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

  • Nicolaou, Mary1
  • Colpo, Marco2
  • Vermeulen, Esther1
  • Elstgeest, Liset E M3
  • Cabout, Mieke3
  • Gibson-Smith, Deborah4
  • Knuppel, Anika5
  • Sini, Giovana2
  • Schoenaker, Danielle A J M6, 7
  • Mishra, Gita D6
  • Lok, Anja8
  • Penninx, Brenda W J H4
  • Bandinelli, Stefania2
  • Brunner, Eric J5
  • Zwinderman, Aiko H9
  • Brouwer, Ingeborg A3
  • Visser, Marjolein3
  • 1 Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Meibergdreef 9, Amsterdam, the Netherlands. , (Netherlands)
  • 2 Azienda USL Toscana Centro, InCHIANTI Study Group, Florence, Italy. , (Italy)
  • 3 Department of Health Sciences, Faculty of Science, Vrije Universiteit, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands. , (Netherlands)
  • 4 Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, de Boelelaan 1117, Amsterdam, the Netherlands. , (Netherlands)
  • 5 Research Department of Epidemiology and Public Health, University College London, UK.
  • 6 School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia. , (Australia)
  • 7 Centre for Behavioral Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia. , (Australia)
  • 8 Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Meibergdreef 9, Amsterdam, the Netherlands. , (Netherlands)
  • 9 Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands. , (Netherlands)
Published Article
Psychological Medicine
Cambridge University Press
Publication Date
Aug 01, 2020
DOI: 10.1017/S0033291719001958
PMID: 31409435


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

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