Cited by 164Nutritional Studies and DietPhytochemicals and Antioxidant ActivitiesTryptophan and brain disorders

Dietary flavonoid intake and risk of incident depression in midlife and older women

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Chang, Shun-Chiao, Cassidy, Aedin, Willett, Walter C, Rimm, Eric B, O’Reilly, Eilis J, Okereke, Olivia I·2016·The American Journal of Clinical Nutrition

Abstract

BACKGROUND: The impact of dietary flavonoid intakes on risk of depression is unclear. OBJECTIVE: We prospectively examined associations between estimated habitual intakes of dietary flavonoids and depression risk. DESIGN: We followed 82,643 women without a previous history of depression at baseline from the Nurses' Health Study [(NHS) aged 53-80 y] and the Nurses' Health Study II [(NHSII) aged 36-55 y]. Intakes of total flavonoids and subclasses (flavonols, flavones, flavanones, anthocyanins, flavan-3-ols, polymeric flavonoids, and proanthocyanidins) were calculated from validated food-frequency questionnaires collected every 2-4 y. Depression was defined as physician- or clinician-diagnosed depression or antidepressant use and was self-reported in response to periodic questionnaires. Cox proportional hazards models were performed to examine associations. RESULTS: A total of 10,752 incident depression cases occurred during a 10-y follow-up. Inverse associations between flavonol, flavone, and flavanone intakes and depression risk were observed. Pooled multivariable-adjusted HRs (95% CIs) were 0.93 (0.88, 0.99), 0.92 (0.86, 0.98), and 0.90 (0.85, 0.96) when comparing the highest (quintile 5) with the lowest (quintile 1) quintiles, respectively, with evidence of linear trends across quintiles (P-trend = 0.0004-0.08). In flavonoid-rich food-based analyses, the HR was 0.82 (95% CI: 0.74, 0.91) among participants who consumed ≥2 servings citrus fruit or juices/d compared with <1 serving/wk. In the NHS only, total flavonoids, polymers, and proanthocyanidin intakes showed significantly (9-12%) lower depression risks. In analyses among late-life NHS participants (aged ≥65 y at baseline or during follow-up), for whom we were able to incorporate depressive symptoms into the outcome definition, higher intakes of all flavonoid subclasses except for flavan-3-ols were associated with significantly lower depression risk; flavones and proanthocyanidins showed the strongest associations (HR for both: 0.83; 95% CI: 0.77, 0.90). CONCLUSIONS: Higher flavonoid intakes may be associated with lower depression risk, particularly among older women. Further studies are needed to confirm these associations.

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Authors
Chang, S.-C., Cassidy, A., Willett, W. C., Rimm, E. B., O’Reilly, E. J., & Okereke, O. I.
Affiliations
  • Harvard University (US)
  • Brigham and Women's Hospital (US)
Corresponding author
Okereke, Olivia I
Venue
The American Journal of Clinical Nutrition
Publisher
Elsevier BV
Published
2016-09
Volume
104
Issue
3
Pages
704-714
ISSN
0002-9165 (ISSN-L)
OpenAlex
W2461740248
Cited by
164
References
58
Citations by year
2026: 15 · 2025: 12 · 2024: 24 · 2023: 12 · 2022: 20 · 2021: 19 · 2020: 24 · 2019: 21 · 2018: 12 · 2017: 4 · 2016: 1
FWCI
12.56
Type
journal article
Language
en
Open access
Locations
  • American Journal of Clinical Nutrition (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Research Portal (Queen's University Belfast) (publishedVersion, cc-by)
  • UEA Digital Repository (University of East Anglia) (acceptedVersion, cc-by)
  • Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
Funders
  • NIH (R01 MH091448, UM1 CA186107, UM1 CA176726)
  • Biotechnology and Biological Sciences Research Council (BB/J004545/1)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
  • Health Sciences › Medicine › Biochemistry › Phytochemicals and Antioxidant Activities
  • Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
Keywords
dietary flavonoids, depression risk, flavonols, flavones, flavanones, proanthocyanidins, flavan-3-ols, anthocyanins, middle-aged women, older women, geriatric depression, depressive symptoms, Nurses' Health Study, Nurses' Health Study II, food frequency questionnaire
MeSH terms
Diet, Healthy, Adult, Aged, Aged, 80 and over, Aging, Antidepressive Agents, Depression, Female, Flavonoids, Follow-Up Studies, Humans, Middle Aged, Nurses, Patient Compliance, Prospective Studies, Psychiatric Status Rating Scales, Risk Factors, United States, Cohort Studies, Incidence, Proportional Hazards Models, Self Report

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