Associations between nutrition and the incidence of depression in middle-aged and older adults: A systematic review and meta-analysis of prospective observational population-based studies

Common questions and misconceptions about caffeine supplementation: what does the scientific evidence really show?

Caffeine is a popular ergogenic aid that has a plethora of evidence highlighting its positive effects. A Google Scholar search using the keywords "caffeine" and "exercise" yields over 200,000 results, emphasizing the extensive research on this topic. However, despite the vast amount of available data, it is intriguing that uncertainties persist regarding the effectiveness and safety of caffeine. These include but are not limited to: 1. Does caffeine dehydrate you at rest? 2. Does caffeine dehydrate you during exercise? 3. Does caffeine promote the loss of body fat? 4. Does habitual caffeine consumption influence the performance response to acute caffeine supplementation? 5. Does caffeine affect upper vs. lower body performance/strength differently? 6. Is there a relationship between caffeine and depression? 7. Can too much caffeine kill you? 8. Are there sex differences regarding caffeine's effects? 9. Does caffeine work for everyone? 10. Does caffeine cause heart problems? 11. Does caffeine promote the loss of bone mineral? 12. Should pregnant women avoid caffeine? 13. Is caffeine addictive? 14. Does waiting 1.5-2.0 hours after waking to consume caffeine help you avoid the afternoon "crash?" To answer these questions, we performed an evidence-based scientific evaluation of the literature regarding caffeine supplementation.

Associations between fruit and vegetable intakes and incident depression in middle-aged and older adults from 10 diverse international longitudinal cohorts

BACKGROUND

Emerging observational evidence supports a role for higher fruit and vegetable intake in protecting against the development of depression. However, there is a scarcity of research in older adults or in low- to middle-income countries (LMICs).

METHODS

Participants were 7801 community-based adults (mean age 68.6 ± 8.0 years, 55.8 % female) without depression, from 10 diverse cohorts, including four cohorts from LMICs. Fruit and vegetable intake was self-reported via comprehensive food frequency questionnaire, short food questionnaire or diet history. Depressive symptoms were assessed using validated measures, and depression defined applying validated cut-offs. The associations between baseline fruit and vegetable intakes and incident depression over a follow-up period of three to nine years were examined using Cox regression. Analyses were performed by cohort with results meta-analysed.

RESULTS

There were 1630 cases of incident depression (21 % of participants) over 40,258 person-years of follow-up. Higher intake of fruit was associated with a lower risk of incident depression (HR 0.87, 95%CI [0.77, 0.99], I2 = 4 %). No association was found between vegetable intake and incident depression (HR 0.93, 95%CI [0.84, 1.04], I2 = 0 %).

LIMITATIONS

Diverse measures used across the different cohorts and the modest sample size of our study compared with prior studies may have prevented an association being detected for vegetable intake.

CONCLUSIONS

Our study supports a role for fruit, but not vegetable intake in protecting against depression. Research investigating different types of fruits and vegetables using standardised measures in larger cohorts of older adults from low- and middle-income countries is warranted.

Dietary Patterns and Geriatric Syndromes in older Mexican adults: Analysis of the 2018-19 National Health and Nutrition Survey

BACKGROUND

The study of dietary patterns in older adults (OA) and their association with geriatric syndromes (GS) is scarce in Latin America.

OBJECTIVE

To describe the association of dietary patterns with GS in the Mexican older adult population, using data from the 2018-19 National Health and Nutrition Survey.

METHODS

Dietary data were collected from 3,511 adults (≥60 years of age, both sexes) using a semi-quantitative food frequency questionnaire. Dietary patterns were derived by principal component analysis based on the consumption of 162 foods from 24 food groups. The GS studied were: frailty, depressive symptoms (DS), low appendicular skeletal muscle mass (ASMM); additionally, we studied inflammation (serum CRP>5 mg/L). Logistic regression models were used.

RESULTS

Four major dietary patterns were identified: a) "Western", b) "Prudent", c) "Soups", and d) "Traditional". The middle and higher tertiles of the "Prudent" pattern were associated with lower odds of DS (OR 0.71, p = 0.04; and OR 0.61, p = 0.008), respectively. The second tertile of the "Soups" pattern was associated with lower odds of low ASMM (OR 0.68, p = 0031) and inflammation (OR 0.58, p = 0.022). The highest tertile of the "Traditional" pattern was associated with low ASMM (OR 1.55, p = 0.008) and lower odds of inflammation (OR 0.69, p = 0.044). No association was found between the "Western" dietary pattern and GS.

CONCLUSIONS

Three of four major dietary patterns were associated with GS in older Mexican adults. Further studies are needed to address strategies to improve diet quality in this age group and its association with health and functional outcomes.

The association of the Prime Diet Quality Score (PDQS) with depression and anxiety symptoms: the Isfahan functional disorders (ISFUN) cohort study

Background: Due to scarce epidemiologic data regarding the Prime Diet Quality Score (PDQS) and mental health disorders, this study aimed to investigate the association of PDQS with depression and anxiety symptoms in Iranian adults.Methods: This cross-sectional analysis was performed using the baseline data collected for the Isfahan functional disorders (ISFUN) cohort study. ISFUN was established in 2017 and enrolled apparently healthy adults, aged 18-65 years in Isfahan, Iran. Information on usual dietary intakes was collected using a validated Dish-based, 106-item food frequency questionnaire. The severity of depression and anxiety was assessed using a validated Iranian version of the Hospital Anxiety and Depression Scale.Results: A total number of1892 participants were enrolled in the present study. In total, 54.50% of subjects were female. In the fully adjusted model, participants with PDQS lower than median compared with those with PDQS higher than median had higher risk of depression (OR =   1.62; 95% CI: 1.11, 2.37) and anxiety (OR: 1.57; 95% CI: 1.08, 2.27). In stratified analysis by sex, males with PDQS lower than median compared with those with PDQS higher than median had greater risk for depressive (OR: 1.57) and anxiety symptoms (OR =   1.52). However, in females, no significant association was found between PDQS and odds of depression, and anxiety in the fully adjusted model.Conclusion: We found evidence indicating a significant inverse association between PDQS and depression and anxiety symptoms among Iranian adults. Further studies, in particular with prospective design, are required to confirm these findings.

Mediterranean diet protects against a neuroinflammatory cortical transcriptome: Associations with brain volumetrics, peripheral inflammation, social isolation, and anxiety in nonhuman primates (Macaca fascicularis)

Mediterranean diets may be neuroprotective and prevent cognitive decline relative to Western diets; however, the underlying biology is poorly understood. We assessed the effects of Western versus Mediterranean-like diets on RNAseq-generated transcriptional profiles in lateral temporal cortex and their relationships with longitudinal changes in neuroanatomy, circulating monocyte gene expression, and observations of social isolation and anxiety in 38 socially-housed, middle-aged female cynomolgus macaques (Macaca fascicularis). Diet resulted in differential expression of seven transcripts (FDR < 0.05). Cyclin dependent kinase 14 (CDK14), a proinflammatory regulator, was lower in the Mediterranean group. The remaining six transcripts [i.e., "lunatic fringe" (LFNG), mannose receptor C type 2 (MRC2), solute carrier family 3 member 2 (SLCA32), butyrophilin subfamily 2 member A1 (BTN2A1), katanin regulatory subunit B1 (KATNB1), and transmembrane protein 268 (TMEM268)] were higher in cortex of the Mediterranean group and generally associated with anti-inflammatory/neuroprotective pathways. KATNB1 encodes a subcomponent of katanin, important in maintaining microtubule homeostasis. BTN2A1 is involved in immunomodulation of γδ T-cells which have anti-neuroinflammatory and neuroprotective effects. CDK14, LFNG, MRC2, and SLCA32 are associated with inflammatory pathways. The latter four differentially expressed cortex transcripts were associated with peripheral monocyte transcript levels, neuroanatomical changes determined by MRI, and with social isolation and anxiety. These results provide important insights into the potential mechanistic processes linking diet, peripheral and central inflammation, and behavior. Collectively, our results provide evidence that, relative to Western diets, Mediterranean diets confer protection against peripheral and central inflammation which is reflected in preserved brain structure and socioemotional behavior. Ultimately, such protective effects may confer resilience to the development of neuropathology and associated disease.

Exercise and Nutrition in the Mental Health of the Older Adult Population: A Randomized Controlled Clinical Trial

(1) Background: Global population aging is changing demographic structures and presents significant challenges for health systems, which must adapt to an increasingly elderly population. (2) Methods: The study employed a randomized controlled trial design with a total of 116 older adults aged 65 or older, randomly assigned to an experimental group (n = 57) undergoing a combined resistance program and Mediterranean diet program and a control group (n = 59) who did not receive any intervention. Anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale (HADS), sleep quality through the Pittsburgh Sleep Quality Index (PSQI), and perceived stress using the Perceived Stress Scale (PSS). (3) Results: Statistically significant improvements (p < 0.05) were observed both within and between groups in anxiety (Cohen's d = 0.38 and 0.78, respectively), depression (Cohen's d = 0.56 and 0.18, respectively), perceived stress (Cohen's d = 0.15 and 0.39, respectively), and in the PSQI domains: subjective sleep quality (Cohen's d = 1.01 and 0.53, respectively), sleep duration (Cohen's d = 0.112 and 0.53, respectively), sleep disturbances (Cohen's d = 1.92 and 0.95, respectively), use of medications (Cohen's d = 0.34 and 0.40, respectively), and the PSQI total score (Cohen's d = 0.68 and 0.49, respectively). No significant differences were observed in sleep latency or daytime dysfunction. (4) Conclusions: The results of the present study suggest that resistance intervention may be an effective therapeutic option to improve mental health and sleep quality in older adults aged 65 or older, offering a non-pharmacological approach to improving overall well-being in this demographic.

Associations between dietary habits and bipolar disorder: a diet-wide mendelian randomization study

Background

Diet/nutrition is critically important in the pathogenesis, progression, and treatment outcomes of various mental disorders. Current research predominantly focuses on the role of diet in the development and treatment of depression, with less attention given to the relationship between diet and Bipolar Disorder (BD).

Method

We employed Mendelian Randomization (MR) to investigate the relationship between 28 dietary habits and BD. An analysis was conducted using publicly available genome-wide association study data from the UK Biobank dataset. Various dietary habits were analyzed as exposures with BD as the outcome, mainly using the Inverse Variance Weighted (IVW) method.

Results

Intake of non-oily fish and sponge pudding both have a positive association with BD. Oily fish, dried fruit, apples, salt, and cooked vegetables intake also appeared potentially risky for BD, although the possibility of false positives cannot be ruled out. Sensitivity analysis further confirmed the robustness of these findings.

Conclusion

Our research provides evidence of a relationship between various dietary habits and BD. It underscores the need for careful dietary management and balance to reduce the risk of BD, suggesting caution with dietary preferences for fish and sponge pudding. Furthermore, more detailed studies are needed to further understand the potential impacts of high-sugar and high-protein diets on BD development.

A Narrative Review of the Association Between Healthy Dietary Patterns and Depression

The purpose of the present review is the investigation of healthy dietary patterns and diet quality in relation to depression risk. Nutritional psychiatry is to develop scientifically based research that defines the role of nutrition and nutrients in various aspects of mental health. Growing evidence from the field suggests that diet may play an important role in the prevention and/or treatment of depression. In contrast, there is evidence that unhealthy diets may increase the risk of depression. This emerging research suggests that dietary interventions could help prevent depression or be an alternative or adjunctive therapy for depression. The Mediterranean diet (MedDiet), the Dietary Approaches to Stop Hypertension (DASH) diet, and the vegetarian diet are examined in this review. The electronic databases PubMed, Scopus, and Google Scholar were searched for relevant studies published during the last five years. We found many results that support that healthy eating patterns (high in vegetables, fruits, whole grains, nuts, seeds, and fish, low in processed foods) are related to a reduction in the risk of depression. The most robust findings are related to MedDiet, where we also found several positive results for the DASH diet. Regarding the vegetarian diet, there are inconsistent reports. Furthermore, a consistent finding refers to a lower Dietary Inflammatory Index (DII) as associated with a lower depression risk. It has been observed that people suffering from depression have poorer nutritional quality, with lower fruit and vegetable intake. This observation may strengthen the argument that nutritional interventions should be incorporated as an important "pillar" in the multifactorial treatment of patients. However, more well-designed studies are needed to establish the relationship between dietary patterns and mental health. In particular, interventional, longitudinal studies could be more enlightening.

Plant-based diet associated with better quality of life in prostate cancer survivors

BACKGROUND

Plant-based diets have many health benefits, including a lower risk of fatal prostate cancer, and greater environmental sustainability. However, less is known regarding the impact of plant-based diets on quality of life among individuals diagnosed with prostate cancer. The authors' objective was to examine the relationship between plant-based diet indices postdiagnosis with quality of life.

METHODS

This prospective cohort study included 3505 participants in the Health Professionals Follow-Up Study (1986-2016) with nonmetastatic prostate cancer. Food-frequency questionnaires were used to calculate overall and healthful plant-based diet indices. Quality-of-life scores were calculated using the Expanded Prostate Cancer Index Composite. Generalized estimating equations were used to examine associations over time between plant-based diet indices and quality-of-life domains (sexual functioning, urinary irritation/obstruction, urinary incontinence, bowel functioning, hormonal/vitality), adjusted for demographics, oncologic history, body mass index, caloric intake, health-related behaviors, and comorbidities.

RESULTS

The median age at prostate cancer diagnosis was 68 years; 48% of patients underwent radical prostatectomy, and 35% received radiation as primary therapy. The median time from diagnosis/treatment to first the quality-of-life questionnaire was 7.0 years. A higher plant-based diet index was associated with better scores for sexual function, urinary irritation/obstruction, urinary incontinence, and hormonal/vitality. Consuming more healthful plant-based foods was also associated with better sexual and bowel function, as well as urinary incontinence and hormonal/vitality scores in the age-adjusted analysis, but not in the multivariable analysis.

CONCLUSIONS

This prospective study provides supportive evidence that greater consumption of healthful plant-based foods is associated with modestly higher scores in quality-of-life domains among patients with prostate cancer.

Exploring the Relationship between Mediterranean Diet Adherence and Subjective Well-Being among Greek and Cypriot Adults

Associations between subjective well-being (SWB) and dietary habits, employment status, and habitual activities are increasingly capturing the focus of researchers as well as policymakers worldwide. This study aimed to explore these associations in a sample of the population in Greece and Cyprus via an online survey. In total, 936 questionnaires (470: Cyprus, 466: Greece) were analyzed to study the associations between the Mediterranean Diet (MD) (using the 14-item MEDAS score, (14-MEDAS)), subjective well-being (SWB), and several socioeconomic factors. Key remarks of this survey highlight the positive impact of MD adherence on some well-being items. Namely, statistically significant differences were found on the following items: Satisfied with life (p < 0.001), Life worthwhile (p < 0.001), Feeling happy (p < 0.001), worried (p = 0.005), and depressed (p = 0.001), when comparing Low MD adherence (14-MEDAS < 5) to High MD adherence (14-MEDAS > 10). Other lifestyle habits such as spending time with friends and family, spending time in nature, and habitual physical activity were associated with aspects of SWB such as Life satisfaction, Life worthwhile, Feeling happy, and energetic. The findings support adherence to the MD, since it is associated with higher life satisfaction and self-reported happiness in this sample and should be considered when developing health policies on well-being.

Social desirability bias is related to children's energy intake in a laboratory test meal paradigm

Dietary intake is notoriously difficult to measure in children. Laboratory test meals address some of the methodological concerns of self-report methods, but may also be susceptible to social desirability bias, referring to the tendency for individuals to adjust their behaviors in order to be perceived more positively. The aim of the current study was to evaluate whether social desirability bias was associated with children's energy intake during a laboratory test meal, and whether this association varied by food type (total caloric intake, snack food intake, fruit/vegetable intake) and sex. A total of 82 children (M age = 9.45 ± 0.85; 50 % girls; 84.1 % rural; 85.4 % White) completed several surveys, including the Children's Social Desirability Scale and had their body composition measured. At lunchtime, they were granted access to a multi-array test meal (>5000 kcal). After adjusting for lean mass, fat mass, depressive symptoms, and parental food restriction, children who reported higher social desirability bias consumed fewer calories from snack foods (B = -11.58, p = .009, semi-partial correlation = -0.28). Boys with higher social desirability bias consumed less calories from fruits and vegetables (B = -6.47, p = .010, semi-partial correlation = -0.411); this association was not significant in girls. The desire to be perceived in a positive manner may influence children's eating behaviors in experimental paradigms. Replication studies with larger, more diverse pediatric samples are needed, as are strategies to reduce the effects of social desirability bias on test meal intake in order to enhance the validity of this dietary assessment approach.

French Society for Biological Psychiatry and Neuropsychopharmacology (AFPBN) guidelines for the management of patients with partially responsive depression and treatment-resistant depression: Update 2024

INTRODUCTION

The purpose of this update is to add newly approved nomenclatures and treatments as well as treatments yet to be approved in major depressive disorder, thus expanding the discussions on the integration of resistance factors into the clinical approach.

METHODS

Unlike the first consensus guidelines based on the RAND/UCLA Appropriateness Method, the French Association for Biological Psychiatry and Neuropsychopharmacology (AFPBN) developed an update of these guidelines for the management of partially responsive depression (PRD) and treatment-resistant depression (TRD). The expert guidelines combine scientific evidence and expert clinicians' opinions to produce recommendations for PRD and TRD.

RESULTS

The recommendations addressed three areas judged as essential for updating the previous 2019 AFPBN guidelines for the management of patients with TRD: (1) the identification of risk factors associated with TRD, (2) the therapeutic management of patients with PRD and TRD, and (3) the indications, the modalities of use and the monitoring of recent glutamate receptor modulating agents (esketamine and ketamine).

CONCLUSION

These consensus-based guidelines make it possible to build bridges between the available empirical literature and clinical practice, with a highlight on the 'real world' of the clinical practice, supported by a pragmatic approach centred on the experience of specialised prescribers in TRD.

Adherence to a Mediterranean Diet Is Inversely Associated with Anxiety and Stress but Not Depression: A Cross-Sectional Analysis of Community-Dwelling Older Australians

Diet quality may be an important modifiable risk factor for mental health disorders. However, these findings have been inconsistent, particularly in older adults. We explored the independent associations between adherence to a Mediterranean diet (MedDiet) and severity of symptoms related to depression, anxiety and stress in older adults from Australia. This was a cross-sectional analysis of older Australians ≥ 60 years. MedDiet adherence was assessed using the Mediterranean Diet Adherence Screener (MEDAS), and the Depression, Anxiety and Stress Scale (DASS-21) was used to assess the severity of negative emotional symptoms. A total of n = 294 participants were included in the final analyses (70.4 ± 6.2 years). Adherence to a MedDiet was inversely associated with the severity of anxiety symptoms (β = -0.118; CI: -0.761, -0.012; p = 0.043) independent of age, gender, BMI, physical activity, sleep, cognitive risk and ability to perform activities of daily living. Furthermore, MedDiet adherence was inversely associated with symptoms of stress (β = -0.151; CI: -0.680, -0.073; p = 0.015) independent of age, gender, BMI, physical activity and sleep. However, no relationship between MedDiet adherence and depressive symptoms was observed. We showed that adherence to a MedDiet is inversely associated with the severity of symptoms related to anxiety and stress but not depression. Exploring these findings with the use of longitudinal analyses and robust clinical trials are needed to better elucidate these findings in older adults.

Vegetables, fruits, and berries - a scoping review for Nordic Nutrition Recommendations 2023

Vegetables, fruits, and berries comprise a large variety of foods and are recognised to play an important role in preventing chronic diseases. Many observational studies have been published during the last decade, and the aim of this scoping review is to describe the overall evidence for the role of vegetables, fruits, and berries for health-related outcomes as a basis for setting and updating food-based dietary guidelines. A scoping review was conducted according to the protocol developed within the Nordic Nutrition Recommendations 2023 project. Current available evidence strengthens the role of consuming vegetables, fruits, and berries in preventing chronic diseases. The most robust evidence is found for cancer in the gastric system and lung cancer, cardiovascular disease, and all-cause mortality. Steeper risk reductions are generally seen at the lower intake ranges, but further reductions have been seen for higher intakes for cardiovascular disease. Weaker associations are seen for type 2 diabetes. There is evidence that suggests a beneficial role also for outcomes such as osteoporosis, depression, cognitive disorders, and frailty in the elderly. The observed associations are supported by several mechanisms, indicting causal effects. Some subgroups of vegetables, fruits, and berries may have greater benefits than other subgroups, supporting a recommendation to consume a variety of these foods.

Low-carbohydrate diet as a nutritional intervention in a major depression disorder: focus on relapse prevention

Objectives: Mood disorders are trending to be among the leading causes of years lived with disability. Despite multiple treatment options, around 30% patients with major depressive disorder (MDD) develop treatment resistant depression (TRD) and fail to respond to current pharmacological therapies. This study aimed to explore the potential benefits of nutritional treatment strategies, along with their molecular mechanisms of action, focusing especially on low-carbohydrate diet (LCHD), ketogenic diet (KD) and other strategies based on carbohydrates intake reduction.Methods: A comprehensive literature review was conducted to determine the impact of LCHD on alleviating depressive symptoms in patients with MDD, along with an explanation of its mode of action.Results: The study revealed significant impact of nutritional interventions based on restriction in carbohydrate intake such as LCHD, KD or sugar-sweetened beverages (SSB) exclusion on anxiety or depression symptoms reduction, mood improvement and lower risk of cognitive impairment or depression. The efficacy of these approaches is further substantiated by their underlying molecular mechanisms, mainly brain-derived neurotrophic factor (BDNF) which is a potential key target of sugar restriction diets in terms of neuroplasticity.Discussion: Healthcare professionals may consider implementing LCHD strategies for MDD and TRD patients to modify the disease process, maintain euthymia, and prevent depressive episode relapses. Ranging from the exclusion of SSB to the adherence to rigorous LCHD regimens, these nutritional approaches are safe, straightforward to implement, and may confer benefits for well-being and relapse prevention in this specific patient population.

Diets intervene osteoporosis via gut-bone axis

Osteoporosis is a systemic skeletal disease that seriously endangers the health of middle-aged and older adults. Recently, with the continuous deepening of research, an increasing number of studies have revealed gut microbiota as a potential target for osteoporosis, and the research concept of the gut-bone axis has gradually emerged. Additionally, the intake of dietary nutrients and the adoption of dietary patterns may affect the gut microbiota, and alterations in the gut microbiota might also influence the metabolic status of the host, thus adjusting bone metabolism. Based on the gut-bone axis, dietary intake can also participate in the modulation of bone metabolism by altering abundance, diversity, and composition of gut microbiota. Herein, combined with emerging literatures and relevant studies, this review is aimed to summarize the impacts of different dietary components and patterns on osteoporosis by acting on gut microbiota, as well as underlying mechanisms and proper dietary recommendations.

The effect of Mediterranean diet instructions on depression, anxiety, stress, and anthropometric indices: A randomized, double-blind, controlled clinical trial

Evidence suggests that adopting a healthy diet, such as the Mediterranean Diet (MD), can positively affect mental health. To further explore this, a study was conducted to determine the impact of MD instruction over 12 weeks on depression, anxiety, stress, and anthropometric indices. The study is a randomized, double-blind, controlled clinical trial with sixty participants who reported stress, anxiety, and depression conducted in Tabriz, Iran (2022-2023). They were randomly assigned to either the intervention group (n = 30), which received MD instruction, or the control group (n = 30), which received standard healthy nutrition education. Both groups were asked to follow their respective nutrition education plans for 12 weeks. After 12 weeks, depression, anxiety, and stress levels were measured using the DASS-21 questionnaire, and anthropometric indices were assessed. Initially, the unadjusted DASS-21 scores for depression, anxiety, and stress did not show significant differences between the two groups. However, after adjusting for baseline variables (model 2), all scores decreased significantly (the P-value for all scores was < 0.001). There was no significant difference in weight and BMI between the intervention and control groups. However, after adjusting the results based on baseline values (Model 2) and adherence to the program (Model 3), weight and BMI were significantly reduced in the MD group (P-values for both cases and both models were < 0.001). Overall, despite some significant findings, the results were not noticeable from a clinical perspective. The study provides some indications that following the Mediterranean diet may lead to improvements in weight and mental well-being.

The Role of a Plant-Only (Vegan) Diet in Gastroesophageal Reflux Disease: Online Survey of the Italian General Population

The relationship between food and the pathophysiological mechanisms of gastroesophageal reflux disease (GERD) is unclear. There are few data on the impact of dietary habits on GERD symptoms and on the incidence of GERD in subjects undergoing plant-based diets. In this study, we investigated the association between diet and GERD, using data collected through an online survey of the Italian general population. In total, 1077 subjects participated in the study. GERD was defined according to the Montreal Consensus. For all subjects age, gender, body mass index (BMI), marital status, education, occupation, alcohol consumption, and smoking habits were recorded. All participants also completed the SF-36 questionnaire on Quality of Life. A total of 402 subjects (37.3%) were vegans and 675 (62.7%) non-vegans. The prevalence of GERD in the total population was 9%. Subjects with GERD-related symptoms recorded a worse quality of life according to SF-36 analysis (p < 0.05 for all dimensions). In multivariate analysis, after adjusting for confounders, participants undergoing a vegan diet had a significantly lower risk of GERD (OR = 0.47, 95% CI 0.28-0.81, p = 0.006). These findings should be taken into account to inform the lifestyle management of GERD.

Mediterranean Diet Protects Against a Neuroinflammatory Cortical Transcriptome: Associations with Brain Volumetrics, Peripheral Inflammation, Social Isolation and Anxiety

INTRODUCTION

Mediterranean diets may be neuroprotective and prevent cognitive decline relative to Western diets, however the underlying biology is poorly understood.

METHODS

We assessed the effects of Western vs. Mediterranean-like diets on RNAseq generated transcriptional profiles in temporal cortex and their relationships with changes in MRI neuroimaging phenotypes, circulating monocyte gene expression, and observations of social isolation and anxiety in 38 socially-housed, middle-aged female cynomolgus macaques.

RESULTS

Diet resulted in differential expression of seven transcripts (FDR<0.05). Cyclin dependent kinase 14 ( CDK14 ), a proinflammatory regulator, was lower in the Mediterranean group. The remaining six transcripts [i.e., "lunatic fringe" ( LFNG ), mannose receptor C type 2 ( MRC2 ), solute carrier family 3 member 2 ( SLCA32 ), butyrophilin subfamily 2 member A1 ( BTN2A1 ), katanin regulatory subunit B1 ( KATNB1 ), and transmembrane protein 268 ( TMEM268 )] were higher in cortex of the Mediterranean group and generally associated with anti-inflammatory/neuroprotective pathways. KATNB1 encodes a subcomponent of katanin, important in maintaining microtubule homeostasis. BTN2A1 is involved in immunomodulation of γδ T-cells which have anti-neuroinflammatory and neuroprotective effects. CDK14 , LFNG , MRC2, and SLCA32 are associated with inflammatory pathways. The latter four differentially expressed cortex transcripts were associated with monocyte transcript levels, changes in AD-relevant brain volumes determined by MRI over the course of the study, and social isolation and anxiety. CDK14 was positively correlated with monocyte inflammatory transcripts, changes in total brain, gray matter, cortical gray matter volumes, and time alone and anxious behavior, and negatively correlated with changes in total white matter and cerebrospinal fluid (CSF) volumes. In contrast, LFNG , MRC2 , and SLCA32 were negatively correlated with monocyte inflammatory transcripts and changes in total gray matter volume, and positively correlated with CSF volume changes, and SLCA32 was negatively correlated with time alone.

DISCUSSION

Collectively, our results suggest that relative to Western diets, Mediterranean diets confer protection against peripheral and central inflammation which is reflected in preserved brain structure and behavior.

Adverse childhood experiences and depressive symptoms among middle-aged or older adults in China and the mediating role of short sleep duration

BACKGROUND

Limited research has simultaneously examined the link between adverse childhood experiences (ACEs), short sleep duration, and depressive symptoms among middle-aged or older Chinese adults. This study aims to investigate the association between ACEs and later-life depressive symptoms, and to examine the mediating role of short sleep duration (<6 h/night) in this association.

METHODS

Data of 11,452 participants aged ≥45 years were obtained from the China Health and Retirement Longitudinal Study. Information on ACEs, depressive symptoms, and sleep duration were reported via questionnaires. The mediating effect of short sleep duration in the association between ACEs and depressive symptoms was examined by Baron and Kenny's causal steps method and Karlson/Holm/Breen (KHB) method.

RESULTS

Compared to non-exposed group, exposure to ACEs was significantly associated with increased odds of depressive symptoms in a dose-response pattern. The odds ratio of depressive symptoms increased from 1.27 (95 % CI: 1.11-1.46) for one ACE to 3.38 (95 % CI: 2.92-3.90) for ≥4 ACEs. The KHB method identified significant mediating role of short sleep duration in the association between experiencing three or more ACEs and depressive symptoms, with the proportional mediation estimated at 8.96 % and 8.85 % for the groups with 3 ACEs and ≥4 ACEs, respectively. The results were consistent across genders and gender did not moderate these associations.

LIMITATIONS

The cross-sectional design limited the ability to make causal inference.

CONCLUSIONS

ACEs were positively associated with depressive symptoms, and short sleep duration partially mediated this association. Promoting optimal sleep duration among ACE-exposed individuals might improve their mental health.

A meta-analysis of the association between loneliness and all-cause mortality in older adults

Despite the well-established association between loneliness and all-cause mortality in older adults, it remains unknown whether this association holds for older adults of different sex and whether it is influenced by different samples and study characteristics. Thus, this meta-analysis aims to examine moderators of the association between loneliness and all-cause mortality in older adults. To this end, relevant literature was retrieved from the PubMed, Embase, PsycINFO, Web of Science, Chinese National Knowledge Infrastructure, Weipu, and Wanfang databases (inception to May 2023) and was processed in the Comprehensive Meta-Analysis 3.3 software. Moreover, subgroup analysis was performed to explore the sources of heterogeneity and further explore potential moderators. Funnel plots, Begg's test, and Egger's linear regression test were used to examine the publication bias, and sensitivity analysis was used to test the robustness of the results. Thirty-six studies involving 128,927 older adults were included in this meta-analysis. In general, loneliness was related to an increase in all-cause mortality in older adults (HR = 1.09, 95% CI = 1.06-1.12, I2 = 63.31%, p < 0.001). The overall effect size for older men was 1.18 (95% CI = 1.04-1.33, p = 0.010). The association between loneliness and all-cause mortality was found to be significantly influenced by the source country of the data, follow-up length, and covariates for chronic disease as moderators. In conclusion, loneliness among older adults deserves more attention, and services are needed to improve their mental health.

The interactive effects of psychosocial stress and diet composition on health in primates

Social disadvantage and diet composition independently impact myriad dimensions of health. They are closely entwined, as social disadvantage often yields poor diet quality, and may interact to fuel differential health outcomes. This paper reviews effects of psychosocial stress and diet composition on health in nonhuman primates and their implications for aging and human health. We examined the effects of social subordination stress and Mediterranean versus Western diet on multiple systems. We report that psychosocial stress and Western diet have independent and additive adverse effects on hypothalamic-pituitary-adrenal and autonomic nervous system reactivity to psychological stressors, brain structure, and ovarian function. Compared to the Mediterranean diet, the Western diet resulted in accelerated aging, nonalcoholic fatty liver disease, insulin resistance, gut microbial changes associated with increased disease risk, neuroinflammation, neuroanatomical perturbations, anxiety, and social isolation. This comprehensive, multisystem investigation lays the foundation for future investigations of the mechanistic underpinnings of psychosocial stress and diet effects on health, and advances the promise of the Mediterranean diet as a therapeutic intervention on psychosocial stress.

Prospective observational studies on nutrition intake and the incidence of cognitive impairment in middle-aged and older adults: A protocol for systematic review and meta-analysis

INTRODUCTION

According to several studies, a specific dietary pattern can reduce the risk of dementia and cognitive impairment. However, the robustness of these results has not been tested. The study intends to investigate the association between nutrition intake and cognitive impairment in middle-aged and older adults (≥45-years) and provide reliable, evidence-based references for healthcare decision-makers, researchers, and policymakers.

REVIEW QUESTION

Are the dietary characteristics of community-dwelling adults (≥45-years) associated with the occurrence of cognitive impairment?

OBJECTIVES

The primary objective of this protocol is to synthesize the longitudinal observational evidence on the relationship between nutrition intake patterns and the incidence of cognitive impairment in middle-aged and older adults (≥45-years), and to provide detailed dietary recommendations for the prevention of cognitive impairment in this population.

METHODS AND ANALYSIS

Cohort studies conducted among adults (≥45-years) will be included. The following electronic databases will be searched for relevant records published by July 2023, with a restriction on language to English: Pubmed, Medline, Embase, Web of science, Cochrane Library. The studies will be selected, the data will be extracted, and the bias risk will be assessed by two independent investigators. The Meta-analysis of Observational Studies in Epidemiology guidelines will be followed to summarize observational studies, and the protocol will adhere to the recommendations from the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols 2015 statement. Endnote X9 will be used to manage data screening. We will use Review Manager 5.4 and Stata 16.0 to conduct data analysis, and a random-effects model will be applied to pool clinically homogenous studies. The results will be presented based on the form of nutrition intake. For assessing publication bias, Egger's test and visual inspection of funnel plots will be utilized.

ETHICS AND DISSEMINATION

As this study does not involve primary data, ethical approval is not required. The final report will be published in a peer-reviewed journal.

PROSPERO REGISTRATION NUMBER

A registration number of DOI 10.17605/OSF.IO/NAKC3 was assigned to it on October 15, 2022 on Prospero.

Prevalence of Depression and Fish Consumption among First Year Spanish University Students: UniHcos Project

The World Health Organization estimates that one fifth of university students have experienced major depressive disorder at some point in their lives. Nutrition may be one of the modifiable factors that influence the development of depression. Specifically, low omega-3 fatty acid and vitamin D levels, both nutrients found in high quantities in fish, have been linked to depressive disorders. The main objective of this study was to evaluate the prevalence of depression among young Spanish university students, in addition to the pattern of fish consumption among students and the possible relationship between fish consumption and the presence of depression. Data were collected retrospectively from a nationally representative sample of 11,485 Spanish university students aged 18 years or older in 11 Spanish universities, from 2012 to 2022. The respondents were analyzed according to frequency of consumption and compliance with weekly recommendations for fish intake and the presence of depression. Regression models were also performed to determine students' odds of depression as a function of compliance with recommendations according to selected sociodemographic variables. The prevalence of depression was 10.5%; it was more prevalent in women, older students and in those with both high and low BMIs. In addition, it was also more prevalent in those that lived outside the family home, with roommates and those who were employed. Sixty-seven percent of the students met the fish intake recommendations. The most common frequency of fish consumption was 1-2 times/week (44.2%), and the least frequent was 2.3% daily fish consumption. Students from northern universities were more likely to consume fish (68.4%) than those from southern universities (66.4%). Non-consumption of fish was found to increase the risk of depression (ORa = 1.45 (1.28-1.64); AF = 31.0% (21.9-39.0)), but it was the student's own conditions that had the greatest influence on the development of the disorder. In summary, a lower consumption of fish seems to be associated with a higher incidence of depression in Spanish university students; however, other social factors of the student may influence the development of the disorder, and all of this should be taken into account for the development of prevention strategies.

Inflammatory properties of diet mediate the effect of epilepsy on moderate to severe depression: Results from NHANES 2013-2018

BACKGROUND

Depression is a major public health problem, and epilepsy and a high-inflammatory diet are important causes of depression. We aimed to explore the level of dietary inflammation in epileptic patients and its relationship with moderate to severe depression (MSD).

METHODS

This cross-sectional study included 12,788 participants aged 20-80 years from the NHANES database from 2013 to 2018. Depressive symptoms were evaluated using the nine-item Patient Health Questionnaire (PHQ-9), and epilepsy was diagnosed based on the use of antiepileptic drugs within the previous 30 days. Dietary inflammatory index (DII) scores and energy-adjusted DII (E-DII) scores were calculated based on dietary recalls of the past 24 h, and average DII (ADII) and energy-adjusted ADII (E-ADII) were calculated based on two 24-hour dietary recalls.

RESULTS

The DII, E-DII, and ADII scores and prevalence of MSD were significantly increased in epileptic patients compared with non-epilepsy subjects. The E-ADII score (P = 0.078) was weakly associated with comorbid MSD in patients with epilepsy. Mediation models showed that dietary inflammation scores mediated 2.31 % to 12.25 % of epilepsy-related MSD. In stratified analysis, an increased prevalence of MSD was present in the Quartile 2 subgroup based on DII and E-ADII scores and in the Quartile 3 subgroup of epileptic patients based on DII, E-DII, and ADII scores.

CONCLUSIONS

Epileptics consume more proinflammatory foods and nutrients than control subjects. MSD in patients with epilepsy is associated with their high inflammatory diet. Suggesting an urgent need for rational dietary management in the epileptic population.

Health risk behaviour and persistent and incident depression among middle-aged and older adults in South Africa

The aim of this study was to assess the association between five health risk behaviours and persistent and incident depressive symptoms in a longitudinal study in South Africa. The sample included 5059 men and women (≥40 years) in 2014/2015, and 4176 in 2018/2019 of the 'Health and Ageing in Africa: A Longitudinal Study of an INDEPTH Community in South Africa'. Depressive symptoms were assessed with the Centre for Epidemiologic Studies Depression scale. Multivariable logistic regression analysis was conducted to assess the associations between five health risk behaviours and persistent and incident depressive symptoms. Results indicate that 5.0% of participants had depressive symptoms at both wave 1 and 2 (persistent depressive symptoms), and 27.9% had incident depressive symptoms in wave 2. Higher education and moderate baseline physical activity were negatively associated and those with cardiovascular disease were positively associated with persistent depressive symptoms. Middle wealth index was negative, and being HIV positive and baseline tobacco use were positively associated with incident depressive symptoms. In conclusion, of five health risk behaviours assessed (inadequate fruit/vegetable intake, alcohol dependence, tobacco use, physical activity, and sedentary behaviour), only moderate physical activity was protective against persistent depressive symptoms, and tobacco use was associated with incident depressive symptoms.

The Association between Vegan, Vegetarian, and Omnivore Diet Quality and Depressive Symptoms in Adults: A Cross-Sectional Study

Dietary patterns and depressive symptoms are associated in cross-sectional and prospective-designed research. However, limited research has considered depression risk related to meat-based and plant-based dietary patterns. This study explores the association between diet quality and depressive symptoms across omnivore, vegan, and vegetarian dietary patterns. A cross-sectional online survey utilised the Dietary Screening Tool (DST) and the Centre for Epidemiological Studies of Depression Scale (CESD-20) to measure diet quality and depressive symptoms, respectively. A total of 496 participants identified as either omnivores (n = 129), vegetarians (n = 151), or vegans (n = 216). ANOVA with Bonferroni post hoc corrections indicates that dietary quality was significantly different between groups F(2, 493) = 23.61, p < 0.001 for omnivores and vegetarians and omnivores and vegans. Diet quality was highest in the vegan sample, followed by vegetarian and omnivore patterns. The results show a significant, moderately negative relationship between higher diet quality and lower depressive symptoms (r = -0.385, p < 0.001) across groups. Hierarchical regression showed that diet quality accounted for 13% of the variability in depressive symptoms for the omnivore sample, 6% for vegetarians, and 8% for vegans. This study suggests that diet quality in a meat-based or plant-based diet could be a modifiable lifestyle factor with the potential to reduce the risk of depressive symptoms. The study indicates a greater protective role of a high-quality plant-based diet and lower depressive symptoms. Further intervention research is needed to understand the bi-directional relationship between diet quality and depressive symptoms across dietary patterns.

Association between dietary patterns and depression: an umbrella review of meta-analyses of observational studies and intervention trials

CONTEXT

Depression is the most common causes of disease burden worldwide (GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392:1789-1858).

OBJECTIVE

An umbrella review has been performed to assess the strength and validity of the available observational and trial evidence for the association between a variety of dietary patterns and depression.

DATA SOURCES

MEDLINE/PubMed, Scopus, Web of Science, EMBASE, PsycINFO, and Cochrane Database were searched.

DATA EXTRACTION

The Joanna Briggs Institute Umbrella Review Methodology was used.

DATA ANALYSIS

The review included 19 articles, covering a relatively wide range of dietary patterns: healthy dietary patterns (n = 8), Mediterranean diet (MedDiet) (n = 6), Dietary Inflammatory Index (DII) (n = 5), Western diet (n = 4), Dietary Approaches to Stop Hypertension (DASH) (n = 2), vegetarian diets (n = 4), and other dietary interventions (n = 2). The methodological quality of the included meta-analyses was generally low or critically low. The strength of the evidence was generally weak, although convincing or suggestive evidence was found for an inverse relationship between MedDiet/DII and depression. Higher adherence to the MedDiet and lower DII score were significantly associated with lower risk of depression.

CONCLUSION

Considering the generally high heterogeneity and low quality of the available evidence, further studies adopting more coherent and uniform methodologies are needed.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42020223376.

Genetic and environmental influences on fruit and vegetable consumption and depression in older adults

BACKGROUND

Prior work suggests that higher fruit and vegetable consumption may protect against depression in older adults. Better understanding of the influence of genetic and environmental factors on fruit and vegetable intakes may lead to the design of more effective dietary strategies to increase intakes. In turn this may reduce the occurrence of depression in older adults.

OBJECTIVES

The primary aim of this study is to estimate the genetic and environmental influences on the consumption of fruit and vegetables in older adults. The secondary aim is an exploratory analysis into possible shared genetic influences on fruit and vegetable intakes and depression.

METHODS

Analysis of observational data from 374 twins (67.1% female; 208 monozygotic (MZ); 166 dizygotic (DZ)) aged ≥ 65 years drawn from the Older Australian Twins Study. Dietary data were obtained using a validated food frequency questionnaire and depressive symptoms were measured using the 15-item short form Geriatric Depression Scale. The contribution of genetic and environmental influences on fruit and vegetable intake were estimated by comparing MZ and DZ twin intakes using structural equation modelling. A tri-variate twin model was used to estimate the genetic and environmental correlation between total fruit and vegetable intakes and depression.

RESULTS

In this study, vegetable intake was moderately influenced by genetics (0.39 95%CI 0.22, 0.54). Heritability was highest for brassica vegetables (0.40 95%CI 0.24, 0.54). Overall fruit intake was not significantly heritable. No significant genetic correlations were detected between fruit and vegetable intake and depressive symptoms.

CONCLUSIONS

Vegetable consumption, particularly bitter tasting brassica vegetables, was significantly influenced by genetics, although environmental influences were also apparent. Consumption of fruit was only influenced by the environment, with no genetic influence detected, suggesting strategies targeting the food environment may be particularly effective for encouraging fruit consumption.

Impact of nonalcoholic fatty liver disease-related metabolic state on depression

Nonalcoholic fatty liver disease (NAFLD), also recently referred as metabolic (dysfunction)-associated fatty liver disease (MAFLD), is characterized by hepatocyte steatosis in the setting of metabolic risk conditions and in the absence of an underlying precursor, for instance alcohol consumption, hepatotropic viruses and hepatotoxic drugs. A possible association between NAFLD and depression has been proposed, owing to intersecting pathophysiological pathways. This narrative review aimed to summarize the current evidence that illustrate the potential pathophysiological and clinical linkage between NAFLD-related metabolic state and depression. Prefrontal cortex lesions are suggested to be a consequence of liver steatosis-associated systematic hyperinflammatory state, a phenomenon also occurring in depression. In addition, depressive symptoms are present in neurotransmitter imbalances. These abnormalities seem to be correlated with NAFLD/MAFLD, in terms of insulin resistance (IR), ammonia and gut dysbiosis' impact on serotonin, dopamine, noradrenaline levels and gamma aminobutyric acid receptors. Furthermore, reduced levels of nesfatin-1 and copine-6-associated BDNF (brain-derived neurotrophic factor) levels have been considered as a probable link between NAFLD and depression. Regarding NAFLD-related gut dysbiosis, it stimulates mediators including lipopolysaccharides, short-chain fatty acids and bile acids, which play significant role in depression. Finally, western diet and IR, which are mainstay components of NAFLD/MAFLD, are, also, substantiated to affect neurotransmitters in hippocampus and produce neurotoxic lipids that contribute to neurologic dysfunction, and thus trigger emotional disturbances, mainly depressive symptoms.

Identifying transdiagnostically relevant risk and protective factors for internalizing psychopathology: An umbrella review of longitudinal meta-analyses

Internalizing mental disorders are highly comorbid with one another, and evidence suggests that etiological processes contributing to these disorders often overlap. This systematic umbrella review aimed to synthesize meta-analytic evidence from observational longitudinal studies to provide a comprehensive overview of potentially modifiable risk and protective factors across the depressive, anxiety, and eating disorder psychopathology domains. Six databases were searched from inception to August 2022. Only meta-analyses of longitudinal studies that accounted for baseline psychopathology (either via exclusion of baseline cases or statistical adjustment for baseline symptoms) were included. Methodological quality of meta-analyses was evaluated using the AMSTAR 2, and quality of evidence for each analysis was rated using GRADE. Study selection, quality assessment, and data extraction were conducted in duplicate by independent reviewers. The protocol for this review was registered with PROSPERO (CRD42020185575). Sixty-one meta-analyses were included, corresponding to 137 meta-analytic estimates for unique risk/protective factor-psychopathology relationships. Most potential risk/protective factors, however, were examined only in relation to depressive psychopathology. Concern over mistakes and self-esteem were the only risk and protective factors, respectively, identified as statistically significant across depressive, anxiety, and eating disorder psychopathology domains. Eight risk factors and four protective factors also emerged as having transdiagnostic relevance across depressive and anxiety domains. Results suggest intervention targets that may be valuable for preventing/treating the spectrum of internalizing psychopathology and reducing comorbidity. However, few factors were identified as transdiagnostically relevant across all three internalizing domains, highlighting the need for more research investigating similar sets of potential risk/protective factors across internalizing domains.

Modern Diets and the Health of Our Planet: An Investigation into the Environmental Impacts of Food Choices

Popular modern diets are often seen as a panacea for improving health and promoting weight reduction. While there is a large body of literature reporting the health benefits of popular diets, few studies have described their planetary benefits. Our investigation aims to evaluate the simultaneous impacts of six popular diets within the United States on both human and planetary health. Using carbon footprint databases and representative meal plans, the environmental and health-related impacts of the Standard American, Mediterranean, vegan, paleo, keto, and climatarian diets are compared using the currently available literature. Results indicate that diets that exhibit lower carbon footprints also have positive effects on human health. The diets found to have the lowest environmental impacts were the vegan, climatarian, and Mediterranean diets. These low-carbon-footprint diets can likely be attributed to a reduced reliance on ruminant meat (cattle and sheep) and processed food consumption, while diets with high carbon footprints are more dependent on ruminant meat and saturated fat. Moderate consumption of meats such as chicken, pork, and fish in conjunction with an emphasis on locally grown fruits and vegetables can be maintained without adversely affecting the planetary carbon footprint and with the added benefit of promoting good health. Thus, making simple substitutions within each individual's diet can be advertised as an effective approach to collectively lower the environmental impact in tandem with improving health and longevity.

Patterns of unhealthy behaviours during adolescence and subsequent anxiety and depression in adulthood: a prospective register linkage study of the HUNT survey and health registries

BACKGROUND

There is increasing need for prospective investigations in the preventing role of health-related behaviours on mental health problems. The aim of this study is to identify patterns of health-related behaviours in adolescence, and the association between the behavioural patterns and the subsequent diagnoses and/or drug treatment for anxiety and/or depression in adulthood.

METHODS

This prospective study consisted of 13-19-year-old participants in the Trøndelag Health Study (Young-HUNT3) in 2006-2008 (n = 2061, 1205 females and 856 males) in Norway, who also participated in HUNT4 (2017-2019). Survey data on health-related behaviours in adolescence, including low level of physical activity, low consumption of wholegrain bread, fish, fruit, vegetables and high consumption of sugar-sweetened beverages and insomnia were linked on an individual level to prospective information on drug use and diagnosis in national health registries. The different patterns of health-related behaviours were identified through latent class analysis. Subsequent anxiety or depression was defined as at least one recording in either of three registries covering recorded diagnosis in primary and specialist healthcare, or dispensed prescription drugs during 2008-2019. Additionally, self-reported psychological distress measured in young adulthood was applied as a supplemental outcome measure.

RESULTS

Four patterns of health-related behaviours were identified: high risk behaviours (class 1), moderate to high risk behaviours (class 2), low to moderate risk behaviours (class 3) and low risk behaviours (class 4). Adolescents in class 3 showed higher odds of subsequent diagnoses for anxiety and/or depression in primary and specialist healthcare compared to class 4 participants. In addition, both class 1 and class 4 participants had higher odds for self-reported psychological distress than those class 4 (OR = 1.56 and OR = 1.86, respectively).

CONCLUSIONS

Our findings suggest that health-related behaviours are clustered among Norwegian adolescents. The patterns of unhealthy behaviours during adolescence only partly increased the risk of anxiety and depression in adulthood. Promoting healthy behaviours during adolescence may potentially reduce the burden of mental illness in adulthood, but further research is needed to clarify the nature of the relationships.

The Association of Adherence to the Mediterranean Diet with Depression in Older Adults Longitudinally Taking into Account Cognitive Status: Results from the HELIAD Study

Although research has generally shown a negative association between depression and adherence to the Mediterranean diet (MeDi), the literature related to older adults is controversial, perhaps partially due to the fact that cognitive status has not been considered. The aim of the current work was to investigate the association between MeDi and incident depression in a representative cohort of people, taking into account their cognitive status in multiple ways. The sample was drawn from the HELIAD study, a longitudinal study including a follow-up of 3 years after the baseline assessment. In total, 879 participants without depression at baseline were included (55.4% women, mean age ± Standard Deviation: 73.3 ± 5.0 years). Depression was determined as a score in the Geriatric depression scale ≥6 and/or antidepressant medication and/or clinical diagnosis of depression. Cox proportional hazard models adjusted for age, sex and education were employed. In the basic model, adherence to the MeDi was negatively associated with depression. In the most conservative model, excluding participants with dementia and Mild Cognitive Impairment, and after controlling for the baseline Cognitive Status, each unit (range 0−55) increase in MeDi was associated with a 6.2% decrease in the risk for depression (p < 0.001). These findings indicate that MeDi is negatively associated with depression longitudinally in older adults, above and beyond cognitive status.

Loneliness and resilience are associated with nutrition risk after the first wave of COVID-19 in community-dwelling older Canadians

Nutrition risk is linked to hospitalization, frailty, depression, and death. Loneliness during the coronavirus disease 2019 (COVID-19) pandemic may have heightened nutrition risk. We sought to determine prevalence of high nutrition risk and whether loneliness, mental health, and assistance with meal preparation/delivery were associated with risk in community-dwelling older adults (65+ years) after the first wave of COVID-19 in association analyses and when adjusting for meaningful covariates. Data were collected from 12 May 2020 to 19 August 2020. Descriptive statistics, association analyses, and linear regression analyses were conducted. For our total sample of 272 participants (78 ± 7.3 years old, 70% female), the median Seniors in the Community: Risk evaluation for Eating and Nutrition (SCREEN-8) score (nutrition risk) was 35 [1st quartile, 3rd quartile: 29, 40], and 64% were at high risk (SCREEN-8 < 38). Fifteen percent felt lonely two or more days a week. Loneliness and meal assistance were associated with high nutrition risk in association analyses. In multivariable analyses adjusting for other lifestyle factors, loneliness was negatively associated with SCREEN-8 scores (-2.92, 95% confidence interval [-5.51, -0.34]), as was smoking (-3.63, [-7.07, -0.19]). Higher SCREEN-8 scores were associated with higher education (2.71, [0.76, 4.66]), living with others (3.17, [1.35, 4.99]), higher self-reported health (0.11, [0.05, 0.16]), and resilience (1.28, [0.04, 2.52]). Loneliness, but not mental health and meal assistance, was associated with nutrition risk in older adults after the first wave of COVID-19. Future research should consider longitudinal associations among loneliness, resilience, and nutrition.

Association between Dietary Patterns and Depression in Chinese Older Adults: A Longitudinal Study Based on CLHLS

(1) Objective: This study aimed to investigate the relationship between dietary patterns and depression in Chinese older adults. (2) Method: A cohort study was conducted on the relationship between dietary patterns and the risk of depression in older adults based on the China Health and Longevity Longitudinal Survey (CLHLS) from 2011 to 2014. Exploratory factor analysis was used to identify dietary patterns. The relationship between dietary patterns and the risk of depression after four years was examined using logistic regression, and subgroup analysis was carried out to determine whether the association differed by gender. (3) Results: A total of 2873 older adults were included in our cohort study. Three dietary patterns were identified: vegetable-egg-bean-milk pattern, meat-fish pattern, and salt-preserved vegetable-garlic pattern. The vegetable-egg-beans-milk pattern was negatively correlated with the risk of geriatric depression development (adjusted OR = 0.65 (95%CI: 0.49-0.87)), and the salt-preserved vegetable-garlic pattern was positively associated with aged depression risk (adjusted OR = 1.33 (95CI: 1.00-1.77)). The meat-fish pattern was not associated with the risk of depression in older adults. These associations were consistent in both men and women. (4) Conclusions: In this cohort study, the vegetable-egg-beans-milk dietary pattern was associated with lower risk of depression, while the salt-preserved vegetable-garlic dietary pattern was associated with higher risk of depression, and there were no gender differences in these associations.

Mediterranean Diet Interventions for Depressive Symptoms in Adults with Depressive Disorders: A Protocol for a Systematic Review and Meta-Analysis

The associations between Mediterranean diet (MD) adherence and depression levels have been synthesized from observational studies. However, a systematic review with meta-analysis including randomized controlled trials (RCTs) on this relationship in adults with depressive disorders remains lacking. This protocol was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis for Protocols statement. MEDLINE (PubMed), Cochrane CENTRAL, PsycINFO, Scopus, and Web of Science databases will be systematically searched to identify studies published from database inception up to 30 September 2022. The inclusion criteria will comprise RCTs reporting pre-post changes in depression status (symptoms or remission) after a MD intervention compared to a control condition in adults over 18 years with depressive disorders. Pooled effect sizes and 95% confidence intervals will be calculated using the DerSimonian random-effects model. This study protocol determines the methodological approach for the systematic review and meta-analysis that will summarize the available evidence on the efficacy of MD interventions on depressive symptoms in adults with depressive disorders. The findings from this review may have implications for public mental health programs. The results will be disseminated through peer-reviewed publication, conference presentation, and infographics. No ethical approval will be required since only published data will be used. PROSPERO registration number: CRD42022341895.

Longitudinal correlates of fruit and vegetable consumption with depressive symptoms among middle-aged and older adults in South Africa

BACKGROUND

Fruit and vegetable intake may influence mental well-being. The aim of this study was to assess longitudinal associations between fruit and vegetable intake and depressive symptoms among rural South Africans.

METHODS

This longitudinal community study enrolled 3,891 adults (≥ 40 years) from the "Health and Ageing in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI)". Fruit and vegetable intake was assessed by self-report at wave 1, and depressive symptoms were assessed using the Center for Epidemiological Studies Depression Scale at wave 1 and 2. Outcomes were incident and persistent depressive symptoms at wave 2. Logistic regression was used to assess the associations between fruit and vegetable intake at wave 1 and incident, and persistent depressive symptoms.

RESULTS

Results indicate that in the fully adjusted model for individuals with no depressive symptoms at baseline, we found no significant association between frequency of fruit or vegetables intake and incident depressive symptoms. We also found no significant association between frequency of fruit or vegetable intake and persistent depressive symptoms.

CONCLUSION

Fruit and vegetable intake was not significantly associated with incident and persistent depressive symptoms.

Mediterranean Diet Adherence and Risk of Depressive Symptomatology in a French Population-Based Cohort of Older Adults

Several foods from the Mediterranean Diet (MeDi) have already been characterized as beneficial for depression risk, while studies focusing on adherence to the overall MeDi are lacking among older adults at higher risk of depression. The aim of this study was to assess the association between MeDi adherence and the risk of depressive symptomatology (DS) in an older French cohort followed for 15 years. Participants from the Three-City Bordeaux cohort answered a food frequency questionnaire used to assess their MeDi adherence. The Center for Epidemiologic Studies Depression (CES-D) scale score of 16 or greater and/or use of antidepressant treatment ascertained at each visit defined incident DS. Random-effect logistic regression models were adjusted for potential confounders. Among 1018 participants, aged 75.6 years (SD 4.8 years) on average at baseline, 400 incident cases of DS were identified during the follow-up. Only when restricting the definition of DS to a CES-D score ≥ 16 was a borderline-significant trend towards a benefit of greater adherence to the MeDi with reduced odds of DS found (p-value = 0.053). In this large sample of older French adults, a potential benefit of greater adherence to the MeDi regarding the risk of DS would depend on the definition of DS.

Association between Dietary Patterns and the Risk of Depressive Symptoms in the Older Adults in Rural China

Geriatric depression, a chronic condition, has become a substantial burden in rural China. This study aimed to assess the association between dietary patterns and the risk of geriatric depression in rural China. Between March 2018 and June 2019, 3304 participants were recruited for this cross-sectional study in rural Tianjin, China. Principal component analysis was used to determine the major dietary patterns. The associations between dietary patterns and the risk of geriatric depression were assessed using a logistic regression model. Four dietary patterns were identified: vegetables-fruit, animal food, processed food, and milk-egg. The study found that vegetable-fruit (Q2 vs. Q1: OR = 0.62, 95% CI: 0.46–0.83; Q3 vs. Q1: OR = 0.54, 95% CI: 0.38–0.75; Q4 vs. Q1: OR = 0.39, 95% CI: 0.26–0.57) and animal food patterns (Q3 vs. Q1: OR = 0.69, 95% CI: 0.50–0.95; Q4 vs. Q1: OR = 0.58, 95% CI: 0.41–0.82) were associated with a decreased risk of depression, and inflammatory dietary pattern (Q2 vs. Q1: OR = 1.71, 95% CI: 1.23–2.38; Q3 vs. Q1: OR = 1.70, 95% CI: 1.22–2.36; Q4 vs. Q1: OR = 1.44, 95% CI: 1.03–2.03) was associated with an increased risk of depression. The present findings reinforce the importance of adopting an adequate diet consisting of vegetables, fruit and animal foods, while limiting the intake of pro-inflammatory foods, to decrease the risk of depression.

Cognitive, behavioural or cognitive-behavioural self-help interventions for subclinical depression in older adults: A systematic review and meta-analysis

BACKGROUND

Subclinical depression is a risk factor for the development of major depression in older adults. We aimed to determine the effectiveness of pure self-help or self-help with minimal support to reduce depressive symptoms and to prevent the onset of major depression in this population.

METHODS

This was a systematic review and meta-analysis of trials that used self-administrated cognitive, behavioural or cognitive-behavioural interventions for older adults with subclinical depression compared to control groups. Medline, Embase, PsycInfo and Cochrane databases were searched for relevant studies.

RESULTS

We analysed eight trials involving 1449 participants. A small but significant effect favouring the intervention was found at short-term [d = 0.33; 95% CI (Confidence Interval): 0.20-0.47] and at long-term (d = 0.22; 95% CI: 0.04-0.40) for depressive symptoms. None of the studies looked at the preventive effect of self-help interventions in reducing the probability of a subsequent diagnosis of major depression.

LIMITATIONS

The low number of studies meant that it was not possible to test for publication bias. The absence of pre-published protocols for many of the studies meant that there is a possibility of selective reporting bias for some of the primary studies.

CONCLUSIONS

There is some evidence that cognitive-behavioural self-help interventions may reduce depressive symptoms in older adults with subclinical depression. However, no study examined whether the intervention had a preventative effect in reducing the likelihood of a subsequent diagnosis of major depression.

A Possible Antidepressive Effect of Dietary Interventions: Emergent Findings and Research Challenges

Purpose

Despite recent advancements in the treatment of depression, the prevalence of affected individuals continues to grow. The development of new strategies has been required and emerging evidence has linked a possible antidepressant effect with dietary interventions. In this review, we discuss recent findings about the possible antidepressant effect of dietary interventions with an emphasis on the results of randomized controlled trials.

Recent findings

A high consumption of refined sugars and saturated fat and a low dietary content of fruits and vegetables has been associated with the development of depression. There is evidence supporting a small to moderate beneficial effect of a Mediterranean-type diet in depression. In addition, new dietary protocols are being studied for their use as possible interventions, such as the ketogenic diet, Nordic diet, and plant-based diet.

Summary

Lifestyle interventions surrounding diet and nutrition are a relatively affordable way to enhance response to treatment and to be employed as an adjunct in mental health care. Most studies, however, are limited by the difficulty in controlling for the placebo effect. Mediterranean-style diets seem to be the most promising as an adjunctive treatment for mood disorders. Larger randomized controlled trials that could assess predictors of response to dietary interventions are needed to establish a clear positive effect of diet and guide clinical care and nutritional recommendations concerning mental health care.

The Joint Association Between Multiple Dietary Patterns and Depressive Symptoms in Adults Aged 55 and Over in Northern China

Background

Depression is a common psychiatric disorder in older adults that affects their health-related quality of life. Two percent of adults over the age of 55 suffer from major depression, and the prevalence of depression increases with age. Even in the absence of major depressive disorder, 10–15% of older adults have clinically significant depressive symptoms.

Objectives

Epidemiological studies on the association between different gender eating patterns and depression show inconsistent associations. Our study examined whether different gender eating patterns are related to depression. We consider eating patterns individually and as a joint exposure to predefined eating patterns.

Methods

Principal component analysis (PCA) was performed on the data of the 24-h diet recall dietary intake, and the dietary pattern was determined. Linear regression models are used to explore the relationship between different diets and depression of men and women; weighted quantile sum (WQS) regression, quantile g calculation (qgcomp) and Bayesian kernel machine regression (BKMR) are performed as Secondary analysis.

Results

In the dietary patterns model, we found that the vegetable and fruit-based diet has a significant inhibitory effect in women, and the egg-milk-based diet has a significant inhibitory effect in men. We found that when all dietary factors are above the 55th percentile, there is a significant positive correlation between multiple dietary patterns and depression risk. We also determined a positive correlation between meat and obesity risk and a negative correlation between egg and milk and vegetables and fruits.

Conclusions

In the study population, after controlling for other baseline indicators and predictors of dietary pattern exposure, a fruit and vegetable-based diet was associated with a slightly healthier and lower risk of depression, while a meat-based dietary pattern associated with a higher risk of depression, and this association effect varies between genders.

Fasting Interventions for Stress, Anxiety and Depressive Symptoms: A Systematic Review and Meta-Analysis

Background. Fasting interventions have shown effectiveness in alleviating stress, anxiety and depressive symptoms. However, no quantitative analysis has been carried out thus far. The objective was to determine the effectiveness of fasting interventions on stress, anxiety and depression and if these interventions were associated with increased or decreased fatigue/energy. Methods. Overall, 11 studies and 1436 participants were included in the quantitative analyses. Results. After limiting analyses to randomized controlled trials with low risk of bias, we found that fasting groups had lower anxiety (b = −0.508, p = 0.038), depression levels (b= −0.281, p = 0.012) and body mass index compared to controls without increased fatigue. There was no publication bias and no heterogeneity for these results. These interventions were safe, even in patients with type 2 diabetes. Conclusions. These results should be taken with a caveat. These results are preliminary and encouraging and fasting appears to be a safe intervention. Data are not sufficient to recommend one fasting intervention more than the others. No study was carried out in psychiatric populations and further trials should be carried out in these populations that may be good candidates for fasting interventions.

Microbial Therapeutics in Neurocognitive and Psychiatric Disorders

Microbial therapeutics, which include gut biotics and fecal transplantation, are interventions designed to improve the gut microbiome. Gut biotics can be considered as the administration of direct microbial populations. The delivery of this can be done through live microbial flora, certain food like fiber, microbial products (metabolites and elements) obtained through the fermentation of food products, or as genetically engineered substances, that may have therapeutic benefit on different health disorders. Dietary intervention and pharmacological supplements with gut biotics aim at correcting disruption of the gut microbiota by repopulating with beneficial microorganism leading to decrease in gut permeability, inflammation, and alteration in metabolic activities, through a variety of mechanisms of action. Our understanding of the pharmacokinetics of microbial therapeutics has improved with in vitro models, sampling techniques in the gut, and tools for the reliable identification of gut biotics. Evidence from human studies points out that prebiotics, probiotics and synbiotics have the potential for treating and preventing mental health disorders, whereas with paraprobiotics, proteobiotics and postbiotics, the research is limited at this point. Some animal studies point out that gut biotics can be used with conventional treatments for a synergistic effect on mental health disorders. If future research shows that there is a possibility of synergistic effect of psychotropic medications with gut biotics, then a gut biotic or nutritional prescription can be given along with psychotropics. Even though the overall safety of gut biotics seems to be good, caution is needed to watch for any known and unknown side effects as well as the need for risk benefit analysis with certain vulnerable populations. Future research is needed before wide spread use of natural and genetically engineered gut biotics. Regulatory framework for gut biotics needs to be optimized. Holistic understanding of gut dysbiosis, along with life style factors, by health care providers is necessary for the better management of these conditions. In conclusion, microbial therapeutics are a new psychotherapeutic approach which offer some hope in certain conditions like dementia and depression. Future of microbial therapeutics will be driven by well-done randomized controlled trials and longitudinal research, as well as by replication studies in human subjects.

Multi-omics data reveals the disturbance of glycerophospholipid metabolism caused by disordered gut microbiota in depressed mice

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Three important ”metabolite type-bacterial genus” correlated pairs were identified.

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Peripheral and central GP metabolism was disordered in depressed mice.

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Four differential NEs from tryptophan pathway in hippocampus were found.

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“Firmicutes-SCFAs-GP metabolism-Tryptophan pathway” was possible way in gut-brain.

Introduction

Although researchers have done intensive research on depression, its pathogenesis is still not fully explained. More and more evidence suggests that gut microbiota is closely related to the onset of depression; but its specific functional ways are not clearly identified.

Objectives

The purpose of our work was to find out how the gut microbiota was involved in the onset of depression, and to identify the potential ways to link the gut and brain in mice with depressive-like behaviors (DLB).

Methods

We used the chronic restraint stress (CRS)-induced depression model here. Gut microbiota compositions in fecal samples, lipid metabolism (in fecal, serum and hippocampus samples) and neurotransmitters in hippocampus samples were detected.

Results

We found that the 7 of 13 differential genera that significantly correlated with DLB belonged to phylum Firmicutes. The differential lipid metabolites in fecal samples mainly belonged to glycerophospholipids (GP) and fatty acids (FA) metabolism, and three important “metabolite type-bacterial taxa” correlated pairs were identified: “FA/GP-Firmicutes”, “FA/GP-Akkermansia”, and “FA/GP-Bifidobacterium”. The key differential lipid metabolites significantly correlated with DLB mainly belonged to FA and GP, and the DLB-related metagenomic genes were consistently enriched in GP metabolism and FA metabolism. Three significantly changed short-chain fatty acids (SCFAs) were significantly correlated with the majority of differential genera. Meanwhile, we found that the differential lipid metabolites in serum and hippocampus samples were mainly mapped into the GP metabolism, and there were four differential neurotransmitters from the tryptophan pathway in hippocampus samples.

Conclusion

Together, our findings could provide novel insights into the role of “microbiota-gut-brain” (MGB) axis in depression, and indicate that the gut microbiota might have a vital role in the onset of DLB by affecting the peripheral/central GP metabolism and tryptophan pathway. The “Firmicutes-SCFAs-GP metabolism-Tryptophan pathway” might be a possible way to link the gut and brain in depressed mice.