The relationship between the dietary inflammatory index (DII®) and incident depressive symptoms: A longitudinal cohort study

Nitin Shivappa, James R Hébert, Nicola Veronese, Maria Gabriella Caruso, Maria Notarnicola, Stefania Maggi, Brendon Stubbs, Joseph Firth, Michele Fornaro, Marco Solmi

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Diet is a common source of inflammation, and inflammation is associated with depression. We examined the association between the dietary inflammatory index (DII®), a validated measure of inflammatory potential of the diet, and risk of depression in a cohort of older North American adults.

METHODS: This longitudinal study, with a follow-up of 8 years, included 3648 participants (1577 males, 2071 females; mean age: 60.6 years) with/at risk of knee osteoarthritis. DII® scores were calculated using the validated Block Brief 2000 Food-Frequency Questionnaire. Center for Epidemiological Studies Depression-20 scale was used to define depressive symptoms. The relationship between baseline DII® score and incident depression was assessed through Cox's regression analysis, adjusted for potential confounders, and reported as hazard ratios (HRs).

RESULTS: In total, 837 individuals (310 men and 527 women) developed incident depressive symptoms over the course of 8 years. Participants in the most pro-inflammatory group (quartile 4) had approximately 24% higher risk of developing depressive symptoms compared to subjects with the most anti-inflammatory diet (HR: 1.24; 95% CI: 1.01-1.53; p = 0.04).

CONCLUSION: These results suggest that a pro-inflammatory diet may be associated with higher incidence of depressive symptoms in a cohort of older Americans. Transitioning to a more anti-inflammatory diet may reduce depression risk.

Original languageEnglish
Pages (from-to)39-44
Number of pages6
JournalJournal of Affective Disorders
Publication statusPublished - Aug 1 2018


  • Adult
  • Aged
  • Cohort Studies
  • Depression/epidemiology
  • Diet/adverse effects
  • Diet Surveys/statistics & numerical data
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Inflammation/etiology
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Psychiatric Status Rating Scales


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