Fruit and vegetable consumption and risk of depression: accumulative evidence from an updated systematic review and meta-analysis of epidemiological studies

• Published in: British journal of nutrition 2018-05, Vol.119 (10), p.1087-1101
• Main Authors: Saghafian, Faezeh, Malmir, Hanieh, Saneei, Parvane, Milajerdi, Alireza, Larijani, Bagher, Esmaillzadeh, Ahmad
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Anxiety; Case-Control Studies; Cohort Studies; Consumption; Cross-Sectional Studies; Depression - epidemiology; Depression - prevention & control; Diet - statistics & numerical data; Epidemiology; Evidence-based medicine; Female; Fruit; Fruits; Humans; Male; MEDLINE; Mental depression; Mental disorders; Mental health; Meta-analysis; Middle Aged; Nonlinear response; Observational studies; Odds Ratio; Regression analysis; Review-Systematic with Meta-Analysis; Reviews; Risk assessment; Risk Factors; Risk reduction; Scientific papers; Systematic review; Systematic Reviews; Upgrading; Vegetables; Womens health
• ISSN: 0007-1145; 1475-2662
• DOI: 10.1017/S0007114518000697

Findings from observational studies investigating the association between fruit and vegetable consumption and risk of depression were inconsistent. We conducted a systematic review and meta-analysis to summarise available data on the association between fruit and vegetable intake and depression. A systematic literature search of relevant reports published in Medline/PubMed, ISI (Web of Science), SCOPUS and Google Scholar until Oct 2017 was conducted. Data from 27 publications (sixteen cross-sectional, nine cohort and two case–control studies) on fruit, vegetables and/or total fruit and vegetable consumption in relation to depression were included in the systematic review. A total of eighteen studies that reported relative risks (RR), hazard ratios or OR for the relationship were included in the meta-analysis. The pooled RR for depression in the highest v. the lowest category of fruit intake was 0·83 (95 % CI 0·71, 0·98) in cohort studies and 0·76 (95 % CI 0·63, 0·92) in cross-sectional studies. Consumption of vegetables was also associated with a 14 % lower risk of depression (overall RR=0·86; 95 % CI 0·75, 0·98) in cohort studies and a 25 % lower risk of depression (overall RR=0·75; 95 % CI 0·62, 0·91) in cross-sectional studies. Moreover, an inverse significant association was observed between intake of total fruit and vegetables and risk of depression (overall RR=0·80; 95 % CI 0·65, 0·98) in cross-sectional studies. In a non-linear dose–response association, we failed to find any significant association between fruit or vegetable intake and risk of depression (fruit (cross-sectional studies): P non-linearty=0·12; vegetables (cross-sectional studies): P non-linearty