Michel Lucas1, Patricia Chocano-Bedoya2, Matthias B Schulze, Mathias B Shulze3, Fariba Mirzaei2, Éilis J O'Reilly4, Olivia I Okereke5, Frank B Hu6, Walter C Willett6, Alberto Ascherio6. 1. Department of Nutrition, Harvard School of Public Health, MA 02115, USA; Department of Social and Preventive Medicine, Laval University, Québec G1V 2M2, Canada. Electronic address: mlucas@hsph.harvard.edu. 2. Department of Nutrition, Harvard School of Public Health, MA 02115, USA. 3. Department of Molecular Epidemiology, German Institute of Human Nutrition, Nuthetal 14558, Germany. 4. Department of Nutrition, Harvard School of Public Health, MA 02115, USA; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, MA 02115, USA. 5. Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, MA 02115, USA; Department of Epidemiology, Harvard School of Public Health, MA 02115, USA; Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School, MA 02115, USA. 6. Department of Nutrition, Harvard School of Public Health, MA 02115, USA; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, MA 02115, USA; Department of Epidemiology, Harvard School of Public Health, MA 02115, USA.
Abstract
BACKGROUND: Inflammation is considered as a mechanism leading to depression, but the association between inflammatory dietary pattern and depression risk is unknown. METHODS: Using reduced-rank regression, we identified a dietary pattern that was related to plasma levels of inflammatory markers (C-reactive protein, interleukin-6, tumor necrosis factor α receptor 2), and we conducted a prospective analysis of the relationship of this pattern and depression risk among participants in the Nurses' Health Study. A total of 43,685 women (aged 50-77) without depression at baseline (1996) were included and followed up until 2008. Diet information was obtained from food frequency questionnaires completed between 1984 through 2002 and computed as cumulative average of dietary intakes with a 2-year latency applied. We used a strict definition of depression that required both self-reported physician-diagnosed depression and use of antidepressants, and a broader definition that included women who reported either clinical diagnosis or antidepressant use. RESULTS: During the 12-year follow-up, we documented 2594 incident cases of depression using the stricter definition and 6446 using the broader definition. After adjustment for body mass index and other potential confounders, relative risks comparing extreme quintiles of the inflammatory dietary pattern were 1.41 (95% confidence interval [CI], 1.22, 1.63; P-trend<.001) for the strict definition and 1.29 (95% CI, 1.18, 1.41; P-trend<.001) for the broader definition of depression. CONCLUSIONS: The inflammatory dietary pattern is associated with a higher depression risk. This finding suggests that chronic inflammation may underlie the association between diet and depression.
BACKGROUND:Inflammation is considered as a mechanism leading to depression, but the association between inflammatory dietary pattern and depression risk is unknown. METHODS: Using reduced-rank regression, we identified a dietary pattern that was related to plasma levels of inflammatory markers (C-reactive protein, interleukin-6, tumor necrosis factor α receptor 2), and we conducted a prospective analysis of the relationship of this pattern and depression risk among participants in the Nurses' Health Study. A total of 43,685 women (aged 50-77) without depression at baseline (1996) were included and followed up until 2008. Diet information was obtained from food frequency questionnaires completed between 1984 through 2002 and computed as cumulative average of dietary intakes with a 2-year latency applied. We used a strict definition of depression that required both self-reported physician-diagnosed depression and use of antidepressants, and a broader definition that included women who reported either clinical diagnosis or antidepressant use. RESULTS: During the 12-year follow-up, we documented 2594 incident cases of depression using the stricter definition and 6446 using the broader definition. After adjustment for body mass index and other potential confounders, relative risks comparing extreme quintiles of the inflammatory dietary pattern were 1.41 (95% confidence interval [CI], 1.22, 1.63; P-trend<.001) for the strict definition and 1.29 (95% CI, 1.18, 1.41; P-trend<.001) for the broader definition of depression. CONCLUSIONS: The inflammatory dietary pattern is associated with a higher depression risk. This finding suggests that chronic inflammation may underlie the association between diet and depression.
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