symptoms e/o medications’.
Fig. 4.
Fig. 4.
Prospective association between dietary patterns at baseline and ‘depressive symptoms’ at follow-up.
Fig. 5.
Fig. 5.
Prospective association between dietary patterns at baseline and incidence of ‘high depressive symptoms’ at follow-up.
Fig. 6.
Fig. 6.
Prospective association between dietary patterns at baseline and incidence of ‘high depressive symptoms e/o medications’ at follow-up.
See this image and copyright information in PMC

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