title: Prospective association between adherence to the Mediterranean diet and risk of depressive symptoms in the French SU.VI.MAX cohort.
abstract: OBJECTIVE
  This study examines whether adherence to the Mediterranean Diet (MD) measured by several dietary indexes was associated with incident depressive symptoms in a large French cohort.
  
  
  METHODS
  The study sample consisted of 3523 participants from the Supplémentation en Vitamines et Minéraux Antioxydants (SU.VI.MAX) cohort who had at least three dietary records at baseline during the first 2 years of follow-up (1994-1996), free of depression at the beginning of the study (1996-1997) and available Center for Epidemiologic Studies Depression Scale (CES-D) data at the end of follow-up (2007-2009). The rMED was computed. Incident depressive symptoms were defined by a CES-D score ≥17 for men and ≥23 for women in 2007-2009. Odds ratios (OR) and 95% confidence intervals (95% CI) were estimated using multivariable logistic regression models. Several sensitivity analyses were performed.
  
  
  RESULTS
  In the present study, 172 incident cases of depressive symptoms were identified during the follow-up (mean = 12.6 years). After adjustment for a wide range of potential confounders, adherence to the rMED score (continuous variable) was significantly associated with incident depressive symptoms in men (OR 0.91; 95% CI 0.83-0.99; p = 0.03), but not in women. Use of the Literature-Based Adherence Score to the Mediterranean Diet (LAMD) and the classic MD score (MDS) provide similar findings.
  
  
  CONCLUSIONS
  In the current study, higher adherence to the Mediterranean Diet at midlife was associated with a lower risk of incident depressive symptoms, particularly in men, increasing scientific evidence for a beneficial role of Mediterranean Diet on health. Further investigations in particular among women are needed.
authors.affiliation: Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, SMBH Université Paris 13, Bobigny, France. m.adjibade@eren.smbh.univ-paris13.fr.
authors.forename: Moufidath
authors.initials: M
authors.lastname: Adjibade
authors.affiliation: Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, SMBH Université Paris 13, Bobigny, France.
authors.forename: Karen E
authors.initials: KE
authors.lastname: Assmann
authors.affiliation: Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, SMBH Université Paris 13, Bobigny, France.
authors.forename: Valentina A
authors.initials: VA
authors.lastname: Andreeva
authors.affiliation: Faculté de Médecine, Sorbonne Paris Cité, Université Paris Descartes, Paris, France.|Service de psychiatrie de l'adulte et du sujet âgé, AP-HP, Hôpitaux Universitaires Paris Ouest, Paris, France.|Centre de Psychiatrie et Neurosciences, Inserm (U894), Paris, France.
authors.forename: Cédric
authors.initials: C
authors.lastname: Lemogne
authors.affiliation: Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, SMBH Université Paris 13, Bobigny, France.|Département de Santé Publique, Hôpital Avicenne, Bobigny, France.
authors.forename: Serge
authors.initials: S
authors.lastname: Hercberg
authors.affiliation: Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, SMBH Université Paris 13, Bobigny, France.
authors.forename: Pilar
authors.initials: P
authors.lastname: Galan
authors.affiliation: Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, SMBH Université Paris 13, Bobigny, France.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Kesse-Guyot
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D015930:Diet Records; D038441:Diet, Mediterranean; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012306:Risk; D057566:Self Report; D012680:Sensitivity and Specificity; D012737:Sex Factors
keywords: Depressive symptoms; Mediterranean diet; Mental health; Prospective study