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Association between the Prime Diet Quality Score and depressive symptoms in a Mediterranean population with metabolic syndrome. Cross-sectional and 2-year follow-up assessment from PREDIMED-PLUS study

Published online by Cambridge University Press:  29 October 2021

Naomi Cano-Ibáñez*
Affiliation:
Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
Lluis Serra-Majem
Affiliation:
Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
Sandra Martín-Peláez
Affiliation:
Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
Miguel Ángel Martínez-González
Affiliation:
Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain University of Navarra, Department of Preventive Medicine and Public Health, IDISNA, Pamplona, Spain Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
Jordi Salas-Salvadó
Affiliation:
Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Universitat Rovira i Virgili, Department de Bioquímica i Biotecnología, Unitat de Nutrició Humana, Reus, Spain Hospital Universitari San Joan de Reus, Human Nutrition Unit, Reus, Spain Institut d’Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
Maria Dolores Corella Piquer
Affiliation:
Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Department of Preventive Medicine, University of Valencia, Valencia, Spain
Camille Lassale
Affiliation:
Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
José Alfredo Martínez Hernandez
Affiliation:
Department of Nutrition, Food Sciences and Physiology, Center for Nutrition Research, University of Navarra, IdisNA, Pamplona, Spain Nutritional Control of the Epigenome, Precision Nutrition and Obesity Program IMDEA Food, CEI UAM + CSIC, Madrid, Spain
Ángel M. Alonso-Gómez
Affiliation:
Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Bioaraba Health Research Institute, Cardiovascular, Respiratory and Metabolic Area, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
Julia Wärnberg
Affiliation:
Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Department of Nursing, School of Health Sciences, University of Malaga-Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
Jesús Vioque Lopez
Affiliation:
Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain Instituto de Investigación Sanitario y Biomédica de Alicante, (ISABIAL-UMH), Alicante, Spain
Dora Romaguera
Affiliation:
Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
José López-Miranda
Affiliation:
Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain
Ramon Estruch
Affiliation:
Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Department of Internal Medicine, Institut dÌnvestigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
Ana María Gómez-Pérez
Affiliation:
Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Virgen de la Victoria Hospital, Department of Endocrinology, Instituto de Investigación Biomédica de Málga (IBIMA), University of Málaga, Málaga, Spain
José Manuel Santos-Lozano
Affiliation:
Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
Fernando Fernández-Aranda
Affiliation:
Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Department of Psychiatry, University Hospital of Bellvitge-IDIBELL and School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
Aurora Bueno-Cavanillas
Affiliation:
Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
Josep A. Tur
Affiliation:
Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain
Vicente Martín
Affiliation:
Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain Institute of Biomedicine (IBIOMED), University of León, León, Spain
Xavier Pintó Sala
Affiliation:
Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
Miguel Delgado-Rodríguez
Affiliation:
Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain Center for Advanced Studies in Olive Grove and Olive Oils, University of Jaén, Jaén, Spain
Pilar Matía Martín
Affiliation:
Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
Josep Vidal
Affiliation:
CIBER Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Department of Endocrinology, Institut dÌnvestigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
Jersy J. Cárdenas
Affiliation:
Department of Endocrinology and Nutrition, Hospital Fundación Jiménez-Díaz, Instituto de Investigaciones Biomédicas IISFJD, University Autónoma, Madrid, Spain
Lidia Daimiel Ruiz
Affiliation:
Nutritional Control of the Epigenome, Precision Nutrition and Obesity Program IMDEA Food, CEI UAM + CSIC, Madrid, Spain
Emilio Ros
Affiliation:
Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Lipid Clinic, Department of Endocrinology and Nutrition, Institut d’Investigació Biomédiques August Pi Sunyer (IDIBAPS), Hospital Clinic, Barcelona, Spain
Pilar Buil-Cosiales
Affiliation:
Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain University of Navarra, Department of Preventive Medicine and Public Health, IDISNA, Pamplona, Spain Servicio Navarro de Salud-Osasunbidea-Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, Spain
Nerea Becerra-Tomás
Affiliation:
Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Universitat Rovira i Virgili, Department de Bioquímica i Biotecnología, Unitat de Nutrició Humana, Reus, Spain Hospital Universitari San Joan de Reus, Human Nutrition Unit, Reus, Spain Institut d’Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
Carmen Saiz
Affiliation:
Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Department of Preventive Medicine, University of Valencia, Valencia, Spain
Miguel-Ángel Muñoz-Perez
Affiliation:
Unitat de Suport a la Recerca en Atenció Primaria de Barcelona, IDIAP Jordi Gol, Primary Care Division, Institut Català de la Salut, Barcelona, Spain
Itziar Abete
Affiliation:
Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain University of Navarra, Department of Preventive Medicine and Public Health, IDISNA, Pamplona, Spain Department of Nutrition, Food Sciences and Physiology, Center for Nutrition Research, University of Navarra, IdisNA, Pamplona, Spain
Lucas Tojal-Sierra
Affiliation:
Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Bioaraba Health Research Institute, Cardiovascular, Respiratory and Metabolic Area, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
Olga Fernández-Barceló
Affiliation:
Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Department of Nursing, School of Health Sciences, University of Malaga-Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
Andrea Bernabé-Casanova
Affiliation:
Centro de Salud Raval-Elche. Elche, Alicante, Spain
Jadwiga Konieczna
Affiliation:
Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
Antonio García-Ríos
Affiliation:
Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain
Rosa Casas
Affiliation:
Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Department of Internal Medicine, Institut dÌnvestigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
Maria Rosa Bernal-López
Affiliation:
Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Virgen de la Victoria Hospital, Department of Endocrinology, Instituto de Investigación Biomédica de Málga (IBIMA), University of Málaga, Málaga, Spain
José Lapetra
Affiliation:
Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
Estefanía Toledo
Affiliation:
Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain University of Navarra, Department of Preventive Medicine and Public Health, IDISNA, Pamplona, Spain
Carlos Gómez-Martínez
Affiliation:
Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Universitat Rovira i Virgili, Department de Bioquímica i Biotecnología, Unitat de Nutrició Humana, Reus, Spain Hospital Universitari San Joan de Reus, Human Nutrition Unit, Reus, Spain Institut d’Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
Oscar Coltell
Affiliation:
Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Department of Computer Languages and Systems, University Jaume I, Castellon, Spain
Mireia Malcampo-Manrúbia
Affiliation:
Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
María Angeles Zulet
Affiliation:
Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain University of Navarra, Department of Preventive Medicine and Public Health, IDISNA, Pamplona, Spain Department of Nutrition, Food Sciences and Physiology, Center for Nutrition Research, University of Navarra, IdisNA, Pamplona, Spain
Carolina Sorto-Sánchez
Affiliation:
Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Bioaraba Health Research Institute, Cardiovascular, Respiratory and Metabolic Area, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
Alfredo Gea
Affiliation:
Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain University of Navarra, Department of Preventive Medicine and Public Health, IDISNA, Pamplona, Spain
José Luis Hernández-Fleta
Affiliation:
Psychiatry Service, Hospital Dr. Negrín, Gran Canaria, Las Palmas de Gran Canaria, Spain
Olga Castañer Niño
Affiliation:
Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
Almudena Sánchez-Villegas
Affiliation:
Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain ISFOOD - Institute for Innovation & Sustainable Development in Food Chain, Universidad Pública de Navarra (UPNA), IdiSNA, Instituto de Investigación Sanitaria de Navarra, Spain
*
*Corresponding author: Naomi Cano-Ibáñez, email ncaiba@ugr.es

Abstract

The burden of depression is increasing worldwide, specifically in older adults. Unhealthy dietary patterns may partly explain this phenomenon. In the Spanish PREDIMED-Plus study, we explored (1) the cross-sectional association between the adherence to the Prime Diet Quality Score (PDQS), an a priori-defined high-quality food pattern, and the prevalence of depressive symptoms at baseline (cross-sectional analysis) and (2) the prospective association of baseline PDQS with changes in depressive symptomatology after 2 years of follow-up. After exclusions, we assessed 6612 participants in the cross-sectional analysis and 5523 participants in the prospective analysis. An energy-adjusted high-quality dietary score (PDQS) was assessed using a validated FFQ. The cross-sectional association between PDQS and the prevalence of depression or presence of depressive symptoms and the prospective changes in depressive symptoms were evaluated through multivariable regression models (logistic and linear models and mixed linear-effects models). PDQS was inversely associated with depressive status in the cross-sectional analysis. Participants in the highest quintile of PDQS (Q5) showed a significantly reduced odds of depression prevalence as compared to participants in the lowest quartile of PDQS (Q1) (OR (95 %) CI = 0·82 (0·68, 0·98))). The baseline prevalence of depression decreased across PDQS quintiles (Pfor trend = 0·015). A statistically significant association between PDQS and changes in depressive symptoms after 2-years follow-up was found (β (95 %) CI = −0·67 z-score (–1·17, −0·18). A higher PDQS was cross-sectionally related to a lower depressive status. Nevertheless, the null finding in our prospective analysis raises the possibility of reverse causality. Further prospective investigation is required to ascertain the association between PDQS and changes in depressive symptoms along time.

Type
Research Article
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Nutrition Society

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