Skip to main content
SpringerLink
Log in

Nut Consumption and Depression: Cross-Sectional and Longitudinal Analyses in Two Cohorts of Older Adults

  • Original Research
  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

To assess the cross-sectional and longitudinal associations between nut consumption and depression in two cohorts of older adults.

Design, Setting, Participants and Measurements

The first cohort (Seniors-ENRICA-I or SE-I) included a representative sample of Spanish noninstitutionalized adults aged ≥65 years interviewed in 2010 and 2013. The second cohort (SE-II) included individuals from the Madrid region, Spain, aged ≥65 years interviewed in 2017 and in 2019. Nut consumption was estimated with a validated computer-based diet history. Depression was defined as self-reported physician-diagnosed depression or the use of antidepressants. Logistic regression models were adjusted for the main confounders. The DerSimonian and Laird random-effect method was used to meta-analyze the results from both studies. A participant-level pooled analysis was conducted to examine the robustness of our analyses.

Results

The SE-I included 2278 individuals (233 prevalent cases) in the cross-sectional analysis and 1534 (108 incident cases) in the longitudinal analysis; the corresponding figures for SE-II were 2726 (407 prevalent cases) and 1566 (74 incident cases). In the meta-analysis of cross-sectional results from the two studies, compared to consuming <1 serving (30 g) of nuts/week, the odds ratio (95% confidence interval) for depression was 0.90 (0.64, 1.16) for consuming 1 to <3 servings/week and 0.92 (0.70, 1.13) for consuming ≥3 servings/week; the corresponding figures for the longitudinal results were 0.90 (0.41, 1.38) and 0.66 (0.35, 0.97).

Conclusion

Nut consumption was associated with a lower risk of depression in a pooled longitudinal analysis using data from two cohorts of older adults. Nuts should be recommended as part of a healthy diet in older adults.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1
Figure 2

Data availability: Data described in the manuscript, code book, and analytic code will be made available upon request pending application and approval.

References

  1. Mental GBD, Collaborators D. Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet Psychiatry. 2022;9(2):137–150. doi:https://doi.org/10.1016/S2215-0366(21)00395-3

    Article  Google Scholar 

  2. Daly M, Sutin A, Robinson E. Longitudinal changes in mental health and the COVID-19 pandemic: Evidence from the UK Household Longitudinal Study. Psychol Med. 2020;(01). doi:https://doi.org/10.1017/S0033291720004432

  3. Rodríguez-Gómez I, Sánchez-Martín C, García-García F, et al. The medium-term consequences of COVID-19 lockdown on lifestyle among Spanish older people with hypertension, pulmonary, cardiovascular, and musculoskeletal-diseases, depression, and cancer. Epidemiol Heal. 2022;Feb 21:e20. doi:https://doi.org/10.4178/epih.e2022026

  4. Institute of Health Metrics and Evaluation. Global Health Data Exchange (GHDx). Published 2019. Accessed March 28, 2019. http://ghdx.healthdata.org/gbd-results-tool?params=gbd-api-2019-permalink/d780dffbe8a381b25e1416884959e88b

  5. Zenebe Y, Akele B, W/Selassie M, Necho M. Prevalence and determinants of depression among old age: a systematic review and meta-analysis. Ann Gen Psychiatry. 2021;20(1):1–19. doi:https://doi.org/10.1186/s12991-021-00375-x

    Article  Google Scholar 

  6. Patel V, Chisholm D, Parikh R, et al. Addressing the burden of mental, neurological, and substance use disorders: Key messages from Disease Control Priorities, 3rd edition. Lancet. 2016;387(10028):1672–1685. doi:https://doi.org/10.1016/S0140-6736(15)00390-6

    Article  PubMed  Google Scholar 

  7. Sarris J, Logan AC, Akbaraly TN, et al. International Society for Nutritional Psychiatry Research consensus position statement: Nutritional medicine in modern psychiatry. World Psychiatry. 2015;14(3):370–371. doi:https://doi.org/10.1002/wps.20223

    Article  PubMed  PubMed Central  Google Scholar 

  8. Estruch R, Ros E, Salas-Salvadó J, et al. Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra-Virgin Olive Oil or Nuts. N Engl J Med. 2018;378(25):e34. doi:https://doi.org/10.1056/NEJMoa1800389

    Article  CAS  PubMed  Google Scholar 

  9. Nishi SK, Babio N, Gómez-Martínez C, et al. Mediterranean, DASH, and MIND Dietary Patterns and Cognitive Function: The 2-Year Longitudinal Changes in an Older Spanish Cohort. Front Aging Neurosci. 2021;13(December). doi:https://doi.org/10.3389/fnagi.2021.782067

  10. Van Den Brink AC, Brouwer-Brolsma EM, Berendsen AAM, Van De Rest O. The Mediterranean, Dietary Approaches to Stop Hypertension (DASH), and Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) Diets Are Associated with Less Cognitive Decline and a Lower Risk of Alzheimer’s Disease-A Review. Adv Nutr. 2019;10(6):1040–1065. doi:https://doi.org/10.1093/advances/nmz054

    Article  PubMed  PubMed Central  Google Scholar 

  11. Shafiei F, Salari-Moghaddam A, Larijani B, Esmaillzadeh A. Adherence to the mediterranean diet and risk of depression: A systematic review and updated metaanalysis of observational studies. Nutr Rev. 2019;77(4):230–239. doi:https://doi.org/10.1093/nutrit/nuy070

    Article  PubMed  Google Scholar 

  12. Ros E, Singh A, O’keefe JH. Nuts: Natural pleiotropic nutraceuticals. Nutrients. 2021;13(9):1–28. doi:https://doi.org/10.3390/nu13093269

    Article  Google Scholar 

  13. Theodore LE, Kellow NJ, Mcneil EA, Close EO, Coad EG, Cardoso BR. Nut Consumption for Cognitive Performance: A Systematic Review. Adv Nutr. 2021;12(3):777–792. doi:https://doi.org/10.1093/advances/nmaa153

    Article  PubMed  Google Scholar 

  14. Fernández-Rodríguez R, Jiménez-López E, Garrido-Miguel M, Martínez-Ortega IA, Martínez-Vizcaíno V, Mesas AE. Does the evidence support a relationship between higher levels of nut consumption, lower risk of depression, and better mood state in the general population? A systematic review. Nutr Rev. Published online April 7, 2022:nuac022. doi:https://doi.org/10.1093/nutrit/nuac022

  15. Ren M, Zhang H, Qi J, et al. An almond-based low carbohydrate diet improves depression and glycometabolism in patients with type 2 diabetes through modulating gut microbiota and glp-1: A randomized controlled trial. Nutrients. 2020;12(10):1–21. doi:https://doi.org/10.3390/nu12103036

    Article  Google Scholar 

  16. Rodríguez-Artalejo F, Graciani A, Guallar-Castillón P, et al. [Rationale and methods of the study on nutrition and cardiovascular risk in Spain (ENRICA)]. Rev Esp Cardiol. 2011;64(10):876–882. doi:https://doi.org/10.1016/j.recesp.2011.05.019

    Article  PubMed  Google Scholar 

  17. Ortolá R, García-Esquinas E, Sotos-Prieto M, et al. Mediterranean Diet and Changes in Frequency, Severity, and Localization of Pain in Older Adults: The Seniors-ENRICA Cohorts. J Gerontol A Biol Sci Med Sci. 2022;77(1):122–130. doi:https://doi.org/10.1093/gerona/glab109

    Article  PubMed  Google Scholar 

  18. Guallar-Castillón P, Sagardui-Villamor J, Balboa-Castillo T, et al. Validity and reproducibility of a Spanish dietary history. PLoS One. 2014;9(1):1–11. doi:https://doi.org/10.1371/journal.pone.0086074

    Article  Google Scholar 

  19. Cabanas-Sánchez V, Esteban-Cornejo I, Migueles JH, et al. Twenty four-hour activity cycle in older adults using wrist-worn accelerometers: The seniors-ENRICA-2 study. Scand J Med Sci Sport. 2020;30(4):700–708. doi:https://doi.org/10.1111/sms.13612

    Article  Google Scholar 

  20. Pols MA, Peeters P, Ocke M, Slimani N, Bueno-de-Mesquita HB, Collette HJA. Estimation of reproducibility and relative validity of the questions included in the EPIC Physical Activity Questionnaire. Int J Epidemiol. 1997;26 Suppl 1:S181—9. doi:https://doi.org/10.1093/ije/26.suppl_1.S181

  21. Schröder H, Fitó M, Estruch R, et al. A short screener is valid for assessing Mediterranean diet adherence among older Spanish men and women. J Nutr. 2011;141(6):1140–1145. doi:https://doi.org/10.3945/jn.110.135566

    Article  PubMed  Google Scholar 

  22. Fresán U, Bes-Rastrollo M, Segovia-Siapco G, et al. Does the MIND diet decrease depression risk? A comparison with Mediterranean diet in the SUN cohort. Eur J Nutr. 2019;58(3):1271–1282. doi:https://doi.org/10.1007/s00394-018-1653-x

    Article  PubMed  Google Scholar 

  23. Su Q, Yu B, He H, et al. Nut Consumption Is Associated With Depressive Symptoms Among Chinese Adults. Depress Anxiety. 2016;33(11):1065–1072. doi:https://doi.org/10.1002/da.22516

    Article  PubMed  Google Scholar 

  24. Arab L, Guo R, Elashoff D. Lower Depression Scores among Walnut Consumers in NHANES. Nutrients. 2019;11(2). doi:https://doi.org/10.3390/nu11020275

    Google Scholar 

  25. DerSimonian R, Kacker R. Random-effects model for meta-analysis of clinical trials: an update. Contemp Clin Trials. 2007;28(2):105–114. doi:https://doi.org/10.1016/j.cct.2006.04.004

    Article  PubMed  Google Scholar 

  26. Rusu ME, Mocan A, Ferreira ICFR, Popa DS. Health benefits of nut consumption in middle-aged and elderly population. Antioxidants. 2019;8(8):1–37. doi:https://doi.org/10.3390/antiox8080302

    Article  Google Scholar 

  27. Tan SY, Tey SL, Brown R. Can nuts mitigate malnutrition in older adults? A conceptual framework. Nutrients. 2018;10(10):1–15. doi:https://doi.org/10.3390/nu10101448

    Article  Google Scholar 

  28. Tan SY, Tey SL, Brown R. Nuts and older adults’ health: A narrative review. Int J Environ Res Public Health. 2021;18(4):1–26. doi:https://doi.org/10.3390/ijerph18041848

    Article  Google Scholar 

  29. Arias-Fernández L, Machado-Fragua MD, Graciani A, et al. Prospective Association Between Nut Consumption and Physical Function in Older Men and Women. J Gerontol A Biol Sci Med Sci. 2019;74(7):1091–1097. doi:https://doi.org/10.1093/gerona/gly171

    Article  PubMed  Google Scholar 

  30. Bishop NJ, Zuniga KE. Investigating walnut consumption and cognitive trajectories in a representative sample of older US adults. Public Health Nutr. 2021;24(7):1741–1752. doi:https://doi.org/10.1017/S1368980020001287

    Article  PubMed  Google Scholar 

  31. Rakic JM, Tanprasertsuk J, Scott TM, et al. Effects of daily almond consumption for six months on cognitive measures in healthy middle-aged to older adults: a randomized control trial. Nutr Neurosci. Published online 2021. doi:https://doi.org/10.1080/1028415X.2020.1868805

  32. Tan SY, Georgousopoulou EN, Cardoso BR, Daly RM, George ES. Associations between nut intake, cognitive function and non-alcoholic fatty liver disease (NAFLD) in older adults in the United States: NHANES 2011-14. BMC Geriatr. 2021;21(1):1–12. doi:https://doi.org/10.1186/s12877-021-02239-1

    Article  Google Scholar 

  33. Jia S, Hou Y, Wang D, Zhao X. Flavonoids for depression and anxiety: a systematic review and meta-analysis. Crit Rev Food Sci Nutr. Published online April 9, 2022:1-11. doi:https://doi.org/10.1080/10408398.2022.2057914

  34. Cofán M, Rajaram S, Sala-Vila A, et al. Effects of 2-Year Walnut-Supplemented Diet on Inflammatory Biomarkers. J Am Coll Cardiol. 2020;76(19):2282–2284. doi:https://doi.org/10.1016/j.jacc.2020.07.071

    Article  PubMed  Google Scholar 

  35. Bolling BW, Chen CYO, McKay DL, Blumberg JB. Tree nut phytochemicals: Composition, antioxidant capacity, bioactivity, impact factors. A systematic review of almonds, Brazils, cashews, hazelnuts, macadamias, pecans, pine nuts, pistachios and walnuts. Nutr Res Rev. 2011;24(2):244–275. doi:https://doi.org/10.1017/S095442241100014X

    Article  CAS  PubMed  Google Scholar 

  36. Maslowski KM, Vieira AT, Ng A, et al. Regulation of inflammatory responses by gut microbiota and chemoattractant receptor GPR43. Nature. 2009;461(7268):1282–1286. doi:https://doi.org/10.1038/nature08530

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Simpson CA, Diaz-Arteche C, Eliby D, Schwartz OS, Simmons JG, Cowan CSM. The gut microbiota in anxiety and depression–A systematic review. Clin Psychol Rev. 2021;83(July 2020):101943. doi:https://doi.org/10.1016/j.cpr.2020.101943

    Article  PubMed  Google Scholar 

  38. Swann OG, Kilpatrick M, Breslin M, Oddy WH. Dietary fiber and its associations with depression and inflammation. Nutr Rev. 2020;78(5):394–411. doi:https://doi.org/10.1093/nutrit/nuz072

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We thank all participants in the Seniors-ENRICA studies.

Funding

Funding: This work was supported by the Fondo de Investigación Sociosanitaria (FIS) grants 19/319 (State Secretary of R + D + I and FEDER/FSE), the REACT EU Program, Comunidad de Madrid and the European Regional Development Fund (ERDF) - European Union: FACINGLCOVID-CM project, and FEDER funds from the European Union (CB16/10/00477). A.E.M. is financially supported by a ‘Beatriz Galindo’ contract (BEAGAL18/00093) from the Spanish Ministry of Education, Culture and Sport. B. B.-P. is supported by a grant from the Universidad de Castilla-La Mancha co-financed by the European Social Fund (2020-PREDUCLM-16746). R.F.-R. is supported by a grant from the Spanish Ministry of Education, Culture and Sport (FPU 19/00167). The funders played no role in the study design, data collection or analysis, decision to publish, or preparation of the manuscript.

Author information

Authors and Affiliations

  1. Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain

    R. Fernández-Rodríguez, Vicente Martínez-Vizcaíno, B. Bizzozero-Peroni & A. E. Mesas

  2. Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain

    R. Ortolá, F. Rodríguez-Artalejo, E. García-Esquinas & E. López-García

  3. CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain

    R. Ortolá, F. Rodríguez-Artalejo, E. García-Esquinas & E. López-García

  4. Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile

    Vicente Martínez-Vizcaíno

  5. Instituto Superior de Educación Física, Universidad de la República, Rivera, Uruguay

    B. Bizzozero-Peroni

  6. IMDEA Food Institute. CEI UAM+CSIC, Madrid, Spain

    F. Rodríguez-Artalejo & E. López-García

  7. National Center for Epidemiology. Instituto de Salud Carlos III., Madrid, Spain

    E. García-Esquinas

  8. Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina, Paraná, Brazil

    A. E. Mesas

Authors
  1. R. Fernández-Rodríguez
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. R. Ortolá
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Vicente Martínez-Vizcaíno
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. B. Bizzozero-Peroni
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. F. Rodríguez-Artalejo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. E. García-Esquinas
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. E. López-García
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. A. E. Mesas
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Author contributions: Rubén Fernández-Rodríguez contributed to the conception and design, analysis and interpretation of data, and drafting and revision of the paper for important intellectual content. Rosario Ortolá contributed to acquisition of data and drafting and revision of the paper for important intellectual content. Vicente Martínez-Vizcaíno contributed to the conception and design and the drafting and revision of the paper for important intellectual content. Bruno Bizzozero-Peroni contributed to drafting and revision of the paper for important intellectual content. Fernando Rodríguez-Artalejo contributed to the conception and design, acquisition of data, and drafting and revision of the paper for important intellectual content. Esther García-Esquinas contributed to acquisition of data and drafting and revision of the paper for important intellectual content. Esther López-García contributed to acquisition of data and drafting and revision of the paper for important intellectual content. Arthur Eumann Mesas contributed to the conception and design, analysis and interpretation of data, and drafting and revision of the paper for important intellectual content. All authors approved the final approval of the manuscript.

Corresponding author

Correspondence to Vicente Martínez-Vizcaíno.

Ethics declarations

Statement of Ethics: Both the SE-I and SE-II studies were approved by the Clinical Research Ethics Committee of the La Paz University Hospital in Madrid, and participants provided informed written consent.

Additional information

Conflicts of interest: The authors declare no conflicts of interest.

Supplementary Material

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fernández-Rodríguez, R., Ortolá, R., Martínez-Vizcaíno, V. et al. Nut Consumption and Depression: Cross-Sectional and Longitudinal Analyses in Two Cohorts of Older Adults. J Nutr Health Aging 27, 448–456 (2023). https://doi.org/10.1007/s12603-023-1927-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12603-023-1927-8

Key words

Search

Navigation