Healthy dietary patterns are associated with lower long-term depressive symptoms in older women

Abstract Background In contrast to depression in younger adults, late-life depression is more likely to be modified by external factors, such as diet. There is a noticeable discrepancy in late-life depression between European regions, with a 32% prevalence in Central and Eastern Europe, and 17% in Scandinavia. A large gap in prevalence in depression is also present between the sexes, as well as among age groups across all countries. In our study, we aimed to longitudinally assess the relationship of three dietary scores with depressive symptoms in a Czech aging cohort, and analyze the sex differences. Methods In total, 4117 subjects (54.2% women) aged 45-69 years from Czechia were followed from 2002 to 2018. Healthy Diet Indicator, Mediterranean Diet Score, and Eastern European Diet Score were calculated from baseline dietary data, and categorized as low, medium, and high dietary adherence. Depressive symptoms were assessed using CES-D-10 questionnaire. Other characteristics included age, sex, marital status, employment status, education, and smoking status. The longitudinal relationship was assessed using growth curve modelling for men and women separately. Results In women, medium and high adherence to Healthy Diet Indicator was associated with lower intensity of depressive symptoms over time (β=-0.85, 95% CI [-1.24; -0.47]); (β=-0.94, 95% CI [-1.50; -0.37]) compared to women with a low adherence. Mean depressive symptoms were also lower in women with a high adherence to Mediterranean (β=-0.72, 95% CI [-1.23; -0.21]) and Eastern European diet (β=-1.10, 95% CI [-1.34; -0.56]). Conclusions Our results suggest a negative relationship between adherence to healthy dietary patterns and lower depressive symptoms in older women. There was no evidence for the impact of diet on depressive symptoms in men. Our results provide further reasoning to assess the role of sex in nutritional psychiatry. Key messages • Higher adherence to a healthy diet may attenuate depressive symptoms in Czech aging women. • The role of sex in nutritional psychiatry requires further investigation.