CLINICAL QUESTION

Does a diet that includes high fruit and vegetable intake decrease the risk of depression in adults?

EVIDENCE-BASED ANSWER

A diet that includes high fruit and vegetable intake is associated with a decreased risk of depression by 9% to 15% in adults 45 years and older. (Strength of Recommendation [SOR]: B, meta-analysis of cohort studies.) In women, greater consumption of fruits and vegetables is associated with a decreased risk of depression and depressive symptoms. (SOR: B, one retrospective longitudinal study and one case-control study.)

EVIDENCE SUMMARY

A 2021 systematic review and meta-analysis (four longitudinal, prospective, cohort studies; N = 176,686) reviewed the incidence of depression and fruit and vegetable consumption levels in community-dwelling adults 45 years and older.¹ The studies included participants of different age groups: 53 years and older; 45 to 64 years; 53 to 58 years, with an average age of 56 years; and 50 to 79 years, with an average age of 64 years. Studies were excluded if participants had specific health conditions (eg, pregnancy, obesity) or eating patterns (eg, fasting). Studies also were excluded if they examined only biomarkers (eg, glycemic index, dietary inflammatory index). Incidence of depression was measured by various methods across the studies.