title: A prospective cohort study to examine the association between dietary patterns and depressive symptoms in older Chinese people in Hong Kong.
abstract: BACKGROUND
  Dietary patterns are culturally specific and there is limited data on the association of dietary patterns with late-life depression in Chinese. This study examined the associations between dietary patterns and baseline and subsequent depressive symptoms in community-dwelling Chinese older people in Hong Kong.
  
  
  METHODS
  Participants aged ≥65 year participating in a cohort study examining the risk factors for osteoporosis completed a validated food frequency questionnaire at baseline between 2001 and 2003. Factor analysis was used to identify three dietary patterns: "vegetables-fruits" pattern, "snacks-drinks-milk products" pattern, and "meat-fish" pattern. Depressive symptoms were measured at baseline and 4-year using the validated Geriatric Depression Scale. Multiple logistic regression was used for cross-sectional analysis (n = 2,902) to assess the associations between dietary patterns and the presence of depressive symptoms, and for longitudinal analysis (n = 2,211) on their associations with 4-year depressive symptoms, with adjustment for socio-demographic and lifestyle factors.
  
  
  RESULTS
  The highest quartile of "vegetables-fruits" pattern score was associated with reduced likelihood of depressive symptoms [Adjusted OR = 0.55 (95% CI: 0.36-0.83), ptrend = 0.017] compared to the lowest quartile at baseline. Similar inverse trend was observed for the highest quartile of "snacks-drinks-milk products" pattern score [Adjusted OR = 0.41 (95% CI: 0.26-0.65), ptrend<0.001] compared to the lowest quartile. There was no association of "meat-fish" pattern with the presence of depressive symptoms at baseline. None of the dietary patterns were associated with subsequent depressive symptoms at 4-year.
  
  
  CONCLUSIONS
  Higher "vegetables-fruits" and "snacks-drinks-milk products" pattern scores were associated with reduced likelihood of baseline depressive symptoms in Chinese older people in Hong Kong. The longitudinal analyses failed to show any causal relationship between dietary patterns and depressive symptoms in this population.
authors.affiliation: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong.
authors.forename: Ruth
authors.initials: R
authors.lastname: Chan
authors.affiliation: The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong.
authors.forename: Dicken
authors.initials: D
authors.lastname: Chan
authors.affiliation: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong.
authors.forename: Jean
authors.initials: J
authors.lastname: Woo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D003863:Depression / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D005518:Food Preferences; D006723:Hong Kong; D006801:Humans; D008297:Male; D011446:Prospective Studies