Association between Dietary Patterns and Depressive Symptoms Over Time: A 10-Year Follow-Up Study of the GAZEL Cohort

Abstract

BackgroundData on the association between dietary patterns and depression are scarce. The objective of this study was to examine the longitudinal association between dietary patterns and depressive symptoms assessed repeatedly over 10 years in the French occupational GAZEL cohort.MethodsA total of 9,272 men and 3,132 women, aged 45–60 years in 1998, completed a 35-item Food Frequency Questionnaire (FFQ) at baseline. Dietary patterns were derived by Principal Component Analysis. Depressive symptoms were assessed by the Center for Epidemiologic Studies Depression scale (CES-D) in 1999, 2002, 2005 and 2008. The main outcome measure was the repeated measures of CES-D. Longitudinal analyses were performed with logistic regression based on generalized estimating equations.Principal FindingsThe highest quartile of low-fat, western, high snack and high fat-sweet diets in men and low-fat and high snack diets in women were associated with higher likelihood of depressive symptoms at the start of the follow-up compared to the lowest quartile (OR between 1.16 and 1.50). Conversely, the highest quartile of traditional diet (characterized by fish and fruit consumption) was associated with a lower likelihood of depressive symptoms in women compared to the lowest quartile, with OR = 0.63 [95%CI, 0.50 to 0.80], as the healthy pattern (characterized by vegetables consumption) with OR = 0.72 [95%CI, 0.63 to 0.83] and OR = 0.75 [95%CI, 0.61 to 0.93] in men and women, respectively. However, there was probably a reverse causality effect for the healthy pattern.ConclusionThis longitudinal study shows that several dietary patterns are associated with depressive symptoms and these associations track over time.

The role of emotional states in fruit and vegetable consumption in Brazilian adults

“…In the same light, a cohort study of 3,486 participants showed that people with dietary patterns based on FV and fish had lower rates of depression symptoms 7 . Another cohort study of 9,272 men and 3,132 women, aged between 45 and 60 years old, showed that a higher FV intake was associated with a lower likelihood of depressive symptoms 14 . Other large cross-sectional studies of elderly subjects in China 17 and college students 15 demonstrated that lower FV consumption was associated with the presence of stress and depressive symptoms.…”

“…This suggests that men and women might react differently to stressful situations and emotional demands and those psychological symptoms tend to more directly influence women's eating habits. It has been suggested that women might be more likely to eat in response to stressful situations 14,29,30 , at which times they would increase the total amount of consumed food 31 or, in particular, the consumption of carbohydrates and fats 32 . However, women tend to consume more fruits when they are not under stress 32,33 .…”

“…Because exposure and outcome were measured at the same time point, reverse causality may be present. Thus, it could be reasoned that, because emotions can affect the quality and quantity of consumed food, consumption could also affect emotional wellbeing 7,14,43 . Thus, longitudinal studies are needed to elucidate the causal relationships.…”

“…Aspects such as anger, sadness, daily stressors and other stressful situations may affect the whole process of intake (e.g., motivation to eat, food choices, chewing, time spent eating, amount of food intake), as well as metabolism and digestion 13 . Several studies have reported the association between adequate consumption of FV and favourable mental states 7,8,[14][15][16][17] . Absence of association has also been reported 18 .…”

Food patterns and the prevention of depression

“…Principal component analysis (Factor Analysis approach) has also been developed in several cohort studies to identify post-hoc (empirically derived) food patterns (38)(39)(40)(41)(42)(43)(44) . Results obtained for MeDiet are consistent with those reported using a priori-defined food pattern (38) .…”