This study has several limitations. First, in contrast to a clinical diagnosis, the CES-D measures past-week depressive symptoms which may vary over time due to the scale's sensitivity to reactions to life events and individual-level cycles of symptomology (Radloff, 1977). However, the CES-D has shown adequate test-retest validity for intervals of up to 12 months (Radloff, 1977) which supports its use in longitudinal studies conducted previously on this topic (Adjibade et al., 2018;Akbaraly et al., 2013;Le Port et al., 2012;Vermeulen et al., 2018). Second, while we included current use of antidepressants in the outcome to indicate depression in the absence of symptoms, there are important limitations to this measure. Some antidepressant medications are prescribed for other conditions like chronic pain and anxiety, and we were unable to distinguish these indications from clinical depression. Additionally, prescribing practices may have changed over time, so **data** on antidepressant use may not reflect the underlying presence of depression in the population. However, antidepressant use has been included in previous studies of the diet-depression relationship (Chocano-Bedoya et al., 2013;Sánchez-Villegas et al., 2015), and our sensitivity analysis that omitted antidepressants from the outcome did not produce materially different results from our primary analysis. Third, the study is limited by two assessments periods, necessitating our assumption that AHEI scores represented the usual diet before and after the baseline assessment. Diets of the Strong Heart