Mediterranean dietary pattern and depression: the PREDIMED randomized trial
Open accessAbstract
Background: A few observational studies have found an inverse association between adherence to a Mediterranean diet and the risk of depression. Randomized trials with an intervention based on this dietary pattern could provide the most definitive answer to the findings reported by observational studies. The aim of this study was to compare in a randomized trial the effects of two Mediterranean diets versus a low-fat diet on depression risk after at least 3 years of intervention. Methods: This was a multicenter, randomized, primary prevention field trial of cardiovascular disease (Prevención con Dieta Mediterránea (PREDIMED Study)) based on community-dwelling men aged 55 to 80 years and women aged 60 to 80 years at high risk of cardiovascular disease (51% of them had type 2 diabetes; DM2) attending primary care centers affiliated with 11 Spanish teaching hospitals. Primary analyses were performed on an intention-to-treat basis. Cox regression models were used to assess the relationship between the nutritional intervention groups and the incidence of depression. Results: We identified 224 new cases of depression during follow-up. There was an inverse association with depression for participants assigned to a Mediterranean diet supplemented with nuts (multivariate hazard ratio (HR) 0.78; 95% confidence interval (CI) 0.55 to 1.10) compared with participants assigned to the control group, although this was not significant. However, when the analysis was restricted to participants with DM2, the magnitude of the effect of the intervention with the Mediterranean diet supplemented with nuts did reach statistical significance (multivariate HR = 0.59; 95% CI 0.36 to 0.98). Conclusions: The result suggest that a Mediterranean diet supplemented with nuts could exert a beneficial effect on the risk of depression in patients with DM2. Trial registration: This trial has been registered in the Current Controlled Trials with the number ISRCTN 35739639
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Large epidemiological studies have implicated dietary factors in some psychiatric disorders as risk factors and potential therapies.
“a number of large epidemiological studies have implicated dietary factors in some of these disorders [1–5], both in terms of risk factors [6] as well as potential therapies [2, 5, 7].”
From Role of diet and its effects on the gut microbiome in the pathophysiology of mental disorders (2022) · cites this paper as [3]
Mediterranean-like diets can promote healthy brain function as demonstrated in a variety of dietary intervention trials in depression and in cognitive decline.
“Such Mediterranean-like diets can promote healthy brain function as demonstrated in a variety of dietary intervention trials in depression and in cognitive decline [1–3, 6].”
From Role of diet and its effects on the gut microbiome in the pathophysiology of mental disorders (2022) · cites this paper as [3]
Two recent RCTs confirmed the benefits of Mediterranean-style diet on depression.
“While two recent RCTs confirmed the benefits of Mediterranean-style diet on depression [1, 3]”
From Role of diet and its effects on the gut microbiome in the pathophysiology of mental disorders (2022) · cites this paper as [3]
The PREDIMED study suggests an interconnectedness of cardiovascular disease and mental illness.
“this study suggests an interconnectedness of two very prevalent chronic diseases: cardiovascular disease and mental illness [3].”
From Role of diet and its effects on the gut microbiome in the pathophysiology of mental disorders (2022) · cites this paper as [3]
In the subset of patients with type-2 diabetes in PREDIMED, the risk for depression was 40% lower in the intervention group compared to the control group, which was statistically significant.
“However, in the subset of patients with type-2 diabetes, the risk for depression was 40% lower in the intervention group when compared to the control group, which was found to be statistically significant.”
From Role of diet and its effects on the gut microbiome in the pathophysiology of mental disorders (2022) · cites this paper as [3]
In a secondary analysis of the PREDIMED study, the average risk for depression for the intervention group was 20% lower, but not statistically significant.
“Even though not statistically significant, the average risk for depression for the intervention group was 20% lower.”
From Role of diet and its effects on the gut microbiome in the pathophysiology of mental disorders (2022) · cites this paper as [3]
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References 62 · Cited by 403
- Authors
- Sánchez-Villegas, A., Martínez-González, M. A., Estruch, R., Salas-Salvadó, J., Corella, D., Covas, M. I., Arós, F., Romaguera, D., Gómez-Gracia, E., Lapetra, J., Pintó, X., Martínez, J. A., Lamuela-Raventós, R. M., Ros, E., Gea, A., Wärnberg, J., & Serra-Majem, L.
- Affiliations
- Instituto de Salud Carlos III (ES)
- Universitat de València (ES)
- ORCID
- Venue
- BMC Medicine
- Published
- 2013-09-20
- Volume
- 11
- Issue
- 1
- Pages
- 208-208
- ISSN
- 1741-7015 (ISSN-L)
- PMC
- PMC3848350
- OpenAlex
- W2137437179
- Cited by
- 403
- References
- 62
- Citations by year
- 2026: 21 · 2025: 25 · 2024: 30 · 2023: 28 · 2022: 43 · 2021: 32 · 2020: 89 · 2019: 23 · 2018: 29 · 2017: 17 · 2016: 25 · 2015: 24 · 2014: 15 · 2013: 1
- FWCI
- 22.10
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Medicine (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Dipòsit Digital de la Universitat de Barcelona (Universitat de Barcelona) (publishedVersion, cc-by)
- Acceda (Universidad de Las Palmas de Gran Canaria) (submittedVersion)
- Deposito Adademico Digital Universidad De Navarra (University of Navarra) (submittedVersion, other-oa)
- Docusalut (Conselleria de Salut i Consum del Govern de les Illes Balears) (submittedVersion, cc-by)
- Hispana (submittedVersion, cc-by)
- RECERCAT (Consorci de Serveis Universitaris de Catalunya) (submittedVersion, cc-by)
- Funders
- Generalitat de Catalunya
- Fundación Mapfre (Fundación Mapfre 2010)
- Generalitat Valenciana (CS2010-AP-111, GVACOMP2011-151, ACOMP06109, CS2011-AP-042, GVACOMP2010-181, GVACOMP2011-151, GVACOMP2010-181)
- Ministerio de Ciencia e Innovación (AGL2010-22319-C03, G03/140, AGL-2009-13906-C02 and AGL2010-22319-C03, PI10/02658, AGL-2009-13906- C02)
- Centro Nacional de Investigaciones Cardiovasculares (06/2007, CNIC 06/2007)
- Junta de Andalucía
- Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición (PI10/02658, G03/140)
- Gobierno de Navarra
- Instituto de Salud Carlos III (PI 07/0473, PI1002658, RTIC G03/140, PI071138, RD06/0045, PI07/0954, PI11/, PI05/2584, RTIC RD06/0045, CP 06/00100, G03/140, PI1001407, P11/02505, PI11/01647)
- European Regional Development Fund (PI11/01647, PI07-0954, PI04–2239, CP06/00100, 06/0045, PI 07/0473, PI 05/2584, P11/02505, PI10/01407, RTIC G03/140, (RD 06/0045, PI07/1138, PI10/02658, G03/140)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- Mediterranean diet, depression, PREDIMED trial, nuts, type 2 diabetes, low-fat diet, dietary intervention, cardiovascular disease prevention, older adults, depression incidence
- MeSH terms
- Olive Oil, Aged, Aged, 80 and over, Cardiovascular Diseases, Depression, Diabetes Mellitus, Type 2, Female, Humans, Male, Middle Aged, Nuts, Plant Oils, Risk Factors, Spain, Diet, Mediterranean
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