title: High glycemic index diet as a risk factor for depression: analyses from the Women's Health Initiative.
abstract: BACKGROUND
  The consumption of sweetened beverages, refined foods, and pastries has been shown to be associated with an increased risk of depression in longitudinal studies. However, any influence that refined carbohydrates has on mood could be commensurate with their proportion in the overall diet; studies are therefore needed that measure overall intakes of carbohydrate and sugar, glycemic index (GI), and glycemic load.
  
  
  OBJECTIVE
  We hypothesized that higher dietary GI and glycemic load would be associated with greater odds of the prevalence and incidence of depression.
  
  
  METHODS
  This was a prospective cohort study to investigate the relations between dietary GI, glycemic load, and other carbohydrate measures (added sugars, total sugars, glucose, sucrose, lactose, fructose, starch, carbohydrate) and depression in postmenopausal women who participated in the Women's Health Initiative Observational Study at baseline between 1994 and 1998 (n = 87,618) and at the 3-y follow-up (n = 69,954).
  
  
  RESULTS
  We found a progressively higher dietary GI to be associated with increasing odds of incident depression in fully adjusted models (OR for the fifth compared with first quintile: 1.22; 95% CI: 1.09, 1.37), with the trend being statistically significant (P = 0.0032). Progressively higher consumption of dietary added sugars was also associated with increasing odds of incident depression (OR for the fifth compared with first quintile: 1.23; 95% CI: 1.07, 1.41; P-trend = 0.0029). Higher consumption of lactose, fiber, nonjuice fruit, and vegetables was significantly associated with lower odds of incident depression, and nonwhole/refined grain consumption was associated with increased odds of depression.
  
  
  CONCLUSIONS
  The results from this study suggest that high-GI diets could be a risk factor for depression in postmenopausal women. Randomized trials should be undertaken to examine the question of whether diets rich in low-GI foods could serve as treatments and primary preventive measures for depression in postmenopausal women.
authors.affiliation: Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY; jeg64@columbia.edu.
authors.forename: James E
authors.initials: JE
authors.lastname: Gangwisch
authors.affiliation: Program of Public Health and Department of Preventive Medicine, Stony Brook Medicine, Stony Brook University, Stony Brook, NY;
authors.forename: Lauren
authors.initials: L
authors.lastname: Hale
authors.affiliation: Department of Public Health Sciences, School of Medicine, University of California-Davis, Davis, CA;
authors.forename: Lorena
authors.initials: L
authors.lastname: Garcia
authors.affiliation: Department of Psychiatry, New York University Langone Medical Center, New York, NY;
authors.forename: Dolores
authors.initials: D
authors.lastname: Malaspina
authors.affiliation: Department of Psychiatry, New York University Langone Medical Center, New York, NY;
authors.forename: Mark G
authors.initials: MG
authors.lastname: Opler
authors.affiliation: Center for the Study of Aging and Human Development and the Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC; and.
authors.forename: Martha E
authors.initials: ME
authors.lastname: Payne
authors.affiliation: Health Partners Institute for Education and Research and Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN.
authors.forename: Rebecca C
authors.initials: RC
authors.lastname: Rossom
authors.affiliation: Department of Preventive Medicine, Stony Brook Medicine, Stony Brook University, Stony Brook, NY;
authors.forename: Dorothy
authors.initials: D
authors.lastname: Lane
mesh_terms: D000368:Aged; D000375:Aging; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000209:etiology*; D004032:Diet / Q000009:adverse effects*; D004040:Dietary Carbohydrates / Q000009:adverse effects*; D005260:Female; D038321:Glycemic Index; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008875:Middle Aged; D064427:Nutritive Sweeteners / Q000009:adverse effects*; D017698:Postmenopause; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
chemical_list: D004040:Dietary Carbohydrates; D064427:Nutritive Sweeteners
keywords: depression; epidemiology; glycemic index; glycemic load; postmenopausal women