There is a growing interest in understanding the role of inflammation in the diet–depression relationship. The present study examined whether the Dietary Inflammatory Index (DII; a measure of the inflammatory potential of individuals’ diets) is associated with recurrent depressive symptoms (DepS) (Center for Epidemiologic Studies Depression Scale score > 16 or taking antidepressants both at baseline and follow-up) assessed over 5 years in middle-aged men (n = 3,178) and women (n = 1,068) from the Whitehall II Study. For each increment of 1 SD of DII score, odds of recurrent DepS increased by 66% (95% confidence interval [CI] = [1.30, 2.12]) in women, whereas no significant association between DII and recurrent DepS was observed in men (odds ratio [OR] = 1.12; 95% CI = [0.92, 1.36]). This association was little attenuated after adjustment for confounders and after taking into account levels of interleukin-6 and C-reactive protein. In conclusion, there is an association between proinflammatory diet and recurrent DepS in women that seems to not be driven by circulating inflammatory markers.
AkbaralyT. N.BrunnerE. J.FerrieJ. E.MarmotM. G.KivimakiM.Singh-ManouxA. (2009). Dietary pattern and depressive symptoms in middle age. The British Journal of Psychiatry, 195(5), 408–413. doi:10.1192/bjp.bp.108.058925.
2.
AkbaralyT. N.FerrieJ. E.BerrC.BrunnerE. J.HeadJ.MarmotM. G.. . . KivimakiM. (2011). Alternative Healthy Eating Index and mortality over 18 y of follow-up: Results from the Whitehall II cohort. The American Journal of Clinical Nutrition, 94(1), 247–253. doi:10.3945/ajcn.111.013128
3.
AkbaralyT. N.SabiaS.ShipleyM. J.BattyG. D.KivimakiM. (2013). Adherence to healthy dietary guidelines and future depressive symptoms: Evidence for sex differentials in the Whitehall II study. The American Journal of Clinical Nutrition, 97(2), 419–427.
4.
AkbaralyT. N.ShipleyM. J.FerrieJ. E.VirtanenM.LoweG.HamerM.KivimakiM. (2015). Long-term adherence to healthy dietary guidelines and chronic inflammation in the prospective Whitehall II study. The American Journal of Medicine, 128(2), 152–160.e154. doi:10.1016/j.amjmed.2014.10.002
5.
BinghamS. A.GillC.WelchA.CassidyA.RunswickS. A.OakesS.. . . DayN. E. (1997). Validation of dietary assessment methods in the UK arm of EPIC using weighed records, and 24-hour urinary nitrogen and potassium and serum vitamin C and carotenoids as biomarkers. International Journal of Epidemiology, 26(Suppl 1), S137–S151.
6.
BlancoC.OkudaM.MarkowitzJ. C.LiuS. M.GrantB. F.HasinD. S. (2010). The epidemiology of chronic major depressive disorder and dysthymic disorder: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry, 71(12), 1645–1656. doi:10.4088/JCP.09m05663gry
7.
BrunnerE.StalloneD.JunejaM.BinghamS.MarmotM. (2001). Dietary assessment in Whitehall II: Comparison of 7 d diet diary and food-frequency questionnaire and validity against biomarkers. British Journal of Nutrition, 86(3), 405–414.
8.
CrumR. M.AnthonyJ. C.BassettS. S.FolsteinM. F. (1993). Population-based norms for the Mini-Mental State Examination by age and educational level. JAMA, 269(18), 2386–2391.
9.
GimenoD.BrunnerE. J.LoweG. D.RumleyA.MarmotM. G.FerrieJ. E. (2007). Adult socioeconomic position, C-reactive protein and interleukin-6 in the Whitehall II prospective study. European Journal of Epidemiology, 22(10), 675–683.
10.
GimenoD.DelclosG. L.FerrieJ. E.De VogliR.ElovainioM.MarmotM. G.KivimakiM. (2011). Association of CRP and IL-6 with lung function in a middle-aged population initially free from self-reported respiratory problems: The Whitehall II study. European Journal of Epidemiology, 26(2), 135–144. doi:10.1007/s10654-010-9526-5
11.
GimenoD.KivimakiM.BrunnerE. J.ElovainioM.De VogliR.SteptoeA.. . . FerrieJ. E. (2009). Associations of C-reactive protein and interleukin-6 with cognitive symptoms of depression: 12-year follow-up of the Whitehall II study. Psychological Medicine, 39(3), 413–423. doi:10.1017/s0033291708003723
12.
HaapakoskiR.MathieuJ.EbmeierK. P.AleniusH.KivimakiM. (2015). Cumulative meta-analysis of interleukins 6 and 1beta, tumour necrosis factor alpha and C-reactive protein in patients with major depressive disorder. Brain, Behavior, and Immunity, 49, 206–215. doi:10.1016/j.bbi.2015.06.001
13.
HebertJ. R.ClemowL.PbertL.OckeneI. S.OckeneJ. K. (1995). Social desirability bias in dietary self-reportmaycompromise the validity of dietary intake measures. International Journal of Epidemiology, 24(2), 389–398.
14.
HebertJ. R.EbbelingC. B.MatthewsC. E.HurleyT. G.MaY.DrukerS.ClemowL. (2002). Systematic errors in middle-aged women’s estimates of energy intake: Comparing three self-report measures to total energy expenditure from doubly labeled water. Annals of Epidemiology, 12(8), 577–586.
15.
HebertJ. R.MaY.ClemowL.OckeneI. S.SaperiaG.StanekE. J.III. . . OckeneJ. K. (1997). Gender differences in social desirability and social approval bias in dietary self-report. American Journal of Epidemiology, 146(12), 1046–1055.
16.
HebertJ. R.PetersonK. E.HurleyT. G.StoddardA. M.CohenN.FieldA. E.SorensenG. (2001). The effect of social desirability trait on self-reported dietary measures among multi-ethnic female health center employees. Annals of Epidemiology, 11(6), 417–427.
17.
JackaF. N.CherbuinN.AnsteyK. J.ButterworthP. (2014). Dietary patterns and depressive symptoms over time: Examining the relationships with socioeconomic position, health behaviours and cardiovascular risk. PLoS One, 9(1), e87657. doi:10.1371/journal.pone.0087657
18.
JackaF. N.MykletunA.BerkM.BjellandI.TellG. S. (2011). The association between habitual diet quality and the common mental disorders in community-dwelling adults: The Hordaland Health study. Psychosomatic Medicine, 73(6), 483–490. doi:10.1097/PSY.0b013e318222831a
19.
JackaF. N.PascoJ. A.MykletunA.WilliamsL. J.HodgeA. M.O’ReillyS. L.BerkM. (2010). Association of Western and traditional diets with depression and anxiety in women. The American Journal of Psychiatry, 167(3), 305–311. doi:10.1176/appi.ajp.2009.09060881
20.
KhandakerG. M.PearsonR. M.ZammitS.LewisG.JonesP. B. (2014). Association of serum interleukin 6 and C-reactive protein in childhood with depression and psychosis in young adult life: A population-based longitudinal study. JAMA Psychiatry, 71(10), 1121–1128. doi:10.1001/jamapsychiatry.2014.1332
21.
KivimakiM.ShipleyM. J.BattyG. D.HamerM.AkbaralyT. N.KumariM.. . . Singh-ManouxA. (2014). Long-term inflammation increases risk of common mental disorder: A cohort study. Molecular Psychiatry, 19(2), 149–150. doi:10.1038/mp.2013.35
22.
LaiJ. S.HilesS.BisqueraA.HureA. J.McEvoyM.AttiaJ. (2014). A systematic review and meta-analysis of dietary patterns and depression in community-dwelling adults. The American Journal of Clinical Nutrition, 99(1), 181–197. doi:10.3945/ajcn.113.069880
23.
Le PortA.GueguenA.Kesse-GuyotE.MelchiorM.LemogneC.NabiH.. . . CzernichowS. (2012). Association between dietary patterns and depressive symptoms over time: A 10-year follow-up study of the GAZEL cohort. PLoS One, 7(12), e51593. doi:10.1371/journal.pone.0051593
24.
LucasM.Chocano-BedoyaP.SchulzeM. B.MirzaeiF.O’ReillyE. J.OkerekeO. I.. . . AscherioA. (2014). Inflammatory dietary pattern and risk of depression among women. Brain, Behavior, and Immunity, 36, 46–53. doi:10.1016/j.bbi.2013.09.014
25.
MarmotM.BrunnerE. (2005). Cohort profile: The Whitehall II study. International Journal of Epidemiology, 34(2), 251–256.
26.
OpieR. S.ItsiopoulosC.ParlettaN.Sanchez-VillegasA.AkbaralyT. N.RuusunenA.JackaF. N. (2015). Dietary recommendations for the prevention of depression. Nutritional Neuroscience. doi:10.1179/1476830515y.0000000043
27.
RadloffL. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.
28.
SabiaS.DugravotA.KivimakiM.BrunnerE.ShipleyM. J.Singh-ManouxA. (2012). Effect of intensity and type of physical activity on mortality: Results from the Whitehall II cohort study. American Journal of Public Health, 102(4), 698–704.
29.
Sanchez-VillegasA.Henriquez-SanchezP.Ruiz-CanelaM.LahortigaF.MoleroP.ToledoE.Martinez-GonzalezM. A. (2015). A longitudinal analysis of diet quality scores and the risk of incident depression in the SUN Project. BMC Medicine, 13(1), 197. doi:10.1186/s12916-015-0428-y
30.
Sanchez-VillegasA.Martinez-GonzalezM. A. (2013). Diet, a new target to prevent depression?BMC Medicine, 11, 3. doi:10.1186/1741-7015-11-3
31.
Sanchez-VillegasA.Ruiz-CanelaM.de la Fuente-ArrillagaC.GeaA.ShivappaN.HebertJ. R.Martinez-GonzalezM. A. (2015). Dietary inflammatory index, cardiometabolic conditions and depression in the Seguimiento Universidad de Navarra cohort study. British Journal of Nutrition, 114(9), 1471–1479. doi:10.1017/s0007114515003074
32.
SarrisJ.LoganA. C.AkbaralyT. N.AmmingerG. P.Balanza-MartinezV.FreemanM. P.. . . JackaF. N. (2015). Nutritional medicine as mainstream in psychiatry. Lancet Psychiatry, 2(3), 271–274. doi:10.1016/s2215-0366(14)00051-0
33.
SarrisJ.LoganA. C.AkbaralyT. N.Paul AmmingerG.Balanza-MartinezV.FreemanM. P.. . . JackaF. N. (2015). International Society for Nutritional Psychiatry Research consensus position statement: Nutritional medicine in modern psychiatry. World Psychiatry, 14(3), 370–371. doi:10.1002/wps.20223
34.
ShivappaN.SteckS. E.HurleyT. G.HusseyJ. R.HebertJ. R. (2014). Designing and developing a literature-derived, population-based dietary inflammatory index. Public Health Nutrition, 17(8), 1689–1696. doi:10.1017/s1368980013002115
35.
ShivappaN.SteckS. E.HurleyT. G.HusseyJ. R.MaY.OckeneI. S.. . . HebertJ. R. (2014). A population-based dietary inflammatory index predicts levels of C-reactive protein in the Seasonal Variation of Blood Cholesterol Study (SEASONS). Public Health Nutrition, 17(8), 1825–1833. doi:10.1017/s1368980013002565
36.
St. JohnP. D.BlandfordA. A.StrainL. A. (2006). Depressive symptoms among older adults in urban and rural areas. International Journal of Geriatric Psychiatry, 21(12), 1175–1180.
37.
StommelM.GivenB. A.GivenC. W.KalaianH. A.SchulzR.McCorkleR. (1993). Gender bias in the measurement properties of the Center for Epidemiologic Studies Depression Scale (CES-D). Psychiatry Research, 49(3), 239–250.
38.
Sukoff RizzoS. J.NealS. J.HughesZ. A.BeynaM.Rosenzweig-LipsonS.MossS. J.BrandonN. J. (2012). Evidence for sustained elevation of IL-6 in the CNS as a key contributor of depressive-like phenotypes. Translational Psychiatry, 2, e199. doi:10.1038/tp.2012.120
39.
van ZoonenK.BuntrockC.EbertD.D.SmitF.ReynoldsC. F.IIIBeekmanA. T.CuijpersP. (2014). Preventing the onset of major depressive disorder: A meta-analytic review of psychological interventions. International Journal of Epidemiology, 43(2), 318–329. doi:10.1093/ije/dyt175
40.
VirtanenM.ShipleyM. J.BattyG. D.HamerM.AllanC. L.LoweG. D.. . . KivimakiM. (2015). Interleukin-6 as a predictor of symptom resolution in psychological distress: A cohort study. Psychological Medicine, 45(10), 2137–2144. doi:10.1017/s0033291715000070
41.
WhitefordH. A.DegenhardtL.RehmJ.BaxterA. J.FerrariA. J.ErskineH. E.. . . VosT. (2013). Global burden of disease attributable to mental and substance use disorders: Findings from the Global Burden of Disease Study 2010. Lancet, 382(9904), 1575–1586. doi:10.1016/s0140-6736(13)61611-6
42.
WillettW. C.SampsonL.StampferM. J.RosnerB.BainC.WitschiJ.. . . SpeizerF. E. (1985). Reproducibility and validity of a semiquantitative food frequency questionnaire. American Journal of Epidemiology, 122(1), 51–65.
43.
Wium-AndersenM. K.OrstedD. D.NielsenS. F.NordestgaardB. G. (2013). Elevated C-reactive protein levels, psychological distress, and depression in 73, 131 individuals. JAMA Psychiatry, 70(2), 176–184. doi:10.1001/2013.jamapsychiatry.102
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
