Mediterranean Diet, Food Consumption and Risk of Late-Life Depression: The Mugello Study

Unraveling the intricate dance of the Mediterranean diet and gut microbiota in autoimmune resilience

The nutritional habits regulate the gut microbiota and increase risk of an autoimmune disease. Western diet is rich in sugars, meat, and poly-unsaturated fatty acids, which lead to dysbiosis of intestinal microbiota, disruption of gut epithelial barrier and chronic mucosal inflammation. In contrast, the Mediterranean Diet (MedDiet) is abundant in ω3 fatty acids, fruits, and vegetables, possessing anti-inflammatory properties that contribute to the restoration of gut eubiosis. Numerous studies have extensively examined the impact of MedDiet and its components on both health and various disease states. Additionally, specific investigations have explored the correlation between MedDiet, microbiota, and the risk of autoimmune diseases. Furthermore, the MedDiet has been linked to a reduced risk of cardiovascular diseases, playing a pivotal role in lowering mortality rates among individuals with autoimmune diseases and comorbidities. The aim of the present review is to specifically highlight current knowledge regarding possible interactions of MedDiet with the patterns of intestinal microbiota focusing on autoimmunity and a blueprint through dietary modulations for the prevention and management of disease's activity and progression.

Physical Activity Time, Alcohol Consumption, Mediterranean Diet, and Anxiety in Education Science Students

Student lifestyles change during university. This research aimed to classify university students according to their levels of physical activity, alcohol consumption, adherence to the Mediterranean diet, and anxiety and studied the relationships between the variables using a multigroup equation model according to gender. The sample was composed of 549 participants (M = 23.06; S.D. = 6.22), of whom 409 were women and 140 were men. Validated and adapted instruments such as the Beck Anxiety Inventory, the PREDIMED Questionnaire, and the Alcohol Use Disorder Identification Test were used. The data revealed four clusters through Ward's method and the k-means method. Regarding the exploratory model, differences were found in the effects of the variables according to sex. In conclusion, alcohol consumption was positively associated with the Mediterranean diet, and physical activity was negatively associated with the Mediterranean diet and anxiety.

Which clinical factors and biochemical parameters are associated with late-life major depression?

INTRODUCTION

Late-life major depression (MD) is a frequent and high-cost psychiatric disorder. Our purpose was to detect clinical and biological factors possibly associated with this condition to better prevent and treat it.

METHODS

We recruited 343 patients, consecutively admitted for a Major Depressive Episode to the inpatient clinic of Policlinico of Milan and ASST Monza, Italy. A large set of clinical and biochemical variables was collected from clinical charts. Univariate analyses were performed both dividing the sample into two groups (age < or ≥65) and considering age as a continuous quantitative variable. Regression analyses were then performed considering as independent variables only those statistically significant at univariate analyses.

RESULTS

Patients aged ≥ 65 resulted in having longer duration of illness, shorter duration of last antidepressant therapy, higher number of antidepressants assumed in the past, higher frequency of treatment-resistant depression, higher frequency of overweight/obesity and diabetes. As for biochemical parameters, patients ≥ 65 showed lower total plasmatic proteins and albumin, higher uric acid and creatinine.

CONCLUSIONS

These preliminary results suggest less effectiveness of antidepressants, more susceptibility to metabolic disorders and poor nutritional status in patients with late-life depression; such aspects may consequently be taken into consideration for a proper therapeutic approach. KEY POINTSDepression in late life seems to be associated with poorer response to antidepressants;Clinicians should prefer compounds with minimal pharmacokinetic interactions and less risk of side effects including metabolic ones;The poor nutritional status and the higher risk of metabolic disorders in older patients points out the importance of proper diet and healthy lifestyle in this group of subjects;Further studies are needed to confirm the results of this research.

Nordic diet and its benefits in neurological function: a systematic review of observational and intervention studies

Introduction

Neurological disorders have been considered the major contributors to global long-term disability and lower quality of life. Lifestyle factors, such as dietary patterns, are increasingly recognized as important determinants of neurological function. Some dietary behaviors, such as Nordic diet (ND) were likely to have protective effects on brain function. However, an understanding of the effectiveness of the ND pattern to improve neurological function and brain health is not fully understood. We review the current evidence that supports the ND pattern in various aspects of neurological function and addresses both proven and less established mechanisms of action based on its food ingredients and biochemical compounds.

Methods

In this systematic review, PubMed, Web of Science, and Scopus databases were searched from inception to February 2023. Observational and intervention studies were included.

Results

Of the 627 screened studies, 5 observational studies (including three cohorts and two cross-sectional studies) and 3 intervention studies investigating the association between ND and neurological function. Observational studies investigated the association of ND with the following neurological functions: cognition, stroke, and neuropsychological function. Intervention studies investigated the effects of ND on cognition and depression.

Discussion

Despite the limited literature on ND and its association with neurological function, several aspects of ND may lead to some health benefits suggesting neuroprotective effects. The current state of knowledge attributes the possible effects of characteristic components of the ND to its antioxidant, anti-inflammatory, lipid-lowering, gut-brain-axis modulating, and ligand activities in cell signaling pathways. Based on existing evidence, the ND may be considered a recommended dietary approach for the improvement of neurological function and brain health.

Systematic review registration

[https://www.crd.york.ac.uk/prospero/], identifier [CRD2023451117].

The gut-derived metabolites as mediators of the effect of healthy nutrition on the brain

Nutrition is now well recognized to be an environmental factor which positively or negatively influences the risk to develop neurological and psychiatric disorders. The gut microbiota has recently been shown to be an important actor mediating the relationship between environmental factors, including nutrition, and brain function. While its composition has been widely studied and associated with the risk of brain diseases, the mechanisms underlying the relationship between the gut and brain diseases remain to be explored. The wide range of bioactive molecules produced by the gut microbiota, called gut-derived metabolites (GDM), represent new players in the gut to brain interactions and become interesting target to promote brain health. The aim of this narrative review is to highlight some GDMs of interest that are produced in response to healthy food consumption and to summarize what is known about their potential effects on brain function. Overall, GDMs represent future useful biomarkers for the development of personalized nutrition. Indeed, their quantification after nutritional interventions is a useful tool to determine individuals' ability to produce microbiota-derived bioactive compounds upon consumption of specific food or nutrients. Moreover, GDMs represent also a new therapeutic approach to counteract the lack of response to conventional nutritional interventions.

The Brain-Gut-Microbiota Interplay in Depression: a key to design innovative therapeutic approaches

Depression is the most prevalent mental disorder in the world associated with huge socio-economic consequences. While depressive-related symptoms are well known, the molecular mechanisms underlying disease pathophysiology and progression remain largely unknown. The gut microbiota (GM) is emerging as a key regulator of the central nervous system homeostasis by exerting fundamental immune and metabolic functions. In turn, the brain influences the intestinal microbial composition through neuroendocrine signals, within the so-called gut microbiota-brain axis. The balance of this bidirectional crosstalk is important to ensure neurogenesis, preserve the integrity of the blood-brain barrier and avoid neuroinflammation. Conversely, dysbiosis and gut permeability negatively affect brain development, behavior, and cognition. Furthermore, although not fully defined yet, changes in the GM composition in depressed patients are reported to influence the pharmacokinetics of common antidepressants by affecting their absorption, metabolism, and activity. Similarly, neuropsychiatric drugs may shape in turn the GM with an impact on the efficacy and toxicity of the pharmacological intervention itself. Consequently, strategies aimed at re-establishing the correct homeostatic gut balance (i.e., prebiotics, probiotics, fecal microbiota transplantation, and dietary interventions) represent an innovative approach to improve the pharmacotherapy of depression. Among these, probiotics and the Mediterranean diet, alone or in combination with the standard of care, hold promise for clinical application. Therefore, the disclosure of the intricate network between GM and depression will give precious insights for innovative diagnostic and therapeutic approaches towards depression, with profound implications for drug development and clinical practice.

Does the Mediterranean Diet Have Any Effect on Lipid Profile, Central Obesity and Liver Enzymes in Non-Alcoholic Fatty Liver Disease (NAFLD) Subjects? A Systematic Review and Meta-Analysis of Randomized Control Trials

The effectiveness of the Mediterranean diet (MD) in non-alcoholic fatty liver disease (NAFLD) subjects has been evaluated in several randomized controlled trials (RCTs). This systematic review and meta-analysis aimed to evaluate the overall effects of MD intervention in a cohort of NAFLD patients targeting specific markers such as central obesity, lipid profile, liver enzymes and fibrosis, and intrahepatic fat (IHF). Google Scholar, PubMed, and Scopus were explored to collect relevant studies from the last 10 years. RCTs with NAFLD subjects were included in this systematic review with a mean intervention duration from 6 weeks to 1 year, and different intervention strategies, mainly including energy restriction MD (normal or low glycaemic index), low-fat MD with increased monounsaturated and polyunsaturated fatty acids, and increased exercise expenditure. The outcomes measured in this meta-analysis were gamma-glutamyl transferase (GGT), alanine aminotransferase (ALT), total cholesterol (TC), waist circumference (WC), and liver fibrosis. Ten randomized controlled trials, which involved a total of 737 adults with NAFLD, were included. According to the results, the MD seems to decrease the liver stiffness (kPa) by -0.42 (CI95% -0.92, 0.09) (p = 0.10) and significantly reduce the TC by -0.46 mg/dl (CI95% -0.55, -0.38) (p = 0.001), while no significant findings were documented for liver enzymes and WC among patients with NAFLD. In conclusion, the MD might reduce indirect and direct outcomes linked with NAFLD severity, such as TC, liver fibrosis, and WC, although it is important to consider the variations across trials. Further RCTs are necessary to corroborate the findings obtained and provide further evidence on the role of the MD in the modulation of other disorders related to NAFLD.

The relationship between the Mediterranean diet and Axis I disorders: A systematic review of observational studies

Axis I disorders are one of the major health burdens worldwide. Evidence suggests that Mediterranean diet has key biological factors associated with reducing the progression of these disorders. This systematic review aimed to clarify the relationship between Mediterranean diet and Axis I disorders. PubMed and Scopus databases were searched from January 2016 up to June 2021. Those observational studies in English language that assessed the relationship between Mediterranean diet and Axis I disorders (such as depression, anxiety, eating disorders, schizophrenia, etc.) were included in this review. The Newcastle-Ottawa Scale was used to evaluate the quality of studies. Thirty-six studies (15 cohorts, 19 cross-sectional, and 2 case-control) met the inclusion criteria. The results revealed that more than two-thirds of the studies (25 studies, 69.44%) had significant protective relationship between receiving Mediterranean diet and reducing the symptoms or incidence of Axis I disorders. Most studies were performed on depression (29 studies measured depression at least as one of the Axis I disorders), of which 72.41% reported an inverse relationship. There were also 9 studies on anxiety (studies that measured anxiety at least as one of the Axis I disorders), that 77.77% of them observed protective association. Moreover, majority of the studies (25 studies, 69.44%) had high quality, of which 76% found an inverse relationship. In conclusion, it seems that the Mediterranean diet can reduce the symptoms or the occurrence of Axis I disorders (especially depression and anxiety). However, more extensive review studies, particularly with interventional designs, are necessary to prove the result.

A Reciprocal Link Between Gut Microbiota, Inflammation and Depression: A Place for Probiotics?

Depression is a severe mental disorder that places a significant economic burden on public health. The reciprocal link between the trillions of bacteria in the gut, the microbiota, and depression is a controversial topic in neuroscience research and has drawn the attention of public interest and press coverage in recent years. Mounting pieces of evidence shed light on the role of the gut microbiota in depression, which is suggested to involve immune, endocrine, and neural pathways that are the main components of the microbiota-gut-brain axis. The gut microbiota play major roles in brain development and physiology and ultimately behavior. The bidirectional communication between the gut microbiota and brain function has been extensively explored in animal models of depression and clinical research in humans. Certain gut microbiota strains have been associated with the pathophysiology of depression. Therefore, oral intake of probiotics, the beneficial living bacteria and yeast, may represent a therapeutic approach for depression treatment. In this review, we summarize the findings describing the possible links between the gut microbiota and depression, focusing mainly on the inflammatory markers and sex hormones. By discussing preclinical and clinical studies on probiotics as a supplementary therapy for depression, we suggest that probiotics may be beneficial in alleviating depressive symptoms, possibly through immune modulation. Still, further comprehensive studies are required to draw a more solid conclusion regarding the efficacy of probiotics and their mechanisms of action.

Pertinence of nutriments for a stalwart body

Nutrition plays a significant role in the prevention and treatment of common diseases. Some superb dietary choices such as functional foods and nutriments can surely help fight against certain diseases and provide various advantages to an individual's health. Plants have been regarded as a primary source of highly effective conventional drugs leading to the development of potential novel agents, which may boost the treatment. Growing demand for functional foods acts as an aid for the producers to expand in agriculture and pave the way for innovation and research by the nutraceutical industry. The given review highlights how various functional foods such as tomatoes, chocolates, garlic and flaxseed are currently being defined, their sources, benefit in treating various ailments and the challenges with their use.

Extra-Virgin Olive Oil Improves Depression Symptoms Without Affecting Salivary Cortisol and Brain-Derived Neurotrophic Factor in Patients With Major Depression: A Double-Blind Randomized Controlled Trial

BACKGROUND

Many patients with depression are reluctant to take psychiatric medications. Hence, complementary therapies such as nutritional considerations could be advantageous. The antidepressant potential of olive oil has been proved in observational studies.

OBJECTIVE

The effect of extra-virgin olive oil (EVOO) on depression symptoms and cortisol and brain-derived neurotrophic factor (BDNF) levels in patients with depression was examined.

DESIGN AND PARTICIPANTS

This was a double-blind randomized controlled trial conducted on 73 patients suffering from major depressive disorder in Shiraz, Iran, in 2016.

INTERVENTION

The patients were randomly assigned to intervention (EVOO) and control (sunflower oil) groups and consumed 25 mL/d of the corresponding oil for 52 days.

MAIN OUTCOME MEASURES

Depression symptoms were assessed by Beck Depression Inventory-II (BDI-II) and 7-item Hamilton Depression Rating Scale (HAMD-7). Salivary cortisol levels were determined immediately after awakening and 30 minutes later. Cortisol awakening response and the area under the curve with respect to ground and increase were computed. Serum BDNF concentrations were also measured.

STATISTICAL ANALYSES PERFORMED

Statistical analysis was conducted based on intention-to-treat and per-protocol approaches. Within-group changes were examined with repeated measures (for BDI-II and HAMD-7) and with paired t test (for other variables). Between-group comparisons were performed with analysis of covariance after adjustment for confounding factors.

RESULTS

In intention-to-treat analysis, HAMD-7 score was the only variable with significant changes within and between groups, the latter as a greater decline in EVOO group (P = .001). BDI-II score did not show significant change in either group but the between-group comparison revealed a significant difference (P = .021). EVOO showed antidepressant effect in severely depressed patients (P = .017 for BDI-II and 0.008 for HAMD-7) but not in mild/moderate depression category. Serum BDNF concentrations, salivary cortisol levels at immediately after awakening (T₀) and 30 minutes later, cortisol awakening response, the area under the curve with respect to ground and increase did not change within or between groups. Results of per-protocol analysis were not different.

CONCLUSIONS

The results of this study suggested beneficial effects of EVOO on depression symptoms in patients with severe depression but not in those with mild to moderate depression. The effects were significant from both statistical and clinical points of view.

Dietary patterns and depression risk in older adults: systematic review and meta-analysis

CONTEXT

Diet may be one of the modifiable environmental factors that could reduce depressive symptoms or abate the development of depression without side effects. However, previous reviews mainly focused on general adult populations.

OBJECTIVE

The aim of this systematic review and meta-analysis was to explore the association between healthy dietary patterns and depression risk in older adults.

DATA SOURCES

Eight databases were searched up to September 2019. The inclusion criteria were older adults aged ≥ 65 years, healthy dietary patterns, depression assessed by a physician or by validated screening tools, and quantitative study design.

DATA EXTRACTION

Data were extracted independently by 2 researchers, and the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline was followed.

DATA ANALYSIS

Meta-analysis was conducted by calculating the pooled odds ratio (OR) and 95% CIs. A total of 18 eligible studies were meta-analyzed. Results showed that a healthy dietary pattern is associated with a reduced risk of depression in older adults (OR, 0.85; 95%CI, 0.78-0.92; P < 0.001). There was high heterogeneity (I2 = 64.9%; P < 0.001) among the studies. Subgroup analyses indicated that sample size and depression screening tools were the main sources of study heterogeneity.

CONCLUSIONS

An inverse association between healthy dietary patterns and depression risk in older adults was found. However, the high heterogeneity among the studies should be considered.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD 42020169195.

Impact of a Nordic diet on psychological function in young students

BACKGROUND

There has been a rapid increase in the prevalence of psychiatric and psychological disease, and this has attracted interest in identifying modifiable lifestyle factors that may affect an individual's mood. Diet is one potential lifestyle factor that may affect psychological function.

AIM

This study aimed to investigate the relationship between adherence to the health-promoting Nordic diet (ND) with neuropsychological function in young women.

METHODS

The study comprised 181 female students aged between 18 and 25 years. Psychological function was evaluated using a series of standardized questionnaires, including the Cognitive Ability Questionnaire, Depression Anxiety Stress Scale, Insomnia Severity Index, Epworth Sleep Scale and Quality of Life Questionnaire. A validated food frequency questionnaire, which included 65 types of foods, was used to evaluate the amount of different foods consumed.

RESULTS

Evaluation of the dietary composition of the participants showed that the rate of adherence to the ND was positively associated with total energy, carbohydrates, protein, fibre, iron, magnesium, potassium, zinc, folate, phosphorus, vitamin C, thiamine, riboflavin, niacin, vitamins B6 and B12, carotene, whole grain, legumes, cabbage/vegetables, vegetables and fruit (p<0.05). Linear regression showed cabbage/vegetable consumption was inversely related to scores of stress (β=-0.04; p=0.038) and anxiety (β=-0.02; p=0.049) and directly associated with the quality-of-life score (0.02; p=0.036).

CONCLUSIONS

Adherence to a ND with a high intake of cabbage/vegetables was inversely associated with stress and anxiety scores and directly associated with health-related quality of life.

Fruit and Vegetable Intake and Mental Health in Adults: A Systematic Review

The role of a properly balanced diet in the prevention and treatment of mental disorders has been suggested, while vegetables and fruits have a high content of nutrients that may be of importance in the case of depressive disorders. The aim of the study was to conduct a systematic review of the observational studies analyzing association between fruit and vegetable intake and mental health in adults. The search adhered to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and the review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42019138148). A search for peer-reviewed observational studies published until June 2019 was performed in PubMed and Web of Science databases, followed by an additional manual search for publications conducted via analyzing the references of the found studies. With respect to the intake of fruit and/or vegetable, studies that assessed the intake of fruits and/or vegetables, or their processed products (e.g., juices), as a measure expressed in grams or as the number of portions were included. Those studies that assessed the general dietary patterns were not included in the present analysis. With respect to mental health, studies that assessed all the aspects of mental health in both healthy participants and subjects with physical health problems were included, but those conducted in groups of patients with intellectual disabilities, dementia, and eating disorders were excluded. To assess bias, the Newcastle-Ottawa Scale (NOS) was applied. A total of 5911 studies were independently extracted by 2 researchers and verified if they met the inclusion criteria using a 2-stage procedure (based on the title, based on the abstract). After reviewing the full text, a total of 61 studies were selected. A narrative synthesis of the findings from the included studies was performed, which was structured around the type of outcome. The studies included mainly focused on depression and depressive symptoms, but also other characteristics ranging from general and mental well-being, quality of life, sleep quality, life satisfaction, flourishing, mood, self-efficacy, curiosity, creativity, optimism, self-esteem, stress, nervousness, or happiness, to anxiety, minor psychiatric disorders, distress, or attempted suicide, were analyzed. The most prominent results indicated that high total intake of fruits and vegetables, and some of their specific subgroups including berries, citrus, and green leafy vegetables, may promote higher levels of optimism and self-efficacy, as well as reduce the level of psychological distress, ambiguity, and cancer fatalism, and protect against depressive symptoms. However, it must be indicated that the studies included were conducted using various methodologies and in different populations, so their results were not always sufficiently comparable, which is a limitation. Taken together, it can be concluded that fruits and/or vegetables, and some of their specific subgroups, as well as processed fruits and vegetables, seems to have a positive influence on mental health, as stated in the vast majority of the included studies. Therefore, the general recommendation to consume at least 5 portions of fruit and vegetables a day may be beneficial also for mental health.

Healthy dietary indices and risk of depressive outcomes: a systematic review and meta-analysis of observational studies

With depression being the psychiatric disorder incurring the largest societal costs in developed countries, there is a need to gather evidence on the role of nutrition in depression, to help develop recommendations and guide future psychiatric health care. The aim of this systematic review was to synthesize the link between diet quality, measured using a range of predefined indices, and depressive outcomes. Medline, Embase and PsychInfo were searched up to 31st May 2018 for studies that examined adherence to a healthy diet in relation to depressive symptoms or clinical depression. Where possible, estimates were pooled using random effect meta-analysis with stratification by observational study design and dietary score. A total of 20 longitudinal and 21 cross-sectional studies were included. These studies utilized an array of dietary measures, including: different measures of adherence to the Mediterranean diet, the Healthy Eating Index (HEI) and Alternative HEI (AHEI), the Dietary Approaches to Stop Hypertension, and the Dietary Inflammatory Index. The most compelling evidence was found for the Mediterranean diet and incident depression, with a combined relative risk estimate of highest vs. lowest adherence category from four longitudinal studies of 0.67 (95% CI 0.55-0.82). A lower Dietary Inflammatory Index was also associated with lower depression incidence in four longitudinal studies (relative risk 0.76; 95% CI: 0.63-0.92). There were fewer longitudinal studies using other indices, but they and cross-sectional evidence also suggest an inverse association between healthy diet and depression (e.g., relative risk 0.65; 95% CI 0.50-0.84 for HEI/AHEI). To conclude, adhering to a healthy diet, in particular a traditional Mediterranean diet, or avoiding a pro-inflammatory diet appears to confer some protection against depression in observational studies. This provides a reasonable evidence base to assess the role of dietary interventions to prevent depression. This systematic review was registered in the PROSPERO International Prospective Register of Systematic Reviews under the number CRD42017080579.

Adherence to the Mediterranean diet and risk of depression: a systematic review and updated meta-analysis of observational studies

CONTEXT

More than 300 million people worldwide have been diagnosed with depression, which is a leading cause of disability and disease burden. Elucidating dietary patterns that may reduce the risk of depression could help reduce the incidence of other diseases.

DATA SOURCES

PubMed/MEDLINE, ISI Web of Science, Scopus, Embase, and Google Scholar databases were searched to identify relevant publications up to May 2018.

STUDY SELECTION

All observational studies that considered the Mediterranean diet as the exposure variable and depression as the main outcome or as one of the outcome variables were included in this systematic review and meta-analysis. Two authors independently screened 3229 publications. A total of 14 observational studies were included in the meta-analysis.

DATA EXTRACTION

Two authors independently extracted the data and assessed the risk of bias.

RESULTS

The studies in the meta-analysis included a total of 56 043 participants. When 5 effect sizes from 4 cohort studies were combined, no significant association was observed between adherence to the Mediterranean diet and risk of depression (overall hazard ratio = 0.95; 95%CI, 0.79-1.16). When 3 effect sizes from 3 cohort studies that reported β coefficients were combined, again no significant association was found (β = -0.00; 95%CI, -0.12, 0.12). However, when 9 effect sizes from 9 cross-sectional studies were combined, an inverse significant association was found between adherence to the Mediterranean diet and risk of depression (overall odds ratio = 0.72; 95%CI, 0.60-0.87).

CONCLUSIONS

The analysis of cohort studies revealed no significant association was found between adherence to the Mediterranean diet and risk of depression. However, an inverse significant association between adherence to the Mediterranean diet and odds of depression in cross-sectional studies.

Sugar-sweetened beverages consumption and the risk of depression: A meta-analysis of observational studies

BACKGROUND

It remains inconsistent whether sugar-sweetened beverages (SSBs) consumption increases the risk of depression. Thus, we carried out a meta-analysis to evaluate the association between SSBs consumption and the risk of depression.

METHODS

PubMed and Web of Science were searched for relevant articles published up to June 2018. Pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated by the fixed-effects model or random effect model based on heterogeneity test.

RESULTS

10 observational studies involving 37,131 depression cases among 365,289 participants were included. The combined risk of depression for the highest versus lowest consumption of SSBs was 1.31 (95% CI 1.24-1.39). The findings were consistent in the cross-sectional studies (RR = 1.38; 95% CI 1.26-1.52) as well as in the cohort studies (RR = 1.30; 95% CI 1.19-1.41) A nonlinear dose-response relationship was found (P_nonlinearity = 0.0103) for depression risk and SSBs consumption. Compared with SSBs nondrinkers, those who drank the equivalent of 2 cups/day of cola might increase the risk of depression by 5% (RR = 1.05; 95% CI 1.01-1.09). And the equivalent of 3cans/day of cola might have approximately 25% higher risk of depression.

LIMITATIONS

10 studies were included in this meta-analysis, of which only 4 were cohort studies, and more cohort studies need to be performed in the future.

CONCLUSIONS

This meta-analysis indicates that SSBs consumption might be associated with a modestly higher risk of depression. The results need to be further confirmed in the future.

CLOCK gene polymorphisms and quality of aging in a cohort of nonagenarians - The MUGELLO Study

A total of 356 elderly subjects [257F; 88–106 years] were genotyped for three polymorphisms of the CLOCK gene by TaqMan real-time PCR approach, in order to find associations with quality of aging. Subjects homozygous for the minor allele of rs1801260 were less frequently overweight (p = 0.046), had higher fasting glucose levels (p = 0.037), better scores at the Clock Drawing Test (CDT) (p = 0.047) and worse scores at the Geriatric Depression Scale (p = 0.032). Subjects homozygous for the minor allele of rs11932595 showed higher fasting glucose levels (p = 0.044) and better scores at CDT (p = 0.030). Conversely, subjects homozygous for the minor allele of rs4580704 showed higher triglyceride (p = 0.012), and LDL-cholesterol levels (p = 0.44), and a greater adherence to the Mediterranean diet (MD) (p = 0.044). In addition, AAC, AAG, GGC and AGC (rs1801260–rs11932595–rs4580704) haplotypes were analyzed: AAG was associated with higher risk of overweight (p = 0.008), hypertriglyceridemia (p = 0.040) and hypercholesterolemia (p = 0.036); GGC with lower risk of hyperglycemia (p = 0.022), better sleep pattern (p = 0.001) and with better score at mini-mental state examination (p = 0.010); AGC with lower risk of depression (p = 0.026) and AAC with lower adherence to the MD (p = 0.028). Therefore, CLOCK gene polymorphisms let us hypothesize an involvement in the quality of aging in a cohort of nonagenarians.

HDL Cholesterol Is Independently Associated with Cognitive Function in Males But Not in Females within a Cohort of Nonagenarians: The MUGELLO Study

OBJECTIVES

To investigate the possible relationship between lipid profile and cognitive functions in a cohort of nonagenarians enrolled within the Mugello Study, an epidemiological study aimed at investigating both clinically relevant geriatric items and various health issues.

DESIGN

Cross-sectional survey.

SETTING

This study focused on oldest old community-dwelling participants.

PARTICIPANTS

Three hundred twenty-five nonagenarians (218 F, median age: 92 years).

MEASUREMENTS

Participants were evaluated through laboratory, instrumental examinations and questionnaires concerning lifestyle, dietary habits and cognitive status.

RESULTS

Females are older, with a lower level of education, live more prevalently on their own and have higher values for total cholesterol and high-density lipoprotein cholesterol (HDL) compared to males. With regard to functional and cognitive measures females report a significantly lower skill level in the physical activity performance, with a level of independence that is better for both basic and instrumental activities. In order to investigate whether there was an association between lipid variables and cognitive function as measured by the Mini-Mental State Examination a multiple regression analysis was performed with adjustments for confounding variables based on gender. In males, HDL cholesterol showed a significant relationship with Mini-Mental State Examination after a complete adjustment with years of education, physical activity performance and daily living activities (β = 0.174; p=0.037). In females HDL cholesterol showed a significant association only in the model adjusted for age and body mass index, losing its associations as soon as the cohabitation state and the depression status entered the model.

CONCLUSION

Our results support the hypothesis that HDL cholesterol is significantly linked to cognitive functions, especially in males of a cohort of very old people.