title: Relationship between adherence to Dietary Approaches to Stop Hypertension (DASH) diet indices and incidence of depression during up to 8 years of follow-up.
abstract: OBJECTIVE
  Our aim was to evaluate the relationship between adherence to different Dietary Approaches to Stop Hypertension (DASH) diet indices and the risk of depression.
  
  
  METHODS
  In a prospective study we assessed 14051 participants of a dynamic (permanently ongoing recruitment) prospective cohort (the Seguimiento Universidad de Navarra (SUN) Project), initially free of depression. At baseline, a validated FFQ was used to assess adherence to four previously proposed DASH indices (Dixon, Mellen, Fung and Günther). To define the outcome we applied two definitions of depression: a less conservative definition including only self-reported physician-diagnosed depression (410 incident cases) and a more conservative definition that required both clinical diagnosis of depression and use of antidepressants (113 incident cases). Cox regression and restricted cubic splines analyses were performed.
  
  
  RESULTS
  After a median follow-up period of 8 years, the multiple-adjusted model showed an inverse association with the Fung DASH score (hazard ratio (HR)=0·76; 95 % CI 0·61, 0·94) when we used the less conservative definition of depression, and also under the more conservative definition (HR=0·63; 95 % CI 0·41, 0·95). We observed a weak inverse association with the Mellen DASH score, but no statistically significant association was found for the other definitions. The restricted cubic splines analyses suggested that these associations were non-linear (U-shaped).
  
  
  CONCLUSIONS
  Moderate adherence to the DASH diet as operationalized by Fung and Mellen was related to lower depression risk. Since these associations were non-linear, additional prospective studies are required before the results can be generalized and clinical recommendations can be given.
authors.affiliation: 1Department of Preventive Medicine and Public Health,University of Navarra,C/Irunlarrea 1,31008 Pamplona,Spain.
authors.forename: Aurora
authors.initials: A
authors.lastname: Perez-Cornago
authors.affiliation: 2Department of Clinical Sciences,University of Las Palmas de Gran Canaria,Las Palmas de Gran Canaria,Spain.
authors.forename: Almudena
authors.initials: A
authors.lastname: Sanchez-Villegas
authors.affiliation: 1Department of Preventive Medicine and Public Health,University of Navarra,C/Irunlarrea 1,31008 Pamplona,Spain.
authors.forename: Maira
authors.initials: M
authors.lastname: Bes-Rastrollo
authors.affiliation: 1Department of Preventive Medicine and Public Health,University of Navarra,C/Irunlarrea 1,31008 Pamplona,Spain.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Gea
authors.affiliation: 4Department of Psychiatry and Medical Psychology,University Clinic of Navarra,Pamplona,Spain.
authors.forename: Patricio
authors.initials: P
authors.lastname: Molero
authors.affiliation: 4Department of Psychiatry and Medical Psychology,University Clinic of Navarra,Pamplona,Spain.
authors.forename: Francisca
authors.initials: F
authors.lastname: Lahortiga-Ramos
authors.affiliation: 1Department of Preventive Medicine and Public Health,University of Navarra,C/Irunlarrea 1,31008 Pamplona,Spain.
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Martinez-Gonzalez
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D003863:Depression / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D000073601:Dietary Approaches To Stop Hypertension / Q000523:psychology; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D015203:Reproducibility of Results; D057566:Self Report; D013030:Spain / Q000453:epidemiology; D014495:Universities
chemical_list: D000928:Antidepressive Agents
keywords: DASH; Depression; Dietary pattern; Mood; SUN cohort