European Journal of Nutrition

, Volume 57, Issue 7, pp 2409–2419 | Cite as

Micronutrient intake adequacy and depression risk in the SUN cohort study

  • Almudena Sánchez-VillegasEmail author
  • Aurora Pérez-Cornago
  • Itziar Zazpe
  • Susana Santiago
  • Francisca Lahortiga
  • Miguel Angel Martínez-González
Original Contribution



The aim of the study was to prospectively assess the association between micronutrient intake adequacy and risk of depression.


This dynamic cohort study involves Spanish university graduates (SUN Project). Dietary intake was assessed at baseline and after 10 years of follow-up with a semi-quantitative food frequency questionnaire. Micronutrient intake adequacy for vitamins B1, B2, B3, B6, B12, C, A, D, E, folic acid, zinc, iodine, selenium, iron, calcium, potassium, phosphorus, magnesium and chrome was estimated. Inadequate intake for each nutrient was defined when the intake of the nutrient was below the estimated average requirements (EAR) if available or the adequate intake levels, if EARs were not available. We compared participants with inadequate intake for ≥4 nutrients vs. those with one nutrient. Participants were classified as having incident depression if they had no previous history of depression or antidepressants use at baseline, but they reported during follow-up a new clinical diagnosis of depression by a physician, use of antidepressant drugs, or both. Time-dependent multivariable Cox regression models were fitted.


After a median follow-up of 8.5 years, 953 new cases of depression were observed among 13,983 participants. Participants with inadequate intake for ≥4 nutrients showed a significantly higher risk of depression [multivariable hazard ratio (HR) = 1.37; 95% confidence interval (CI) 1.01–1.85]. When the analyses were updated with repeated assessments of intakes, the association was attenuated and it was no longer statistically significant (Multivariable HR = 1.11; 95% CI 0.82–1.51).


Micronutrient inadequacy in four or more micronutrients could exert a moderate role in the development of depression.


Cohort Depression Micronutrients Nutritional adequacy 



The SUN Project has received funding from the Spanish Government-Instituto de Salud Carlos III, and the European Regional Development Fund (FEDER) (RD 06/0045, CIBER-OBN, Grants PI10/02658, PI10/02293, PI13/00615, PI14/01668, PI14/01798, PI14/01764, and G03/140), the Navarra Regional Government (45/2011, 122/2014), and the University of Navarra. We are indebted to the participants of the SUN Project for their continued cooperation and participation. We thank the other members of the SUN Group: Alonso A, Barrio López MT, Basterra-Gortari FJ, Benito Corchón S, Bes-Rastrollo M, Beunza JJ, Carlos Chillerón S, Carmona L, Cervantes S, de Irala Estévez J, de la Fuente Arrillaga C, de la Rosa PA, Delgado Rodríguez M, Donat Vargas CL, Donázar M, Fernández Montero A, Galbete Ciáurriz C, García López M, Gea Sánchez A, Goñi Ochandorena E, Guillén Grima F, Hernández A, Llorca J, López del Burgo C, Marí Sanchís A, Martí del Moral A, Martín Calvo N, Martínez JA, Molero P, Núñez-Córdoba JM, Pimenta AM, Ruiz-Canela M, Ruiz Zambrana A, Sánchez Adán D, Sayón Orea C, Toledo Atucha E, Toledo Atucha J, Vázquez Ruiz Z.

Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Supplementary material

394_2017_1514_MOESM1_ESM.docx (30 kb)
Supplementary material 1 (DOCX 30 kb)


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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Almudena Sánchez-Villegas
    • 1
    • 2
    Email author
  • Aurora Pérez-Cornago
    • 3
  • Itziar Zazpe
    • 2
    • 4
  • Susana Santiago
    • 4
  • Francisca Lahortiga
    • 5
  • Miguel Angel Martínez-González
    • 2
    • 6
    • 7
  1. 1.Nutrition Research Group, Research Institute of Biomedical and Health SciencesUniversity of Las Palmas de Gran CanariaLas Palmas de Gran CanariaSpain
  2. 2.Ciber de Fisiopatología de la Obesidad y Nutrición (CIBER OBN), Instituto de Salud Carlos IIIMadridSpain
  3. 3.Cancer Epidemiology Unit, Nuffield Department of Population HealthUniversity of OxfordOxfordUK
  4. 4.Department of Nutrition and Food Sciences and PhysiologyUniversity of Navarra-IDISNAPamplonaSpain
  5. 5.Department of Psychiatry and Medical PsychologyUniversity Clinic of NavarraPamplonaSpain
  6. 6.Department of Preventive Medicine and Public HealthUniversity of Navarra-IDISNANavarraSpain
  7. 7.Department of NutritionHarvard TH Chan School of Public HealthBostonUSA

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