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Buczkowska M, Iob E. Testing the causal relationship of fat and sugar intake with depression and cortisol: a Mendelian Randomisation study. Transl Psychiatry 2024; 14:368. [PMID: 39256365 PMCID: PMC11387734 DOI: 10.1038/s41398-024-03089-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 08/24/2024] [Accepted: 09/02/2024] [Indexed: 09/12/2024] Open
Abstract
Unhealthy diets high in fat and sugar content may have an impact on psychological health and increase the risk of Major Depressive Disorder (MDD) and stress levels. On the other hand, MDD and stress might be related to food choices and intake. However, it is not clear whether diet, and specifically fat and sugar intake, is causally related to stress and MDD, and whether this relationship may be bi-directional. This study utilised Mendelian Randomisation (MR) to investigate the causal nature of the relationship of fat and sugar intake with MDD and cortisol (as a proxy of stress), and to shed light on the direction of this relationship. Summary-level data for all exposure and outcome variables were obtained from large-scale, non-overlapping GWASs in individuals of European ancestry. Bidirectional analyses were performed: one with macronutrients as exposures and one with MDD/cortisol as exposures. Random-effects inverse-variance weighted regression was used as the primary analytic method for genetic instruments with at least two single nucleotide polymorphisms (SNPs) available (and individual Wald ratio was used when only one SNP was available). Higher levels of genetically predicted relative sugar intake were causally associated with lower MDD risk, for both genome-wide significant p-value threshold of p < 1 × 10-8, (OR = 0.553, 95% CI: 0.395-0.775) and relaxed p-value threshold of p < 1 × 10-6 (OR = 0.786, 95% CI: 0.630-0.981). No reverse causality was detected in the opposite direction as MDD was not associated with sugar consumption. The associations observed for all the other pairs of variables were weak and imprecise. A number of limitations was present in the study, such as low-SNP based heritability for some exposures, inability to prove whether variants were correlated with unmeasured confounders and self-reporting of MDD data. Lifestyle and/or pharmacological interventions targeting sugar-related physiological mechanisms may help to reduce depressive symptoms. However, more research is necessary on short- and long-term effects of sugar on the risk of MDD. Additionally, future studies should investigate whether the amount and type of sugar consumed may underlie the impact of sugar on mood and stress levels.
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Affiliation(s)
- Matylda Buczkowska
- Institute for Global Health, University College London, London, UK.
- Department of Epidemiology and Public Health, University College London, London, UK.
| | - Eleonora Iob
- Department of Epidemiology and Public Health, University College London, London, UK
- Social, Genetic & Developmental Psychiatry (SGDP) Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Dun-Campbell K, Hartwell G, Maani N, Tompson A, van Schalkwyk MC, Petticrew M. Commercial determinants of mental ill health: An umbrella review. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003605. [PMID: 39196874 DOI: 10.1371/journal.pgph.0003605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 07/24/2024] [Indexed: 08/30/2024]
Abstract
Mental ill health has complex and interrelated underlying causes, with wider determinants of health often overlooked as risk factors. The 'commercial determinants of health' are gradually receiving more attention and recognition but there is a relative lack of awareness of the commercial determinants of mental health. This aim of this umbrella review was to synthesise systematic review level evidence for the association between commercial determinants and mental health outcomes. This umbrella review included evidence from high, middle, and low-income countries. We included terms related to broader commercial activities and terms focused on six key unhealthy commodities (tobacco, alcohol, ultra-processed foods, gambling, social media, fossil fuels) and the impacts of fossil fuel consumption (climate change, air pollution, wider pollution). We included 65 reviews and found evidence from high quality reviews for associations between alcohol, tobacco, gambling, social media, ultra-processed foods and air pollution and depression; alcohol, tobacco, gambling, social media, climate change and air pollution with suicide; climate change and air pollution with anxiety; and social media with self-harm. There was a lack of evidence examining wider practices of commercial industries. Our umbrella review demonstrates that by broadening the focus on commercial determinants, the influence of commercial products and activities on mental ill health can be better understood. The lack of research examining broader commercial practices on mental ill health is an area that should be addressed. Our review highlights the existing base of high-quality evidence for many of these unhealthy commodities' impacts on mental ill health and indicates that commercial determinants is a valuable framework for understanding the drivers of mental ill health.
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Affiliation(s)
- Kate Dun-Campbell
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Greg Hartwell
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Nason Maani
- School of Social and Political Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Alice Tompson
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - May Ci van Schalkwyk
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Mark Petticrew
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Xie Y, Wu Z, Qian Q, Yang H, Ma J, Luan W, Shang S, Li X. Apple polyphenol extract ameliorates sugary-diet-induced depression-like behaviors in male C57BL/6 mice by inhibiting the inflammation of the gut-brain axis. Food Funct 2024; 15:2939-2959. [PMID: 38406886 DOI: 10.1039/d3fo04606k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
To explore whether apple polyphenol extract (APE) ameliorates sugary-diet-induced depression-like behaviors, thirty male C57BL/6 mice (3-4 weeks old) were assigned to three groups randomly to receive different treatments for 8 consecutive weeks: (1) control group (CON), (2) S-HSD group (60% high sucrose diet feeding with 0.1 mg mL-1 sucralose solution as drinking water), and (3) S-APE group (S-HSD feeding with 500 mg per (kg bw day) APE solution gavage). The S-HSD group showed significant depression-like behaviors compared with the CON group, which was manifested by an increased number of buried marbles in the marble burying test, prolonged immobility time in both the tail suspension test and forced swimming test, and cognitive impairment based on the Morris water maze test. However, APE intervention significantly improved the depression-like behaviors by reducing serum levels of corticosterone and adrenocorticotropic hormone, and increasing the serum level of IL-10. Moreover, APE intervention inhibited the activation of the NF-κB inflammatory pathway, elevated colonic MUC-2 protein expression, and elevated the colonic and hippocampal tight junction proteins of occludin and ZO-1. Furthermore, APE intervention increased the richness and diversity of gut microbiota by regulating the composition of microbiota, with increased relative abundance of Firmicutes and Bacteroidota, decreased relative abundance of Verrucomicrobiota at the phylum level, significantly lowered relative abundance of Akkermansia at the genus level, and rebalanced abnormal relative abundance of Muribaculaceae_unclassified, Coriobacteriaceae_UCG-002, and Lachnoclostridium induced by S-HSD feeding. Thus, our study supports the potential application of APE as a dietary intervention for ameliorating depression-like behavioral disorders.
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Affiliation(s)
- Yisha Xie
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, 215123, PR China.
| | - Zhengli Wu
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, 215123, PR China.
| | - Qingfan Qian
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, 215123, PR China.
| | - Hao Yang
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, 215123, PR China.
| | - Jieyu Ma
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, 215123, PR China.
| | - Wenxue Luan
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, 215123, PR China.
| | - Siyuan Shang
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, 215123, PR China.
| | - Xinli Li
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, 215123, PR China.
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, PR China
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Zhang L, Sun H, Liu Z, Yang J, Liu Y. Association between dietary sugar intake and depression in US adults: a cross-sectional study using data from the National Health and Nutrition Examination Survey 2011-2018. BMC Psychiatry 2024; 24:110. [PMID: 38326834 PMCID: PMC10851576 DOI: 10.1186/s12888-024-05531-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 01/17/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Studies examining whether diet sugar intake increases the risk of depression have produced inconsistent results. Therefore, we investigated this relationship, using the US' National Health and Nutrition Examination Survey (NHANES) database. METHODS This cross-sectional study included 18,439 adults (aged ≥ 20 years) from NHANES (2011-2018). Depressive symptoms were assessed using the nine-item version of the Patient Health Questionnaire (PHQ-9). Covariates, including age, sex, race/ethnicity, poverty-income ratio, education, marital status, hypertension, diabetes mellitus, cardiovascular disease, alcohol intake, smoking status, physical activity, and dietary energy intake, were adjusted in multivariate logistic regression models. Subgroup and threshold saturation effect analyses were performed. RESULTS After adjusting for potential confounders, we found that a 100 g/day increase in dietary sugar intake correlated with a 28% higher prevalence of depression (odds ratio = 1.28, 95% confidence interval = 1.17-1.40, P < 0.001). CONCLUSION Dietary sugar intake is positively associated with depression in US adults.
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Affiliation(s)
- Lu Zhang
- The First Clinical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Haiyang Sun
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zihui Liu
- Experimental Center, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Jiguo Yang
- College of Acupuncture and Massage, Shandong University of Traditional Chinese Medicine, Jinan, China.
| | - Yuanxiang Liu
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China.
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Li L, Yang P, Duan Y, Xie J, Liu M, Zhou Y, Luo X, Zhang C, Li Y, Wang J, Chen Z, Zhang X, Cheng ASK. Association between dietary diversity, sedentary time outside of work and depressive symptoms among knowledge workers: a multi-center cross-sectional study. BMC Public Health 2024; 24:53. [PMID: 38166945 PMCID: PMC10762993 DOI: 10.1186/s12889-023-17567-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 12/22/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Low-diversity diets and sedentary status are risk factors for depressive symptoms, while knowledge workers were ignored before. The purpose of this current study was to examine the relationship between dietary diversity, sedentary time spent outside of work, and depressive symptoms among knowledge workers. STUDY DESIGN AND METHODS This was a multicenter and cross-sectional design that included 118,723 knowledge workers. Participants self-reported online between January 2018 and December 2020. Demographic information, the Dietary Diversity Scale, the Patient Health Questionnaire-9, dietary habits (which included eating three meals on time, midnight snacking, overeating, social engagement, coffee consumption, sugary drink consumption, smoking and alcohol use), sedentary time spent outside of work and physical activity were investigated. RESULTS The relationships between demographic information, dietary habits and dietary diversity, and depressive symptoms were estimated. Compared with the first and second levels of dietary diversity, the third level of dietary diversity (OR: 0.91; 95% CI: 0.84-0.98) reduced the risk of depressive symptoms. Knowledge workers with different degrees of sedentary status (2-4 h (OR: 1.11; 95% CI: 1.07-1.14), 4-6 h (OR: 1.21; 95% CI: 1.17-1.26), and > 6 h (OR: 1.49; 95% CI: 1.43-1.56), presented a progressively higher risk of depressive symptoms. CONCLUSION High amounts of sedentary time spent after work and low levels of dietary diversity are risk factors for depressive symptoms. In addition, an irregular diet and overeating are also major risk factors for knowledge workers.
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Affiliation(s)
- Lijun Li
- Health Management Center, The Third Xiangya Hospital of Central South University, Changsha, China
- Nursing Department, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Pingting Yang
- Health Management Center, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Yinglong Duan
- Nursing Department, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Jianfei Xie
- Nursing Department, The Third Xiangya Hospital of Central South University, Changsha, China.
| | - Min Liu
- Nursing Department, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Yi Zhou
- Xiangya Nursing School of Central South University, Changsha, China
| | - Xiaofei Luo
- Xiangya Nursing School of Central South University, Changsha, China
| | - Chun Zhang
- Xiangya Nursing School of Central South University, Changsha, China
| | - Ying Li
- Health Management Center, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Jiangang Wang
- Health Management Center, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Zhiheng Chen
- Health Management Center, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Xiaohong Zhang
- Nursing Department, The Third Xiangya Hospital of Central South University, Changsha, China.
| | - Andy S K Cheng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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Vahid F, Rahmani W, Davoodi SH, Bohn T. Mental Health Conditions, Including Depression and Stress, Are Associated with Increased Odds of Gastric Cancer-Insights into the Role of Diet: A Case-Control Study. Nutrients 2023; 15:4981. [PMID: 38068839 PMCID: PMC10708069 DOI: 10.3390/nu15234981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 10/23/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023] Open
Abstract
Several risk factors, including nutritional/lifestyle ones, play a role in gastric cancer etiology. Further interactions with mental health have also been emphasized. We hypothesized that individuals with mental disorders would exhibit compromised nutrient intake, increasing their risk of gastric cancer. The state of mental health was evaluated in 82 patients with gastric cancer and 95 healthy controls using the 21-item Depression-Anxiety-Stress Scale. The participants' dietary intakes were evaluated by a 168-item food frequency questionnaire. Based on fully adjusted logistic regressions, there was a significant association between depression (OR = 1.938, CI 95%: 1.009-3.723) and stress (OR = 2.630, CI 95%: 1.014-6.819) with increased odds of gastric cancer. According to fully adjusted multinomial regressions, vitamins A and B6, beta-carotene, and black tea decreased the odds of depression, based on comparing the control group with cases of depression, while sugar and salt increased its odds. The highest significant association was found for salt intake and anxiety in cases with present anxiety (OR = 4.899, 95% CI: 2.218-10.819), and the highest significant protective effect was found for vitamin B6 and depression in cases with present depression (OR = 0.132, 95% CI: 0.055-0.320). However, considering causal relationships and clarifying the underlying mechanisms is imperative and requires further investigation. Advising healthy dietary patterns, e.g., a Mediterranean diet rich in vitamins, minerals, and phytochemicals such as vitamin A, B6, beta-carotene, and fiber, is expected to reduce the odds of gastric cancer, possibly related to lower levels of anxiety and depression.
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Affiliation(s)
- Farhad Vahid
- Nutrition and Health Research Group, Department of Precision Health, Luxembourg Institute of Health, 1445 Strassen, Luxembourg;
| | - Wena Rahmani
- School of Medicine, Arak University of Medical Science, Arak 3848176941, Iran
| | - Sayed Hossein Davoodi
- Department of Cellular and Molecular Nutrition, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 1981619573, Iran
| | - Torsten Bohn
- Nutrition and Health Research Group, Department of Precision Health, Luxembourg Institute of Health, 1445 Strassen, Luxembourg;
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Santos-Cruz LF, Sigrist-Flores SC, Castañeda-Partida L, Heres-Pulido ME, Dueñas-García IE, Piedra-Ibarra E, Ponciano-Gómez A, Jiménez-Flores R, Campos-Aguilar M. Effects of Fructose and Palmitic Acid on Gene Expression in Drosophila melanogaster Larvae: Implications for Neurodegenerative Diseases. Int J Mol Sci 2023; 24:10279. [PMID: 37373426 DOI: 10.3390/ijms241210279] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 06/08/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023] Open
Abstract
One of the largest health problems worldwide is the development of chronic noncommunicable diseases due to the consumption of hypercaloric diets. Among the most common alterations are cardiovascular diseases, and a high correlation between overnutrition and neurodegenerative diseases has also been found. The urgency in the study of specific damage to tissues such as the brain and intestine led us to use Drosophila melanogaster to study the metabolic effects caused by the consumption of fructose and palmitic acid in specific tissues. Thus, third instar larvae (96 ± 4 h) of the wild Canton-S strain of D. melanogaster were used to perform transcriptomic profiling in brain and midgut tissues to test for the potential metabolic effects of a diet supplemented with fructose and palmitic acid. Our data infer that this diet can alter the biosynthesis of proteins at the mRNA level that participate in the synthesis of amino acids, as well as fundamental enzymes for the dopaminergic and GABAergic systems in the midgut and brain. These also demonstrated alterations in the tissues of flies that may help explain the development of various reported human diseases associated with the consumption of fructose and palmitic acid in humans. These studies will not only help to better understand the mechanisms by which the consumption of these alimentary products is related to the development of neuronal diseases but may also contribute to the prevention of these conditions.
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Affiliation(s)
- Luis Felipe Santos-Cruz
- Toxicología Genética, Biología, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Los Barrios N° 1, Los Reyes Iztacala, Tlalnepantla 54090, Mexico
| | - Santiago Cristobal Sigrist-Flores
- Laboratorio de Inmunología (UMF), Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Los Barrios N° 1, Los Reyes Iztacala, Tlalnepantla 54090, Mexico
| | - Laura Castañeda-Partida
- Toxicología Genética, Biología, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Los Barrios N° 1, Los Reyes Iztacala, Tlalnepantla 54090, Mexico
| | - María Eugenia Heres-Pulido
- Toxicología Genética, Biología, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Los Barrios N° 1, Los Reyes Iztacala, Tlalnepantla 54090, Mexico
| | - Irma Elena Dueñas-García
- Toxicología Genética, Biología, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Los Barrios N° 1, Los Reyes Iztacala, Tlalnepantla 54090, Mexico
| | - Elías Piedra-Ibarra
- Fisiología Vegetal (UBIPRO), Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Los Barrios N° 1, Los Reyes Iztacala, Tlalnepantla 54090, Mexico
| | - Alberto Ponciano-Gómez
- Laboratorio de Inmunología (UMF), Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Los Barrios N° 1, Los Reyes Iztacala, Tlalnepantla 54090, Mexico
| | - Rafael Jiménez-Flores
- Laboratorio de Inmunología (UMF), Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Los Barrios N° 1, Los Reyes Iztacala, Tlalnepantla 54090, Mexico
| | - Myriam Campos-Aguilar
- Laboratorio de Inmunología (UMF), Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Los Barrios N° 1, Los Reyes Iztacala, Tlalnepantla 54090, Mexico
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Witek K, Wydra K, Suder A, Filip M. Maternal monosaccharide diets evoke cognitive, locomotor, and emotional disturbances in adolescent and young adult offspring rats. Front Nutr 2023; 10:1176213. [PMID: 37229474 PMCID: PMC10203434 DOI: 10.3389/fnut.2023.1176213] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 04/12/2023] [Indexed: 05/27/2023] Open
Abstract
Anxiety and depression are the most common mental disorders affecting people worldwide. Recent studies have highlighted that a maternal high-sugar diet (HSD) could be a risk factor for neurobehavioural dysregulations, including mood disorders. Increased consumption of added sugar in food such as refined fructose/glucose can increase the risk of metabolic disorders and impact susceptibility to mental disorders. Furthermore, a few papers have reported disabilities in learning and memory among offspring after maternal HSD, thus suggesting a relationship between maternal nutrition and offspring neurogenesis. In this study, we evaluated the impact of maternal monosaccharide consumption based on a glucose (GLU) or fructose (FRU) diet during pregnancy and lactation in adolescent and young adult offspring rats of both sexes on cognitive, locomotor, and emotional disturbances. Locomotor activity, short-term memory, anxiety-like and depressive-like behavior were evaluated in the offspring. We report for the first time that the maternal GLU or FRU diet is sufficient to evoke anxiety-like behavior among adolescent and young adult offspring. Moreover, we found that maternal monosaccharide diets lead to hyperactivity and depressive-like behavior in male adolescent rats. We also noticed that a maternal FRU diet significantly enhanced novelty-seeking behavior only in young adult male rats. Our novel findings indicated that the maternal monosaccharide diet, especially a diet enriched in FRU, resulted in strong behavioral alterations in offspring rats at early life stages. This study also revealed that male rats were more susceptible to hyperactivity and anxiety- and depressive-like phenotypes than female rats. These results suggest that maternal monosaccharide consumption during pregnancy and lactation is an important factor affecting the emotional status of offspring.
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Li P, Yin F, Zhao Y, Liu Y, Zhang R, Wang J, Lu W, Wang Q, Zhang J. Total sugar intake is associated with higher prevalence of depressive symptoms in obese adults. Front Public Health 2023; 10:1069162. [PMID: 36711384 PMCID: PMC9880186 DOI: 10.3389/fpubh.2022.1069162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 12/28/2022] [Indexed: 01/14/2023] Open
Abstract
Background The existing literature has repeatedly assessed the association between sugar-sweetened beverages and depressive symptoms, but studies of the association of total dietary sugar with depressive symptoms and of this association in obese adults are scarce. Thus, the purpose of this cross-sectional study was to assess the association between total sugar consumption and depressive symptoms in the study population and then in the population stratified by body mass index. Methods This study was conducted in a nationally representative sample of 16,009 adults from the 2011-2018 National Health and Nutrition Examination Survey in the US. Total sugar intake was assessed by 24 h dietary recalls, and depressive symptoms were assessed by the nine-item Patient Health Questionnaire. Logistic regression models were used to evaluate the association between total sugar consumption and depressive symptoms. Results Total sugar intake was positively associated with higher prevalence of depressive symptoms, and the adjusted odds ratio (95% confidence interval) of depressive symptoms for the highest vs. lowest quintile of total sugar intake was 1.56 (1.18, 2.05). In stratified analysis, we found a positive association between total sugar intake and depressive symptoms in adults with body mass index ≥30 kg/m2 (P for trend = 0.013), whereas no association was found in normal weight or overweight adults. Conclusions A higher intake of total sugar was associated with increased odds of clinically relevant depressive symptoms among obese adults. Further studies are necessary to confirm the role of total sugar in depressive symptoms among obese adults.
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Affiliation(s)
- Ping Li
- Department of Nutrition, First Hospital of Qinhuangdao, Qinhuangdao, China
| | - Fuzai Yin
- Department of Endocrinology, First Hospital of Qinhuangdao, Qinhuangdao, China
| | - Yanru Zhao
- Department of Nutrition, First Hospital of Qinhuangdao, Qinhuangdao, China
| | - Yali Liu
- Health Management Centre, First Hospital of Qinhuangdao, Qinhuangdao, China
| | - Ru Zhang
- Department of Traditional Chinese Medicine, First Hospital of Qinhuangdao, Qinhuangdao, China
| | - Jia Wang
- Department of Nutrition, First Hospital of Qinhuangdao, Qinhuangdao, China
| | - Wenqi Lu
- Department of Nutrition, First Hospital of Qinhuangdao, Qinhuangdao, China
| | - Qingsheng Wang
- Department of Cardiology, First Hospital of Qinhuangdao, Qinhuangdao, China
| | - Jing Zhang
- Department of Cardiology, First Hospital of Qinhuangdao, Qinhuangdao, China
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10
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Qiu C, He W, Li Y, Jiang F, Pan Y, Zhang M, Lin D, Zhang K, Yang Y, Wang W, Hua P. Formation of halogenated disinfection byproducts in chlorinated real water during making hot beverage: Effect of sugar addition. CHEMOSPHERE 2022; 305:135417. [PMID: 35750228 DOI: 10.1016/j.chemosphere.2022.135417] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/06/2022] [Accepted: 06/16/2022] [Indexed: 06/15/2023]
Abstract
Chlorine disinfection is widely applied in drinking water treatment plant to inactivate pathogens in drinking water, but it unintentionally reacts with organic matter present in source waters and generates halogenated disinfection byproducts (DBPs). Sugar is one of the most commonly used seasoning in our diet. The addition of sugar could significantly improve the taste of the beverages; however, the effects of sugar on DBP formation and transformation remain unknown. In this study, the effects of sugar type and dose on the halogenated DBP formation in chlorinated boiled real tap water were evaluated during making hot beverages. We found that sugar can react with chlorine residual in tap water and generate halogenated DBPs. As the most commonly used table sugar, the addition of sucrose in the water sample at 100 or 500 mg/L as C could increase the level of total organic halogen (TOX) by ∼35%, when compared with the boiled tap water sample without sugar addition. In addition, fifteen reported and new polar brominated and chlorinated DBPs were detected and proposed from the reaction between chlorine and sucrose; accordingly, the corresponding transformation pathways were also proposed. Moreover, the DBP formation in the chlorinated boiled real tap water samples with the addition of xylose, glucose, sucrose, maltose and lactose were also investigated. By comparing with the TOX levels in the water samples with different sugar addition and their calculated TOX risk indexes, it was suggested that applying xylose as a sweetener in beverages could not only obtain a relatively high sweetness but also minimize the adverse effect inducing by halogenated DBPs during making hot beverages.
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Affiliation(s)
- Chuyin Qiu
- School of Environment, Guangdong Provincial Key Laboratory of Chemical Pollution and Environmental Safety & MOE Key Laboratory of Theoretical Chemistry of Environment, South China Normal University, Guangzhou, 510006, China
| | - Weiting He
- School of Environment, Guangdong Provincial Key Laboratory of Chemical Pollution and Environmental Safety & MOE Key Laboratory of Theoretical Chemistry of Environment, South China Normal University, Guangzhou, 510006, China
| | - Yu Li
- School of Environment, Guangdong Provincial Key Laboratory of Chemical Pollution and Environmental Safety & MOE Key Laboratory of Theoretical Chemistry of Environment, South China Normal University, Guangzhou, 510006, China.
| | - Feng Jiang
- School of Environmental Science & Engineering, Sun Yat-sen University, Guangzhou, 510275, China
| | - Yang Pan
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing, 210023, China
| | - Meihui Zhang
- School of Environment, Guangdong Provincial Key Laboratory of Chemical Pollution and Environmental Safety & MOE Key Laboratory of Theoretical Chemistry of Environment, South China Normal University, Guangzhou, 510006, China
| | - Daying Lin
- School of Environment, Guangdong Provincial Key Laboratory of Chemical Pollution and Environmental Safety & MOE Key Laboratory of Theoretical Chemistry of Environment, South China Normal University, Guangzhou, 510006, China
| | - Kaili Zhang
- School of Environment, Guangdong Provincial Key Laboratory of Chemical Pollution and Environmental Safety & MOE Key Laboratory of Theoretical Chemistry of Environment, South China Normal University, Guangzhou, 510006, China
| | - Yanduo Yang
- School of Environmental Science & Engineering, Sun Yat-sen University, Guangzhou, 510275, China
| | - Wen Wang
- School of Environmental Science & Safety Engineering, Tianjin University of Technology, Tianjin, 300384, China
| | - Pei Hua
- School of Environment, Guangdong Provincial Key Laboratory of Chemical Pollution and Environmental Safety & MOE Key Laboratory of Theoretical Chemistry of Environment, South China Normal University, Guangzhou, 510006, China
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11
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Witek K, Wydra K, Filip M. A High-Sugar Diet Consumption, Metabolism and Health Impacts with a Focus on the Development of Substance Use Disorder: A Narrative Review. Nutrients 2022; 14:2940. [PMID: 35889898 PMCID: PMC9323357 DOI: 10.3390/nu14142940] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/13/2022] [Accepted: 07/15/2022] [Indexed: 01/01/2023] Open
Abstract
Carbohydrates are important macronutrients in human and rodent diet patterns that play a key role in crucial metabolic pathways and provide the necessary energy for proper body functioning. Sugar homeostasis and intake require complex hormonal and nervous control to proper body energy balance. Added sugar in processed food results in metabolic, cardiovascular, and nervous disorders. Epidemiological reports have shown enhanced consumption of sweet products in children and adults, especially in reproductive age and in pregnant women, which can lead to the susceptibility of offspring's health to diseases in early life or in adulthood and proneness to mental disorders. In this review, we discuss the impacts of high-sugar diet (HSD) or sugar intake during the perinatal and/or postnatal periods on neural and behavioural disturbances as well as on the development of substance use disorder (SUD). Since several emotional behavioural disturbances are recognized as predictors of SUD, we also present how HSD enhances impulsive behaviour, stress, anxiety and depression. Apart from the influence of HSD on these mood disturbances, added sugar can render food addiction. Both food and addictive substances change the sensitivity of the brain rewarding neurotransmission signalling. The results of the collected studies could be important in assessing sugar intake, especially via maternal dietary patterns, from the clinical perspective of SUD prevention or pre-existing emotional disorders. Methodology: This narrative review focuses on the roles of a high-sugar diet (HSD) and added sugar in foods and on the impacts of glucose and fructose on the development of substance use disorder (SUD) and on the behavioural predictors of drugs abuse. The literature was reviewed by two authors independently according to the topic of the review. We searched the PubMed and Scopus databases and Multidisciplinary Digital Publishing Institute open access scientific journals using the following keyword search strategy depending on the theme of the chapter: "high-sugar diet" OR "high-carbohydrate diet" OR "sugar" OR "glucose" OR "fructose" OR "added sugar" AND keywords. We excluded inaccessible or pay-walled articles, abstracts, conference papers, editorials, letters, commentary, and short notes. Reviews, experimental studies, and epidemiological data, published since 1990s, were searched and collected depending on the chapter structure. After the search, all duplicates are thrown out and full texts were read, and findings were rescreened. After the selection process, appropriate papers were included to present in this review.
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Affiliation(s)
| | | | - Małgorzata Filip
- Department of Drug Addiction Pharmacology, Maj Institute of Pharmacology Polish Academy of Sciences, Smętna Street 12, 31-343 Kraków, Poland; (K.W.); (K.W.)
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12
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Negrão LD, Natacci LC, Zsigovics Alfino MC, Marchiori VF, Oliveti DH, Ferreira Carioca AA, Torres EAFDS. NuMoOS – COVID-19 Nutrition and Mood Online Survey: Perception about dietary aspects, stress, anxiety, and depression in the social isolation of Coronavirus Disease 2019. Clin Nutr ESPEN 2022; 50:101-110. [PMID: 35871910 PMCID: PMC9233753 DOI: 10.1016/j.clnesp.2022.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/07/2022] [Accepted: 06/20/2022] [Indexed: 10/31/2022]
Abstract
Background Methods Results Conclusions
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13
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Yang H, Cui X, Dijst M, Tian S, Chen J, Huang J. Association Between Natural/Built Campus Environment and Depression Among Chinese Undergraduates: Multiscale Evidence for the Moderating Role of Socioeconomic Factors After Controlling for Residential Self-Selection. Front Public Health 2022; 10:844541. [PMID: 35480591 PMCID: PMC9037627 DOI: 10.3389/fpubh.2022.844541] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 02/02/2022] [Indexed: 11/13/2022] Open
Abstract
Aim Evidence on the association between natural-built environments and depression is largely derived from the general population and prone to residential self-selection bias because of the nature of cross-sectional research design. Despite emerging adulthood, which includes the university years, is a critical stage for forming life-long health habits, studies on this topic focusing on undergraduate students are limited. The current study aims to illustrate the underlying mechanisms for how the campus-based environments affect depression in undergraduate students. Methods Based on a nationwide representative analytical sample of 22,009 Chinese undergraduates in 2018, we examined participants' reports of depression and campus-centered natural/built environments within multiple buffer sizes including 0.5, 1.0, and 2.5 km. After disentangling residential self-selection, we explored the moderating role of the socioeconomic attributes of undergraduates. The depression outcome was measured by the nine-item Patient Health Questionnaire (PHQ9). Indicators of exposure to green and blue space, transportation infrastructure, and food environments were objectively assessed using different circular buffers around each campus address. Results Modeling results indicated that campus neighborhoods with more scattered trees (0.5 km), water (0.5, 1.0, and 2.5 km), and street intersections (1.0 and 2.5 km) were protective against depression. In contrast, those living near denser distributions of outlets serving take-away sweets and fast food (0.5, 1.0, and 2.5 km) were susceptible to depression. These associations were modified by undergraduates' socioeconomic attributes (e.g., grade, Hukou status, and ethnicity) and varied according to geographical scales and exposure metrics. Conclusion To deliver effective environmental interventions to curb the prevalence of depression among undergraduate students, further planning policies should focus on the careful conception of the campus-based environment, especially regarding different spatial scales.
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Affiliation(s)
- Haoran Yang
- The Centre for Modern Chinese City Studies, Research Center for China Administrative Division, Future City Lab, East China Normal University, Shanghai, China
| | - Xiangfen Cui
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, China
| | - Martin Dijst
- Department of Urban Development and Mobility, Luxembourg Institute of Socio-Economic Research (LISER), Esch-sur-Alzette, Luxembourg
| | - Senlin Tian
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, China
| | - Jie Chen
- Faculty of Land Resource Engineering, Kunming University of Science and Technology, Kunming, China
| | - Jianhong Huang
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, China
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14
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Soares JLM, Rocha VA, Sanudo A, Miot HA, Bagatin E. Prevalence and factors associated with gynoid lipodystrophy in Brazilian adolescent girls: a cross-sectional study. Int J Dermatol 2022; 61:861-866. [PMID: 35080006 DOI: 10.1111/ijd.16061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 11/18/2021] [Accepted: 12/27/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Gynoid lipodystrophy (GLD), or female cellulitis, is a chronic multifactorial disorder characterized by the irregular appearance of the skin surface on the thighs and gluteal regions, which affects 80-90% of women after puberty. No curative treatments are available, and there is a paucity of epidemiological studies related to its prevalence, quality of life impact, and risk factors. We aimed to identify the prevalence and factors associated with the development of GLD in Brazilian adolescent girls. METHODS A cross-sectional study examined adolescent girls from São Paulo, Brazil. The explored factors were grouped: familial history, gynecological and hormonal characteristics, exercise practice, nutrition and diet, anthropometric measures, body mass index, and body composition, according to GLD severity assessed through multivariate hierarchic statistics. RESULTS In total, 184 girls, aged from 12 to 18 years, were included in the study. The overall prevalence of GLD was 77.7% (CI 95% 71.7-82.1%); moderate and severe categories of GLD occurred in 56.5% (CI 95% 48.9-62.5%) of the sample. An impact on the quality of life was identified in 39.7% of the girls. GLD was independently associated with higher body mass index, early menarche, higher carbohydrate intake, lower water consumption, menstrual irregularity, familial report of GLD, and less exercise practice. CONCLUSION Gynoid lipodystrophy is a multifactorial disorder; its onset in adolescent girls is associated with familial occurrence, body composition, diet habits, exercise, and hormonal factors. These results support further interventions for GLD prevention and treatment.
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Affiliation(s)
| | | | - Adriana Sanudo
- Departamento de Medicina Preventiva, UNIFESP, São Paulo, SP, Brazil
| | - Hélio Amante Miot
- Departamento de Dermatologia e Radioterapia, FMB-UNESP, Botucatu, SP, Brazil
| | - Ediléia Bagatin
- Departamento de Dermatologia, UNIFESP, São Paulo, SP, Brazil
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15
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Ocklenburg S, Borawski J. Vegetarian diet and depression scores: A meta-analysis. J Affect Disord 2021; 294:813-815. [PMID: 34375207 DOI: 10.1016/j.jad.2021.07.098] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 06/26/2021] [Accepted: 07/11/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Several studies have suggested an association between vegetarian diet and higher depression scores. However, some studies have also shown an effect in the opposite direction, indicating lower depression scores in vegetarians. Given this discrepancy in the literature, this meta-analysis was aimed to determine whether there is a significant association between vegetarian diet and depression scores across different published studies. METHODS A keyword search in major databases was conducted. Studies reporting depression scores in vegetarians and a non-vegetarian control group were included. Meta-analysis following a conditional random-effects procedure was conducted in R. RESULTS After duplicates were removed and studies were analyzed for inclusion criteria, k=13 studies with an overall n of 49889 participants (8057 vegetarians and 41832 non-vegetarian controls) were included in the analysis. Random-effects meta-analysis revealed a significant difference between vegetarians and non-vegetarians, with vegetarians showing higher depression scores than non-vegetarians. LIMITATIONS The heterogeneity between studies was high and geographical variation in study location was low, limiting cross-cultural insights. CONCLUSIONS Vegetarians show higher depression scores than non-vegetarians. However, due to high heterogeneity of published studies, more empirical research is needed before any final conclusions can be drawn. Also, empirical studies from a higher number of different countries would be desirable.
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Affiliation(s)
- Sebastian Ocklenburg
- Institute of Cognitive Neuroscience, Biopsychology, Department of Psychology, Ruhr-University Bochum, Bochum, Germany.
| | - Jette Borawski
- Department of Psychology, University of Duisburg-Essen, Essen, Germany
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16
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The Relationship between Adherence to the Mediterranean Diet, Intake of Specific Foods and Depression in an Adult Population (45-75 Years) in Primary Health Care. A Cross-Sectional Descriptive Study. Nutrients 2021; 13:nu13082724. [PMID: 34444884 PMCID: PMC8399773 DOI: 10.3390/nu13082724] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 07/30/2021] [Accepted: 08/05/2021] [Indexed: 01/06/2023] Open
Abstract
Background: The relationship between the quality of the diet and the adherence to the Mediterranean diet with the presence of persistent or recurrent depressive symptoms have been described. The objective of this study is to analyze the relationship between adherence to the Mediterranean diet and the intake of specific foods in primary care patients aged 45 to 75, having subclinical or major depression. The study also specifically analyzes this relationship in individuals suffering from chronic diseases. Methods: A cross-sectional descriptive study was conducted. 3062 subjects met the inclusion criteria from the EIRA study. Sociodemographic variables, clinical morbidity, depression symptomatology (PHQ-9) and adherence to Mediterranean diet (MEDAS) were collected. Results: Being female, younger, with a higher BMI, consuming more than 1 serving of red meat a day and drinking more than one carbonated or sugary drink daily, not consuming 3 servings of nuts a week and not eating 2 vegetables cooked in olive oil a week are predictors of having higher depressive symptomatology. Conclusions: Assessing the type of diet of patients presenting depressive symptoms and promoting adherence to a healthy diet is important, especially in patients with chronic diseases. However, depression is a very complex issue and the relationship between nutrition and depression must be further examined.
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17
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Yoshizaki T, Togo F. Objectively measured chronotype and social jetlag are associated with habitual dietary intake in undergraduate students. Nutr Res 2021; 90:36-45. [PMID: 34038836 DOI: 10.1016/j.nutres.2021.04.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 03/31/2021] [Accepted: 04/13/2021] [Indexed: 11/29/2022]
Abstract
This study aimed to investigate the associations between objectively measured sleep timing and habitual dietary intake among university students. We hypothesized that a later chronotype and larger social jetlag (SJL) are associated with an undesirable dietary intake. The 82 healthy university students included in this study were asked to undertake a seven-day wrist activity recording. All the participants also completed a self-administered questionnaire during the recording period, including questions on demographic characteristics and habitual dietary intakes. Dietary intake and the score for adherence to the Japanese Food Guide Spinning Top (food guide score) over the previous month were evaluated using a self-reported diet history questionnaire. Nocturnal sleep timing and total sleep time for each night were estimated using the recorded wrist activity. Chronotype was calculated as weekend (WE) mid-sleep time corrected for catch-up sleep on weekdays (WDs). SJL was calculated by subtracting WD mid-sleep time from WE mid-sleep time. Multivariable linear regression showed that a later chronotype was significantly (P < .05) associated with a lower consumption of eggs, greater consumption of grains, and lower food guide score. Multivariable linear regression also showed significant (P < .05) associations of a larger value in SJL with a lower total energy intake, lower consumption of grains, and greater consumption of sugar and confectioneries. The results suggest that chronotype and SJL may be differently associated with undesirable dietary intake in young adults. These findings have important implications for developing novel strategies, focusing on sleep timing, for improving dietary intakes and preventing lifestyle-related diseases.
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Affiliation(s)
- Takahiro Yoshizaki
- Department of Food and Life Sciences, Faculty of Food and Nutritional Sciences, Toyo University, 1-1-1 Izumino, Oura-gun, Itakura-machi, Gunma 374-0193, Japan.
| | - Fumiharu Togo
- Educational Physiology Laboratory, Graduate School of Education, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
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18
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García-Montero C, Fraile-Martínez O, Gómez-Lahoz AM, Pekarek L, Castellanos AJ, Noguerales-Fraguas F, Coca S, Guijarro LG, García-Honduvilla N, Asúnsolo A, Sanchez-Trujillo L, Lahera G, Bujan J, Monserrat J, Álvarez-Mon M, Álvarez-Mon MA, Ortega MA. Nutritional Components in Western Diet Versus Mediterranean Diet at the Gut Microbiota-Immune System Interplay. Implications for Health and Disease. Nutrients 2021; 13:699. [PMID: 33671569 PMCID: PMC7927055 DOI: 10.3390/nu13020699] [Citation(s) in RCA: 172] [Impact Index Per Article: 57.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 02/12/2021] [Accepted: 02/18/2021] [Indexed: 02/06/2023] Open
Abstract
The most prevalent diseases of our time, non-communicable diseases (NCDs) (including obesity, type 2 diabetes, cardiovascular diseases and some types of cancer) are rising worldwide. All of them share the condition of an "inflammatory disorder", with impaired immune functions frequently caused or accompanied by alterations in gut microbiota. These multifactorial maladies also have in common malnutrition related to physiopathology. In this context, diet is the greatest modulator of immune system-microbiota crosstalk, and much interest, and new challenges, are arising in the area of precision nutrition as a way towards treatment and prevention. It is a fact that the westernized diet (WD) is partly responsible for the increased prevalence of NCDs, negatively affecting both gut microbiota and the immune system. Conversely, other nutritional approaches, such as Mediterranean diet (MD), positively influence immune system and gut microbiota, and is proposed not only as a potential tool in the clinical management of different disease conditions, but also for prevention and health promotion globally. Thus, the purpose of this review is to determine the regulatory role of nutritional components of WD and MD in the gut microbiota and immune system interplay, in order to understand, and create awareness of, the influence of diet over both key components.
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Affiliation(s)
- Cielo García-Montero
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (C.G.-M.); (O.F.-M.); (A.M.G.-L.); (L.P.); (A.J.C.); (N.G.-H.); (J.B.); (J.M.)
| | - Oscar Fraile-Martínez
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (C.G.-M.); (O.F.-M.); (A.M.G.-L.); (L.P.); (A.J.C.); (N.G.-H.); (J.B.); (J.M.)
| | - Ana M. Gómez-Lahoz
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (C.G.-M.); (O.F.-M.); (A.M.G.-L.); (L.P.); (A.J.C.); (N.G.-H.); (J.B.); (J.M.)
| | - Leonel Pekarek
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (C.G.-M.); (O.F.-M.); (A.M.G.-L.); (L.P.); (A.J.C.); (N.G.-H.); (J.B.); (J.M.)
| | - Alejandro J. Castellanos
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (C.G.-M.); (O.F.-M.); (A.M.G.-L.); (L.P.); (A.J.C.); (N.G.-H.); (J.B.); (J.M.)
| | - Fernando Noguerales-Fraguas
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain; (F.N.-F.); (A.A.)
- Department of General Surgery, Príncipe de Asturias Hospital, 28806 Alcalá de Henares, Spain
| | - Santiago Coca
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (C.G.-M.); (O.F.-M.); (A.M.G.-L.); (L.P.); (A.J.C.); (N.G.-H.); (J.B.); (J.M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; (S.C.); (L.S.-T.)
- University Center for the Defense of Madrid (CUD-ACD), 28047 Madrid, Spain
| | - Luis G. Guijarro
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; (S.C.); (L.S.-T.)
- Unit of Biochemistry and Molecular Biology (CIBEREHD), Department of System Biology, University of Alcalá, 28801 Alcalá de Henares, Spain;
| | - Natalio García-Honduvilla
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (C.G.-M.); (O.F.-M.); (A.M.G.-L.); (L.P.); (A.J.C.); (N.G.-H.); (J.B.); (J.M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; (S.C.); (L.S.-T.)
- University Center for the Defense of Madrid (CUD-ACD), 28047 Madrid, Spain
| | - Angel Asúnsolo
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain; (F.N.-F.); (A.A.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; (S.C.); (L.S.-T.)
| | - Lara Sanchez-Trujillo
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (C.G.-M.); (O.F.-M.); (A.M.G.-L.); (L.P.); (A.J.C.); (N.G.-H.); (J.B.); (J.M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; (S.C.); (L.S.-T.)
- Service of Pediatric, Hospital Universitario Principe de Asturias, Alcalá de Henares,28806 Madrid, Spain
| | - Guillermo Lahera
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (C.G.-M.); (O.F.-M.); (A.M.G.-L.); (L.P.); (A.J.C.); (N.G.-H.); (J.B.); (J.M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; (S.C.); (L.S.-T.)
- Psychiatry Service, Center for Biomedical Research in the Mental Health Network, University Hospital Príncipe de Asturias, 28806 Alcalá de Henares, Spain;
| | - Julia Bujan
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (C.G.-M.); (O.F.-M.); (A.M.G.-L.); (L.P.); (A.J.C.); (N.G.-H.); (J.B.); (J.M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; (S.C.); (L.S.-T.)
- University Center for the Defense of Madrid (CUD-ACD), 28047 Madrid, Spain
| | - Jorge Monserrat
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (C.G.-M.); (O.F.-M.); (A.M.G.-L.); (L.P.); (A.J.C.); (N.G.-H.); (J.B.); (J.M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; (S.C.); (L.S.-T.)
- University Center for the Defense of Madrid (CUD-ACD), 28047 Madrid, Spain
| | - Melchor Álvarez-Mon
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (C.G.-M.); (O.F.-M.); (A.M.G.-L.); (L.P.); (A.J.C.); (N.G.-H.); (J.B.); (J.M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; (S.C.); (L.S.-T.)
- University Center for the Defense of Madrid (CUD-ACD), 28047 Madrid, Spain
- Immune System Diseases-Rheumatology, Oncology Service an Internal Medicine, University Hospital Príncipe de Asturias, (CIBEREHD), 28806 Alcalá de Henares, Spain;
| | - Miguel A. Álvarez-Mon
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (C.G.-M.); (O.F.-M.); (A.M.G.-L.); (L.P.); (A.J.C.); (N.G.-H.); (J.B.); (J.M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; (S.C.); (L.S.-T.)
- University Center for the Defense of Madrid (CUD-ACD), 28047 Madrid, Spain
- Department of Psychiatry and Medical Psychology, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain
| | - Miguel A. Ortega
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (C.G.-M.); (O.F.-M.); (A.M.G.-L.); (L.P.); (A.J.C.); (N.G.-H.); (J.B.); (J.M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; (S.C.); (L.S.-T.)
- University Center for the Defense of Madrid (CUD-ACD), 28047 Madrid, Spain
- Cancer Registry and Pathology Department, Hospital Universitario Principe de Asturias, 28806 Alcalá de Henares, Spain;
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