title: Dietary patterns are associated with the prevalence of elevated depressive symptoms and the risk of getting a hospital discharge diagnosis of depression in middle-aged or older Finnish men.
abstract: BACKGROUND
  Previous studies assessing the role of dietary factors in depression have mainly focused on nutrients, while the association between dietary patterns and depression is less studied.
  
  
  OBJECTIVE
  The aim was to assess the role of dietary patterns in depression in both cross-sectional and prospective analyses.
  
  
  METHODS
  The study population consisted of 1003 Finnish middle-aged or older men from the Kuopio Ischemic Heart Disease Risk Factor Study. Food consumption was assessed by food frequency questionnaire in 1991-1993 and dietary patterns from 25 predefined food groups were extracted by factor analysis. Depressive symptoms were assessed with the self-administered Human Population Laboratory Depression Scale, cut-off point of five or more indicating elevated depressive symptoms.
  
  
  RESULTS
  Altogether 72 (7.2%) subjects had elevated depressive symptoms. Three dietary patterns were identified: "prudent", "Western" and "mixed". In cross-sectional analysis, after adjustments for age, examination year, BMI, smoking, alcohol consumption, education, marital status, leisure-time physical activity, history of mental illness and cardiovascular disease the prudent dietary pattern was associated with a 25% lower prevalence of elevated depressive symptoms (OR: 0.75; 95% CI: 0.57, 0.99; P=0.036), whereas the Western dietary pattern was associated with increased prevalence of elevated depressive symptoms (OR: 1.41; 95% CI: 1.08, 1.84; P=0.011). In the prospective analysis (16.5 follow-up years), the prudent dietary pattern was inversely associated with the risk of getting a hospital discharge diagnosis of depression (HR: 0.66; 95% CI 0.47, 0.93; P=0.018).
  
  
  CONCLUSIONS
  Adherence to healthy dietary pattern is associated with lower risk of getting a hospital discharge diagnosis of depression.
authors.affiliation: University of Eastern Finland, Kuopio Campus, Institute of Public Health and Clinical Nutrition, P.O. Box 1627, FI-70211 Kuopio, Finland; Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland. Electronic address: anu.ruusunen@uef.fi.
authors.forename: Anu
authors.initials: A
authors.lastname: Ruusunen
authors.affiliation: Department of Psychiatry, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
authors.forename: Soili M
authors.initials: SM
authors.lastname: Lehto
authors.affiliation: University of Eastern Finland, Kuopio Campus, Institute of Public Health and Clinical Nutrition, P.O. Box 1627, FI-70211 Kuopio, Finland.
authors.forename: Jaakko
authors.initials: J
authors.lastname: Mursu
authors.affiliation: Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland; Department of Psychiatry, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
authors.forename: Tommi
authors.initials: T
authors.lastname: Tolmunen
authors.affiliation: University of Eastern Finland, Kuopio Campus, Institute of Public Health and Clinical Nutrition, P.O. Box 1627, FI-70211 Kuopio, Finland.
authors.forename: Tomi-Pekka
authors.initials: TP
authors.lastname: Tuomainen
authors.affiliation: University of Eastern Finland, Kuopio Campus, Institute of Public Health and Clinical Nutrition, P.O. Box 1627, FI-70211 Kuopio, Finland.
authors.forename: Jussi
authors.initials: J
authors.lastname: Kauhanen
authors.affiliation: University of Eastern Finland, Kuopio Campus, Institute of Public Health and Clinical Nutrition, P.O. Box 1627, FI-70211 Kuopio, Finland.
authors.forename: Sari
authors.initials: S
authors.lastname: Voutilainen
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D004032:Diet / Q000523:psychology* / Q000706:statistics & numerical data; D005163:Factor Analysis, Statistical; D005247:Feeding Behavior / Q000523:psychology*; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors
keywords: Depression; Depressive symptoms; Diet; Dietary pattern; Factor analysis