Abstract
BACKGROUND/OBJECTIVES: This study examined the association between adherence to the Mediterranean dietary approaches to stop hypertension Intervention for Neurodegenerative Delay (MIND) diet, its components, and recurrent depressive symptoms (DepSs). METHODS: The analyses included 4824 participants (73% men, mean age = 61; SD = 5.9) from the British Whitehall II cohort study. The MIND diet scores were derived from a validated 127-item food frequency questionnaire in 2002-2004. DepSs were assessed by the Center for Epidemiologic Studies Depression Scale (score ≥ 16) or by use of antidepressant drugs, and recurrence was defined as having DepSs in at least two of the four repeated measurements in the 2002-2004, 2007-2009, 2012-2013, and 2015-2016 follow-up phases. RESULTS: Recurrent DepSs were observed in 13.3% of the participants over 13 years of follow-up. After adjusting for potential confounders, participants in the highest tertile of the MIND diet score (where a higher score represents a higher diet quality) had 26% lower odds of experiencing recurrent DepSs (OR = 0.74; 95% CI 0.58-0.93) compared to those in the lowest tertile. In mutually adjusted analyses of 14 MIND diet components in relation to recurrent DepSs, independent associations were observed for green leafy vegetables (OR = 0.59, 95% CI: 0.45-0.78), other vegetables (OR = 0.43, 95% CI:0.24-0.77), and berries (OR = 0.74, 95% CI: 0.61-0.89). CONCLUSIONS: In this British prospective cohort, good adherence to the MIND diet, particularly to the recommendations for vegetables and berries, was associated with a lower risk of recurrent depressive symptoms, independent of socio-economic, health behavior, and health status factors, including baseline cognitive impairment and antecedents of DepSs.