Prospective association between adherence to the Mediterranean diet and risk of depressive symptoms in the French SU.VI.MAX cohort
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This study examines whether adherence to the Mediterranean Diet (MD) measured by several dietary indexes was associated with incident depressive symptoms in a large French cohort.
The study sample consisted of 3523 participants from the Supplémentation en Vitamines et Minéraux Antioxydants (SU.VI.MAX) cohort who had at least three dietary records at baseline during the first 2 years of follow-up (1994–1996), free of depression at the beginning of the study (1996–1997) and available Center for Epidemiologic Studies Depression Scale (CES-D) data at the end of follow-up (2007–2009). The rMED was computed. Incident depressive symptoms were defined by a CES-D score ≥17 for men and ≥23 for women in 2007–2009. Odds ratios (OR) and 95% confidence intervals (95% CI) were estimated using multivariable logistic regression models. Several sensitivity analyses were performed.
In the present study, 172 incident cases of depressive symptoms were identified during the follow-up (mean = 12.6 years). After adjustment for a wide range of potential confounders, adherence to the rMED score (continuous variable) was significantly associated with incident depressive symptoms in men (OR 0.91; 95% CI 0.83–0.99; p = 0.03), but not in women. Use of the Literature-Based Adherence Score to the Mediterranean Diet (LAMD) and the classic MD score (MDS) provide similar findings.
In the current study, higher adherence to the Mediterranean Diet at midlife was associated with a lower risk of incident depressive symptoms, particularly in men, increasing scientific evidence for a beneficial role of Mediterranean Diet on health. Further investigations in particular among women are needed.
KeywordsMental health Depressive symptoms Mediterranean diet Prospective study
The authors thank Younes Esseddik, Paul Flanzy, Yasmina Chelghoum, and Than Duong Van (computer scientists), Rachida Mehroug (Logistic assistant) and Nathalie Arnault, Véronique Gourlet, Fabien Szabo, Laurent Bourhis, and Stephen Besseau (statisticians) for their technical contribution to the SU.VI.MAX study as well as all participants of the SU.VI.MAX study. The study was funded by the French National Research Agency (n°ANR-05-PNRA-010) and the French Ministry of Health (DGS) and a 2013 research grant from the Société Française d’Hypertension Artérielle n°R13024KK RAK13204KKA. The funding bodies did not have any involvement in the design/conduct of the research, or in data analysis/interpretation, or in writing/approval of the manuscript. Moufidath Adjibade and Karen E. Assmann were supported by a doctoral fellowship from the Ecole Doctorale Galilée, Paris 13 University, Sorbonne Paris Cité.
Compliance with ethical standards
Conflict of interest
Cédric Lemogne has received honoraria for board membership from Lundbeck and for speaking at invited symposia from Astra Zeneca, Daiichi-Sankyo, Lundbeck and Servier. None of the other authors declare any conflict of interest.
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