Fruit and vegetable intake, physical activity, and depressive symptoms in the African American Health (AAH) study

Effects of Mediterranean and Western dietary patterns on perceived stress and mental distress

Compared to the Western diet, the Mediterranean diet has many known benefits for both mental health and physical health; however, little is known about the effect of these dietary patterns on perceived stress and mental distress. To assess the relationship between dietary patterns, perceived stress and mental wellbeing, an anonymous online questionnaire targeting adults 18 and older was distributed via several social media platforms and email listservs. The survey included demographic questions, the Food-Mood Questionnaire, the Perceived Stress Scale and the Kessler Psychological Distress scale (K-6). A total of 1591 participants completed the survey. The data was analyzed using Principal Component Analysis and Pearson Correlation Coefficient in SPSS version 28.0. The results showed significant negative correlations between perceived stress and mental distress with several components of the Mediterranean diet, such as whole grains, seafood, fruits, vegetables, and beans. Despite being attributed to the Western diet, meat produced a negative correlation with perceived stress and mental distress. However, significant positive correlations between perceived stress and mental distress and the Western diet, such as fast food and high glycemic index food, were detected. Our findings provide evidence that dietary patterns modulate the stress response and suggest that incorporating components of the Mediterranean diet is beneficial for mental wellbeing and stress reduction.

Association of Plant-Based Diet Indices and Abdominal Obesity with Mental Disorders among Older Chinese Adults

We aimed to explore the correlation between plant-based diet indices and abdominal obesity with depression and anxiety among older Chinese adults. This study used a cross-sectional design using data from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). We used a simplified food frequency questionnaire to evaluate the overall plant-based diet index (PDI), the healthful plant-based diet index (hPDI), and the unhealthful plant-based diet index (uPDI) separately, based on the potential health effects of the foods. Waist circumference (WC) was used to define abdominal obesity. The 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10) and the 7-item Generalized Anxiety Disorder Scale (GAD-7) were applied to estimate depression symptoms and anxiety symptoms, respectively. Multi-adjusted binary logistic regression models were conducted to explore the effects of the three plant-based diet indices, abdominal obesity status, and their interaction on depression and anxiety. We enrolled a total of 11,623 participants aged 83.21 ± 10.98 years, of which 3140 (27.0%) participants had depression and 1361 (11.7%) had anxiety. The trend in the prevalence of depression/anxiety across increasing quartiles of the plant-based diet indices was statistically significant after controlling for potential confounders (p-trend < 0.05). Abdominal obesity was related to a lower prevalence of depression (OR = 0.86, 95% CI: 0.77-0.95) and anxiety (OR = 0.79, 95% CI: 0.69-0.90) compared with non-abdominal obesity. The protective effects of the PDI and hPDI against depression (OR = 0.52, 95% CI: 0.41-0.64; OR = 0.59, 95% CI: 0.48-0.73, respectively) and anxiety (OR = 0.75, 95% CI: 0.57-1.00; OR = 0.52, 95% CI: 0.39-0.70, respectively) were more pronounced in non-abdominally obese participants. The harmful effects of the uPDI against depression (OR = 1.78, 95% CI: 1.42-2.23) and anxiety (OR = 1.56, 95% CI: 1.16-2.10) were more pronounced in non-abdominally obese participants. In addition, a significant interaction between the plant-based diet indices and abdominal obesity was observed in terms of causing the prevalence of depression and anxiety. Consuming more of a healthful plant-based diet and less of an animal-based diet is related to a lower prevalence of depression and anxiety. A healthful plant-based diet plays a vital role in non-abdominally obese individuals.

Indigenous population and major depressive disorder in later life: a study based on the data from Longitudinal Ageing Study in India

BACKGROUND

Existing evidence suggests that the indigenous older population who live with their families and friends might experience lesser depressive symptoms due to better emotional support and well-being. The present study aimed to investigate the differentials in the prevalence of the major depressive disorder among tribal and non-tribal older populations in India and to explore the contribution of socio-demographic, health-related, and household factors in such disparities.

METHODS

A cross-sectional study was conducted using data from the Longitudinal Aging Study in India (2017-18). The analytical sample included 30,637 older adults, among whom 5,025 and 25,612 belonged to the Scheduled Tribe (ST) and non-Scheduled Tribe (non-ST) social groups, respectively. Major depressive disorder assessed by the Composite International Diagnostic Interview short-form (CIDI-SF) scale was the outcome variable. Descriptive statistics, bivariate and multivariable regression and, decomposition analyses were conducted.

RESULTS

About 4.8% and 8.9% of older adults from the ST and non-ST social groups had major depression. For both tribal and non-tribal groups, older adults who were unmarried, dissatisfied with living arrangements, and those who faced lifetime discrimination were at increased risk of major depression. Findings from differences due to characteristics (E) revealed that if the regional differences were minimized, it would decrease the ST-non-ST gap in major depression by about 19.6%. Similarly, equal self-rated health status and chronic conditions among ST and non-ST groups would decrease the gap in major depression by almost 9.6% and 7.9%, respectively. Additionally, an equal status of Instrumental Activities of Daily Living (IADL) and Activities of Daily Living (ADL) among older adults would decrease the gap in major depression by about 3.8% and 3% respectively. Also, findings from differences due to coefficients (C) revealed that if older adults from the ST group had the same status of ADL as of older adults from the non-ST group, it would decrease the gap in major depression by about 11.8%.

CONCLUSION

The findings revealed a greater prevalence of major depression in older adults belonging to the non-ST group than the ST group. For both tribal and non-tribal groups, older adults who were unmarried, dissatisfied with living arrangements, and those who faced lifetime discrimination were at increased risk of major depression and these factors along with health-related variables contributed to significant ST-non-ST gap in depression, advantageous to tribal population; suggesting further research on the coping mechanisms of mental illnesses among indigenous population in India.

Light-intensity physical activity and mental ill health: a systematic review of observational studies in the general population

Background

Most of theevidence has focused on examining the influence of moderate-to-vigorous intensity physical activity on mental health, but he role of light intensity physical activity (LIPA) is less understood. The purpose of this systematic review was to assess the relationship between time spent in LIPA and mental ill health across the lifespan.

Methods

Data were obtained from online databases (Medline, Embase, Scopus, PsychInfo and CINAHL). The search and collection of eligible studies was conducted up to May 28, 2020. Observational studies conducted in the general population and reporting on the association between LIPA (1.6–2.9 metabolic equivalents; either self-reported or device-based measured) and mental ill health were included.

Results

Twenty-two studies were included in the review (16 cross-sectional and 6 longitudinal). In older adults (≥ 65 years) and adults (18–64 years), the evidence examining the relationship between LIPA and depressive symptoms is mixed. Data on anxiety, psychological distress and overall mental health are scarce, and results are inconclusive. There is no evidence suggesting favorable associations between LIPA and anxiety in college students. Finally, very limited data was found in adolescents (11–17 years) (n = 2 studies) and children (6–10 years) (n = 2 studies), but the evidence suggests that LIPA does not influence mental health outcomes in these age groups.

Conclusions

This review provided mostly cross-sectional evidence indicating that LIPA may not be associated with mental health outcomes across age groups. Future research efforts employing prospective research designs are warranted to better understand the role of LIPA on mental ill health across age groups.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12966-021-01196-7.

Gender Differences in Healthy and Unhealthy Food Consumption and Its Relationship with Depression in Young Adulthood

This study explores the relationship between the consumption of healthy and unhealthy foods and depression among young adults and the moderating effect of gender on these relationships. The National Longitudinal Survey of Youth 1979 for Children and Young Adults (NLSY79 CY) was used. A total of 2983 young adults were selected for the final sample. Logistic Regression Analysis and Ordinary Linear Regression were conducted to examine the research questions. Young men were overall more likely than young women to engage in negative eating habits. The consumption of healthy foods, which included fruits and vegetables, had a significant inverse relationship with depression. An interaction effect was found, indicating that gender moderated the relationship between fruit consumption and depression among young adults. Young males need to be taught more about the importance of good eating habits. Eating more fruits and vegetables (healthy foods) is more important than avoiding fast food or soft drinks (unhealthy foods) for young adults' mental health. The gender differences in the effect of fruit consumption implies that increased fruit consumption may be critical to reduce young females' depression.

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

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

Low fruit and vegetable intake is associated with depression among Korean adults in data from the 2014 Korea National Health and Nutrition Examination Survey

BACKGROUND

Depression is a major mental disorder worldwide. The prevalence of depression among Korean adults was estimated to be 5.6% in 2006 and 6.7% in 2011, and that increased to 10.3% in 2013. Using national data, the present study investigated the association between vegetable and fruit intake and the prevalence of depression among Korean adults.

METHODS

This analysis used data from 4349 subjects aged 19 years and older who participated in the Korea National Health and Nutrition Examination Survey (KNHANES, 2014). Depression was assessed using the self-reported Patient Health Questionnaire (PHQ)-9. Food and nutrient intake was assessed using the 24-h recall method. Individual food intake was categorized into 18 food groups. The statistical analyses in this study were performed by adopting stratification, clustering, and sample weight variables using SPSS Ver. 23.0. Cronbach's α was used to determine the internal consistency of the PHQ-9 items. Logistic regression analysis was used to estimate the odds ratios of depression adjusted for several confounders.

RESULTS

The depression rate of all subjects was between 8.7 and 4.7% and decreased as vegetable and fruit intake increased. With regard to sex, the depression rate decreased from 6.4 to 2.5% in males and from 11.4 to 6.6% in females as vegetable and fruit intake increased. Thus, the results of this study reveal an inverse association between vegetable and fruit intake and depression. The odds ratios show that vegetable and fruit intake was inversely associated with depression with no adjustment. When the data were adjusted for age, energy intake, obesity, smoking, drinking, stress, eating-out frequency, breakfast, and food security, subjects exhibited significantly lower rates of depression with higher vegetable and fruit intakes.

CONCLUSIONS

This is the first study to investigate the association between vegetable and fruit consumption and depression in a Korean population. Additional epidemiological studies are needed to find the underlying reasons for that association.

Assessing the effects of vegetable consumption on the psychological health of healthy adults: a systematic review of prospective research

BACKGROUND

To alleviate the immense health and economic burden of mental illness, modifiable targets to promote psychological health are required. Emerging evidence suggests that both fruit and vegetable (F&V) consumption may play an important role. However, the precise contribution of vegetable consumption, which may represent a more potent target than the consumption of fruit, has received little attention.

OBJECTIVES

This review aimed to synthesize and evaluate research investigating the effects of vegetable consumption on mental health and psychological well-being in nonclinical, healthy adult populations. We aimed to provide insight into the causal relation between vegetable consumption and these outcomes.

METHODS

Only studies with prospective or experimental data were included. The survey of the literature was last implemented on 1 February, 2019.

RESULTS

Ten eligible studies were identified, with a total sample size of n = 33,645, that measured vegetable intake separately from fruit, or combined this with fruit intake. Where studies explored the independent effects of fruit and vegetable consumption on psychological health (n = 3), 2 reported a preferential effect of vegetables (compared with fruit) on psychological well-being, whereas 1 reported a superior effect of fruit intake on odds reduction of symptoms of depression. More broadly, there was evidence that consuming the recommended amount of F&V (and exceeding this) was associated with increased psychological well-being. However, the effects of F&V consumption on mental health symptoms were inconsistent.

CONCLUSIONS

Increased F&V consumption has a positive effect on psychological well-being and there appears to be a preferential effect of vegetables (compared with fruit) from the limited data examined. The effect of F&V intake on mental health is less clear and, at present, there are no clear data to support a preferential effect of vegetable intake on mental health outcomes. Hence, additional research is warranted to investigate the influence of vegetables, compared with fruit, on psychological health in order to inform nutrition-based interventions. This review was registered at www.crd.york.ac.uk/prospero as CRD42017072880.

Factors associated with regular physical activity participation among people with severe mental ill health

PURPOSE

People with severe mental ill health (SMI) are less physically active and more sedentary than the general population. There is limited research investigating the correlates of physical activity (PA) in people with SMI impeding the development of successful interventions. This study aimed to assess the factors associated with regular participation of PA among a large sample of people with SMI.

METHODS

The data for this study were collected from the 'Closing the Gap: Lifestyle Health and Wellbeing' (HWB) cohort that collected data through self-administered questionnaire from participants with SMI. Self-reported participation in regular PA was the main outcome variable. Potential predictors of PA were grouped as demographic, biological, psychological and behavioural variables. Multivariable logistic regressions were conducted considering PA participation as the dependent variable adjusted for possible correlated predictors.

RESULTS

In total, 3287 people with SMI [mean (SD) age 47.7 (14.58) years, 59% male] were included; 38% reported undertaking regular PA and 61% wanted to undertake more physical activity. Multivariable logistic regressions showed that the following factors were associated with undertaking more regular PA: being male, aged 18-65 years, having a body mass index between 18.5 and 30 kg/m², having better self-perceived general health condition, not having a health problem that limits activity, giving higher importance to maintain a healthy lifestyle, and eating more fruit and vegetables.

CONCLUSIONS

Having a better self-perceived general health and placing importance on maintaining a healthy lifestyle were important predictors of regular PA. Lifestyle interventions targeting increased PA among people with SMI should be shaped by their health perception and informed by their needs.

Adhering to a vegetarian diet may create a greater risk of depressive symptoms in the elderly male Chinese population

BACKGROUND

A vegetarian diet may be a risk factor for depression, but this relationship was unclear in the elderly Chinese population.

METHODS

Self-report data were gathered from 1051 elderly persons using the Cohort of Elderly Health and Environment Controllable Factors, which was created in West Anhui, China. The depressive symptoms were set as binary, ordinal, and continuous outcomes, respectively, whereas the dietary structures were computed as an ordinal variable and a dummy variable. Multiple logistic regression, ordinal regression, and linear regression were used to assess the relationship by adjusting the potential confounding variables with p-values of <0.1 in univariate analysis.

RESULTS

The elderly participants who had a vegetable-based diet had the highest GDS scores of 8.78 ± 6.894 (p = 0.001) and the highest rate of depression (32.9%, p = 0.003). After adjustment for the potential confounders, elderly men who had a vegetable-based diet had a higher rate of depression (OR[95%CI]: 1.62[1.07-2.46], 4.71[1.38-16.03]), more severe symptoms of depression (OR[95%CI]: 8.85[2.94-34.12]), and higher GDS scores (β[95%CI]: 1.46[0.70-2.22], 2.97[1.28-4.67]) than male participants who had a meat-based diet, but this was not the case in women.

LIMITATIONS

All data were self-reported. The study lacked quantitatively evaluated dietary intake. The duration of the current dietary structures and comorbidities were not reported. The cross-sectional study made the causal role uncertain.

CONCLUSIONS

Vegetarian diets may pose a greater risk of depressive symptoms among the elderly Chinese population, especially elderly men. Given the cross-sectional nature of this study, the causal role was uncertain. Further prospective studies, in particular among elderly women, are needed.

New insights into the anorexia of ageing: from prevention to treatment

PURPOSE OF REVIEW

Undernutrition in older adults is associated with frailty, functional decline, and mortality. The 'anorexia of ageing' is the age-related appetite and weight loss underpinning such undernutrition. This review examines the latest evidence for its prevention and treatment.

RECENT FINDINGS

Existing nutritional therapies for the anorexia of ageing include supporting nutritional intake with fortified food or supplements, including protein, omega-3 fatty acids, multivitamins, and vitamin D. The Mediterranean diet provides high fat intake and nutrient density in a moderate volume of colourful and flavoursome food and is strengthening in evidence for healthy ageing. Studies of the gut microbiome, which potentially regulates normal appetite by acting on the brain-gut communication axis, are pertinent. Utilisation of the genetic profile of individuals to determine nutritional needs is an exciting advancement of the past decade and may become common practice.

SUMMARY

Prevention or early treatment of the anorexia of ageing in older adults is critical. Latest evidence suggests that once significant weight loss has occurred, aggressive nutritional support may not result in improved outcomes.

Association between a vegetarian diet and emotional symptoms: a cross-sectional study among adolescents in four developing countries

BACKGROUND

Studies assessing the association between vegetarianism and mental health have found divergent results. Evidence from adolescents in developing countries is scarce.

OBJECTIVE

To evaluate the association between a vegetarian diet and emotional symptoms in 15-year-old adolescents from Ethiopia, India, Peru and Vietnam.

METHODS

A cross-sectional, secondary analysis of the Young Lives cohort study was used. The exposure variable was the self-report of being a vegetarian (yes or no). The outcome was the level of emotional symptoms, numerically evaluated using the score obtained in the subscale "Emotional Symptoms" of the Strengths and Difficulties Questionnaire (SDQ). We calculated crude and adjusted coefficients (β) with 95% confidence intervals (95% CIs), using generalized linear models of the Gaussian family, considering each sentinel site as a cluster. The analysis was stratified by country. Additionally, we made a global analysis including the four countries.

RESULTS

A total of 3484 adolescents were analyzed. The overall prevalence of vegetarianism was 4.4%, but it varied between countries (from 0.4% in Vietnam to 11.5% in India). The average emotional symptoms score was 3.5 [standard deviation (SD) 2.3] points. The scores were not statistically different between vegetarians and non-vegetarians (p > 0.05). In the adjusted analysis, in Vietnam, vegetarians had lower emotional symptoms scores on average than non-vegetarians [β: -1.79; 95% CI: -3.05 to -0.55]. No differences were found neither in the other countries nor in the overall sample.

CONCLUSION

There was no association between a vegetarian diet and emotional symptoms in the analyzed adolescents of four developing countries.

Fruits and vegetables intake and its subgroups are related to depression: a cross-sectional study from a developing country

BACKGROUND

The association of fruits and vegetables (FV) specific subgroups consumption and depression has not been investigated in healthy adult populations. Therefore, the aim of our study was to determine the relationship between intake of FV as well as their subgroups and depression.

METHODS

This cross-sectional study was conducted on 400 women attending healthcare centers. The scores of depression, anxiety, and stress were measured using the 21-item depression, anxiety and stress scales questionnaire. The participants' anthropometric and physical activity data were collected and the 147-item semi-quantitative FFQ was used for estimating the FV intake.

RESULTS

After adjustment for confounding variables, the participants in the lower quartiles of total FV, total vegetables, total fruits, citrus, other fruits and green leafy vegetables intake were more likely to experience depression compared to those in the higher quartiles (p trend < 0.03).

CONCLUSION

Our findings suggest that higher intake of total FV and some of its specific subgroups might be associated with depression.