Association between dietary inflammatory index and psychological profile in adults

Association between Dietary Inflammatory Index and Hyperemesis Gravidarum

(1) Background: Diet holds a pivotal position in exacerbating or ameliorating chronic inflammation, which has been implicated in the pathogenesis of hyperemesis gravidarum (HG). However, no study has explored the association between dietary inflammatory potential and HG. This study aimed to investigate the potential correlation between following a pro-inflammatory diet and the likelihood of developing HG. (2) Methods: A total of 2033 Chinese pregnant women (mean age: 31.3 ± 3.4 years) were included in this cross-sectional study from April 2021 to September 2022 as part of the China Birth Cohort Study (CBCS). Dietary inflammatory index (DII) scores with 23 food components were constructed through dietary intakes collected via a reliable 108-item semi-quantitative food frequency questionnaire. HG was defined as a pregnancy-unique quantification of emesis (PUQE) score ≥13 points, severe nausea and vomiting leading to weight loss ≥5%, or being hospitalized for treatment due to the disease. The relationship between DII and HG was conducted utilizing binary logistic regression and restricted cubic spline regression. (3) Results: Overall, 8.2% (n = 167) of study participants had HG. The DII scores ranged from -4.04 to 3.82. After adjusting for potential confounders, individuals with the highest tertile of DII score had a higher risk of HG (OR = 1.65, 95% CI: 1.04, 2.62, Ptrend = 0.032). Such an association was stronger in those with pre-pregnancy overweight/obesity (Pinteraction = 0.018). (4) Conclusions: A higher DII score, which serves as a marker for a diet promoting inflammation, is correlated with an elevated risk of developing HG. This finding suggests that dietary recommendations for HG should focus on minimizing the DII through incorporating foods abundant in anti-inflammatory components.

Accelerated biological aging as potential mediator mediates the relationship between pro-inflammatory diets and the risk of depression and anxiety: A prospective analysis from the UK biobank

BACKGROUND

The relationship between inflammatory dietary patterns and the risk of depression/anxiety has not been clearly established due to differences in study populations, geographic regions, sex, and methods of calculating the inflammatory index.

METHODS

We drew upon a prospective cohort in the UK Biobank and calculated the energy-adjusted dietary inflammatory index (E-DII). The follow-up time was defined from the date of completing the last dietary survey questionnaire to the date of diagnosis of depression, anxiety, phobic anxiety, other types of anxiety, death, loss to follow-up, or the respective censoring dates for England (September 30, 2021), Scotland (July 31, 2021), and Wales (February 28, 2018). The final follow-up times end on September 30, 2021, July 31, 2021, and February 28, 2018, for England, Scotland, and Wales, respectively. During the follow-up process, if a participant develops the condition, dies, or is lost to follow-up, the follow-up is terminated. We used Cox regression to evaluate the connection between E-DII and depression/anxiety. We employed restricted cubic spline curves for nonlinear relationships. We also conducted mediation analyses to explore whether biological age mediated the relationship between E-DII and depression. Additionally, we investigated whether genetic susceptibility modified the relationship between E-DII and depression through interaction modeling.

RESULTS

In the final analysis, we included a total of 151,295, 159,695, 165,649, and 160,097 participants for the analysis of depression, all types of anxiety, specific phobia anxiety, and other types of anxiety, respectively. For every one-unit increase in E-DII, the risk of experiencing depression and anxiety increased by 5 % and 4 %, respectively. We identified a "J"-shaped nonlinear relationship (P for nonlinear = 0.003) for both depression and anxiety. A significant association with an elevated risk of depression was observed when E-DII exceeded 0.440, and an increased risk of anxiety was noted when E-DII was more than -0.196. Mediation analysis demonstrated that PhenoAge age acceleration (AA) (For depression, proportion of mediation = 9.6 %; For anxiety, proportion of mediation = 10.1 %) and Klemera-Doubal method Biological Age (KDM AA) (For depression, proportion of mediation = 2.9 %; For anxiety, proportion of mediation = 5.1 %) acted as mediators between E-DII and the development of depression and anxiety (P < 0.05).

CONCLUSIONS

Diets with pro-inflammatory characteristics are associated with a heightened risk of depression and anxiety. Furthermore, the association of pro-inflammatory diets and depression is mediated by biological age.

Diet quality and anxiety: a critical overview with focus on the gut microbiome

Anxiety disorders disproportionally affect females and are frequently comorbid with eating disorders. With the emerging field of nutritional psychiatry, focus has been put on the impact of diet quality in anxiety pathophysiology and gut microbiome underlying mechanisms. While the relationship between diet and anxiety is bidirectional, improving dietary habits could better facilitate the actions of pharmacological and psychological therapies, or prevent their use. A better understanding of how gut bacteria mediate and moderate such relationship could further contribute to develop personalized programs and inform probiotics and prebiotics manufacturing. To date, studies that look simultaneously at diet, the gut microbiome, and anxiety are missing as only pairwise relationships among them have been investigated. Therefore, this study aims at summarizing and integrating the existing knowledge on the dietary effects on anxiety with focus on gut microbiome. Findings on the effects of diet on anxiety are critically summarized and reinterpreted in relation to findings on (i) the effects of diet on the gut microbiome composition, and (ii) the associations between the abundance of certain gut bacteria and anxiety. This novel interpretation suggests a theoretical model where the relationship between diet and anxiety is mediated and/or modulated by the gut microbiome through multiple mechanisms. In parallel, this study critically evaluates methodologies employed in the nutritional field to investigate the effects of diet on anxiety highlighting a lack of systematic operationalization and assessment strategies. Therefore, it ultimately proposes a novel evidence-based approach that can enhance studies validity, reliability, systematicity, and translation to clinical and community settings.

Dietary inflammatory index, genetic susceptibility and risk of incident dementia: a prospective cohort study from UK biobank

BACKGROUND

Genetic factors, diet and inflammation are associated with the development of dementia. In this study, we aimed at evaluating the impact of the dietary inflammatory index (DII) scores and genetic susceptibility on the development of dementia.

METHODS

This prospective study involved 207,301 participants aged between 39 and 72 years from UK biobank. A web-based 24-h dietary questionnaire was collected at least once from participants between 2006 and 2012. The DII was calculated based on inflammatory effect score of nutrients. Individual AD-GRS (Alzheimer's disease genetic risk score) was calculated. Incident dementia was ascertained through hospital or death records.

RESULTS

Of all 207,301 participants, 468 incident cases of all-cause dementia (165 AD, 91 VD and 26 FTD) were reported during a follow-up period of 11.4 years. The participants in the highest quintile (Q) of DII scores reported a higher risk for all-cause dementia (Q5 vs. Q3, hazard ratio (HR) = 1.702; 95% CI: 1.285-2.255) and VD (Q5 vs. Q3, HR = 2.266, 95% CI: 1.133-4.531) compared to participants in the Q3. Besides, when compared with the Q1, there was a higher risk for AD in the subjects of Q5 (Q5 vs. Q1, HR = 1.590; 95% CI: 1.004-2.519). There was a non-linear relationship between DII score and all-cause incidence (P for non-linear = 0.038) by restricted cubic splines. Subgroup analysis found that the increased risk for all-cause dementia and AD was more pronounced in the elderly, women, and higher educated population. Cox regression models indicated that compared with the participants who had a low AD-GRS risk and in the lowest tertile of DII, participants had a high AD-GRS and the highest tertile of DII were associated with a higher risk of AD (HR = 1.757, 95% CI: 1.082-2.855, P = 0.023).

CONCLUSIONS

The DII scores were independently associated with an augmented risk for all-cause dementia, AD and VD. Additionally, high AD-GRS with higher DII scores was significantly associated with a higher risk of AD.

Is there a link between the inflammatory potential of a diet and mental health among patients with migraine? Findings from a cross-sectional survey

AIMS

In this study, we aimed to evaluate the relationship between the dietary inflammatory index (DII) and mental health outcomes among patients with migraine headaches.

METHODS

In this cross-sectional study, 262 subjects were included. The dietary intakes were collected using a validated 168-item semi-quantitative food frequency questionnaire. Items were scored according to their inflammatory potential, so a higher DII indicated a more pro-inflammatory diet. The association between DII and the mental health of participants was investigated using multinomial logistic regression and odds ratio (OR) with a corresponding 95% confidence interval (CI) was reported.

RESULTS

Overall, 224 women and 38 men, with a mean (standard error) DII of -2.96 (0.06), age of 36.1 (0.53) years, and BMI of 25.55 (0.21) kg/m2, comprised our study population. DII was positively associated with a higher risk of depression in patients with the highest adherence to a pro-inflammatory diet compared to those with the lowest adherence (OR = 1.76; 95%CI: 1.04, 3.00; Ptrend = 0.035). Adjustments for age, sex, marital status, smoking status, migraine headache index score, number of family members, mean arterial pressure, medication, physical activity, and BMI intensified the association in a way that the risk of depression was 2.03 times higher in patients with the highest adherence to a pro-inflammatory diet compared to those with the lowest adherence to a pro-inflammatory diet (OR = 2.03; 95%CI: 1.18, 3.49; Ptrend = 0.011).

CONCLUSION

Our findings suggest that depression was positively associated with adherence to a pro-inflammatory diet. However, no significant association was observed between anxiety and stress with DII.

Dietary inflammatory index and neuropsychiatric disorders

Neuropsychiatric disorders (NPDs) are considered a potential threat to mental health. Inflammation predominantly plays a role in the pathophysiology of NPDs. Dietary patterns are widely postulated to be involved in the physiological response to inflammation. This review aims to discuss the literature on how dietary inflammatory index (DII) is related to inflammation and, consequently, NPDs. After comprehensive scrutiny in different databases, the articles that investigated the relation of DII score and various NPDs and psychological circumstances were included. The association between dietary patterns and mental disorders comprising depression, anxiety, and stress proved the role of a proinflammatory diet in these conditions' exacerbation. Aging is another condition closely associated with DII. The impact of proinflammatory and anti-inflammatory diet on sleep quality indicated related disorders like sleep latency and day dysfunctions among the different populations are in relation with the high DII score. The potential effects of genetic backgrounds, dietary patterns, and the gut microbiome on DII are discussed as well. To plan preventive or therapeutic interventions considering the DII, these factors, especially genetic variations, should be considered as there is a growing body of literature indicating the role of personalized medicine in different NPDs. To the best of our knowledge, there is a limited number of RCTs on this subject, so future research should evaluate the causality via RCTs and look for therapeutic interventions with an eye on personalized medicine using information about DII in NPDs.

Dietary Inflammatory Potential, Inflammation-Related Lifestyle Factors, and Incident Anxiety Disorders: A Prospective Cohort Study

It is unclear whether diet-associated inflammation is related to the development of anxiety disorders. We aimed to investigate the association between energy-adjusted dietary inflammatory index (E-DII) scores and the incidence of anxiety disorders, and explore the joint effects of E-DII scores with other inflammatory lifestyles in enhancing anxiety risk. In the UK Biobank Study of 96,679 participants, baseline E-DII scores were calculated from the average intake of at least two 24 h dietary recalls. Multivariable-adjusted Cox models were used to evaluate the associations between E-DII scores and the incidence of total anxiety disorders, and primary types and subtypes; additive and multiplicative interactions of a pro-inflammatory diet and seven inflammatory lifestyles were examined. After a median follow-up of 9.4 years, 2785 incident cases of anxiety disorders occurred. Consuming a pro-inflammatory diet was significantly associated with a higher risk of total anxiety disorders (HRQ4vsQ1 = 1.12, 95% CI = 1.00-1.25), and positive associations were consistently identified for primary types and subtypes of anxiety disorders, with HRs ranging from 1.08 to 1.52, and were present in women only. Both additive and multiplicative interactions of current smoking and a proinflammatory diet on total anxiety risk were identified. A proinflammatory diet was associated with a higher incidence of anxiety disorders, and current smoking may synergize with a proinflammatory diet to promote anxiety risk, particularly among women.

Influence of Food Type on Human Psychological-Behavioral Responses and Crime Reduction

The purpose of this narrative review is to emphasize the importance of food consumption and meal selection on mental health and brain function, including psychological and behavioral reactions such as mood, loving relationships, violence, and criminal activity. Additionally, by being aware of the link between food and mental health, the community can be encouraged to make informed food choices in order to avoid unfavorable outcomes like criminality. Food behaviors are shifting significantly over the world. There are also significant changes in mood, sadness, happiness, and violence, as well as the spread of the variety and severity of mental diseases that lead to violent acts. Food intake and meal selection have evolved over the last ten years as the variety and accessibility of food options have become easier and more diverse. These modifications might have both beneficial and bad consequences. This article examines the relationship between food intake and its impact on marital satisfaction. The goal of this review is to support or refute the claim that food influences mood, love, or criminal behavior, or vice versa. Various diets can have an impact on one's mental health and brain, influencing psychological reactions and behavioral responses such as mood, loving relationships, violence, and even criminal activity. Food insecurity has been demonstrated in various studies to have a negative impact on health and psychological well-being, leading to despair, loss of happiness, marital conflict, and violence. For example, herbal extracts and flavonoids have the potential to improve gut microbiota and treat mood disorders. Understanding how the gut-brain axis communicates might help guide interventions for mood and cognitive function. Since the root of most diseases and behaviors is significantly related to the type of food consumed, this research addresses this issue in order to reduce the cost of treatment and prevention of crime and delinquency at the community level by consciously choosing the food consumed by the society. In other words, prevention is always better than cure.

The role of dietary inflammatory index and physical activity in depressive symptoms: Results from NHANES 2007-2016

BACKGROUND

Depression is a major public health problem. This study was aimed to analyze the relationship between dietary inflammation index (DII), physical activity, and depressive symptoms, and to explore the effect of different lifestyles on depressive symptoms by combining DII and physical activity to form four lifestyle groups.

METHODS

This study analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2016. A total of 21,785 subjects were involved. Depressive symptoms and dietary inflammation were measured by the Patient Health Questionnaire (PHQ-9) and Energy-adjusted Dietary Inflammatory Index, respectively. The participants were divided subgroups by different physical activity combined pro-inflammatory or anti-inflammatory diet groups.

RESULTS

Both pro-inflammatory diet and inactivity were positively associated with depressive symptoms. Compared with the anti-inflammatory diet & active group, the risk of depressive symptoms was 2.061 times higher in the pro-inflammatory diet & inactive group, 1.351 times higher in the pro-inflammatory diet & active group, and 1.603 times higher in the anti-inflammatory diet & inactive group. Physical inactivity was associated with a higher risk of depressive symptoms than a pro-inflammatory diet. Females and the 20-39 age group showed a strong association between lifestyles and depressive symptoms.

LIMITATIONS

Because of the cross-sectional study, no causal conclusions could be drawn. Moreover, PHQ-9 is a relatively basic method of identifying depressive symptoms, more and further research is needed.

CONCLUSIONS

Both a pro-inflammatory diet and physical inactivity were associated with higher risk of depressive symptoms, especially for young and female population.

Relationship between the Dietary Inflammatory Index Score and Cytokine Levels in Chinese Pregnant Women during the Second and Third Trimesters

The impact of dietary inflammatory potential on serum cytokine concentrations in second and third trimesters of Chinese pregnant women is not clear. A total of 175 pregnant women from the Tianjin Maternal and Child Health Education and Service Cohort (TMCHESC) were included. The dietary inflammatory index (DII) was calculated based on 24-h food records. Serum tumor necrosis factor-α (TNF-α), interleukin 1β (IL-1β), IL-6, IL-8, IL-10, C-reactive protein (CRP), and monocyte chemoattractant protein-1 (MCP-1) levels in the second and third trimesters were measured. The mean DII scores (mean ± SD) were -0.07 ± 1.65 and 0.06 ± 1.65 in the second and third trimesters, respectively. In the third trimester, IL-1β (p = 0.039) and MCP-1 (p = 0.035) levels decreased and then increased with increasing DII scores. IL-10 concentrations decreased in pregnant women whose DII scores increased between the second and third trimesters (p = 0.011). Thiamin and vitamin C were negatively correlated with MCP-1 (β = -0.879, and β = -0.003) and IL-6 (β = -0.602, and β = -0.002) levels in the third trimester. In conclusion, the DII score had a U-shaped association with cytokine levels during the third trimester. Changes in DII scores between the second and third trimesters of pregnancy were correlated with cytokine levels during the third trimester.

Dietary inflammatory potential and the incidence of depression and anxiety: a meta-analysis

The potential modifiable role of diet in common psychological disorders, including depression and anxiety, has attracted growing interest. Diet may influence the occurrence of mental disorders through its inflammatory characteristics. The purpose of this meta-analysis was to explore whether dietary inflammatory potential is associated with the risk of depression and anxiety. A systematic literature search was conducted in PubMed, Web of Science, and Embase databases up to February 2021. Articles related to dietary inflammatory potential and risk of depression or anxiety were included. After the elimination of repetitive and irrelevant literature, we conducted quality assessment, publication bias, and sensitivity analysis. In total, 17 studies with a total of 157,409 participants were included in the final analysis. Compared with the lowest inflammatory diet group, the highest group was significantly associated with the incidence of depression and anxiety, with the following pooled odds ratios (ORs) and 95% confidence intervals (95% CIs): 1.45 (1.30 ~ 1.62) for depression and 1.66 (1.41 ~ 1.96) for anxiety. A subgroup analysis by gender showed that this association was more prominent in women. For depression, the increased risk was 49% in women (OR 1.49, 95% CI 1.28 ~ 1.74) and 27% in men (OR 1.27, 95% CI 1.06 ~ 1.52). As for anxiety, the increased risk was 80% in women (OR 1.80, 95% CI 1.30 ~ 2.49) and 47% in men (OR 1.53, 95% CI 0.81 ~ 2.89). As a result, long-term anti-inflammatory eating patterns may prevent depression and anxiety, whereas pro-inflammatory eating patterns may promote these conditions. People should add more fish, fish oil, fresh fruit, walnuts, and brown rice to their diet.

Determination of the relationship between dietary inflammatory index and depression status in female students

Background: The relationship between diet, inflammation and mental health has been receiving increasing interest. However, limited data are available on the inflammatory role of diet in university students, among whom depression is commonly observed. Aim: The aim of our study is to investigate the relationship between dietary inflammatory index (DII) and depression among female students of nutrition and dietetics department, whom we assume to be conscious about health. Methods: DII scores were determined by averaging the 3-day dietary records. Depression status of the students was determined by using Beck Depression Inventory (BDI). Results: Our study was conducted with 122 female university students. The mean total BDI score of the students in the first tertile (more anti-inflammatory effect) was found significantly lower than those of the students in the second and third tertiles (p = 0.001). In addition, there were no significant difference between the depression scores of the students and their grade level (p = 0.114) and place of residence (p = 0.866). We found a positive association between DII and depressive symptoms (Model 1, B = 0.512, %95 CI: 0.236-0.789, p = 0.000). This relationship was also found when adjusting for age, weight, body mass index, smoking status, and presence of chronic disease (Model 2, B = 0.496, %95 CI: 0.217-0.776, p = 0.006; Model 3, B = 0.493, %95 CI: 0.210-0.777, p = 0.024. Conclusion: Supporting that the inflammatory burden of diet is associated with mental health, our findings are of significance for the development of anti-inflammatory nutritional approaches among students who are prone to depression.

The association between dietary inflammatory index and psychological profile among men with spinal cord injury

OBJECTIVE

The present study was designed to examine the relationship between the dietary inflammatory index (DII) and depression, anxiety and stress in Iranian men with spinal cord injury (SCI).

DESIGN

Cross-sectional study.

SETTING

Mottahary SCI clinic, Isfahan, Iran.

PARTICIPANTS

The current study was conducted on 150 men with SCI aged 40-65 years.

OUTCOME MEASURES

Dietary data were collected using a semi-quantitative 148 item food frequency questionnaire (FFQ). The Depression, Anxiety, Stress Scale-21 (DASS-21) was used to assess the psychological profile of the participants.

RESULTS

The DII score ranged from -3.62 to 4.02. Overall, 34% of study participants had at least mild levels of depression and anxiety symptoms and 25% had at least mild levels of stress symptoms. A one-unit increase in the DII was significantly associated with higher scores of depressive symptoms (β = 1.31, 95% CI 0.44-2.18; P = 0.003). Also, a one-unit increase in the DII was associated with higher odds of having at least mild depressive symptoms (OR = 1.77, 95% CI 1.17, 2.67; P = 0.007). No significant association was found between the DII and anxiety and stress.

CONCLUSION

The present study indicated that a higher DII score is associated with higher odds of depressive symptoms in men with SCI. These initial findings highlight the crucial role of the inflammatory potential of diet in the mental health of subjects with SCI. Future prospective studies are warranted to confirm these findings.

The impact of diet and lifestyle on wellbeing in adults during COVID-19 lockdown

A healthy diet and lifestyle may protect against adverse mental health outcomes, which is especially crucial during stressful times, such as the COVID-19 pandemic. This preregistered longitudinal online study explored whether diet and lifestyle (physical activity, sleep, and social interactions) were associated with wellbeing and mood during a light lockdown in Germany. Participants (N = 117, 72 males; 28 ± 9 years old) answered mental health and lifestyle questionnaires (social connections, sleep, activity) followed by submitting 1 week of food and mood-lifestyle diary (food intake, positive and negative mood, mental wellbeing, sleep quality, physical activity level, quantity and quality of social interactions) via a smartphone app. We used multivariate linear and mixed-effects models to associate mood and wellbeing with dietary components and lifestyle factors. Interindividual analyses revealed that sleep and social interaction significantly impacted mood and wellbeing. Interestingly, fruit and vegetable intake correlated with wellbeing, even when controlling for all lifestyle factors. Fruit and vegetable intake also significantly correlated with daily fluctuations in wellbeing within individuals next to sleep, physical activity, and social interactions. We observed gender differences in fruit and vegetable intake and anxiety levels. Our results emphasize the importance of diet contributing to individual wellbeing, even in the challenging times of a pandemic. Future research is necessary to test if our findings could extend to other populations.

Use of the Dietary Inflammatory Index to Assess the Diet of Young Physically Active Men

Background: Chronic inflammation can lead to the development of obesity, diabetes and other chronic diseases. One of the factors causing inflammation is diet. The aim of this study was to assess the inflammatory potential of the diet, expressed by the DII index, in young physically active men. Methods: A total of 94 physically active students aged 19–23 participated in the study. The subjects’ diets were assessed on the basis of 4-day dietary records, which were then analyzed using the computer program “Diet 5.0”. The DII was calculated for each participant based on the individual consumption of the selected dietary components. The concentration of CRP protein was also determined. Results: Participants was divided into groups according to values of DII. Diets with different DIIs provided similar amounts of calories, but differed significantly in the content of many nutrients. Participants whose diets showed the most anti-inflammatory effects consumed significantly more protein, magnesium, iron, zinc, antioxidant vitamins, and B vitamins compared to others. The highest concentration of CRP protein was observed in men whose diet was described as the most pro-inflammatory (Q4 group). A significant relationship was found between DII and body fat (%) in men in the most anti-inflammatory (Q1 group) and neutral diet (Q2–Q3 group). Conclusions: The Dietary Inflammatory Index is a promising method of describing the effect of dietary intake on the risk of inflammation in young, healthy individuals engaging in regular physical activity.

Higher Dietary Inflammatory Index Scores Are Associated With Stress and Anxiety in Dormitory-Residing Female University Students in the United Arab Emirates

Dormitory-residing university students are at-risk of mental health problems related to unhealthy diets. The purpose of this study was to assess the association between dietary inflammatory potential and mental health of dormitory-residing female university students. This cross-sectional study was comprised of 260 undergraduate females residing in dormitories of the largest university in United Arab Emirates during Spring 2019. The Energy-adjusted Dietary Inflammatory Index (E-DIITM) scores calculated from 37 food parameters were derived from two 24-h dietary recalls. The logistic regression analysis was used to estimate odds ratios (ORs) and 95% CIs for the E-DII score in relation to depression, anxiety, and stress. The E-DII scores (mean = 2.98 ± 1.17) were categorized into: tertile 1 (−1.96–2.62), tertile 2 (2.63–3.52), and tertile 3 (3.53–5.60), representing less to more proinflammatory diets. Students in the E-DII tertile 3 had significantly higher depression, anxiety, and stress scores. The logistic regression analysis showed that each point increase in the E-DII score was associated with symptoms of stress (OR = 1.41; 95% CI: 1.12–1.77; p = 0.003) and anxiety (OR = 1.35; 95% CI: 1.07–1.69; p = 0.01). Relative to students in the E-DII tertile 1, those students in the E-DII tertile 3 were more likely to be at higher risk of stress and anxiety ORE−DIItertile3vs1 = 2.89 (1.44–5.79) and 2.88 (1.49–5.56), respectively. Overall, stress and anxiety were associated with proinflammatory diets in dormitory-residing female university students, suggesting the need for targeted interventions to increase the anti-inflammatory capacity of diet and improve mental wellbeing in students on university campuses.

Short-term exposure to an obesogenic diet during adolescence elicits anxiety-related behavior and neuroinflammation: modulatory effects of exogenous neuregulin-1

Childhood obesity leads to hippocampal atrophy and altered cognition. However, the molecular mechanisms underlying these impairments are poorly understood. The neurotrophic factor neuregulin-1 (NRG1) and its cognate ErbB4 receptor play critical roles in hippocampal maturation and function. This study aimed to determine whether exogenous NRG1 administration reduces hippocampal abnormalities and neuroinflammation in rats exposed to an obesogenic Western-like diet (WD). Lewis rats were randomly divided into four groups (12 rats/group): (1) control diet+vehicle (CDV); (2) CD + NRG1 (CDN) (daily intraperitoneal injections: 5 μg/kg/day; between postnatal day, PND 21-PND 41); (3) WD + VEH (WDV); (4) WD + NRG1 (WDN). Neurobehavioral assessments were performed at PND 43-49. Brains were harvested for MRI and molecular analyses at PND 49. We found that NRG1 administration reduced hippocampal volume (7%) and attenuated hippocampal-dependent cued fear conditioning in CD rats (56%). NRG1 administration reduced PSD-95 protein expression (30%) and selectively reduced hippocampal cytokine levels (IL-33, GM-CSF, CCL-2, IFN-γ) while significantly impacting microglia morphology (increased span ratio and reduced circularity). WD rats exhibited reduced right hippocampal volume (7%), altered microglia morphology (reduced density and increased lacunarity), and increased levels of cytokines implicated in neuroinflammation (IL-1α, TNF-α, IL-6). Notably, NRG1 synergized with the WD to increase hippocampal ErbB4 phosphorylation and the tumor necrosis alpha converting enzyme (TACE/ADAM17) protein levels. Although the results did not provide sufficient evidence to conclude that exogenous NRG1 administration is beneficial to alleviate obesity-related outcomes in adolescent rats, we identified a potential novel interaction between obesogenic diet exposure and TACE/ADAM17-NRG1-ErbB4 signaling during hippocampal maturation. Our results indicate that supraoptimal ErbB4 activities may contribute to the abnormal hippocampal structure and cognitive vulnerabilities observed in obese individuals.

Association of Dietary Inflammatory Index (DII) and Depressive Disorders

A lot of evidence shows that inflammation is related to the development of depression. However, the heterogeneity of depression hinders efforts to understand, prevent and treat this disease. The purpose of this comprehensive review is to summarize the links between inflammation and the established core features of depression, which show more homogeneity than the syndrome itself: overreaction to negative information, changes in reward processing, and cognitive control decline, and somatic syndrome. For each core feature, we first briefly outline its relevance to depression and neurobiological basis, and then review the evidence to investigate the potential role of inflammation. We mainly focus on the discovery of the experimental paradigm of exogenous inflammation. We concluded that inflammation may play a role in overreaction to negative information, altered reward responses, and physical symptoms. There is less evidence to support the effect of inflammation on cognitive control by standard neuropsychological measures. Finally, we discussed the implications for future research and recommendations on how to test the role of inflammation in the pathogenesis of heterogeneous mental illness.

Role of BMI in the Relationship Between Dietary Inflammatory Index and Depression: An Intermediary Analysis

Introduction: This study investigated this association and the role of BMI in the inflammatory process in a large population-based observational study.

Methods: A total of 1,865 elderly people (≥55 years) were followed from the Community Cohort Study of Nervous System Diseases (CCSNSD) cohort study from 2018 to 2019 (Mean [SD] age, 66.31 [0.32] years; 716 [38.4%] males). The semi-quantitative FFQ and geriatric depression scale (GDS) were used to evaluate the diet and depressive symptoms of the elderly, respectively. The multivariable logistic regression model estimated the OR and 95% CI between Empirical Dietary Inflammatory Index (E-DII) and depression. The interaction of E-DII and BMI on depressive events was tested, and the mediation analysis of BMI was performed.

Results: As measured by E-DII, the mean (SE) value of the inflammatory potential of the diet in our study was 1.56 (0.12). E-DII ranged from 5.23 to 5.58. In comparison with the first quartile, the elderly from the second quartile (OR: 1.15 [95% CI: 1.09, 1.28]) to the fourth quartile (OR: 1.31 [95% CI: 1.16, 1.42]) have a higher risk of depression before adjustment for BMI. An interaction was observed between E-DII and BMI in terms of the risk of depression (P_Interaction < 0.001). The whole related part is mediated by BMI (31.06%).

Conclusion: Our findings indicate that the higher pro-inflammatory potential of diet is associated with a higher risk of depression, and this association may be mediated by BMI. Further research is needed to verify our findings and clarify the latent mechanism.

The dietary inflammatory index is inversely associated with depression, which is minimally mediated by C-reactive protein

Depression affects 8% of adults in America and is one of the leading causes of disability in Western countries. The dietary inflammatory index (DII) has previously been reported to be associated with inflammation and depression. However, no study to date has looked at the potential mediating effect of inflammation on the association of DII and depression. We hypothesized that the association of DII and depression would be both statistically and clinically mediated substantially by inflammation. We assessed these associations using the cross-sectional National Health and Nutrition Examination Survey (NHANES) 2005-2010 database. Our analysis included 10,022 participants aged 20 years and older. Inflammation was assessed with C-reactive protein (CRP) levels. Diet was measured using two 24 hour dietary recalls. Depression was assessed using the 9-item Patient Health Questionnaire (PHQ-9), which has a score range of 0 to 27, with the higher score showing more severe depressive symptoms. Comparing the highest to lowest DII quartiles, the mean score difference for depression was 0.47 units (95% CI 0.24-0.70, P-trend <.001) in the multivariable adjusted model. In the sex-stratified models, the results remained significant only among females, with the mean score difference of 0.72 (95% CI 0.34-1.10, P-trend <.001). CRP mediated 3.6% of the association between DII and depression in the total population in the fully adjusted model, which was statistically significant (P-trend <.001) but not clinically significant. No mediation association was found in the sex-stratified models. Further studies are needed to assess the associations with various inflammatory biomarkers in larger and more diverse populations.

Circulating Inflammation Markers Partly Explain the Link Between the Dietary Inflammatory Index and Depressive Symptoms

BACKGROUND

Depression is a mood disorder characterized by a high rate of resistance to pharmacological treatments, which has often been linked to chronic inflammation. This can be influenced by different environmental factors, in particular pro-inflammatory diets. However, a mediating role of circulating inflammation has never been observed.

AIM

To test the association between a dietary inflammatory index (DII®) and continuous depressive symptoms (adapted version of PHQ9) in an Italian population cohort (N=13,301), along with potential explanatory effect of a composite index (INFLA-score) based on four circulating inflammatory biomarkers: C-reactive protein, granulocyte-to-lymphocyte ratio, platelet and white blood cell counts.

RESULTS

Significant positive associations were observed between DII and total depressive symptoms (standardized β (SE) = 0.038 (0.005), p < 0.001), and with two factors tagging somatic (0.012 (0.003), p < 0.001) and cognitive symptoms (0.012 (0.003), p < 0.001), after adjustment for different potential confounders (socioeconomic status, chronic health conditions and lifestyles). These associations were about twice as strong in women than in men. INFLA-score explained a small but significant proportion of the association with total depressive symptoms (0.90-2.30%, p < 0.05), which was mainly driven by granulocyte-to-lymphocyte ratio (1.18-1.65%). This effect was even stronger for the somatic (2.66-4.66%) but not for the cognitive factor (0%).

CONCLUSION

These findings support a strong link between inflammatory diet and depression, especially with somatic symptoms and within women. Moreover, they provide novel evidence for a potential explanatory role of circulating inflammation in this association, suggesting new paths for prevention and treatment of major and atypical depression.

A Comprehensive Review of Transaminitis and Irritable Bowel Syndrome

We observed in the literature that irritable bowel syndrome (IBS) may be linked to irregular parameters of the metabolic system (MS) and liver function. For that reason, we conducted this systematic review to comprehensively analyze the association of transaminitis (elevated alanine transaminase (ALT)) with IBS. This review was designed by following methods described in the Cochrane Handbook for Systematic Reviews of Interventions. Published peer-reviewed journal articles were included. Data were extracted based on study design, age, gender, author, date of publication or availability online, publication type, participants, gender (M/F), and types of IBS. Our electronic multiple databases yielded a total of 519 preliminary studies; we then removed duplicate studies and left with 326 studies. After reviewing the full text of these articles, a total of 83 studies were eliminated and lastly, three studies were selected for this systematic review for quantitative and qualitative analysis. All the enrolled subjects in included studies were diagnosed with IBS by the Rome II and III criteria and among these sub-jects, 50.4% had IBS-D, 13.8% had IBS-C, 30.3% had IBS-M, and 3.5% had IBS-U. The prevalence of elevated ALT with other liver enzymes (γ-GT levels and aspartate aminotransferase (AST)) in patients with irritable bowel syndrome whether their body mass index (BMI) was high or not (16.9% vs. 7.7%; p=0.015) and γ-GT (24.1% vs. 11.5%; p=0.037), Lee et al., 2016. The IBS-D subtype was seen more commonly in patients whose alcohol intake was significantly high however their study data showed no significant change in elevation of ALT. The upper limits normal values for serum liver enzymes were de-fined as 41 international per liter in males and 31 international units per liter in females for ALT. No significant relationships were observed between IBS status and elevated γ-GT (OR, 1.647; 95% CI, 0.784-3.461). The review study proposes a potential relation between elevated ALT levels, MS, and IBS, and this review might be the first review in IBS patients to observe the association of elevated ALT in the IBS population. Although further additional trials with a large sample size will be required to confirm these results. Furthermore, for assessing the efficacy of the manipulation of gut microbiota ran-domized controlled trials in a large population of IBS patients are needed to establish a causal-resultant relationship between IBS, MS, and liver damage.

The quality and inflammatory index of the diet of patients with migraine

BACKGROUND

The association between diet and migraine has been reported in the literature, but only a few studies have evaluated whether the diet consumed by patients with migraine differs from individuals without migraine.

OBJECTIVE

Herein, we aimed to investigate whether the quality and the Dietary Inflammatory Index (DII) of diet consumed by migraine patients differ from that consumed by healthy controls. We also evaluated whether the severity of migraine and headache frequency were associated with these parameters.

METHODS

Patients of both sexes, aged between 18 and 65, with episodic migraine and healthy controls were enrolled in this cross-sectional study. Disability and impact caused by migraine and depressive symptoms were evaluated. Dietary intake was assessed using a 24-hour dietary recall and a three-day non-consecutive food record. The quality of the diet was calculated using the Healthy Eating Index (HEI)-2015 adapted to the Brazilian population, and DII was calculated based on the method developed by Shivappa et al. (2014).

RESULTS

Ninety patients with migraine and 62 individuals without migraine were included in this study. The groups did not differ regarding age, sex, marital status, years of schooling, anthropometric characteristics, and depressive symptoms. Patients with migraine had lower HEI total score than controls, indicating that these patients have a lower quality of the diet. Patients with migraine also had higher DII than controls. Nevertheless, HEI and DII scores did not correlate with migraine frequency and severity.

CONCLUSION

This study corroborates the view that the characteristics of the diet might be involved in migraine pathophysiology.

Association Between Dietary Inflammatory Index and Mental Health: A Systematic Review and Dose-Response Meta-Analysis

Objective: We aimed to systematically evaluate the association between Dietary Inflammatory Index (DII) and mental health.

Methods: We searched PubMed, Embase, and Web of Science from their inception to December 31, 2020. Categorical meta-analysis and dose–response meta-analysis were performed to evaluate the association between DII and mental health.

Results: A total of 16 studies were included in this meta-analysis. Compared with the lowest DII category, the highest category was significantly associated with a variety of mental health outcomes, with the following pooled odds ratios (ORs) and 95% confidence intervals (95% CIs): 1.28 (1.17–1.39) for symptoms of depression, 1.27 (1.08–1.49) for symptoms of anxiety, 1.85 (1.43–2.40) for distress, and 4.27 (1.27–14.35) for schizophrenia. Furthermore, there was a linear dose–response relationship between DII and symptoms of depression in that a 1-unit increment in DII was associated with an increased risk of 6% for symptoms of depression (OR: 1.06, 95% CI: 1.03–1.19).

Conclusion: The present study indicates that more pro-inflammatory diet, as estimated by the higher DII score, is associated with symptoms of mental disorder. It may be of clinical and public health significance regarding the development of novel nutritional psychiatry approaches to promote good mental health.

Dietary inflammatory index (DII®) and the risk of depression symptoms in adults

BACKGROUND & AIMS

Findings from observational studies investigating the association between Dietary Inflammatory Index (DII®) scores and depression symptoms (DepS) are inconsistent. This study aims to assess the association between energy-adjusted DII (E-DII™) and DepS using the North West Adelaide Health Study (NWAHS) cohort as well as update a previous meta-analysis.

METHODS

A total of 1743 (mean ± SD age: 56.6 ± 13.6 years, 51% female) study participants from NWAHS were included in the cross-sectional study and 859 (mean ± SD age: 58.4 ± 12.1 years, 52.6% female) in the longitudinal analyses. The Center for Epidemiological Studies Depression Scale (CES-D) was used for the measurement of DepS. E-DII scores were calculated from the dietary data collected using a validated food frequency questionnaire (FFQ). Data from two stages [Stage 3 (2008-10) and North West 15 (NW15) (2015)] were used. Log- and negative binomial regression were used to assess the association between quartiles of E-DII and DepS. A recent meta-analysis was updated by including 12 publications (six cross-sectional and six cohort studies) on the association between DII and DepS.

RESULTS

In the cross-sectional analysis, a higher E-DII score (i.e., more pro-inflammatory diet) was associated with a 79% increase in odds of reporting DepS [OR_Quartile4vs1: 1.79; 95% CI: 1.14-2.81; p = 0.01; p for trend (p_trend) = 0.03]. Males with higher E-DII had a more than two-fold higher odds of DepS (OR_Quartile4vs1: 2.27; 95% CI: 1.02-5.06; p = 0.045; p_trend = 0.09). Females with higher E-DII had an 81% increase in odds of DepS (OR_Quartile4vs1: 1.81; 95% CI: 1.01-3.26; p = 0.046; p_trend = 0.07). These associations were consistent in the longitudinal analysis. Comparing highest to lowest quintiles of E-DII, the updated meta-analysis showed that a pro-inflammatory diet is associated with a 45% increase in odds of having DepS (OR: 1.45; 95% CI: 1.20-1.74; p < 0.01) with higher odds in females (OR: 1.53; 95% CI: 1.16-2.01; p = 0.01) compared to their male counterparts (OR: 1.29; 95% CI: 0.98-1.69; p = 0.15).

CONCLUSION

The data from the NWAHS and the updated meta-analysis of observational studies provide further evidence that a pro-inflammatory diet is positively associated with increased risk of DepS. These findings support the current recommendation on consuming a less inflammatory diet to improve DepS.

Development, validation and utilisation of dish-based dietary assessment tools: a scoping review

Objective:

To summarise the existing evidence of development, validation and current status of utilisation of dish-based dietary assessment tools.

Design:

Scoping review.

Setting:

Systematic search using PubMed and Web of Science.

Results:

We identified twelve tools from seventy-four eligible publications. They were developed for Koreans (n 4), Bangladeshis (n 2), Iranians (n 1), Indians/Malays/Chinese (n 1), Japanese (n 3) and Chinese Americans (n 1). Most tools (10/12) were composed of a dish-based FFQ. Although the development process of a dish list varied among the tools, six studies classified mixed dishes based on the similarity of their characteristics such as food ingredients and cooking methods. Tools were validated against self-reported dietary information (n 9) and concentration biomarkers (n 1). In the eight studies assessing the differences between the tool and a reference, the mean (or median) intake of energy significantly differed in five studies, and 26–83 % of nutrients significantly differed in eight studies. Correlation coefficients for energy ranged from 0·15 to 0·87 across the thirteen studies, and the median correlation coefficients for nutrients ranged from 0·12 to 0·77. Dish-based dietary assessment tools were used in fifty-nine studies mainly to assess diet–disease relationships in target populations.

Conclusions:

Dish-based dietary assessment tools have exclusively been developed and used for Asian-origin populations. Further validation studies, particularly biomarker-based studies, are needed to assess the applicability of tools.

Evidence of the Importance of Dietary Habits Regarding Depressive Symptoms and Depression

BACKGROUND

Mental illness is one of the fastest rising threats to public health, of which depression and anxiety disorders are increasing the most. Research shows that diet is associated with depressive symptoms or depression (depression).

AIM

This study aimed to investigate the diets impact on depression, by reviewing the scientific evidence for prevention and treatment interventions.

METHOD

A systematic review was conducted, and narrative synthesis analysis was performed.

RESULT

Twenty scientific articles were included in this review. The result showed that high adherence to dietary recommendations; avoiding processed foods; intake of anti-inflammatory diet; magnesium and folic acid; various fatty acids; and fish consumption had a depression. Public health professionals that work to support and motivate healthy eating habits may help prevent and treat depression based on the evidence presented in the results of this study. Further research is needed to strengthen a causal relationship and define evidence-based strategies to implement in prevention and treatment by public healthcare.

Dietary Inflammatory Index and Leukoaraiosis in Patients with Ischemic Stroke

OBJECTIVES

Diet may change the chronic levels of systemic inflammation, which in turn influence the development of leukoaraiosis (LA). This study aimed to examine the association between dietary inflammatory index (DII) and LA in patients with ischemic stroke.

METHODS

Patients with first-ever ischemic stroke were enrolled from two centers. A semi-quantitative food frequency questionnaire (FFQ) was used to evaluate diet contents. The DII score of each patient was calculated based on the reported diet contents. Presence and degree of LA were evaluated with a magnetic resonance imaging (MRI) scan. LA was graded according to Fazekas scale.

RESULTS

Of the 497 enrolled patients, 337 (67.8%) were detected with LA. Patients with LA had a higher DII score (0.23 vs -0.88, P < 0.001). Logistic regression analysis detected that patients with highest quartile of DII score had an OR of 3.61 (95% CI: 2.05-6.36, P < 0.001) for LA compared with those with lowest quartile of DII. After adjusting for major confounders, the highest DII quartile remained as an independent predictor for LA (OR = 2.66, 95% CI: 1.41-5.00, P = 0.008).

CONCLUSIONS

A pro-inflammatory diet pattern, as indicated by higher DII values, appears to be associated with a higher risk of LA. This result suggested that dietary-mediated inflammation may involved in the pathogenesis of LA, which warrant further study.

Association between dietary insulin index and load and psychological disorders

The present study was carried out to determine whether the dietary insulin index (DII) and dietary insulin load (DIL) are related to psychological disorders in a cross-sectional study among adults. A total of 3172 Iranian adults (age range of 18–55 years) were included. Data on dietary intakes were collected using a validated dish-based 106-item semi-quantitative FFQ. DII and DIL were calculated using food insulin index values published earlier. To assess depression and anxiety, an Iranian validated version of the Hospital Anxiety and Depression Scale was used. Furthermore, psychological distress was examined using the General Health Questionnaire. Among women, a significant positive association was seen; such that women in the highest quartile of DIL had higher odds of depression than those in the lowest quartile (OR 1·84; 95 % CI 1·14, 2·96). In terms of DII, in the fully adjusted model, women in the top quartile of DII were more likely to be depressed compared with those in the bottom quartile (OR 1·65; 95 % CI 1·05, 2·58). In conclusion, we found a significant positive association between DIL and DII and odds of depression among women, but not in men. However, such findings were not seen for anxiety and psychological distress.

Adherence to the pro-inflammatory diet in relation to prevalence of irritable bowel syndrome

Objective

There is no prior study that examined the association between nutrient-based dietary inflammatory index (DII) and odds of Irritable Bowel Syndrome (IBS). We examined the association between DII score and odds of IBS and its severity among Iranian adults.

Methods

In this cross-sectional study, dietary intakes of 3363 Iranian adults were examined using a validated Dish-based 106-item Semi-quantitative Food Frequency Questionnaire (DS-FFQ). DII was calculated based on dietary intakes derived from DS-FFQ. IBS was assessed using a modified Persian version of Rome III questionnaire.

Results

After adjustment for potential confounders, we found that participants in the highest quintile of DII score had greater chance for IBS compared with those in the lowest quintile (OR: 1.36; 95% CI: 1.03–1.80). By gender, we found a significant association between DII score and IBS among women (OR: 1.41; 95% CI: 1.00–2.00). By BMI status, overweight or obese (BMI ≥ 25 kg/m²) individuals in top quintile of DII score had greater odds for IBS than those in the bottom quintile (OR: 1.64; 95% CI: 1.07–2.53). No significant association was observed between a pro-inflammatory diet and severity of IBS symptoms.

Conclusions

Consumption of a pro-inflammatory diet was associated with increased odds of IBS, in particular among women and those with BMI ≥ 25 kg/m².

Depression and obesity, data from a national administrative database study: Geographic evidence for an epidemiological overlap

Background

Depression and obesity are two major conditions with both psychological and somatic burdens. Some data suggest strong connections between depression and obesity and more particularly associated prevalence of both disorders. However, little is known about the geographical distribution of these two diseases. This study aimed to determine if there is spatial overlap between obesity and depression using data from the entire French territory.

Methods

Data for 5,627 geographic codes for metropolitan France were collected from the two national hospital databases (PMSI-MCO and RIM-P) for the year 2016. We identified people who were depressed, obese or both registered in the two public medico-administrative databases, and we assessed their location. In addition, a multivariable analysis was performed in order to determine geographic interactions between obesity and depression after controlling for age, sex, environmental and socio-economic factors (social/material deprivation, urbanicity/rurality).

Results

1,045,682 people aged 18 years and older were identified. The mapping analysis showed several cold and hot regional clusters of coinciding obesity and depression. The multivariable analysis demonstrated significant geographic interactions, with an increasing probability of finding a high prevalence of obesity in regions with major depression (OR 1.29 95% CI 1.13–1.49, p = 0.0002) and an increased probability of finding a high prevalence of depression in regions with a high ration of obesity (OR 1.32, 95% CI 1.15–1.52, p<0.0001).

Conclusion

Our study confirms the significant bidirectional relationships between obesity and depression at a group level. French geographic patterns reveal a partial overlap between obesity and depression, suggesting these two diseases can be included in a common approach. Further studies should be done to increase the understanding of this complex comorbidity.