TABLE 4.

Association between the Western diet pattern and clinical depression, Nurses’ Health Study 1996–2008¹

	Quintile 1	Quintile 2	Quintile 3	Quintile 4	Quintile 5	P-trend
Strict definition of depression (diagnosis and antidepressant use)
No. of events	557	544	633	607	661	—
Person-years	103,056	103,092	102,949	103,039	102,908	—
Model 1	1.00	0.98 (0.87, 1.11)	1.15 (1.02, 1.30)	1.11 (0.97, 1.26)	1.23 (1.06, 1.43)	0.002
Model 2	1.00	0.95 (0.84, 1.08)	1.09 (0.97, 1.24)	1.04 (0.90, 1.18)	1.12 (0.95, 1.31)	0.12
Model 3	1.00	0.94 (0.83, 1.06)	1.05 (0.93, 1.19)	0.97 (0.85, 1.11)	1.05 (0.89, 1.23)	0.50
Broad definition of depression (diagnosis and/or antidepressant use)
No. of events	1408	1422	1508	1503	1572	—
Person-years	102,202	102,222	102,074	102,148	101,993	—
Model 1	1.00	1.04 (0.96, 1.12)	1.13 (1.04, 1.22)	1.15 (1.06, 1.24)	1.26 (1.15, 1.39)	<0.001
Model 2	1.00	1.01 (0.94, 1.09)	1.07 (0.99, 1.16)	1.08 (0.99, 1.17)	1.15 (1.04, 1.27)	0.01
Model 3	1.00	1.00 (0.93, 1.08)	1.04 (0.96, 1.12)	1.03 (0.94, 1.12)	1.09 (0.99, 1.21)	0.08

¹Cox proportional hazards models were used to calculate RRs (95% CIs). Model 1 was adjusted for age (mo) and total caloric intake (continuous). Model 2 was adjusted as for model 1 and for BMI (continuous), smoking, physical activity (quintiles), menopause status, use of hormonal replacement therapy [never (reference), past, or current], marital status, caffeine (quintiles), multivitamin use (yes or no), retired (yes or no), participation in a community group or volunteering (yes or no), and reported diagnosis of cancer, high blood pressure, hypercholesterolemia, heart disease (myocardial infarction or angina), or diabetes. Model 3 was adjusted as for model 2 and the 5-item Mental Health Inventory at baseline (continuous). All models were adjusted for indicators of missing dietary pattern information in the years 1986–2006.