Relationship between Mediterranean diet and depression in South Korea: the Korea National Health and Nutrition Examination Survey

BACKGROUND: Several studies have shown that adherence to the Mediterranean diet is associated with a lower risk of depression; however, little is known about the Asian population. This study investigated the relationship between adherence to the Mediterranean diet and depression in a sample of the South Korean population. METHODS: In total, 5,849 adults from the 2014 and 2016 Korea National Health and Nutrition Examination Surveys were included in the study. The Mediterranean diet adherence was measured using a modified alternate Mediterranean diet score (mMED) developed to adjust for Korean dietary patterns. The mMED scores using the Food Frequency Questionnaire were divided into four categories (0–2, 3–4, 5–6, and 7–9 points). Subjects with depression were defined as having moderate-to-severe depressive symptoms using the Patient Health Questionnaire-9, with a cutoff value of 10. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). A subgroup analysis was performed based on sex. RESULTS: The results of logistic regression analysis indicated that individuals with higher mMED were 42–73% less likely to report depression compared to individuals with the lowest mMED [ORs (95% CIs) =0.58 (0.37–0.90), 0.50 (0.31–0.80), 0.27 (0.15–0.47)] after adjusting for socio-demographic and health-related variables. In women, individuals with mMED of 7–9 had 71% lower odds of depression [ORs (95% CIs): 0.29 (0.13–0.64)]. In men, individuals with mMED of 5–9 had 55% [ORs (95% CIs): 0.45 (0.23–0.91)] to 79% [ORs (95% CIs): 0.21 (0.08–0.57)] lower odds of depression. CONCLUSION: This study suggests that adherence to the Mediterranean diet is inversely associated with depression in both men and women among Korean adults. This study provides evidence that a Mediterranean diet is crucial in preventing depressive symptoms in Asian populations.