Micronutrient intake adequacy and depression risk in the SUN cohort study
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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.
KeywordsCohort 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.
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