Public Health Nutrition (Mar 2023)
Dietary diversity and depression: cross-sectional and longitudinal analyses in Spanish adult population with metabolic syndrome. Findings from PREDIMED-Plus trial
- Naomi Cano-Ibáñez,
- Lluis Serra-Majem,
- Sandra Martín-Peláez,
- Miguel Ángel Martínez-González,
- Jordi Salas-Salvadó,
- Dolores Corella,
- Camille Lassale,
- Jose Alfredo Martínez,
- Ángel M Alonso-Gómez,
- Julia Wärnberg,
- Jesús Vioque,
- Dora Romaguera,
- José López-Miranda,
- Ramon Estruch,
- Ana María Gómez-Pérez,
- José Lapetra,
- Fernando Fernández-Aranda,
- Aurora Bueno-Cavanillas,
- Josep A Tur,
- Naiara Cubelos,
- Xavier Pintó,
- José Juan Gaforio,
- Pilar Matía-Martín,
- Josep Vidal,
- Cristina Calderón,
- Lidia Daimiel,
- Emilio Ros,
- Alfredo Gea,
- Nancy Babio,
- Ignacio Manuel Gimenez-Alba,
- María Dolores Zomeño-Fajardo,
- Itziar Abete,
- Lucas Tojal Sierra,
- Rita P Romero-Galisteo,
- Manoli García de la Hera,
- Marian Martín-Padillo,
- Antonio García-Ríos,
- Rosa M Casas,
- JC Fernández-García,
- José Manuel Santos-Lozano,
- Estefanía Toledo,
- Nerea Becerra-Tomas,
- Jose V Sorli,
- Helmut Schröder,
- María A Zulet,
- Carolina Sorto-Sánchez,
- Javier Diez-Espino,
- Carlos Gómez-Martínez,
- Montse Fitó,
- Almudena Sánchez-Villegas
Affiliations
- Naomi Cano-Ibáñez
- ORCiD
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Avda. De la Investigación, 11, Granada, 18016, Spain Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
- Lluis Serra-Majem
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
- Sandra Martín-Peláez
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Avda. De la Investigación, 11, Granada, 18016, Spain Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
- Miguel Ángel Martínez-González
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Department of Preventive Medicine and Public Health, IDISNA, University of Navarre, Pamplona, Spain Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Jordi Salas-Salvadó
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain University Hospital of Sant Joan de Reus, Nutrition Unit, Reus, Spain Institut d’Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
- Dolores Corella
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Department of Preventive Medicine, University of Valencia, Valencia, Spain
- Camille Lassale
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Unit of Cardiovascular Risk and Nutrition, Institut Hospital del mar de Investigaciones Médicas Municipal d’Investigació Médica (IMIM), Barcelona, Spain
- Jose Alfredo Martínez
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Department of Nutrition, Food Sciences and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain Cardiometabolic Nutrition Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
- Ángel M Alonso-Gómez
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Bioaraba Health Research Institute, Cardiovascular, Respiratory and Metabolic Area; Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
- Julia Wärnberg
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Department of Nursing, School of Health Sciences, University of Malaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
- Jesús Vioque
- ORCiD
- Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain Nutritional Epidemiology Unit, Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernández (ISABIAL-UMH), Alicante, Spain
- Dora Romaguera
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
- José López-Miranda
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain
- Ramon Estruch
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Department of Internal Medicine, Institut dÌnvestigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
- Ana María Gómez-Pérez
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Virgen de la Victoria Hospital, Department of Endocrinology, Instituto de Investigación Biomédica de Málga (IBIMA), University of Málaga, Málaga, Spain
- José Lapetra
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
- Fernando Fernández-Aranda
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
- Aurora Bueno-Cavanillas
- ORCiD
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Avda. De la Investigación, 11, Granada, 18016, Spain Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
- Josep A Tur
- ORCiD
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain
- Naiara Cubelos
- José Aguado Health Centre, Institute of Biomedicine (IBIOMED), University of León, León, Spain
- Xavier Pintó
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
- José Juan Gaforio
- Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain Center for Advanced Studies in Olive Grove and Olive Oils, University of Jaén, Jaén, Spain
- Pilar Matía-Martín
- Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Josep Vidal
- CIBER Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Department of Endocrinology, Institut dÌnvestigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
- Cristina Calderón
- Department of Endocrinology and Nutrition, Hospital Fundación Jiménez-Díaz, Instituto de Investigaciones Biomédicas IISFJD, University Autónoma, Madrid, Spain
- Lidia Daimiel
- Nutritional Control of the Epigenome Group, Precision Nutrition and Obesity Program, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
- Emilio Ros
- ORCiD
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Department of Endocrinology, Institut dÌnvestigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
- Alfredo Gea
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Department of Preventive Medicine and Public Health, IDISNA, University of Navarre, Pamplona, Spain
- Nancy Babio
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain University Hospital of Sant Joan de Reus, Nutrition Unit, Reus, Spain Institut d’Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
- Ignacio Manuel Gimenez-Alba
- ORCiD
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Department of Preventive Medicine, University of Valencia, Valencia, Spain
- María Dolores Zomeño-Fajardo
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Unit of Cardiovascular Risk and Nutrition, Institut Hospital del mar de Investigaciones Médicas Municipal d’Investigació Médica (IMIM), Barcelona, Spain
- Itziar Abete
- Department of Preventive Medicine and Public Health, IDISNA, University of Navarre, Pamplona, Spain Department of Nutrition, Food Sciences and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain
- Lucas Tojal Sierra
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Bioaraba Health Research Institute, Cardiovascular, Respiratory and Metabolic Area; Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
- Rita P Romero-Galisteo
- Department of Nursing, School of Health Sciences, University of Malaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
- Manoli García de la Hera
- ORCiD
- Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain Nutritional Epidemiology Unit, Miguel Hernández University, ISABIAL-FISABIO, Alicante, Spain
- Marian Martín-Padillo
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
- Antonio García-Ríos
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain
- Rosa M Casas
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Department of Internal Medicine, Institut dÌnvestigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
- JC Fernández-García
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Virgen de la Victoria Hospital, Department of Endocrinology, Instituto de Investigación Biomédica de Málga (IBIMA), University of Málaga, Málaga, Spain
- José Manuel Santos-Lozano
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
- Estefanía Toledo
- ORCiD
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Department of Preventive Medicine and Public Health, IDISNA, University of Navarre, Pamplona, Spain
- Nerea Becerra-Tomas
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain Institut d’Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
- Jose V Sorli
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Department of Preventive Medicine, University of Valencia, Valencia, Spain
- Helmut Schröder
- Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain Unit of Cardiovascular Risk and Nutrition, Institut Hospital del mar de Investigaciones Médicas Municipal d’Investigació Médica (IMIM), Barcelona, Spain
- María A Zulet
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Department of Preventive Medicine and Public Health, IDISNA, University of Navarre, Pamplona, Spain Department of Nutrition, Food Sciences and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain
- Carolina Sorto-Sánchez
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Bioaraba Health Research Institute, Cardiovascular, Respiratory and Metabolic Area; Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
- Javier Diez-Espino
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Department of Preventive Medicine and Public Health, IDISNA, University of Navarre, Pamplona, Spain Servicio Navarro de Salud-Osasunbidea-Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, Spain
- Carlos Gómez-Martínez
- ORCiD
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain Institut d’Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
- Montse Fitó
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Unit of Cardiovascular Risk and Nutrition, Institut Hospital del mar de Investigaciones Médicas Municipal d’Investigació Médica (IMIM), Barcelona, Spain
- Almudena Sánchez-Villegas
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
- DOI
- https://doi.org/10.1017/S1368980022001525
- Journal volume & issue
-
Vol. 26
pp. 598 – 610
Abstract
Abstract Objective: To examine the cross-sectional and longitudinal (2-year follow-up) associations between dietary diversity (DD) and depressive symptoms. Design: An energy-adjusted dietary diversity score (DDS) was assessed using a validated FFQ and was categorised into quartiles (Q). The variety in each food group was classified into four categories of diversity (C). Depressive symptoms were assessed with Beck Depression Inventory-II (Beck II) questionnaire and depression cases defined as physician-diagnosed or Beck II >= 18. Linear and logistic regression models were used. Setting: Spanish older adults with metabolic syndrome (MetS). Participants: A total of 6625 adults aged 55–75 years from the PREDIMED-Plus study with overweight or obesity and MetS. Results: Total DDS was inversely and statistically significantly associated with depression in the cross-sectional analysis conducted; OR Q4 v. Q1 = 0·76 (95 % CI (0·64, 0·90)). This was driven by high diversity compared to low diversity (C3 v. C1) of vegetables (OR = 0·75, 95 % CI (0·57, 0·93)), cereals (OR = 0·72 (95 % CI (0·56, 0·94)) and proteins (OR = 0·27, 95 % CI (0·11, 0·62)). In the longitudinal analysis, there was no significant association between the baseline DDS and changes in depressive symptoms after 2 years of follow-up, except for DD in vegetables C4 v. C1 = (β = 0·70, 95 % CI (0·05, 1·35)). Conclusions: According to our results, DD is inversely associated with depressive symptoms, but eating more diverse does not seem to reduce the risk of future depression. Additional longitudinal studies (with longer follow-up) are needed to confirm these findings.
Keywords
