Dietary total antioxidant capacity and its association with sleep, stress, anxiety, and depression score: A cross-sectional study among diabetic women

The association of composite dietary antioxidant index with periodontitis in NHANES 2009-2014

Background

To date, evidence is rare regarding whether and how dietary antioxidants are associated with the risk of periodontitis. This study aimed to investigate the association of composite dietary antioxidant index (CDAI) with periodontitis and tooth loss, using data from the National Health and Nutrition Examination Survey (2009-2014).

Methods

A cross-sectional analysis was conducted using data from 10,067 adults aged ≥30 years who underwent assessments of periodontal health and the 1st day dietary recall. Based on a crude model and three adjusted models, multivariate regressions were used to examine the relationship between CDAI and periodontitis-related measurements including probing pocket depth, clinical attachment loss and tooth loss. Subgroup analyses and the restricted cubic splines plots were applied to examine the association between CDAI ingredients and periodontitis.

Results

For the subjects with high CDAI scores, increased CDAI was associated with significant (P < 0.05) reduction of severe periodontitis (odd ratio = 0.663, 95% confidence interval: 0.491-0.896) and increased number of remaining teeth (weighted β[SE] = 1.167[0.211]). However, the protective effect of CDAI on periodontitis vanished (P > 0.05) in active smokers and former smokers. There were threshold levels for β-carotene, Vitamin A, C and E intakes where the risk of periodontitis significantly decreased (P < 0.05) above these levels.

Conclusion

Increased CDAI was associated with reduced risk of periodontitis and tooth loss for non-smokers. It was recommendable that proper dietary intakes of β-carotene, Vitamin A, C and E would be of benefit for preventive dental care and adjuvant therapies for periodontitis.

Association between Dietary Antioxidant Capacity in Midlife and Depressive Symptoms in Late Life: The Singapore Chinese Health Study

Preclinical and limited epidemiological studies suggest that oxidative stress may be implicated in geriatric depression. Our study investigated the association between midlife dietary total antioxidant capacity (TAC) and depressive symptoms in late life among 13,712 participants in a population-based cohort of Chinese in Singapore. At baseline (1993-1998), intake of antioxidants from diet and supplements at a mean age of 52.4 years was estimated using a validated food frequency questionnaire to derive two dietary TAC indices from vitamins C and E, carotenoids and flavonoids: the Comprehensive Dietary Antioxidant Index (CDAI) and Vitamin C Equivalent Antioxidant Capacity (VCEAC). At follow-up 3 (2014-2016), when participants were at a mean age of 72.5 years, depressive symptoms were assessed using the Geriatric Depression Scale, and depression, defined as having ≥5 symptoms, was presented in 3173 (23.1%) participants. Both CDAI and VCEAC indices were inversely associated with odds of depressive symptoms in a stepwise manner: the OR (95% CI) comparing the extreme quartiles was 0.73 (0.64-0.83; Ptrend < 0.01) for the CDAI and 0.77 (0.68-0.87; Ptrend < 0.01) for the VCEAC. Specifically, higher intakes of vitamin C, carotenoids, and flavonoids were associated with a lower likelihood of depressive symptoms. Our findings support the recommendation of an antioxidant-rich diet for the prevention of depression.

Composite Dietary Antioxidant Index is negatively associated with olfactory dysfunction among adults in the United States: A cross-sectional study

The Comprehensive Dietary Antioxidant Index (CDAI) plays a crucial role as an indicator of diets rich in antioxidants. Despite its importance, the clinical significance of CDAI concerning olfactory dysfunction (OD) remains unknown. Our study aims to investigate whether there is an association between CDAI and OD within the general adult population aged 20 years and older. We hypothesized a negative correlation between CDAI and OD in the general adult population. A cross-sectional study used data from the National Health and Nutrition Examination Survey (n = 1624; >20 y of age). A multivariate logistic regression model examined the connection between CDAI and OD. Smooth-fitted curves were used to investigate the nonlinear relationship between CDAI and OD. A threshold effect analysis was then used to pinpoint the inflection point. Subgroup analyses were conducted based on gender and age. Multivariate regression analysis revealed a negative correlation between CDAI and OD. After controlling for variables, the risk of OD in the highest quartile of CDAI was significantly lower than in the lowest quartile (Q1) (odds ratio = 0.64; 95% confidence interval, 0.44-0.92; P = .0148). Stratified analysis indicated a significant association between CDAI and OD in individuals younger than age 60 years and male. This research suggests that increasing the co-ingestion of antioxidants within a moderate range can reduce the incidence of OD.

Composite dietary antioxidant index and sleep health: a new insight from cross-sectional study

BACKGROUND

Low-quality sleep and obstructive sleep apnea (OSA) can result in series of chronic diseases. Healthy diet has been considered as an effective and simple strategy to optimize sleep quality. However, current evidence on the correlation of dietary composite antioxidant intake with sleep health remained obscure.

AIM OF THE STUDY

To determine the relationship of composite dietary antioxidant index (CDAI) and sleep health.

METHODS

Cross-sectional analyses were based on National Health and Nutrition Examination Survey (NHANES) 2005-2008. Dietary consumption was assessed by trained staff using 24-h diet recall method and CDAI was calculated based on previous validated approach that included six antioxidants. Sleep-related outcomes were self-reported by a set of questionnaires and classified into OSA, day sleepiness, and insufficient sleep. Weighted logistic regression was conducted to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Restricted cubic spline (RCS) regressions were also used to evaluate the dose-response of CDAI and three sleep-related outcomes.

RESULTS

A total of 7274 subjects included (mean age: 46.97 years) were enrolled in our study, including 3658 were females (52.54%) and 3616 were males (47.46%). Of them, 70.6%, 29.51%, and 35.57% of the subjects reported that they had OSA, day sleepiness and insufficient sleep, respectively. Logistic regression showed the highest quartile of CDAI was inversely associated with the risk of OSA (OR: 0.69, 95%CI: 0.49-0.97), day sleepiness (OR: 0.64, 95%CI: 0.44-0.94) and insufficient sleep (OR: 0.68, 95%CI: 0.50-0.92) compared with the lowest quartile. RCS showed linear relationship of CDAI and insufficient sleep but non-linear relationship of CDAI with OSA and day sleepiness.

CONCLUSIONS

Our results show that CDAI was non-linearly associated with lower risk of OSA and day sleepiness whereas a linear inverse association between CDAI and insufficient sleep was observed. These findings implicate that combined intake of antioxidants could be a promising and effective approach to optimize sleep quality for public.

The Association Between the Composite Dietary Antioxidant Index and Frailty Symptoms: Mediating Effects of Oxidative Stress

Background

There is growing evidence that an antioxidant diet is a protective factor against frailty. However, few studies have examined the effect of comprehensive dietary antioxidants on frailty symptoms. The aim of this study was to examine the relationships between the composite dietary antioxidant index (CDAI) and frailty and the underlying mechanisms involved.

Methods

Based on the National Health and Nutrition Survey (NHANES) 2003-2018, this study included 11,277 older persons aged ≥60 years. In this study, frailty was defined as having a total score >0.21 on the 49-item frailty index. Six dietary antioxidants were selected for use in calculating the CDAI. A weighted multiple logistic regression model with subgroup analysis and restricted cubic splines (RCSs) were used to examine the association between the CDAI and frailty. To examine the role of oxidative stress, mediation analyses were also conducted.

Results

The association between the CDAI score and frailty risk was significant according to the multivariate model. Compared with participants in tertile 1, participants in both tertile 2 and tertile 3 had lower odds of developing frailty symptoms (OR=0.86; 95% CI=0.75-0.97; P=0.02; and OR=0.81; 95% CI=0.70-0.93; P=0.003). According to the subgroup analyses, the differences in interactions were not statistically significant. There was also a potential nonlinear relationship between the CDAI score and frailty risk. The serum albumin concentration and uric acid concentration had significant mediating effects on the association between the CDAI score and frailty index, with 19.25% (P=0.002) and 21.26% (P < 0.001) of the total, respectively.

Conclusion

Frailty is negatively associated with the CDAI score, which may be partially mediated by oxidative stress.

The association between dietary anti-oxidant quality score and psychological disorders among Iranian adults: a population-based study

OBJECTIVE

Evidence linking relation between dietary antioxidant quality score (DAQS) and psychological disorders is limited. Therefore, this study aimed to assess relationship between DAQSs and psychological disorders including depression, anxiety and stress among Iranian adults.

METHODS

This cross-sectional study used data on 7165 participants of the recruitment phase of Yazd Health Study (YaHS) and Taghzieh Mardom-e-Yazd Study (TAMYZ). Dietary intakes and psychological problems were evaluated using a validated semi-quantitative food frequency questionnaire and the validated Iranian version of depression, anxiety and stress scale questionnaire. DAQS was calculated for each person by summing up the assigned scores to a ratio between daily consuming each of the nutrients including vitamin A, C, E, selenium, manganese, zinc and their daily recommended intake (Score of 0 for a ratio of <2/3 and 1 for a ratio of >2/3). Eventually, association between DAQS and psychological disorders was assessed via logistic regression analysis.

RESULTS

Although no significant relationship was observed between DAQS and psychological disorders in general population, a protective role was found for DAQS against anxiety only in women after adjusting history of chronic disease; age; marital status; education level; smoking status; total energy intake and physical activity level (second tertile versus first tertile: OR: 0.63, 95% CI: 0.40-0.99). However, this finding was nonsignificant after further adjustment for body mass index.

CONCLUSION

Average levels of DAQS might be related to psychological distress especially among women. However, more studies are recommended to valid the findings.

Association between the Composite Dietary Antioxidant Index and Stroke: A cross-sectional Study

The composite dietary antioxidant index (CDAI) is indeed a valuable nutritional tool used to evaluate the overall antioxidant capacity of an individual's daily food consumption. The CDAI was calculated from the intake of six antioxidant components in the diet, including vitamin A, vitamin C and vitamin E, carotenoids, selenium, and zinc. This study aimed to determine the association between CDAI and stroke. Utilizing data from the 2003-2018 NHANES dataset, CDAI was computed by summarizing the intake of six dietary antioxidants based on 24-hour dietary recall interviews. The relationship between CDAI and stroke was examined using multivariate logistic regression and restricted cubic spline analysis. This study ultimately included 39,432 participants, of whom 1,527 (3.87%) had a stroke. The multivariate logistic regression model 3 that fully adjusted all confounding variables showed a negative association between CDAI and stroke (OR = 0.97; 95% CI:0.95, 0.99). The highest tertile of CDAI saw a 23% drop in the prevalence of stroke compared to the lowest tertile (OR = 0.77; 95%CI: 0.64,0.92). Restricted cubic spline suggested that this negative correlation was nonlinear with an inflection point of -2.99. Subgroup analyses and interaction tests showed that this negative correlation was more applicable in patients with prediabetes (P < 0.05). There was a non-linear negative correlation between CDAI level and stroke prevalence, and this correlation was more significant in people with pre-diabetes. Appropriate CDAI levels may contribute to the management of stroke risk.

Relationship between composite dietary antioxidant index and depression among overweight and obese adults

BACKGROUND

The use of specific dietary patterns to alleviate depressive symptoms has gained increasing recognition. The Composite Dietary Antioxidant Index (CDAI) is a crucial criterion for assessing antioxidant diets. We examined the relationship between CDAI and depression among overweight and obese adults through a cross-sectional study conducted in the United States.

METHODS

We used weighted multivariate logistic regression models with subgroup analysis to study the relationship between CDAI and depression. Generalized additive models were used to determine whether there was a nonlinear association between them. We developed a two-piece linear regression model to calculate the inflection point utilizing a recursive strategy.

RESULTS

After adjusting for confounding variables, the odds ratios (ORs; 95 % CI) for the correlation between CDAI and depression were 0.75 (0.67, 0.84). A saturation effect emerged for the overweight group, following which we calculated the inflection point for the overweight population, which displayed ORs (95 % CI) of 0.62 (0.47, 0.80) before the inflection point of 0.83 and the ORs (95 % CI) of 1.01 (0.77, 1.31) after 0.83. The interaction was statistically significant in the sex stratification of the obese population.

CONCLUSIONS

Our study highlighted a negative association between CDAI and depression among overweight and obese adults. Saturation effects and sex differences were observed in the overweight population.

Dietary total antioxidant capacity and serum 8-OHdG in patients with schizophrenia

BACKGROUND

Dietary total antioxidant capacity serves as an indicator for dietary quality and reflects daily antioxidant intake. This study aimed to determine the oxidative stress status of patients with schizophrenia and to examine the relationship between dietary total antioxidant capacity (dTAC) and 8-hydroxy-2'-deoxyguanosine (8-OHdG), a marker for oxidative stress.

METHODS

This study was conducted in Turkey and involved 40 patients diagnosed with schizophrenia or schizoaffective disorder according to the Diagnostic and Statistical Manual of Mental Disorders, 5th ed., and 30 healthy controls matched for age and gender. The participants' sociodemographic characteristics and nutritional habits were determined through face-to-face interviews and through the use of questionnaires. The dTAC and dietary oxidative balance scores were calculated using a three-day dietary intake record. 8-OHdG levels were analyzed in the serum samples collected from the subjects.

RESULTS

Dietary ferric reducing antioxidant power (FRAP-1, FRAP-2), Trolox equivalence antioxidant capacity (TEAC), and oxygen radical absorbance capacity (H-ORAC) values were lower in patients with schizophrenia than in the healthy controls (P < 0.05). Serum 8-OHdG levels were found similar in both groups (P > 0.05).

CONCLUSION

Nutritional interventions are needed in patients with schizophrenia given that insufficient antioxidant intake may increase oxidative stress, which in turn affects disease development. Therefore, healthy nutrition, especially sufficient intake of dietary antioxidants, should be encouraged in patients with schizophrenia.

Association between total dietary antioxidant capacity and food groups and incidence of depression in a cohort of Brazilian graduates (CUME Project)

This study aims to evaluate the association between Dietary Total Antioxidant Capacity (dTAC) and Total Antioxidant Capacity of food groups (fgTAC) with the incidence of depression in Brazilian graduates participating in the Cohort of Universities of Minas Gerais (CUME Study). The sample consisted of 2572 participants without a medical diagnosis of depression at baseline who responded to at least one follow-up questionnaire from the CUME Project. The Ferric Reducing Antioxidant Power assay was used to determine dTAC. Incidence of depression was estimated by self-reported medical diagnosis of depression during the years of cohort follow-up. Cox regression models were used to relate dTAC and fgTAC to the incidence of depression. The mean follow-up time was 2·96 (1·00) years, and 246 cases of depression were observed (32·3/1000 person-years). The mean dTAC was 11·03 (4·84) mmol/d. We found no associations between higher dTAC and lower risk of developing depression after adjusting for possible confounders. The incidence of depression was inversely associated with fgTAC of the beans and lentils group (hazard ratio (HR): 0·61; 95 % CI 0·41, 0·90). The fgTAC of the junk food group was positively associated with higher incidence of depression after all adjustments (HR: 1·57; 95 % CI 1·08, 2·26). Our findings do not support an association between dTAC and the incidence of depression in a highly educated Brazilian population. However, associations of fgTAC show the importance of analysing the food matrix in which these antioxidants are inserted. We highlight the need for more prospective studies with different nationalities to confirm these results.

The association of dietary approaches to stop hypertension (DASH) and Mediterranean diet with mental health, sleep quality and chronotype in women with overweight and obesity: a cross-sectional study

PURPOSE

Mental and sleep disorders are global public health problems, especially in Middle Eastern countries, and are significantly associated with circadian rhythm. This study sought to investigate the association between the dietary approaches to stop hypertension (DASH) and Mediterranean diet scores and mental health, sleep quality, and circadian rhythm.

METHODS

We enrolled 266 overweight and obese women, and depression, anxiety, and stress scale (DASS) score, Pittsburgh Sleep Quality Index (PSQI), and Morning-Evening Questionnaire (MEQ), were assessed. The Mediterranean and DASH diet score was measured using a validated semi-quantitative Food Frequency Questionnaire (FFQ). The physical activity was evaluated using the International Physical Activity Questionnaire (IPAQ). Analysis of variance and analysis of covariance, chi-square, and multinomial logistic regression tests were used as appropriate.

RESULTS

Our results showed that there was a significant inverse association between adherence to the Mediterranean diet and mild and moderate anxiety scores (p < 0.05). In addition, there was an inverse association between adherence to the DASH diet and the risk of severe depression and extremely severe stress scores (p < 0.05). Moreover, higher adherence to both dietary scores was associated with good sleep quality (p < 0.05). There was a significant relationship between circadian rhythm and the DASH diet (p < 0.05).

CONCLUSION

A significant association exists between a DASH and Mediterranean diet with sleep status, mental health, and chronotype in women of childbearing age with obesity and overweight.

LEVEL OF EVIDENCE

Level V, Cross-sectional observational study.

Antioxidant and Anti-Inflammatory Effects of Carotenoids in Mood Disorders: An Overview

Depression has a multifactorial etiology comprising family history and unemployment. This review aims to summarize the evidence available for the antioxidant and anti-inflammatory effects of carotenoids in mood disorders. This review article’s methodologies were based on a search of the PubMed database for all linked published papers. Epidemiological studies indicate that a diet rich in vegetables, fruits, nuts, fish, and olive oil may prevent the development of depression. Antioxidant supplementation has been found to combat various stress-induced psychiatric disorders, including depression and anxiety. A growing body of evidence indicates that carotenoids have both antioxidant and anti-inflammatory. Studies also suggest that poor dietary intake, particularly low intakes of fruit and vegetables and high intakes of fast food and other convenience foods, may increase the risk of developing depression. Thus, dietary interventions have the potential to help mitigate the risk of mental health decline in both the general population and those with mood disorders. Considering that carotenoids have both antioxidant and anti-inflammatory effects, it is expected that they might exert a promising antidepressant effect. Nevertheless, further studies (including interventional and mechanistic studies) assessing the effect of carotenoids on preventing and alleviating depression symptoms are needed.

Independent and joint associations of dietary antioxidant intake with risk of post-stroke depression and all-cause mortality

BACKGROUND

Few observational studies have investigated the association of dietary antioxidant intake with post-stroke depression (PSD) risk. We used the cross-sectional and longitudinal design to investigate the independent and joint associations between dietary antioxidant intake and PSD risk and all-cause mortality.

METHODS

Participants from the 2005-2014 National Health and Nutrition Examination Survey (NHANES) aged 20 years and older with stroke were included. Logistic and Cox regression analyses were used to assess the associations of dietary antioxidant intake, including vitamin A, vitamin C, vitamin E, zinc, selenium, and carotenoids, and composite dietary antioxidant index (CDAI) with PSD risk and all-cause mortality.

RESULTS

The highest quartile of dietary vitamin A (OR: 0.54, 95%CI: 0.32, 0.92), total carotenoids (OR: 0.56, 95%CI: 0.34, 0.94), and selenium intake (OR: 0.53, 95%CI: 0.31, 0.90) were associated with decreased PSD risk compared with those in the lowest quartile. The results showed a negative association between CDAI and PSD risk, with the lowest OR in the third quartiles (OR: 0.49, 95%CI: 0.30, 0.83). Furthermore, the highest quartile of dietary vitamin A (HR: 0.63, 95%CI: 0.45, 0.89), vitamin E (HR: 0.69, 95%CI: 0.48, 0.99), zinc (HR: 0.57, 95%CI: 0.40, 0.81), selenium (HR: 0.64, 95%CI: 0.46, 0.90), and total carotenoids (HR: 0.66, 95%CI: 0.47, 0.92) intake and CDAI (HR: 0.56, 95%CI: 0.39, 0.81) were associated with decreased all-cause mortality compared with those in the lowest quartile.

CONCLUSION

Increased intake of dietary antioxidant may protect from depressive symptoms and improve the prognosis of stroke patients.

Anti-Inflammatory, Antioxidant, and Neuroprotective Effects of Polyphenols-Polyphenols as an Element of Diet Therapy in Depressive Disorders

Depressive disorders can affect up to 350 million people worldwide, and in developed countries, the percentage of patients with depressive disorders may be as high as 10%. During depression, activation of pro-inflammatory pathways, mitochondrial dysfunction, increased markers of oxidative stress, and a reduction in the antioxidant effectiveness of the body are observed. It is estimated that approximately 30% of depressed patients do not respond to traditional pharmacological treatments. However, more and more attention is being paid to the influence of active ingredients in food on the course and risk of neurological disorders, including depression. The possibility of using foods containing polyphenols as an element of diet therapy in depression was analyzed in the review. The possibility of whether the consumption of products such as polyphenols could alleviate the course of depression or prevent the progression of it was also considered. Results from preclinical studies demonstrate the potential of phenolic compounds have the potential to reduce depressive behaviors by regulating factors related to oxidative stress, neuroinflammation, and modulation of the intestinal microbiota.

The association between dietary total antioxidant capacity and odds and severity of irritable bowel syndrome among Iranian adults: a cross-sectional study

Background

Little evidence is available in terms of the role of dietary antioxidants in the management of irritable bowel syndrome (IBS) disease. This study aimed to examine the association between dietary total antioxidant capacity (dTAC) and odds of IBS and its severity.

Methods

This cross-sectional study was conducted on 3,362 Iranian adults who were referred to health centers in Isfahan province, Iran. Participants' dietary intakes were collected using a semi-quantitative validated food frequency questionnaire (DS-FFQ). The dTAC was measured by the ferric-reducing antioxidant power (FRAP) method. Multivariable binary or ordinal logistic regression analyses were performed to estimate any associations between dTAC and odds of IBS, IBS severity, and IBS subtypes.

Results

The average age and BMI of the participants and dTAC score were 36.3 ± 7.87 year, 24.9 ± 3.82 kg/m2. The prevalence of IBS, IBS with constipation (IBS-C), IBS with diarrhoea (IBS-D), mixed IBS (IBS-M), and un-subtyped IBS (IBS-U) were 22.2, 7.5, 4.6, 3.8, and 6.2%, respectively. In crude and adjusted models, the results did not show any significant association between dTAC and odds of IBS among whole and gender-age stratified populations. Being in the third compared with the first tertile of dTAC was not also significantly associated with odds of IBS severity. Besides, there were no significant associations between dTAC and odds of IBS-C, IBS-D, IBS-M, and IBS-U.

Conclusion

This study indicates that dTAC may not be associated with the odds of IBS and its severity even after stratification for gender and body mass index.

Non-linear association between composite dietary antioxidant index and depression

Background

Growing evidence has shown that the antioxidant diet is a protective factor against depression. However, the relationship between the Composite Dietary Antioxidant Index (CDAI), an important measure of antioxidant diet, and depression has received little attention. Therefore, we investigated the relationship between CDAI and depression through a cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018.

Methods

The association between CDAI and depression was investigated using a weighted multiple logistic regression model with subgroup analysis. Non-linear correlations were explored using fitted smoothing curves. And we used a recursive method to figure out the turning point and build a weighted two-piece linear regression model.

Results

In the multivariate logistic regression model with full adjustment for confounding variables, the ORs (95% CI) for the association between CDAI and depression were 0.83 (0.78, 0.88). Moreover, a non-linear association was found, with 0.16 being the inflection point. Before the inflection point, each unit increase in CDAI was associated with a 30% decrease in the risk of depression. After the inflection point, the risk of depression was found to be reduced by 11% for each unit increase. None of the interactions in all subgroup analyses were statistically significant.

Conclusions

Our study highlighted a negative non-linear association between CDAI and depression in a nationally representative sample of US adults. Further clinical and basic research is needed to explore their association better.

Anxiolytic and antidepressive potentials of rosmarinic acid: A review with a focus on antioxidant and anti-inflammatory effects

Depression and anxiety are the most prevalent neuropsychiatric disorders that have emerged as global health concerns. Anxiolytic and antidepressant drugs, such as benzodiazepines, selective serotonin reuptake inhibitors, monoamine oxidase inhibitors, and tricyclics, are the first line used in treating anxiety and depression. Although these drugs lack efficacy and have a delayed response time and numerous side effects, their widespread abuse and market continue to grow. Over time, traditional practices using natural and phytochemicals as alternative therapies to chemical drugs have emerged to treat many pathological conditions, including anxiety and depression. Recent preclinical studies have demonstrated that the phenolic compound, rosmarinic acid, is effective against several neuropsychiatric disorders, including anxiety and depression. In addition, rosmarinic acid showed various pharmacological effects, such as cardioprotective, hepatoprotective, lung protective, antioxidant, anti-inflammatory, and neuroprotective effects. However, the potentialities of the use of rosmarinic acid in the treatment of nervous system-related disorders, such as anxiety and depression, are less or not yet reviewed. Therefore, the purpose of this review was to present several preclinical and clinical studies, when available, from different databases investigating the effects of rosmarinic acid on anxiety and depression. These studies showed that rosmarinic acid produces advantageous effects on anxiety and depression through its powerful antioxidant and anti-inflammatory properties. This review will examine and discuss the possibility that the anxiolytic and anti-depressive effects of rosmarinic acid could be associated with its potent antioxidant and anti-inflammatory activities.

Dietary total anti-oxidant capacity is inversely related to the prevalence of depression in adolescent girls

Background

Oxidative stress is considered to be a contributory factor for depression, and is affected by the dietary intake of pro-and anti-oxidants. Dietary total antioxidant capacity (DTAC) is an index which is applied to estimate the cumulative power of antioxidants in the whole diet. The aim of this study was to determine the relationship between DTAC and prevalence of depression in adolescent girls.

Methods

A total of 741 Iranian adolescent girls aged 12–18 years were recruited into this cross-sectional study. Dietary intake and depression severity score were assessed using a food frequency questionnaire and Beck's depression inventory, respectively. To estimate the DTAC, the oxygen radical absorbance capacity method was used for selected foods. To explore the associations between DTAC and depression, logistic regression was applied using crude and adjusted models.

Results

Individuals in the greatest adherence to high DTAC had more intakes of whole grains, legumes, fruits, dried fruits, low fat dairy products, cruciferous vegetables, fiber, magnesium, vitamin C, folate, potassium, zinc, β-carotene, lutein, thiamin, riboflavin, niacin and vitamin B-6 and lower consumption of refined grains. Subjects in the highest quartile of DTAC had a 39% lower odds of depression compared to those in the first quartile (OR = 0.61; 95% CI: 0.38–0.97, P for trend = 0.012); these associations remained significant after adjustments in first, second and third (OR = 0.5; 95% CI: 0.28–0.92, P for trend < 0.001) adjusted models.

Conclusions

An inverse association was observed between the DTAC and the prevalence of depression in our population sample of adolescent girls. Further research needs to be conducted in different areas, including longitudinal studies with larger sample sizes.

The association between dietary inflammatory index, dietary antioxidant index, and mental health in adolescent girls: an analytical study

BACKGROUND

Diet is considered as one of the modifiable factors that appears to exert a vital role in psychological status. In this way, we designed this study to examine the association between dietary inflammatory index (DII), dietary antioxidant index (DAI), and mental health in female adolescents.

METHODS

This cross-sectional study included 364 female adolescents selected from high schools in the five regions of Tabriz, Iran. A 3-day food record was used to extract the dietary data and calculate DII/DAI scores. DII and DAI were estimated to assess the odds of depression, anxiety, and stress based on the Depression Anxiety Stress Scales-21. Adjusted relationships of the DII and DAI with depression, anxiety, and stress were determined using multiple regression after adjusting for age, energy intake, BMI, family income and mother and father education. Overweight was defined as body mass index (BMI)-for-age >  + 1 z-score relative to world health organization standards.

RESULTS

Depression, anxiety, and stress were observed in 21.4%, 26.6%, and 25.7% of subjects, respectively. The percentage of overweight among adolescents was 19.4%. The association between DII and score of mental health profile was positive among subjects in the third tertile of DII compared to subjects in the first tertile. However, this association was not statistically significant after adjusting for confounding variables. Moreover, there was a significant inverse association between DAI and depression and anxiety; and a statistically insignificant association between DAI and stress after adjusting for confounders.

CONCLUSIONS

Our results highlighted the importance of a healthy and anti-inflammatory diet on mental health in female adolescents. Therefore, modifying unhealthy dietary habits are likely to be effective in the management of psychosocial disorders.

Mediterranean Diet on Sleep: A Health Alliance

The Mediterranean diet is a plant-based, antioxidant-rich, unsaturated fat dietary pattern that has been consistently associated with lower rates of noncommunicable diseases and total mortality, so that it is considered one of the healthiest dietary patterns. Clinical trials and mechanistic studies have demonstrated that the Mediterranean diet and its peculiar foods and nutrients exert beneficial effects against inflammation, oxidative stress, dysmetabolism, vascular dysfunction, adiposity, senescence, cognitive decline, neurodegeneration, and tumorigenesis, thus preventing age-associated chronic diseases and improving wellbeing and health. Nocturnal sleep is an essential physiological function, whose alteration is associated with health outcomes and chronic diseases. Scientific evidence suggests that diet and sleep are related in a bidirectional relationship, and the understanding of this association is important given their role in disease prevention. In this review, we surveyed the literature concerning the current state of evidence from epidemiological studies on the impact of the Mediterranean diet on nighttime sleep quantity and quality. The available studies indicate that greater adherence to the Mediterranean diet is associated with adequate sleep duration and with several indicators of better sleep quality. Potential mechanisms mediating the effect of the Mediterranean diet and its foods and nutrients on sleep are described, and gap-in-knowledge and new research agenda to corroborate findings are discussed.

Interaction between Apo A-II -265T > C polymorphism and dietary total antioxidant capacity on some oxidative stress and inflammatory markers in patients with type 2 diabetes mellitus

This work aims to examine the interaction between apo A2 (Apo A-II) -265T > C SNP and dietary total antioxidant capacity (DTAC) on inflammation and oxidative stress in patients with type 2 diabetes mellitus. The present cross-sectional study included 180 patients (35-65 years) with identified Apo A-II genotype. Dietary intakes were assessed by a FFQ. DTAC was computed using the international databases. IL-18 (IL18), high-sensitivity C-reactive protein (hs-CRP), pentraxin (PTX3), serum total antioxidant capacity (TAC), superoxide dismutase (SOD) activity and 8-isoprostaneF2α (PGF2α) markers were obtained according to standard protocols. General linear model was used to evaluate the interaction. The interaction of gene and DTAC (P_FRAP = 0·039 and P_ORAC = 0·042) on PGF2α level was significant after adjusting for confounders. A significant interaction was observed on IL18 level (P_ORAC = 0·018 and P_FRAP = 0·048) and SOD (P_TEAC = 0·037) in obese patients. Among patients whose DTAC was higher than the median intake, the levels of hs-CRP and PGF2α were significantly higher only in individuals with CC genotype. Serum TAC (P_FRAP = 0·030, P_ORAC = 0·049) and SOD were significantly lower in the CC genotype. There was a favourable relationship between the high-DTAC and SOD (obese: P_TEAC = 0·034, non-obese: P_FRAP = 0·001, P_TRAP < 0·0001, P_TEAC = 0·003 and P_ORAC = 0·001) and PGF2α (non-obese: P_ORAC = 0·024) in T-allele carriers. The rs5082 SNP interacts with DTAC to influence several cardiometabolic risk factors. Also, we found dietary recommendations for antioxidant-rich foods intake might be useful in the prevention of diabetes complications in the T carrier more effectively than the CC genotype. Future large studies are required to confirm these results.

Dietary antioxidant consumption and the risk of type 2 diabetes in South Korean adults: a prospective cohort study based on the Health Examinees study

OBJECTIVES

Antioxidants are common dietary compounds with multiple health benefits. This study aimed to identify the association between dietary antioxidant consumption and the incidence of type 2 diabetes (T2D) mellitus (defined using the Korean Diabetes Association criteria) in South Korean adults.

DESIGN

Baseline and follow-up data from the Health Examinees (HEXA) study, a large-scale community-based genomic cohort study conducted in South Korea SETTING: A South Korean community.

PARTICIPANTS

A total of 20 594 participants, aged 40-79 years, who participated in the baseline and follow-up surveys of the HEXA study were included. After an average of 5 years of follow-up, there were 332 men and 360 women with T2D.

RESULTS

Participants with the highest total flavonoid consumption (Q5) had a lower risk of T2D (men: HR 0.63; 95% CI 0.42 to 0.93; p value for trend=0.0169; and women: HR 0.54; 95% CI 0.438 to 0.78; p value for trend=0.0001) than those with the lowest consumption (Q1). Dietary total antioxidant capacity was significantly inversely associated with the development of T2D mellitus in women participants alone (HR 0.58; 95% CI 0.40 to 0.83; p value for trend=0.0004). Stratified analyses according to age and body mass index (BMI) showed that dietary total flavonoid consumption and total antioxidant capacity had a negative association with the development of T2D in women aged >52 years and women with BMI >25 kg/m².

CONCLUSIONS

Dietary flavonoid consumption and total antioxidant capacity were associated with a lower risk of T2D in South Korean adults, especially in women aged >52 years and overweight. The findings of this study may provide reference data for the modification of dietary guidelines for South Koreans.

Lacking Communication Would Increase General Symptom Index Scores of Medical Team Members During COVID-19 Pandemic in China: A Retrospective Cohort Study

There are few studies on the psychological status of medical staff during the COVID-19 outbreak. Our study addresses whether lack of communication affects the psychological status of medical team members supporting Wuhan during the COVID-19 pandemic in China. We used general symptom index (GSI) scores of the Symptom Checklist-90 (SCL-90) to evaluate participants' psychological status. We adopted a stratified sampling method and selected the fourth team, with a total of 137 members, as participants. In total 76.6% and 69.7% of female and male participants, respectively, had bachelor's degrees; 41.6% and 21.2% of female and male participants, respectively, were unmarried. Regarding communication, 14.29% and 6.06% of female and male participants, respectively, reported a lack of communication with the team (LCWT). Additionally, 13.0% and 6.1% of female and male participants, respectively, experienced fear of being infected (FoBI). LCWT and FoBI were positively correlated with GSI score (estimated change = 0.2, 95% CI [0.1-0.3]). When adjusted for gender, age, and FoBI, LCWT was positively correlated with GSI score (P < .05). Increasing communication among medical team members can reduce GSI scores.

Antioxidant vitamin intakes and risk of depression, anxiety and stress among female adolescents

BACKGROUND AND AIM

The relation of some antioxidant nutrients with psychological disorders has been studied previously. The aim of this study was to examine the association between antioxidant vitamin intakes and the risk of depression, anxiety, and stress.

METHODS

This cross-sectional study was conducted on 263 Tehranian female adolescents. Dietary intakes of vitamin E, C, and β-Carotene were determined using a valid and reliable food-frequency questionnaire. Depression, anxiety, and stress scores were characterized by DASS-21 (Depression Anxiety Stress Score-21 items) questionnaire. The multivariable logistic regression models were used to determine the odds ratios (ORs) and 95% confidence intervals (95%CIs) of depression, anxiety, and stress across tertiles of antioxidant vitamin intakes.

RESULTS

The mean ± SD age of participants was 16.20 ± 0.97 years. Also, the mean ± SD depression, anxiety and stress scores of participants were 9.89 ± 4.15, 8.43 ± 4.39 and 14.00 ± 6.45, respectively. In the fully adjusted model, subjects in the highest tertile of β-Carotene had a lower prevalence of depression (OR:0.46, 95%CI:0.23-0.95), anxiety (OR:0.40, 95%CI:0.20-0.81), and stress (OR:0.35, 95%CI:0.17-0.73) compared to the lowest tertile (P for trend<0.05). Moreover, individuals in the top tertile of vitamin E had a lower prevalence of stress, in comparison to the bottom tertile (OR:0.34, 95% CI:0.13-0.89), (P for trend<0.05). However, no significant associations were found between the intakes of vitamin E and C and other psychological disorders.

CONCLUSION

In this study, higher intake of β-Carotene was associated with lower prevalence of depression, anxiety and stress. Also, we found an inverse relationship between vitamin E intake and the risk of stress.

Cross-talk between oxidative stress signaling and microRNA regulatory systems in carcinogenesis: Focused on gastrointestinal cancers

Molecular mechanisms underlying development and progression of gastrointestinal (GI) cancers are mediated by both oxidative stress (OS) and microRNAs (miRNAs) involvement. Notably, OS signaling may regulate the expression of miRNAs, and miRNAs function as imperative players in OS-initiated tumors. Given the defined biological roles of both OS systems and miRNAs in GI carcinogenesis, a possible interplay between these two key cellular networks is considered. A growing body of evidence has indicated a reciprocal connection between OS signaling pathways and miRNA regulatory machines in GI cancer development and progression. Illumination of the molecular cross-talking between miRNAs and the OS would improve our pathophysiological insight into carcinogens. Also, understanding the molecular mechanisms in which these systems are reciprocally regulated may imply in future medical practice mainly GI cancer therapy. Nowadays, therapeutic strategies focusing on miRNA and OS in GI cancer treatment are increasingly delineated. Since the use of antioxidants is limited owing to the contrasting consequences of OS signaling in cancer, the discovery of OS-responsive miRNAs may provide a potential new strategy to overcome OS-mediated GI carcinogenesis. Given the possible interaction between OS and miRNAs in GI cancers, this review aimed to elucidate the existing evidence on the interaction between OS and miRNA regulatory machinery and its role in GI carcinogenesis. In this regard, we will illustrate the function of miRNAs which target OS systems during homeostasis and tumorigenesis. We also discuss the biological cross-talk between OS systems and miRNAs and corresponding cell signaling pathways.

Vegetarian diet and the risk of depression, anxiety, and stress symptoms: a systematic review and meta-analysis of observational studies

Previous studies reported inconsistent findings regarding the consumption of a vegetarian diet with mental health outcomes, specifically depression, anxiety and stress. A systematic review was conducted to summarize the current state of literature regarding our understanding of the association between a vegetarian diet and depression, anxiety and stress. A literature search was completed using Scopus, PubMed, and the Web of Science for relevant articles published prior to July 2020. Prospective cohort and cross-sectional studies conducted on adults reporting risk estimates for the consumption of a vegetarian diet, depression, anxiety, and stress were selected. A fixed effects or a random effects model was performed to pool effect sizes. Results from 13 publications (four cohort studies and nine cross-sectional studies) assessing the relationship between the consumption of a vegetarian diet and depression, anxiety and stress were included. The pooled effect size from 10 studies indicated no association between the consumption of a vegetarian diet and depression (pooled effect size: 1.02, 95% CI: 0.84-1.25, p = 0.817). Further, the pooled effect size from four studies suggests that a vegetarian diet is not associated with anxiety (pooled effect size: 1.09, 95% CI: 0.71-1.68, p = 0.678). Due to insufficient data for stress, we were not able to pool the results. Together, no significant associations were observed between the consumption of a vegetarian diet and depression or anxiety. Future cohort studies are needed to further investigate the effects of a vegetarian diet on these mental health outcomes.