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van der Wal JM, Huth KBS, Lok A, Bockting CL, Stronks K, Nicolaou M. Exploring the mechanisms underlying increased risk of depressive disorder in ethnic minority populations in Europe: A causal loop diagram. Soc Sci Med 2024; 351:116977. [PMID: 38788426 DOI: 10.1016/j.socscimed.2024.116977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 05/11/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Multiple ethnic minority populations in Europe show high risk of major depressive disorder (MDD), with ethnic discrimination and low socioeconomic position (SEP) as established risk factors. How this risk is shaped by the interactions between these, and other social factors, remains to be elucidated. We aimed to develop a causal-loop diagram (CLD) to gain a better understanding of how factors at the intersection of ethnic discrimination and SEP dynamically interact to drive MDD risk. METHODS We iteratively mapped the interactions and feedback loops between factors at the intersection of ethnic discrimination and SEP, drawing input from (i) a series of two interviews with a range of MDD domain experts, (ii) an existing CLD mapping the onset of MDD across psychological, biological, and social dimensions at the level of the individual, and (iii) other relevant literature. RESULTS Through tracing the feedback loops in the resulting CLD, we identified ten driving mechanisms for MDD onset in ethnic minorities (two related to ethnic discrimination, SEP, social network and support, and acculturation, as well as one relating to the living environment and self-stigma towards MDD); and four factors that modulate these mechanisms (recent migration, religious affiliation, neighborhood social environment, and public stigma towards MDD). The intersecting nature of ethnic discrimination and SEP, combined with the reinforcing dynamics of the identified driving mechanisms across time- and spatial scales, underscores the excess exposure to circumstances that increase MDD risk in ethnic minorities. CONCLUSIONS While this CLD requires validation through future studies, the intersecting and reinforcing nature of the identified driving mechanisms highlights that tackling the high risk of MDD in ethnic minorities may require intervening at multiple targets, from the individual (e.g., psychological interventions targeting negative beliefs or reducing stress) to the societal level (e.g., addressing labor market discrimination).
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Affiliation(s)
- J M van der Wal
- Amsterdam UMC, location AMC, Department of Psychiatry, Meibergdreef 5, 1105 AZ, Amsterdam, the Netherlands; Amsterdam UMC, location VUmc, Department of Public and Occupational Health, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands; Centre for Urban Mental Health, University of Amsterdam, Amsterdam, the Netherlands.
| | - K B S Huth
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, the Netherlands; University of Amsterdam, Department of Psychological Methods, Nieuwe Achtergracht 129-B, 1018 WS, Amsterdam, the Netherlands
| | - A Lok
- Amsterdam UMC, location AMC, Department of Psychiatry, Meibergdreef 5, 1105 AZ, Amsterdam, the Netherlands; Centre for Urban Mental Health, University of Amsterdam, Amsterdam, the Netherlands
| | - C L Bockting
- Amsterdam UMC, location AMC, Department of Psychiatry, Meibergdreef 5, 1105 AZ, Amsterdam, the Netherlands; Centre for Urban Mental Health, University of Amsterdam, Amsterdam, the Netherlands
| | - K Stronks
- Amsterdam UMC, location VUmc, Department of Public and Occupational Health, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands; Centre for Urban Mental Health, University of Amsterdam, Amsterdam, the Netherlands
| | - M Nicolaou
- Amsterdam UMC, location VUmc, Department of Public and Occupational Health, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands; Centre for Urban Mental Health, University of Amsterdam, Amsterdam, the Netherlands
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Apostolakopoulou XA, Petinaki E, Kapsoritakis AN, Bonotis K. A Narrative Review of the Association Between Healthy Dietary Patterns and Depression. Cureus 2024; 16:e60920. [PMID: 38910729 PMCID: PMC11193411 DOI: 10.7759/cureus.60920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2024] [Indexed: 06/25/2024] Open
Abstract
The purpose of the present review is the investigation of healthy dietary patterns and diet quality in relation to depression risk. Nutritional psychiatry is to develop scientifically based research that defines the role of nutrition and nutrients in various aspects of mental health. Growing evidence from the field suggests that diet may play an important role in the prevention and/or treatment of depression. In contrast, there is evidence that unhealthy diets may increase the risk of depression. This emerging research suggests that dietary interventions could help prevent depression or be an alternative or adjunctive therapy for depression. The Mediterranean diet (MedDiet), the Dietary Approaches to Stop Hypertension (DASH) diet, and the vegetarian diet are examined in this review. The electronic databases PubMed, Scopus, and Google Scholar were searched for relevant studies published during the last five years. We found many results that support that healthy eating patterns (high in vegetables, fruits, whole grains, nuts, seeds, and fish, low in processed foods) are related to a reduction in the risk of depression. The most robust findings are related to MedDiet, where we also found several positive results for the DASH diet. Regarding the vegetarian diet, there are inconsistent reports. Furthermore, a consistent finding refers to a lower Dietary Inflammatory Index (DII) as associated with a lower depression risk. It has been observed that people suffering from depression have poorer nutritional quality, with lower fruit and vegetable intake. This observation may strengthen the argument that nutritional interventions should be incorporated as an important "pillar" in the multifactorial treatment of patients. However, more well-designed studies are needed to establish the relationship between dietary patterns and mental health. In particular, interventional, longitudinal studies could be more enlightening.
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Affiliation(s)
| | - Efthimia Petinaki
- Department of Clinical and Laboratory Research, University Hospital of Larissa, Larissa, GRC
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3
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Zhu Y, Zhang R, Yin S, Sun Y, Womer F, Liu R, Zeng S, Zhang X, Wang F. Digital Dietary Behaviors in Individuals With Depression: Real-World Behavioral Observation. JMIR Public Health Surveill 2024; 10:e47428. [PMID: 38648087 DOI: 10.2196/47428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 09/02/2023] [Accepted: 03/01/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Depression is often accompanied by changes in behavior, including dietary behaviors. The relationship between dietary behaviors and depression has been widely studied, yet previous research has relied on self-reported data which is subject to recall bias. Electronic device-based behavioral monitoring offers the potential for objective, real-time data collection of a large amount of continuous, long-term behavior data in naturalistic settings. OBJECTIVE The study aims to characterize digital dietary behaviors in depression, and to determine whether these behaviors could be used to detect depression. METHODS A total of 3310 students (2222 healthy controls [HCs], 916 with mild depression, and 172 with moderate-severe depression) were recruited for the study of their dietary behaviors via electronic records over a 1-month period, and depression severity was assessed in the middle of the month. The differences in dietary behaviors across the HCs, mild depression, and moderate-severe depression were determined by ANCOVA (analyses of covariance) with age, gender, BMI, and educational level as covariates. Multivariate logistic regression analyses were used to examine the association between dietary behaviors and depression severity. Support vector machine analysis was used to determine whether changes in dietary behaviors could detect mild and moderate-severe depression. RESULTS The study found that individuals with moderate-severe depression had more irregular eating patterns, more fluctuated feeding times, spent more money on dinner, less diverse food choices, as well as eating breakfast less frequently, and preferred to eat only lunch and dinner, compared with HCs. Moderate-severe depression was found to be negatively associated with the daily 3 regular meals pattern (breakfast-lunch-dinner pattern; OR 0.467, 95% CI 0.239-0.912), and mild depression was positively associated with daily lunch and dinner pattern (OR 1.460, 95% CI 1.016-2.100). These changes in digital dietary behaviors were able to detect mild and moderate-severe depression (accuracy=0.53, precision=0.60), with better accuracy for detecting moderate-severe depression (accuracy=0.67, precision=0.64). CONCLUSIONS This is the first study to develop a profile of changes in digital dietary behaviors in individuals with depression using real-world behavioral monitoring. The results suggest that digital markers may be a promising approach for detecting depression.
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Affiliation(s)
- Yue Zhu
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, China
| | - Ran Zhang
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, China
| | - Shuluo Yin
- School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, China
| | - Yihui Sun
- School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, China
- School of Computer Science and Engineering, Northeastern University, Shenyang, China
| | - Fay Womer
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Rongxun Liu
- Henan Key Laboratory of Immunology and Targeted Drug, Henan Collaborative Innovation Center of Molecular Diagnosis and Laboratory Medicine, School of Laboratory Medicine, Xinxiang Medical University, Xinxiang, China
| | - Sheng Zeng
- School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, China
- School of Computer Science and Engineering, Northeastern University, Shenyang, China
| | - Xizhe Zhang
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, China
| | - Fei Wang
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, China
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Jacovides C, Papadopoulou SK, Pavlidou E, Dakanalis A, Alexatou O, Vorvolakos T, Lechouritis E, Papacosta E, Chrysafi M, Mitsiou M, Mentzelou M, Kosti RI, Giaginis C. Association of Pregnant Women's Perinatal Depression with Sociodemographic, Anthropometric and Lifestyle Factors and Perinatal and Postnatal Outcomes: A Cross-Sectional Study. J Clin Med 2024; 13:2096. [PMID: 38610861 PMCID: PMC11012430 DOI: 10.3390/jcm13072096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 03/25/2024] [Accepted: 04/02/2024] [Indexed: 04/14/2024] Open
Abstract
Background: In recent decades, the incidence of depression has gradually increased in the general population globally. Depression is also common during gestation and could result in detrimental gestational complications for both the mother and the fetus. The survey presented aimed to evaluate whether pregnant women's perinatal depression could be associated with socio-demographic, anthropometry and lifestyle factors, and perinatal and postnatal outcomes. Methods: This is a cross-sectional survey conducted on 5314 pregnant women. Socio-demographic and lifestyle factors were recorded by relevant questionnaires via face-to-face interviews. Anthropometric parameters were measured by qualified personnel. Perinatal depressive symptomatology status was evaluated by Beck's Depression Inventory (BDI-II) questionnaire. Results: Depressive symptoms throughout gestation were found in 35.1% of the enrolled women. Perinatal depression was significantly associated with lower educational and economic level, pre-pregnancy regular smoking and reduced levels of Mediterranean diet adherence levels, a higher prevalence of gestational diabetes and preterm birth, as well as a higher incidence of delivering by caesarean section and abnormal childbirth weight. Perinatal depression was also significantly associated with a higher prevalence of maternal postpartum depression and lower prevalence of exclusive breastfeeding practices, as well as with a higher incidence of childhood asthma. Conclusions: Pregnant women's perinatal depression appears to be associated with various socio-demographic, anthropometry, and lifestyle characteristics and with a higher frequency of several adverse pregnancy complications. The present findings emphasize the importance of pregnant women's perinatal mental health, highlighting the need to develop and apply public strategies and policies for psychological counseling and support of future mothers to minimize probable risk factors that may trigger perinatal depression. Novel well-organized, follow-up surveys of enhanced validity are highly recommended to establish more definitive conclusions.
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Affiliation(s)
- Constantina Jacovides
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece
| | - Sousana K Papadopoulou
- Department of Nutritional Sciences and Dietetics, Faculty of Health Sciences, International Hellenic University, 57001 Thessaloniki, Greece
| | - Eleni Pavlidou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece
| | - Antonios Dakanalis
- Department of Mental Health, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
| | - Olga Alexatou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece
| | - Theofanis Vorvolakos
- Department of Psychiatry, School of Health Sciences, University General Hospital of Alexandroupolis, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Eleftherios Lechouritis
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece
| | - Elena Papacosta
- Department of Physical Education and Sport Sciences, School of Education and Social Sciences, Frederick University, 3080 Limassol, Cyprus
| | - Maria Chrysafi
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece
| | - Maria Mitsiou
- Department of Physiotherapy, School of Health Sciences, International Hellenic University, 57001 Thessaloniki, Greece
| | - Maria Mentzelou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece
| | - Rena I Kosti
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42132 Trikala, Greece
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece
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McGuinness AJ, Loughman A, Foster JA, Jacka F. Mood Disorders: The Gut Bacteriome and Beyond. Biol Psychiatry 2024; 95:319-328. [PMID: 37661007 DOI: 10.1016/j.biopsych.2023.08.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 08/09/2023] [Accepted: 08/29/2023] [Indexed: 09/05/2023]
Abstract
Knowledge of the microbiome-gut-brain axis has revolutionized the field of psychiatry. It is now well recognized that the gut bacteriome is associated with, and likely influences, the pathogenesis of mental disorders, including major depressive disorder and bipolar disorder. However, while substantial advances in the field of microbiome science have been made, we have likely only scratched the surface in our understanding of how these ecosystems might contribute to mental disorder pathophysiology. Beyond the gut bacteriome, research into lesser explored components of the gut microbiome, including the gut virome, mycobiome, archaeome, and parasitome, is increasingly suggesting relevance in psychiatry. The contribution of microbiomes beyond the gut, including the oral, lung, and small intestinal microbiomes, to human health and pathology should not be overlooked. Increasing both our awareness and understanding of these less traversed fields of research are critical to improving the therapeutic benefits of treatments targeting the gut microbiome, including fecal microbiome transplantation, postbiotics and biogenics, and dietary intervention. Interdisciplinary collaborations integrating systems biology approaches are required to fully elucidate how these different microbial components and distinct microbial niches interact with each other and their human hosts. Excitingly, we may be at the start of the next microbiome revolution and thus one step closer to informing the field of precision psychiatry to improve outcomes for those living with mental illness.
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Affiliation(s)
- Amelia J McGuinness
- Food and Mood Centre, Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia.
| | - Amy Loughman
- Food and Mood Centre, Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia
| | - Jane A Foster
- Center for Depression Research and Clinical Care, Department of Psychiatry, UT Southwestern Medical Center, Dallas, Texas
| | - Felice Jacka
- Food and Mood Centre, Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia; College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
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Johnstad PG. Unhealthy behaviors associated with mental health disorders: a systematic comparative review of diet quality, sedentary behavior, and cannabis and tobacco use. Front Public Health 2024; 11:1268339. [PMID: 38249418 PMCID: PMC10797041 DOI: 10.3389/fpubh.2023.1268339] [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: 07/27/2023] [Accepted: 11/14/2023] [Indexed: 01/23/2024] Open
Abstract
Background There are well-established literatures documenting the associations between mental disorders and unhealthy behaviors such as poor diet quality, sedentary behavior, and cannabis and tobacco use. Few studies have attempted to understand the respective findings in light of each other, however. Objective The purpose of this review was to assemble comparable data for each behavior-disorder association and assess the associations in terms of their overall strength. The review aimed to include a representative, but not exhaustive, range of studies that would allow for explorative comparisons. Methods Eligible studies were identified via Pubmed searches and citation searching, restricted to publications no older than 2015 written in English. To obtain comparable data, only studies that reported findings as odds ratios were included, and risk of bias related to study samples, behavioral measurement disparities, and control variables was assessed via sensitivity analyses. Findings for each disorder were compared on the basis of different measures of central tendency. Results From 3,682 records, 294 studies were included. The review found evidence of associations between each of the four unhealthy behaviors and psychosis, depression, anxiety, bipolar disorder, attention-deficit/hyperactivity disorder (ADHD), and post-traumatic stress disorder (PTSD), while personality disorder was only investigated in relation to cannabis and tobacco use. In overall comparison, the associations were generally of similar strength, and only the association between cannabis use and personality disorder was exceptional in terms of being significantly stronger than its counterparts across disorders and across behaviors. Analyses of bias risk identified some influence from behavioral measurement disparities and lack of adequate statistical control, but findings were generally robust across a range of sensitivity analyses. Conclusion This explorative and comparative review found that poor diet quality, sedentary behavior, and cannabis and tobacco use are about equally strongly associated with a range of different mental disorders. Given the general nature of these associations, we should probably understand them to reflect a general and shared etiology. However, the findings in this review should be regarded as tentative until confirmed by more comprehensive investigations.
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Blumenthal JA, Smith PJ, Mabe S, Hinderliter A, Craighead L, Watkins LL, Ingle K, Tyson CC, Lin PH, Kraus WE, Liao L, Sherwood A. Effects of Lifestyle Modification on Psychosocial Function in Patients With Resistant Hypertension: SECONDARY OUTCOMES FROM THE TRIUMPH RANDOMIZED CLINICAL TRIAL. J Cardiopulm Rehabil Prev 2024; 44:64-70. [PMID: 37220236 PMCID: PMC10667561 DOI: 10.1097/hcr.0000000000000801] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
PURPOSE In a secondary analysis of the TRIUMPH clinical trial, psychological outcomes in patients with resistant hypertension (RH) receiving a diet and exercise intervention delivered in a cardiac rehabilitation setting were compared with those receiving a similar prescription of diet and exercise provided in a single counseling session by a health educator. METHODS One hundred forty patients with RH were randomly assigned to a 4-mo program of dietary counseling, behavioral weight management, and exercise (C-LIFE) or a single counseling session providing standardized education and physician advice (SEPA). Participants completed a battery of questionnaires to assess psychological functioning before and after the intervention. A global measure of psychological functioning was derived from the General Health Questionnaire (GHQ), Perceived Stress Scale (PSS), Medical Outcomes Study 36-item Short Form Health Survey, Spielberger State-Trait Anxiety Inventory, Hospital Anxiety and Depression Scale (HADS), Beck Depression Inventory-II, and Patient-Reported Outcomes Measurement Information System (PROMIS) Anger scale. RESULTS Participants in the C-LIFE intervention achieved greater improvements in psychological functioning compared with SEPA (C-LIFE: 58.9 [56.1, 61.8] vs SEPA: 66.5 [62.1, 70.9]; P = .024). Greater improvements were especially evident for the GHQ, PSS, and HADS. Examination of mediation revealed that greater weight loss ( B =-0.17, P = .004) and improved oxygen uptake ( B =-0.12, P = .044) were associated with improved psychological functioning. CONCLUSION Compared with standard education and physician advice, a structured program of diet and exercise not only reduced blood pressure but also improved psychological functioning in patients with RH.
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Affiliation(s)
- James A. Blumenthal
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina (Drs Blumenthal, Watkins, Ingle, and Sherwood and Ms Mabe); Departments of Psychiatry (Dr Smith) and Medicine (Dr Hinderliter), University of North Carolina at Chapel Hill, Chapel Hill; Department of Psychology, Emory University, Atlanta, Georgia (Dr Craighead), and Department of Medicine, Duke University Medical Center, Durham, North Carolina (Drs Tyson, Lin, Kraus, and Liao)
| | - Patrick J. Smith
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina (Drs Blumenthal, Watkins, Ingle, and Sherwood and Ms Mabe); Departments of Psychiatry (Dr Smith) and Medicine (Dr Hinderliter), University of North Carolina at Chapel Hill, Chapel Hill; Department of Psychology, Emory University, Atlanta, Georgia (Dr Craighead), and Department of Medicine, Duke University Medical Center, Durham, North Carolina (Drs Tyson, Lin, Kraus, and Liao)
| | - Stephanie Mabe
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina (Drs Blumenthal, Watkins, Ingle, and Sherwood and Ms Mabe); Departments of Psychiatry (Dr Smith) and Medicine (Dr Hinderliter), University of North Carolina at Chapel Hill, Chapel Hill; Department of Psychology, Emory University, Atlanta, Georgia (Dr Craighead), and Department of Medicine, Duke University Medical Center, Durham, North Carolina (Drs Tyson, Lin, Kraus, and Liao)
| | - Alan Hinderliter
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina (Drs Blumenthal, Watkins, Ingle, and Sherwood and Ms Mabe); Departments of Psychiatry (Dr Smith) and Medicine (Dr Hinderliter), University of North Carolina at Chapel Hill, Chapel Hill; Department of Psychology, Emory University, Atlanta, Georgia (Dr Craighead), and Department of Medicine, Duke University Medical Center, Durham, North Carolina (Drs Tyson, Lin, Kraus, and Liao)
| | - Linda Craighead
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina (Drs Blumenthal, Watkins, Ingle, and Sherwood and Ms Mabe); Departments of Psychiatry (Dr Smith) and Medicine (Dr Hinderliter), University of North Carolina at Chapel Hill, Chapel Hill; Department of Psychology, Emory University, Atlanta, Georgia (Dr Craighead), and Department of Medicine, Duke University Medical Center, Durham, North Carolina (Drs Tyson, Lin, Kraus, and Liao)
| | - Lana L. Watkins
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina (Drs Blumenthal, Watkins, Ingle, and Sherwood and Ms Mabe); Departments of Psychiatry (Dr Smith) and Medicine (Dr Hinderliter), University of North Carolina at Chapel Hill, Chapel Hill; Department of Psychology, Emory University, Atlanta, Georgia (Dr Craighead), and Department of Medicine, Duke University Medical Center, Durham, North Carolina (Drs Tyson, Lin, Kraus, and Liao)
| | - Krista Ingle
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina (Drs Blumenthal, Watkins, Ingle, and Sherwood and Ms Mabe); Departments of Psychiatry (Dr Smith) and Medicine (Dr Hinderliter), University of North Carolina at Chapel Hill, Chapel Hill; Department of Psychology, Emory University, Atlanta, Georgia (Dr Craighead), and Department of Medicine, Duke University Medical Center, Durham, North Carolina (Drs Tyson, Lin, Kraus, and Liao)
| | - Crystal C. Tyson
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina (Drs Blumenthal, Watkins, Ingle, and Sherwood and Ms Mabe); Departments of Psychiatry (Dr Smith) and Medicine (Dr Hinderliter), University of North Carolina at Chapel Hill, Chapel Hill; Department of Psychology, Emory University, Atlanta, Georgia (Dr Craighead), and Department of Medicine, Duke University Medical Center, Durham, North Carolina (Drs Tyson, Lin, Kraus, and Liao)
| | - Pao-Hwa Lin
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina (Drs Blumenthal, Watkins, Ingle, and Sherwood and Ms Mabe); Departments of Psychiatry (Dr Smith) and Medicine (Dr Hinderliter), University of North Carolina at Chapel Hill, Chapel Hill; Department of Psychology, Emory University, Atlanta, Georgia (Dr Craighead), and Department of Medicine, Duke University Medical Center, Durham, North Carolina (Drs Tyson, Lin, Kraus, and Liao)
| | - William E. Kraus
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina (Drs Blumenthal, Watkins, Ingle, and Sherwood and Ms Mabe); Departments of Psychiatry (Dr Smith) and Medicine (Dr Hinderliter), University of North Carolina at Chapel Hill, Chapel Hill; Department of Psychology, Emory University, Atlanta, Georgia (Dr Craighead), and Department of Medicine, Duke University Medical Center, Durham, North Carolina (Drs Tyson, Lin, Kraus, and Liao)
| | - Lawrence Liao
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina (Drs Blumenthal, Watkins, Ingle, and Sherwood and Ms Mabe); Departments of Psychiatry (Dr Smith) and Medicine (Dr Hinderliter), University of North Carolina at Chapel Hill, Chapel Hill; Department of Psychology, Emory University, Atlanta, Georgia (Dr Craighead), and Department of Medicine, Duke University Medical Center, Durham, North Carolina (Drs Tyson, Lin, Kraus, and Liao)
| | - Andrew Sherwood
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina (Drs Blumenthal, Watkins, Ingle, and Sherwood and Ms Mabe); Departments of Psychiatry (Dr Smith) and Medicine (Dr Hinderliter), University of North Carolina at Chapel Hill, Chapel Hill; Department of Psychology, Emory University, Atlanta, Georgia (Dr Craighead), and Department of Medicine, Duke University Medical Center, Durham, North Carolina (Drs Tyson, Lin, Kraus, and Liao)
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Du Z, Guo S, Sun Y, Zhou Q, Jiang Y, Shen Y, Zhu H, Zhou Z, Zhou H. Causal relationships between dietary habits and five major mental disorders: A two-sample Mendelian randomization study. J Affect Disord 2023; 340:607-615. [PMID: 37598719 DOI: 10.1016/j.jad.2023.08.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/16/2023] [Accepted: 08/17/2023] [Indexed: 08/22/2023]
Abstract
OBJECTIVE To explore the causal relationship between dietary habits and five major mental disorders using the two-sample Mendelian randomization (MR) analysis. METHODS This study was based on the summary data of the genome-wide association study (GWAS) on diet and five major mental disorders in the European population. The genetic locus data of five major mental disorders (mania, bipolar disorder, manic depression, depression, schizophrenia) from those who never eat eggs, dairy, wheat, and sugar were used. Two-sample MR analysis was conducted to evaluate the causal relationship between diet and five major mental disorders. RESULTS This study revealed a causal relationship between "Never eat Wheat products" and all five types of mental disorders (mania, bipolar disorder, manic depression, depression, schizophrenia), demonstrating a significant negative correlation (P < 0.05). However, no significant causal relationship was observed between "Never eat Sugar or foods/drinks containing sugar" and any of the five mental disorders (P > 0.05). Furthermore, the study found that the statement "Never eat eggs, dairy, wheat, sugar: I eat all of the above" had a causal relationship with mania, bipolar disorder, and manic depression, showing a significant positive correlation (P < 0.05). However, this statement did not exhibit a significant causal relationship with depression and schizophrenia (P > 0.05). CONCLUSION There was a negative correlation between never eating wheat products and the five mental disorders (mania, bipolar disorder, manic depression, depression, schizophrenia), indicating that never eating wheat products may reduce the risk of mental disorders.
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Affiliation(s)
- Zhiqiang Du
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, Jiangsu, China
| | - Shuaiyi Guo
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, Jiangsu, China
| | - Yifan Sun
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, Jiangsu, China
| | - Qin Zhou
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, Jiangsu, China
| | - Ying Jiang
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, Jiangsu, China
| | - Yuan Shen
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, Jiangsu, China
| | - Haohao Zhu
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, Jiangsu, China.
| | - Zhenhe Zhou
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, Jiangsu, China.
| | - Hongliang Zhou
- Department of Psychology, The Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China.
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Bodnaruc AM, Duquet M, Prud’homme D, Giroux I. Diet and Depression during Peri- and Post-Menopause: A Scoping Review Protocol. Methods Protoc 2023; 6:91. [PMID: 37888023 PMCID: PMC10609501 DOI: 10.3390/mps6050091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 09/19/2023] [Accepted: 09/27/2023] [Indexed: 10/28/2023] Open
Abstract
The aim of the proposed scoping review is to describe and summarize studies assessing the associations between diet-related variables and depression in peri- and post-menopausal women. Studies examining the associations between diet-related variables and mental health indicators in women undergoing menopausal transition or in the post-menopausal period will be systematically retrieved via Medline, EMBASE, PsycINFO, Web of Science, and Scopus databases. All articles identified through the database searches will be imported into Covidence. Following the removal of duplicates, two authors will independently perform title and abstract screening, as well as full-text assessment against eligibility criteria. Data will be extracted using tables developed for observational and experimental studies. The methodological quality of randomized trials, cohort and cross-sectional studies, and case-control studies, will be assessed using the Cochrane risk-of-bias (RoB-2) tool, the NHLBI Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies, and the NHLBI Quality Assessment Tool for Case-Control studies, respectively. Data extraction tables will be used to produce two tables summarizing the main characteristics and findings of the studies included in the review. In the proposed review, we will systematically identify and summarize the currently available evidence on the association between diet-related variables and depression in peri- and post-menopausal women. To our knowledge, this is the first review focusing on this subgroup of the population. Protocol registration: osf.io/b89r6.
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Affiliation(s)
- Alexandra M. Bodnaruc
- School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada; (A.M.B.); (M.D.)
| | - Miryam Duquet
- School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada; (A.M.B.); (M.D.)
| | | | - Isabelle Giroux
- School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada; (A.M.B.); (M.D.)
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Bodnaruc AM, Vincent C, Soto C, Duquet M, Prud’homme D, Giroux I. Gathering the Evidence on Diet and Depression: A Protocol for an Umbrella Review and Updated Meta-Analyses. Methods Protoc 2023; 6:78. [PMID: 37736961 PMCID: PMC10514888 DOI: 10.3390/mps6050078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/25/2023] [Accepted: 08/28/2023] [Indexed: 09/23/2023] Open
Abstract
Our objectives are to perform (1) an umbrella review on diet and depression, (2) a systematic review update on dietary patterns and depression, and (3) updated meta-analyses using studies from the previous two objectives. Systematic reviews examining the relationships between diet and depression and primary studies on the relationship between dietary patterns and depression will be systematically retrieved via several databases. All articles identified through the database searches will be imported into Covidence. Following duplicates removal, two authors will independently perform title and abstract screening and full-text assessment against eligibility criteria. Data will be extracted using tables developed for both systematic reviews and primary studies. The methodological quality of systematic reviews will be assessed using the AMSTAR-2 tool. The risk of bias in randomized trials, cohort and cross-sectional studies, as well as case-control studies, will be assessed with the Cochrane risk-of-bias (RoB-2) tool, the NHLBI Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies, and the NHLBI Quality Assessment Tool for Case-Control studies, respectively. For each dietary variable, data extracted will be used to produce: (1) a summary of systematic reviews' characteristics and results table, (2) a summary of the primary studies characteristics table, (3) a qualitative summary of results from the primary studies table, and (4) a quantitative summary of results in the form of forest plots. The certainty of evidence will be assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Upon completion, this systematic review will be the most comprehensive and up-to-date synthesis of currently available evidence on the relationships between diet and depression. It will serve as a key reference to guide future research and as a resource for health professionals in the fields of nutrition and psychiatry. PROSPERO CRD42022343253.
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Affiliation(s)
- Alexandra M. Bodnaruc
- School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada; (A.M.B.); (C.V.); (C.S.); (M.D.)
| | - Coralie Vincent
- School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada; (A.M.B.); (C.V.); (C.S.); (M.D.)
| | - Carolina Soto
- School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada; (A.M.B.); (C.V.); (C.S.); (M.D.)
| | - Miryam Duquet
- School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada; (A.M.B.); (C.V.); (C.S.); (M.D.)
| | | | - Isabelle Giroux
- School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada; (A.M.B.); (C.V.); (C.S.); (M.D.)
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11
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Carballo-Casla A, Stefler D, Ortolá R, Chen Y, Knuppel A, Ruiz M, Kozela M, Kubinova R, Pajak A, Rodríguez-Artalejo F, Brunner EJ, Bobak M. The Southern European Atlantic diet and depression risk: a European multicohort study. Mol Psychiatry 2023; 28:3475-3483. [PMID: 37353584 PMCID: PMC10618086 DOI: 10.1038/s41380-023-02125-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 05/11/2023] [Accepted: 06/08/2023] [Indexed: 06/25/2023]
Abstract
The Southern European Atlantic diet (SEAD) is the traditional dietary pattern of north-western Spain and northern Portugal, but it may resemble that of other European countries. The SEAD has been found associated with lower risk for myocardial infarction and mortality. Since dietary patterns may also influence mental health, we examined the association between the SEAD and depression risk in southern, central, eastern, and western European populations. We conducted a prospective analysis of five cohorts (13,297 participants aged 45-92 years, free of depression at baseline): Seniors-ENRICA-1 and Seniors-ENRICA-2 (Spain), HAPIEE (Czechia and Poland), and Whitehall-II (United Kingdom). The SEAD comprised cod, other fresh fish, red meat and pork products, dairy, legumes and vegetables, vegetable soup, potatoes, whole-grain bread, and moderate wine consumption. Depression at follow-up was defined according to presence of depressive symptoms (based on available scales), use of prescribed antidepressants, inpatient admissions, or self-reported diagnosis. Associations were adjusted for sociodemographic, lifestyle, and dietary variables. During a median follow-up of 3.9 years (interquartile range 3.4-4.9), there were 1437 new depression cases. Higher adherence to the SEAD was associated with lower depression risk in the pooled sample. Individual food groups showed a similar tendency, albeit non-significant. The fully adjusted odds ratio (95% confidence interval) per 1-standard deviation increment in the SEAD was 0.91 (0.86, 0.96). This association was rather consistent across countries [Spain = 0.86 (0.75, 0.99), Czechia = 0.86 (0.75, 0.99), Poland = 0.97 (0.89, 1.06), United Kingdom = 0.85 (0.75, 0.97); p for interaction = 0.24], and was of similar magnitude as that found for existing healthy dietary patterns. In conclusion, the SEAD was associated with lower depression risk across European populations. This may support the development of mood disorder guidelines for Southern European Atlantic regions based on their traditional diet, and for central, eastern, and western European populations based on the SEAD food groups that are culturally rooted in these places.
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Affiliation(s)
- Adrián Carballo-Casla
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain. Center for Networked Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.
- Department of Epidemiology and Public Health, University College London, London, UK.
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet & Stockholm University, Stockholm, Sweden.
| | - Denes Stefler
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Rosario Ortolá
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain. Center for Networked Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Yuntao Chen
- Department of Epidemiology and Public Health, University College London, London, UK
| | | | - Milagros Ruiz
- Department of Epidemiology and Public Health, University College London, London, UK
- School of Health and Social Care, University of Essex, Colchester, UK
| | - Magdalena Kozela
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland
| | | | - Andrzej Pajak
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain. Center for Networked Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- IMDEA Research Institute on Food & Health Sciences. CEI UAM+CSIC, Madrid, Spain
| | - Eric J Brunner
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Martin Bobak
- Department of Epidemiology and Public Health, University College London, London, UK
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12
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Hwang YG, Pae C, Lee SH, Yook KH, Park CI. Relationship between Mediterranean diet and depression in South Korea: the Korea National Health and Nutrition Examination Survey. Front Nutr 2023; 10:1219743. [PMID: 37476401 PMCID: PMC10354261 DOI: 10.3389/fnut.2023.1219743] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 06/20/2023] [Indexed: 07/22/2023] Open
Abstract
Background Several studies have shown that adherence to the Mediterranean diet is associated with a lower risk of depression; however, little is known about the Asian population. This study investigated the relationship between adherence to the Mediterranean diet and depression in a sample of the South Korean population. Methods In total, 5,849 adults from the 2014 and 2016 Korea National Health and Nutrition Examination Surveys were included in the study. The Mediterranean diet adherence was measured using a modified alternate Mediterranean diet score (mMED) developed to adjust for Korean dietary patterns. The mMED scores using the Food Frequency Questionnaire were divided into four categories (0-2, 3-4, 5-6, and 7-9 points). Subjects with depression were defined as having moderate-to-severe depressive symptoms using the Patient Health Questionnaire-9, with a cutoff value of 10. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). A subgroup analysis was performed based on sex. Results The results of logistic regression analysis indicated that individuals with higher mMED were 42-73% less likely to report depression compared to individuals with the lowest mMED [ORs (95% CIs) =0.58 (0.37-0.90), 0.50 (0.31-0.80), 0.27 (0.15-0.47)] after adjusting for socio-demographic and health-related variables. In women, individuals with mMED of 7-9 had 71% lower odds of depression [ORs (95% CIs): 0.29 (0.13-0.64)]. In men, individuals with mMED of 5-9 had 55% [ORs (95% CIs): 0.45 (0.23-0.91)] to 79% [ORs (95% CIs): 0.21 (0.08-0.57)] lower odds of depression. Conclusion This study suggests that adherence to the Mediterranean diet is inversely associated with depression in both men and women among Korean adults. This study provides evidence that a Mediterranean diet is crucial in preventing depressive symptoms in Asian populations.
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Affiliation(s)
- Yeong-Geon Hwang
- Department of Psychiatry, CHA Bundang Medical Center, Seongnam-si, Republic of Korea
- Graduate School of Clinical Counseling Psychology, CHA University, Seongnam-si, Republic of Korea
| | - Chongwon Pae
- Department of Psychiatry, CHA Bundang Medical Center, Seongnam-si, Republic of Korea
| | - Sang-Hyuk Lee
- Department of Psychiatry, CHA Bundang Medical Center, Seongnam-si, Republic of Korea
| | - Ki-Hwan Yook
- Department of Psychiatry, CHA Bundang Medical Center, Seongnam-si, Republic of Korea
| | - Chun Il Park
- Department of Psychiatry, CHA Bundang Medical Center, Seongnam-si, Republic of Korea
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Marx W, Manger SH, Blencowe M, Murray G, Ho FYY, Lawn S, Blumenthal JA, Schuch F, Stubbs B, Ruusunen A, Desyibelew HD, Dinan TG, Jacka F, Ravindran A, Berk M, O'Neil A. Clinical guidelines for the use of lifestyle-based mental health care in major depressive disorder: World Federation of Societies for Biological Psychiatry (WFSBP) and Australasian Society of Lifestyle Medicine (ASLM) taskforce. World J Biol Psychiatry 2023; 24:333-386. [PMID: 36202135 PMCID: PMC10972571 DOI: 10.1080/15622975.2022.2112074] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/24/2022] [Accepted: 08/07/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVES The primary objectives of these international guidelines were to provide a global audience of clinicians with (a) a series of evidence-based recommendations for the provision of lifestyle-based mental health care in clinical practice for adults with Major Depressive Disorder (MDD) and (b) a series of implementation considerations that may be applicable across a range of settings. METHODS Recommendations and associated evidence-based gradings were based on a series of systematic literature searches of published research as well as the clinical expertise of taskforce members. The focus of the guidelines was eight lifestyle domains: physical activity and exercise, smoking cessation, work-directed interventions, mindfulness-based and stress management therapies, diet, sleep, loneliness and social support, and green space interaction. The following electronic bibliographic databases were searched for articles published prior to June 2020: PubMed, EMBASE, The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Methodology Register), CINAHL, PsycINFO. Evidence grading was based on the level of evidence specific to MDD and risk of bias, in accordance with the World Federation of Societies for Biological Psychiatry criteria. RESULTS Nine recommendations were formed. The recommendations with the highest ratings to improve MDD were the use of physical activity and exercise, relaxation techniques, work-directed interventions, sleep, and mindfulness-based therapies (Grade 2). Interventions related to diet and green space were recommended, but with a lower strength of evidence (Grade 3). Recommendations regarding smoking cessation and loneliness and social support were based on expert opinion. Key implementation considerations included the need for input from allied health professionals and support networks to implement this type of approach, the importance of partnering such recommendations with behaviour change support, and the need to deliver interventions using a biopsychosocial-cultural framework. CONCLUSIONS Lifestyle-based interventions are recommended as a foundational component of mental health care in clinical practice for adults with Major Depressive Disorder, where other evidence-based therapies can be added or used in combination. The findings and recommendations of these guidelines support the need for further research to address existing gaps in efficacy and implementation research, especially for emerging lifestyle-based approaches (e.g. green space, loneliness and social support interventions) where data are limited. Further work is also needed to develop innovative approaches for delivery and models of care, and to support the training of health professionals regarding lifestyle-based mental health care.
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Affiliation(s)
- Wolfgang Marx
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Sam H Manger
- College of Medicine and Dentistry, James Cook University, Queensland, Australia
- Australasian Society of Lifestyle Medicine, Melbourne, Australia
| | - Mark Blencowe
- Australasian Society of Lifestyle Medicine, Melbourne, Australia
| | - Greg Murray
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia
| | - Fiona Yan-Yee Ho
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong SAR
| | - Sharon Lawn
- Lived Experience Australia Ltd, Adelaide, Australia
- Flinders University, College of Medicine and Public Health, Adelaide, Australia
| | - James A. Blumenthal
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham NC 27710
| | - Felipe Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Anu Ruusunen
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland
| | - Hanna Demelash Desyibelew
- Department of Nutrition and Dietetics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | | | - Felice Jacka
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Arun Ravindran
- Department of Psychiatry & Institute of Medical Sciences, University of Toronto. Centre for Addiction and Mental Health, Toronto, Canada
| | - Michael Berk
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Adrienne O'Neil
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
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Varesi A, Campagnoli LIM, Chirumbolo S, Candiano B, Carrara A, Ricevuti G, Esposito C, Pascale A. The Brain-Gut-Microbiota Interplay in Depression: a key to design innovative therapeutic approaches. Pharmacol Res 2023; 192:106799. [PMID: 37211239 DOI: 10.1016/j.phrs.2023.106799] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/17/2023] [Accepted: 05/18/2023] [Indexed: 05/23/2023]
Abstract
Depression is the most prevalent mental disorder in the world associated with huge socio-economic consequences. While depressive-related symptoms are well known, the molecular mechanisms underlying disease pathophysiology and progression remain largely unknown. The gut microbiota (GM) is emerging as a key regulator of the central nervous system homeostasis by exerting fundamental immune and metabolic functions. In turn, the brain influences the intestinal microbial composition through neuroendocrine signals, within the so-called gut microbiota-brain axis. The balance of this bidirectional crosstalk is important to ensure neurogenesis, preserve the integrity of the blood-brain barrier and avoid neuroinflammation. Conversely, dysbiosis and gut permeability negatively affect brain development, behavior, and cognition. Furthermore, although not fully defined yet, changes in the GM composition in depressed patients are reported to influence the pharmacokinetics of common antidepressants by affecting their absorption, metabolism, and activity. Similarly, neuropsychiatric drugs may shape in turn the GM with an impact on the efficacy and toxicity of the pharmacological intervention itself. Consequently, strategies aimed at re-establishing the correct homeostatic gut balance (i.e., prebiotics, probiotics, fecal microbiota transplantation, and dietary interventions) represent an innovative approach to improve the pharmacotherapy of depression. Among these, probiotics and the Mediterranean diet, alone or in combination with the standard of care, hold promise for clinical application. Therefore, the disclosure of the intricate network between GM and depression will give precious insights for innovative diagnostic and therapeutic approaches towards depression, with profound implications for drug development and clinical practice.
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Affiliation(s)
- Angelica Varesi
- Department of Biology and Biotechnology, University of Pavia, Pavia, Italy.
| | | | - Salvatore Chirumbolo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37121 Verona, Italy
| | - Beatrice Candiano
- Department of Drug Sciences, Section of Pharmacology, University of Pavia, Pavia, Italy
| | - Adelaide Carrara
- Child Neurology and Psychiatric Unit, IRCCS Mondino, Pavia, Italy
| | | | - Ciro Esposito
- Department of Internal Medicine and Therapeutics, University of Pavia, Italy; Nephrology and dialysis unit, ICS S. Maugeri SPA SB Hospital, Pavia, Italy; High School in Geriatrics, University of Pavia, Italy
| | - Alessia Pascale
- Department of Drug Sciences, Section of Pharmacology, University of Pavia, Pavia, Italy.
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Rantanen AT, Kautiainen H, Korhonen PE. Depressive symptoms and mortality - effect variation by body mass index: a prospective study in a primary care population. Int J Obes (Lond) 2023; 47:512-519. [PMID: 36977790 DOI: 10.1038/s41366-023-01296-3] [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: 11/03/2022] [Revised: 03/06/2023] [Accepted: 03/14/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND/OBJECTIVE Pre-existing diseases have been found to affect the relationship between body mass index (BMI) and mortality. However, psychiatric disorders common in general population have not been previously addressed. The aim of this study was to assess the relationship of depressive symptoms and BMI with all-cause mortality. METHODS A prospective cohort study in Finnish primary care setting was conducted. A population survey identified 3072 middle-aged subjects who had elevated cardiovascular risk. Subjects who attended clinical examination and completed Beck's Depression Inventory (BDI) (n = 2509) were included in this analysis. Effect of depressive symptoms and BMI on all-cause mortality after 14 years follow-up was estimated in models adjusted for age, sex, education years, current smoking, alcohol use, physical activity, total cholesterol, systolic blood pressure, and glucose disorders. RESULTS When subjects with and without increased depressive symptoms were compared, the fully adjusted hazard ratios (HR) for all-cause mortality in the BMI categories (<25.0, 25.0-29.9, 30.0-34.9, ≥35.0 kg/m2) were 3.26 (95% CI 1.83 to 5.82), 1.31 (95% CI 0.83 to 2.06), 1.27 (95% CI 0.76 to 2.11), and 1.25 (95% CI 0.63 to 2.48), respectively. The lowest risk of death was among non-depressive subjects who had BMI < 25.0 kg/m2. CONCLUSIONS Effect of increased depressive symptoms on all-cause mortality risk seems to vary with BMI. Elevated mortality risk is especially apparent among depressive subjects with normal weight. Among individuals with overweight and obesity, increased depressive symptoms seem not to further increase all-cause mortality.
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Affiliation(s)
- Ansa Talvikki Rantanen
- Department of General Practice, University of Turku and Turku University Hospital, 20520, Turku, Finland.
| | - Hannu Kautiainen
- Folkhälsan Research Center, Helsinki, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Päivi Elina Korhonen
- Department of General Practice, University of Turku and Turku University Hospital, 20520, Turku, Finland
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Parastouei K, Rostami H, Chambari M. The association between a priori dietary patterns and psychological disorders in military personnel. BMC Psychiatry 2023; 23:203. [PMID: 36978014 PMCID: PMC10053979 DOI: 10.1186/s12888-023-04650-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 03/03/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Studies have identified a high prevalence of poor mental health, including depression, anxiety, and stress in military occupations. A low quality diet is one of the potential factors related to mental disorders. This study aimed to investigate the association of a priori dietary patterns, including dietary approach to stop hypertension (DASH), the Mediterranean diet (MD), dietary inflammatory index (DII), and healthy eating index-2015 (HEI-2015) with the odds of depression, anxiety, and stress in military staff. METHODS This cross-sectional study was performed on a total of 400 military staff, aged 38.67 ± 5.22 (ranging from 30 to 60) years, recruited from Iranian military centers. The dietary intake of participants and adherence to the DASH, MD, DII, and HEI-2015 was measured using a 168-item food frequency questionnaire (FFQ). Mental health was evaluated with the use of the Depression, Anxiety, and Stress Scale - 21 (DASS-21). RESULTS The prevalence of depression, anxiety, and stress was 64.5%, 63.2%, and 61.3%, respectively. Individuals with the highest adherence to HEI-2015, compared to those with the lowest adherence, were significantly at lower odds of anxiety (OR = 0.51, 95%CI: 0.27-0.96, p = 0.03), while higher adherence to DII was related to a 2.74-fold increased odds of anxiety (OR = 2.74, 95%CI: 1.06-7.04, p = 0.03). Compared to those with the lowest adherence (quartile 1), quartile 2 of the HEI-2015 was associated with decreased odds of stress (p = 0.04). No association was identified between dietary patterns and depression. CONCLUSION Greater adherence to HEI-2015 and lower adherence to DII are associated with lower odds of anxiety in military staff.
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Affiliation(s)
- Karim Parastouei
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| | - Hosein Rostami
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mahla Chambari
- Noncommunicable Diseases Research Center, Neyshabur University of Medical Sciences, Neyshabur, Iran
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Effect of low-carbohydrate diet on depression and anxiety: A systematic review and meta-analysis of controlled trials. J Affect Disord 2023; 325:206-214. [PMID: 36584702 DOI: 10.1016/j.jad.2022.12.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 10/12/2022] [Accepted: 12/10/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Despite considerable advances in pharmacological and non-pharmacological treatments, mental health illnesses carry many economic and social burdens. Depression and anxiety are known as mental disorders which are highly prevalent worldwide. Previous studies have shown different results. This diet has attracted enormous interest. OBJECTIVE This is the first meta-analysis conducted to review systematically all trials to evaluating the effect of a low carbohydrate diet (LCD) on depression, and anxiety. METHODS PubMed, Web of Science, and Scopus have been searched until 9 September 2021. In total, 8 RCTs (n = 590) were carried out for evaluation the effects of LCDs on depression and anxiety were included. All the trials included in the analyses evaluated patients without a mood disorder. Random model effects meta-analysis was conducted. To evaluate the heterogeneity among the included studies. The egger test was used. Subgroup analyses performed based on regions, assessment methods, carbohydrate intake and duration of studies. RESULTS This study did not show any significant association between a low carbohydrate diet and the of anxiety (SMD = 0.19, 95 % CI -0.10, 0.47; P = 0.20) and also depression (SMD = 0.06, 95 % CI -0.11, 0.24; P = 0.49). If one of the studies is excluded, this diet significantly increases anxiety (SMD = 0.33, 95 % CI 0.12, 0.54; P ≤ 0.001). This study showed that this diet increases anxiety in studies with <26 % carbohydrate intake (SMD = 0.31; 95%CI 0.10, 0.52; P ≤ 0.001; I2 = 0.00, P = 0.52), in the Australia (SMD = 0.29; 95%CI 0.08, 0.49; P = 0.01; I2 = 0.00, P = 0.42), and in studies that used the Spielberger State Anxiety Inventory (SAI) to assess anxiety (SMD = 0.33; 95%CI 0.11, 0.54; P ≤ 0.001; I2 = 0.00, P = 0.54). LIMITATIONS One of the limitations of intervention studies examining the effect of diet is that it is difficult to blind people under intervention. CONCLUSION The present study did not demonstrate significant association between a low carbohydrate diet and improvement of depression and anxiety. More accurate studies are needed to reach definitive conclusions.
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Yelland S, Steenson S, Creedon A, Stanner S. The role of diet in managing menopausal symptoms: A narrative review. NUTR BULL 2023; 48:43-65. [PMID: 36792552 DOI: 10.1111/nbu.12607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/13/2023] [Accepted: 01/16/2023] [Indexed: 02/17/2023]
Abstract
Menopause is a natural stage that occurs when women stop menstruating, during which many women experience physical and psychological symptoms that can affect their quality of life and ability to work. Dietary modifications and food supplements may be explored by some women as alternatives to hormone replacement therapy, although existing reviews and expert position statements have given this limited consideration. This narrative review summarises the current evidence for dietary patterns, and botanical and food supplements, in the management of common menopausal symptoms, including vasomotor symptoms (VMS; hot flushes; night sweats), changes in bodyweight and composition, psychological symptoms (depression; anxiety; cognitive changes), sleep disturbances, joint pain, skin changes and urogenital symptoms. Soy isoflavones may reduce the frequency and/or severity of VMS, although results are inconsistent, and it is unclear whether dietary and supplemental sources have comparable effects. Adopting a healthier dietary pattern may support a healthy bodyweight and benefit VMS. However, evidence suggesting dietary patterns may benefit depression, anxiety, and cognition remains largely observational. While some botanicals, such as black cohosh and St John's Wort, have been reported in some studies to alleviate symptoms (such as VMS and depression), these are not currently recommended due to uncertainty about the appropriate dose and preparation, and potential safety concerns. Evidence for other symptoms is currently too limited to draw conclusions. While further trials at different menopausal stages are needed, adopting a healthier dietary pattern in accordance with dietary guidelines is likely to help support women's health before, during and after the menopausal transition.
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Gianfredi V, Dinu M, Nucci D, Eussen SJPM, Amerio A, Schram MT, Schaper N, Odone A. Association between dietary patterns and depression: an umbrella review of meta-analyses of observational studies and intervention trials. Nutr Rev 2023; 81:346-359. [PMID: 36240456 DOI: 10.1093/nutrit/nuac058] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
CONTEXT Depression is the most common causes of disease burden worldwide (GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392:1789-1858). OBJECTIVE An umbrella review has been performed to assess the strength and validity of the available observational and trial evidence for the association between a variety of dietary patterns and depression. DATA SOURCES MEDLINE/PubMed, Scopus, Web of Science, EMBASE, PsycINFO, and Cochrane Database were searched. DATA EXTRACTION The Joanna Briggs Institute Umbrella Review Methodology was used. DATA ANALYSIS The review included 19 articles, covering a relatively wide range of dietary patterns: healthy dietary patterns (n = 8), Mediterranean diet (MedDiet) (n = 6), Dietary Inflammatory Index (DII) (n = 5), Western diet (n = 4), Dietary Approaches to Stop Hypertension (DASH) (n = 2), vegetarian diets (n = 4), and other dietary interventions (n = 2). The methodological quality of the included meta-analyses was generally low or critically low. The strength of the evidence was generally weak, although convincing or suggestive evidence was found for an inverse relationship between MedDiet/DII and depression. Higher adherence to the MedDiet and lower DII score were significantly associated with lower risk of depression. CONCLUSION Considering the generally high heterogeneity and low quality of the available evidence, further studies adopting more coherent and uniform methodologies are needed. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42020223376.
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Affiliation(s)
- Vincenza Gianfredi
- are with the Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.,are with the CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands.,is with the Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Monica Dinu
- is with the Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Daniele Nucci
- is with the Nutritional Support Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Simone J P M Eussen
- are with the Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.,are with the CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands.,is with the Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
| | - Andrea Amerio
- is with the Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy.,is with the IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,is with the Department of Psychiatry, Tufts University, Boston, MA, USA
| | - Miranda T Schram
- are with the CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands.,are with the Department of Internal Medicine, Maastricht University, Maastricht, The Netherlands.,is with the MHeNS School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.,is with the Heart and Vascular Center, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Nicolaas Schaper
- are with the Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.,are with the CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands.,are with the Department of Internal Medicine, Maastricht University, Maastricht, The Netherlands
| | - Anna Odone
- is with the Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
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Solomou S, Logue J, Reilly S, Perez-Algorta G. A systematic review of the association of diet quality with the mental health of university students: implications in health education practice. HEALTH EDUCATION RESEARCH 2023; 38:28-68. [PMID: 36441584 PMCID: PMC9853940 DOI: 10.1093/her/cyac035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 10/13/2022] [Accepted: 10/31/2022] [Indexed: 06/16/2023]
Abstract
University students are at risk of experiencing mental health problems during the transition from home to university. This transition can also adversely affect their diet quality. This review aims to examine bidirectional associations from observational studies regarding the influence of diet quality on the mental health of university students, and vice versa. The databases PubMed, CINAHL, EMBASE, PsycINFO, The Cochrane Library and Web of Science were searched using relevant search terms. The searches were last updated on 15 July 2022. Majority of studies (36 out of 45) found that good diet quality of students was associated with better mental health in terms of depression, anxiety, stress and overall general mental well-being. Moreover, majority of studies (19 out of 23) found that stress and anxiety of students were associated with poorer diet quality. The effect sizes observed were generally small-moderate. Healthy diets of students have been associated with better mental health in terms of depression, anxiety, stress or other mental health issues. Stress experienced by university students has been associated with unhealthy diets. There are implications for health education research, as interventions to improve diet quality at the university level could reduce mental health issues; additionally, interventions to support students under stress may lead to healthier dietary habits when living on campuses. Randomized controlled trials and intervention studies are needed to further investigate these implications.
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Affiliation(s)
| | - Jennifer Logue
- Faculty of Health and Medicine, Lancaster University, Bailrigg, Lancaster LA1 4YW, UK
| | - Siobhan Reilly
- Faculty of Health and Medicine, Lancaster University, Bailrigg, Lancaster LA1 4YW, UK
- Faculty of Health Studies, University of Bradford, Richmond Road, Bradford, West Yorkshire BD7 1DP, UK
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21
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Dinu M, Lotti S, Napoletano A, Corrao A, Pagliai G, Tristan Asensi M, Gianfredi V, Nucci D, Colombini B, Sofi F. Association between Psychological Disorders, Mediterranean Diet, and Chronotype in a Group of Italian Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010335. [PMID: 36612656 PMCID: PMC9819730 DOI: 10.3390/ijerph20010335] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/21/2022] [Accepted: 12/22/2022] [Indexed: 05/30/2023]
Abstract
Mental health conditions are a significant contributor to the global burden of disease. The aim of this study was to explore the association between psychological disorders, Mediterranean diet (MD), and chronotype. A total of 344 participants (74% women) with a mean age of 33.5 ± 13 years were recruited. According to the Depression Anxiety Stress Scale (DASS-21) score, 22% of participants had symptoms of depression, 23% anxiety, and 10% stress. The assessment of MD adherence through the Medi-Lite score revealed that participants with psychological disorders had significantly (p < 0.05) lower MD adherence than those without these conditions. Furthermore, less than 10% of the subjects with at least one symptom reported consuming the optimal amount of fruit and vegetables, while 72% showed excessive consumption of meat and meat products. Regarding chronotype, evening subjects reported the lowest MD adherence and the highest prevalence of all three psychological disorders analyzed. A multivariate analysis showed that female gender, age, being unmarried/single, sedentary lifestyle, and low MD adherence were associated with a significantly higher risk of depression, anxiety, and stress. Future studies are needed to explore the relationship between mental health and risk factors to improve personal and global population health.
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Affiliation(s)
- Monica Dinu
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Sofia Lotti
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Antonia Napoletano
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Abigail Corrao
- Department of Human Science, Georgetown University, Washington, DC 20057, USA
| | - Giuditta Pagliai
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Marta Tristan Asensi
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Vincenza Gianfredi
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy
- CAPHRI Care and Public Health Research Institute, Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Daniele Nucci
- Nutritional Support Unit, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata, 64, 35128 Padua, Italy
| | - Barbara Colombini
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Francesco Sofi
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
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22
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Association between the Prime Diet Quality Score and depressive symptoms in a Mediterranean population with metabolic syndrome. Cross-sectional and 2-year follow-up assessment from PREDIMED-PLUS study. Br J Nutr 2022; 128:1170-1179. [PMID: 34713791 DOI: 10.1017/s0007114521004323] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The burden of depression is increasing worldwide, specifically in older adults. Unhealthy dietary patterns may partly explain this phenomenon. In the Spanish PREDIMED-Plus study, we explored (1) the cross-sectional association between the adherence to the Prime Diet Quality Score (PDQS), an a priori-defined high-quality food pattern, and the prevalence of depressive symptoms at baseline (cross-sectional analysis) and (2) the prospective association of baseline PDQS with changes in depressive symptomatology after 2 years of follow-up. After exclusions, we assessed 6612 participants in the cross-sectional analysis and 5523 participants in the prospective analysis. An energy-adjusted high-quality dietary score (PDQS) was assessed using a validated FFQ. The cross-sectional association between PDQS and the prevalence of depression or presence of depressive symptoms and the prospective changes in depressive symptoms were evaluated through multivariable regression models (logistic and linear models and mixed linear-effects models). PDQS was inversely associated with depressive status in the cross-sectional analysis. Participants in the highest quintile of PDQS (Q5) showed a significantly reduced odds of depression prevalence as compared to participants in the lowest quartile of PDQS (Q1) (OR (95 %) CI = 0·82 (0·68, 0·98))). The baseline prevalence of depression decreased across PDQS quintiles (Pfor trend = 0·015). A statistically significant association between PDQS and changes in depressive symptoms after 2-years follow-up was found (β (95 %) CI = -0·67 z-score (-1·17, -0·18). A higher PDQS was cross-sectionally related to a lower depressive status. Nevertheless, the null finding in our prospective analysis raises the possibility of reverse causality. Further prospective investigation is required to ascertain the association between PDQS and changes in depressive symptoms along time.
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23
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Aguilar-Latorre A, Pérez Algorta G, Navarro-Guzmán C, Serrano-Ripoll MJ, Oliván-Blázquez B. Effectiveness of a lifestyle modification programme in the treatment of depression symptoms in primary care. Front Med (Lausanne) 2022; 9:954644. [PMID: 35957845 PMCID: PMC9361711 DOI: 10.3389/fmed.2022.954644] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 07/07/2022] [Indexed: 11/19/2022] Open
Abstract
Background Depression symptoms are prevalent in the general population, and their onset and continuation may be related to biological and psychosocial factors, many of which are related to lifestyle aspects. Health promotion and lifestyle modification programmes (LMPs) may be effective on reducing the symptoms. The objective of this study was to analyse the clinical effectiveness of a LMP and a LMP plus Information and Communication Technologies, when compared to Treatment as Usual (TAU) over 6 months. The interventions were offered as an adjuvant treatment delivered in Primary Healthcare Centers (PHCs) for people with depression symptoms. Methods We conducted an open-label, multicentre, pragmatic, randomized clinical trial. Participants were recruited from several PHCs. Those participants visiting general practitioner for any reason, who also met the inclusion criteria (scoring 10 to 30 points on the Beck II Self-Applied Depression Inventory) were invited to take part in the study. TAU+LMP consisted of six weekly 90-min group sessions focused on improving lifestyle. TAU+LMP + ICTs replicated the TAU+LMP format, plus the addition of a wearable smartwatch to measure daily minutes walked and sleep patterns. A total of 188 participants consented to participate in the study and were randomized. We used linear mixed models, with a random intercept and an unstructured covariance to evaluate the impact of the interventions compared to TAU. Results Both interventions showed a statistically significant reduction on depressive symptoms compared to TAU (TAU+LMP vs. TAU slope difference, b = −3.38, 95% CI= [−5.286, −1.474] p = 0.001 and TAU+LMP+ICTs vs. TAU slope difference, b = −4.05, 95% CI = [−5.919, −2.197], p < 0.001). These reductions imply a moderate effect size. In the TAU+LMP+ICTs there was a significant increase regarding minutes walking per week (b = 99.77) and adherence to Mediterranean diet (b = 0.702). In the TAU+LMP there was a significant decrease regarding bad sleep quality (b = −1.24). Conclusion TAU+LMPs administered in PHCs to people experiencing depression symptoms were effective on reducing these symptoms compared to TAU. They also have a positive impact on changing several lifestyle factors. These findings indicate that these interventions can be promising strategies for PHCs.
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Affiliation(s)
- Alejandra Aguilar-Latorre
- Primary Healthcare Center Arrabal, Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
| | - Guillermo Pérez Algorta
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, United Kingdom
| | | | - María J. Serrano-Ripoll
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma, Spain
- Research in Preventive Activities and Promotion and in Cancer Illes Balears (GRAPP-CAIB), Balearic Islands Health Research Institute (IdISBa), Palma, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
- *Correspondence: María J. Serrano-Ripoll
| | - Bárbara Oliván-Blázquez
- Primary Healthcare Center Arrabal, Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
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24
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Tuck NJ, Farrow CV, Thomas JM. Frequency of fruit consumption and savoury snacking predict psychological health; selective mediation via cognitive failures. Br J Nutr 2022; 129:1-26. [PMID: 35616008 PMCID: PMC9899573 DOI: 10.1017/s0007114522001660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 04/29/2022] [Accepted: 05/18/2022] [Indexed: 11/06/2022]
Abstract
While there is growing interest in the link between diet and psychological health, there is a surprising lack of studies investigating the precise associations between nutrient-rich foods (such as fruit and vegetables) versus nutrient-poor foods (such as energy-dense savoury and sweet snacks), and psychological health. Similarly, the psychological processes underpinning the relationship between dietary intake and psychological health remain unclear. Hence, the present study aimed to explore the relationship between dietary consumption and psychological health, with cognitive processes as a theoretical mediator. This cross-sectional online study included 428 healthy adults (53% female; mean age= 39.7, SD= 13.0), with participants completing a range of validated questionnaires measuring dietary habits and psychological health. Stepwise multiple regression revealed that more frequent consumption of fruit was associated with reduced symptoms of depression (β = -.109, p = 0.025) and greater positive psychological wellbeing (β = .187, p < 0.001). Conversely, more frequent savoury snacking was associated with increased anxiety (β = .127, p = 0.005). Further, mediation analyses revealed that more frequent consumption of savoury snacks was associated with increased symptoms of depression, stress, anxiety, and reduced psychological wellbeing, via an increase in cognitive failures (ps < 0.001). These results provide new insights on the independent associations between certain types of food and psychological health, and the psychological mechanisms that may mediate these. Further work is now required to establish causality and determine whether these may represent modifiable dietary targets that can directly (and indirectly) influence our psychological health.
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25
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Metri NJ, Ee C, Wardle J, Ng CH, Siskind D, Brakoulias V, Ho FYY, Wong VWH, Naidoo U, Eaton M, Firth J, Sarris J. Assessing dietary, exercise, and non-pharmacological modalities within psychiatric hospitals. Gen Hosp Psychiatry 2022; 76:31-35. [PMID: 35358900 DOI: 10.1016/j.genhosppsych.2022.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Najwa-Joelle Metri
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia.
| | - Carolyn Ee
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia
| | - Jon Wardle
- National Centre for Naturopathic Medicine, Southern Cross University, Lismore, NSW, Australia
| | - Chee H Ng
- Professorial Unit, The Melbourne Clinic, Department of Psychiatry, The University of Melbourne, Richmond, Victoria, Australia
| | - Dan Siskind
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Vlasios Brakoulias
- Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia; Western Sydney Local Health District Mental Health Services, Sydney, NSW, Australia
| | - Fiona Yan-Yee Ho
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong
| | | | - Uma Naidoo
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Melissa Eaton
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia; School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia
| | - Joseph Firth
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia; Division of Psychology & Mental Health, The University of Manchester, Manchester, UK
| | - Jerome Sarris
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia; Professorial Unit, The Melbourne Clinic, Department of Psychiatry, The University of Melbourne, Richmond, Victoria, Australia; Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia
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26
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Marx W, Lane MM, Hockey M, Aslam H, Walder K, Borsini A, Firth J, Pariante CM, Berding K, Cryan JF, Clarke G, Craig JM, Su KP, Mischoulon D, Gomez-Pinilla F, Foster JA, Cani PD, Thuret S, Staudacher HM, Sánchez-Villegas A, Arshad H, Akbaraly T, O'Neil A, Jacka FN. Diet and depression: future needs to unlock the potential. Mol Psychiatry 2022; 27:778-780. [PMID: 34754110 DOI: 10.1038/s41380-021-01360-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/03/2021] [Accepted: 10/08/2021] [Indexed: 11/09/2022]
Affiliation(s)
- Wolfgang Marx
- IMPACT (The Institute for Mental and Physical Health and Clinical Translation), Food and Mood Centre, Deakin University, Geelong, VIC, Australia.
| | - Melissa M Lane
- IMPACT (The Institute for Mental and Physical Health and Clinical Translation), Food and Mood Centre, Deakin University, Geelong, VIC, Australia
| | - Meghan Hockey
- IMPACT (The Institute for Mental and Physical Health and Clinical Translation), Food and Mood Centre, Deakin University, Geelong, VIC, Australia
| | - Hajara Aslam
- IMPACT (The Institute for Mental and Physical Health and Clinical Translation), Food and Mood Centre, Deakin University, Geelong, VIC, Australia
| | - Ken Walder
- IMPACT (The Institute for Mental and Physical Health and Clinical Translation), Metabolic Research Unit, Deakin University, Geelong, VIC, Australia
| | - Alessandra Borsini
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK.,NICM Health Research Institute, Western Sydney University, Westmead, NSW, Australia
| | - Carmine M Pariante
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Kirsten Berding
- APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - John F Cryan
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - Gerard Clarke
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Department of Psychiatry and Neurobehavioural Science, University College Cork, Cork, Ireland.,INFANT Research Centre, University College Cork, Cork, Ireland
| | - Jeffrey M Craig
- IMPACT (The Institute for Mental and Physical Health and Clinical Translation), Metabolic Research Unit, Deakin University, Geelong, VIC, Australia
| | - Kuan-Pin Su
- Departments of Psychiatry and Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung, Taiwan.,An-Nan Hospital, China Medical University, Tainan, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan
| | - David Mischoulon
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Fernando Gomez-Pinilla
- Departments of Neurosurgery and Integrative Biology and Physiology, University of California Los Angeles, Los Angeles, CA, USA
| | - Jane A Foster
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Patrice D Cani
- WELBIO- Walloon Excellence in Life Sciences and BIOtechnology, Metabolism and Nutrition Research Group, Louvain Drug Research Institute, UCLouvain, Université catholique de Louvain, Brussels, Belgium
| | - Sandrine Thuret
- Basic and Clinical Neuroscience Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Heidi M Staudacher
- IMPACT (The Institute for Mental and Physical Health and Clinical Translation), Food and Mood Centre, Deakin University, Geelong, VIC, Australia
| | - Almudena Sánchez-Villegas
- Nutrition Research Group, Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas, Spain.,Biomedical Research Center Network on Obesity and Nutrition (CIBERobn), Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain
| | - Husnain Arshad
- Université Paris-Saclay, UVSQ, Inserm, CESP, "DevPsy", 94807, Villejuif, France
| | - Tasnime Akbaraly
- Université Paris-Saclay, UVSQ, Inserm, CESP, "DevPsy", 94807, Villejuif, France.,Department of Epidemiology and Public Health, University College London, London, UK
| | - Adrienne O'Neil
- IMPACT (The Institute for Mental and Physical Health and Clinical Translation), Food and Mood Centre, Deakin University, Geelong, VIC, Australia
| | - Felice N Jacka
- IMPACT (The Institute for Mental and Physical Health and Clinical Translation), Food and Mood Centre, Deakin University, Geelong, VIC, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Black Dog Institute, Sydney, NSW, Australia.,James Cook University, Townsville, QLD, Australia
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27
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28
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Bonaccio M, Costanzo S, Bracone F, Gialluisi A, Di Castelnuovo A, Ruggiero E, Esposito S, Olivieri M, Persichillo M, Cerletti C, Donati MB, de Gaetano G, Iacoviello L. Psychological distress resulting from the COVID-19 confinement is associated with unhealthy dietary changes in two Italian population-based cohorts. Eur J Nutr 2021; 61:1491-1505. [PMID: 34846604 PMCID: PMC8631258 DOI: 10.1007/s00394-021-02752-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 11/20/2021] [Indexed: 02/02/2023]
Abstract
Purpose To examine the relationship between psychological distress resulting from the COVID-19 lockdown and dietary changes. Methods Cross-sectional analysis from 2 retrospective Italian cohorts recruited from May to September 2020: (1) The Moli-LOCK cohort consists of 1401 participants from the Moli-sani Study (n = 24,325) who were administered a telephone-based questionnaire to assess lifestyles and psychological factors during confinement; (2) the ALT RISCOVID-19 is a web-based survey of 1340 individuals distributed throughout Italy who self-responded to the same questionnaire using Google® forms. Psychological distress was measured by assessments of depression (PHQ-9 and depressive items from the Screening Questionnaire for Disaster Mental Health- SQD-D), anxiety (GAD-7), stress (PSS-4), and post-traumatic stress disorder (SQD-P). Diet quality was assessed either as changes in consumption of ultra-processed foods (UPF) or adherence to Mediterranean diet (MD). Results In ALT RISCOVID-19, increased UPF intake was directly associated with depression (both PHQ-9 and SQD-D; p < 0.0001), anxiety (p < 0.0001), stress (p = 0.001) and SQD-P (p = 0.001); similar results were obtained in the Moli-LOCK cohort except for perceived stress. When psychometric scales were analysed simultaneously, only depression (SQD-D) remained associated with UPF (both cohorts). In both cohorts, psychological distress poorly influenced changes toward an MD, except for depression (SQD-D) that resulted inversely associated in the ALT RISCOVID-19 participants (β = − 0.16; 95% CI − 0.26, − 0.06). Conclusions Psychological distress from the COVID-19 confinement is directly associated with unhealthy dietary modifications in two Italian cohorts. In view of possible future restrictive measures to contain pandemic, public health actions are warranted to mitigate the impact of psychological distress on diet quality. Supplementary Information The online version contains supplementary material available at 10.1007/s00394-021-02752-4.
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Affiliation(s)
- Marialaura Bonaccio
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Via dell'Elettronica, 86077, Pozzilli, IS, Italy.
| | - Simona Costanzo
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Via dell'Elettronica, 86077, Pozzilli, IS, Italy
| | - Francesca Bracone
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Via dell'Elettronica, 86077, Pozzilli, IS, Italy
| | - Alessandro Gialluisi
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Via dell'Elettronica, 86077, Pozzilli, IS, Italy
| | | | - Emilia Ruggiero
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Via dell'Elettronica, 86077, Pozzilli, IS, Italy
| | - Simona Esposito
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Via dell'Elettronica, 86077, Pozzilli, IS, Italy
| | | | - Mariarosaria Persichillo
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Via dell'Elettronica, 86077, Pozzilli, IS, Italy
| | - Chiara Cerletti
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Via dell'Elettronica, 86077, Pozzilli, IS, Italy
| | - Maria Benedetta Donati
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Via dell'Elettronica, 86077, Pozzilli, IS, Italy
| | - Giovanni de Gaetano
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Via dell'Elettronica, 86077, Pozzilli, IS, Italy
| | - Licia Iacoviello
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Via dell'Elettronica, 86077, Pozzilli, IS, Italy.,Department of Medicine and Surgery, Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese, Italy
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Davila-Torres DM, Vilcas-Solís GE, Rodríguez-Vásquez M, Calizaya-Milla YE, Saintila J. Eating habits and mental health among rugby players of the Peruvian pre-selection during the second quarantine due to the COVID-19 pandemic. SAGE Open Med 2021; 9:20503121211043718. [PMID: 34504708 PMCID: PMC8423319 DOI: 10.1177/20503121211043718] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 08/15/2021] [Indexed: 11/23/2022] Open
Abstract
Objectives: Social isolation during the COVID-19 pandemic impacts the mental health and
diet of populations. Aim: The aim of the study was to evaluate whether the eating habits and mental
health status of the rugby players of the Peruvian pre-selection were
affected by the second quarantine of the COVID-19 pandemic. Methods: A cross-sectional study was carried out through a pre-structured online
survey in 74 players, 42 men (56.8%) and 32 women (43.2%). The mean age was
20.5 ± 4.4 years. Participants completed a validated food frequency
questionnaire and depression, anxiety, and stress scale-21 (DASS-21). Results: 58.1% of the respondents reported that their dietary intake remained the same
or increased. 58.3% of the players experienced anxiety, among which 26.4%
reported moderate and severe symptoms. A greater proportion of participants
<20 years old reported depression compared to those ⩾20 years (68.6% vs
31.4%, p = 0.010). Those who reported inadequate food
intake were more likely to report depressive symptoms (p =
0.006). Conclusion: These findings reaffirm the need to implement programs of psychological
support and nutritional counseling among athletes to reduce negative
symptoms and better face mental health and dietary challenges in these times
of crisis.
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Affiliation(s)
- Diego M Davila-Torres
- Escuela de Nutrición Humana, Facultad de Ciencias de la Salud, Universidad Peruana Unión, Lima, Perú
| | - Gabriela E Vilcas-Solís
- Escuela de Nutrición Humana, Facultad de Ciencias de la Salud, Universidad Peruana Unión, Lima, Perú
| | - Mery Rodríguez-Vásquez
- Escuela de Nutrición Humana, Facultad de Ciencias de la Salud, Universidad Peruana Unión, Lima, Perú
| | - Yaquelin E Calizaya-Milla
- Escuela de Nutrición Humana, Facultad de Ciencias de la Salud, Universidad Peruana Unión, Lima, Perú.,Grupo de Investigación en Nutrición y Estilo de Vida (GINEV), Escuela de Nutrición Humana, Universidad Peruana Unión, Lima, Perú
| | - Jacksaint Saintila
- Escuela de Nutrición Humana, Facultad de Ciencias de la Salud, Universidad Peruana Unión, Lima, Perú.,Grupo de Investigación en Nutrición y Estilo de Vida (GINEV), Escuela de Nutrición Humana, Universidad Peruana Unión, Lima, Perú
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30
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Yoon YS, Oh SW. Relationship between psychological distress and the adherence to the Korean healthy eating index (KHEI): the Korea National Health and Nutrition Examination Survey (KNHANES) 2013 and 2015. Nutr Res Pract 2021; 15:516-527. [PMID: 34349884 PMCID: PMC8313388 DOI: 10.4162/nrp.2021.15.4.516] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 08/31/2020] [Accepted: 10/01/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND/OBJECTIVES This study examined the association of depressive symptoms, stress perception, and suicidal ideation with overall dietary quality using the newly developed Korean healthy eating index (KHEI). SUBJECTS/METHODS This study included 9,607 adults (3,939 men and 5,668 women, ≥ 19 years) who participated in the 6th Korea National Health and Nutrition Examination Survey 2013 and 2015. The KHEI scores were calculated using the food frequency questionnaire data. Survey logistic regression analyses were performed to analyze the association between psychiatric distress and dietary quality. RESULTS The percentage of subjects with experience of depressive mood, higher stress perception, and suicidal ideation was 8.2%, 25.0%, and 3.7% in men and 15.4%, 27.3%, and 6.0% in women, respectively. The mean KHEI score was 61.5 ± 0.29 in men and 64.8 ± 0.24 in women (P < 0.001). The present study found a difference in the adherence to specific dietary components of the KHEI between sexes. Men experiencing depressive symptoms were less likely to eat meat, fish, eggs, and beans, while depressed women showed lower vegetable intake. Both men and women with suicidal ideation showed a lower intake of vegetables. The men with stress had a lower breakfast eating score than those without stress (7.21 vs. 6.77, P = 0.016). The multivariate-adjusted odds ratios for depressive symptoms, stress perception, and the suicidal idea in women with the highest quartile of KHEI scores compared to the lowest quartile was 0.69 (95% confidence interval, 0.51-0.92), 0.73 (0.58-0.82), and 0.52 (0.33-0.82), respectively and significant dose-response associations were observed (P for trends < 0.05 for all). On the other hand, these associations were not observed in men after adjusting for the confounding variables (P for trends > 0.05 for all). CONCLUSIONS Poor adherence to dietary recommendations is associated with psychological distress, especially in women.
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Affiliation(s)
- Yeong Sook Yoon
- Department of Family Medicine, Inje University Ilsan Paik Hospital, Goyang 10380, Korea
| | - Sang Woo Oh
- Department of Family Medicine, Center for Obesity, Metabolism, and Nutrition, Dongguk University Ilsan Hospital, Goyang 10326, Korea
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Guzek D, Głąbska D, Groele B, Gutkowska K. Fruit and Vegetable Dietary Patterns and Mental Health in Women: A Systematic Review. Nutr Rev 2021; 80:1357-1370. [PMID: 34041545 PMCID: PMC9086786 DOI: 10.1093/nutrit/nuab007] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
CONTEXT Mental health may be influenced by some dietary patterns. Among common elements of beneficial patterns is high fruit and vegetable intake. However, no systematic review has been conducted to date, to our knowledge, that has assessed the influence of fruit and vegetable dietary patterns on a broad spectrum of mental health. OBJECTIVE We conducted a systematic review, using the PRISMA guidelines, of the observational studies analyzing the association between the dietary pattern of fruit and vegetables and the broad aspects of mental health in adult women. DATA SOURCES The databases PubMed and Web of Science were searched, and additional manual search for observational peer-reviewed studies was conducted for studies published until June 2019. DATA EXTRACTION A total of 5911 studies were extracted and verified based on title and abstract for the inclusion criteria. All procedures were conducted independently by 2 researchers. The final number of included studies was 30. The review was structured around the type of observed outcome. DATA ANALYSIS The included studies had defined habitual intake associated with dietary patterns with the intake of specific fruit and/or vegetables, and/or fruit or vegetable products (eg, juices), as well as any aspect of the broad spectrum of general mental health. The Newcastle-Ottawa Scale was used to assess bias. The observed association was not stated in all the included studies; some of them revealed a reverse relationship, but only for the vegetarian/vegan diet. A vegetarian diet may be characterized by high consumption of fruits and vegetables, but it sometimes may not be properly balanced, due to excluded products. This may be the reason of observed situation. CONCLUSIONS A general positive influence was observed for the dietary patterns characterized by high consumption of fruit and vegetables and of fruit or vegetable products by women. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42019138148.
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Affiliation(s)
- Dominika Guzek
- D. Guzek and K. Gutkowska are with the Department of Food Market and Consumer Research, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences, Warsaw, Poland. D. Głąbska and B. Groele are with the Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences, Warsaw, Poland
| | - Dominika Głąbska
- D. Guzek and K. Gutkowska are with the Department of Food Market and Consumer Research, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences, Warsaw, Poland. D. Głąbska and B. Groele are with the Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences, Warsaw, Poland
| | - Barbara Groele
- D. Guzek and K. Gutkowska are with the Department of Food Market and Consumer Research, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences, Warsaw, Poland. D. Głąbska and B. Groele are with the Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences, Warsaw, Poland
| | - Krystyna Gutkowska
- D. Guzek and K. Gutkowska are with the Department of Food Market and Consumer Research, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences, Warsaw, Poland. D. Głąbska and B. Groele are with the Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences, Warsaw, Poland
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Associations of Dietary Patterns with Incident Depression: The Maastricht Study. Nutrients 2021; 13:nu13031034. [PMID: 33806882 PMCID: PMC8004955 DOI: 10.3390/nu13031034] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/11/2021] [Accepted: 03/19/2021] [Indexed: 12/14/2022] Open
Abstract
Our aim was to assess the association between a priori defined dietary patterns and incident depressive symptoms. We used data from The Maastricht Study, a population-based cohort study (n = 2646, mean (SD) age 59.9 (8.0) years, 49.5% women; 15,188 person-years of follow-up). Level of adherence to the Dutch Healthy Diet (DHD), Mediterranean Diet, and Dietary Approaches To Stop Hypertension (DASH) were derived from a validated Food Frequency Questionnaire. Depressive symptoms were assessed at baseline and annually over seven-year-follow-up (using the 9-item Patient Health Questionnaire). We used Cox proportional hazards regression analyses to assess the association between dietary patterns and depressive symptoms. One standard deviation (SD) higher adherence in the DHD and DASH was associated with a lower hazard ratio (HR) of depressive symptoms with HRs (95%CI) of 0.78 (0.69–0.89) and 0.87 (0.77–0.98), respectively, after adjustment for sociodemographic and cardiovascular risk factors. After further adjustment for lifestyle factors, the HR per one SD higher DHD was 0.83 (0.73–0.96), whereas adherence to Mediterranean and DASH diets was not associated with incident depressive symptoms. Higher adherence to the DHD lowered risk of incident depressive symptoms. Adherence to healthy diet could be an effective non-pharmacological preventive measure to reduce the incidence of depression.
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Patsalos O, Keeler J, Schmidt U, Penninx BWJH, Young AH, Himmerich H. Diet, Obesity, and Depression: A Systematic Review. J Pers Med 2021; 11:jpm11030176. [PMID: 33802480 PMCID: PMC7999659 DOI: 10.3390/jpm11030176] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/19/2021] [Accepted: 02/24/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Obesity and depression co-occur in a significant proportion of the population. Mechanisms linking the two disorders include the immune and the endocrine system, psychological and social mechanisms. The aim of this systematic review was to ascertain whether weight loss through dietary interventions has the additional effect of ameliorating depressive symptoms in obese patients. METHODS We systematically searched three databases (Pubmed, Medline, Embase) for longitudinal clinical trials testing a dietary intervention in people with obesity and depression or symptoms of depression. RESULTS Twenty-four longitudinal clinical studies met the eligibility criteria with a total of 3244 included patients. Seventeen studies examined the effects of calorie-restricted diets and eight studies examined dietary supplements (two studies examined both). Only three studies examined people with a diagnosis of both obesity and depression. The majority of studies showed that interventions using a calorie-restricted diet resulted in decreases in depression scores, with effect sizes between ≈0.2 and ≈0.6. The results were less clear for dietary supplements. CONCLUSIONS People with obesity and depression appear to be a specific subgroup of depressed patients in which calorie-restricted diets might constitute a promising personalized treatment approach. The reduction of depressive symptoms may be related to immunoendocrine and psychosocial mechanisms.
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Affiliation(s)
- Olivia Patsalos
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK; (O.P.); (J.K.); (U.S.); (A.H.Y.)
| | - Johanna Keeler
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK; (O.P.); (J.K.); (U.S.); (A.H.Y.)
| | - Ulrike Schmidt
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK; (O.P.); (J.K.); (U.S.); (A.H.Y.)
- South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK
| | - Brenda W. J. H. Penninx
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, 1081 BT Amsterdam, The Netherlands;
| | - Allan H. Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK; (O.P.); (J.K.); (U.S.); (A.H.Y.)
- South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK
| | - Hubertus Himmerich
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK; (O.P.); (J.K.); (U.S.); (A.H.Y.)
- South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK
- Correspondence:
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Dietary Patterns are Differentially Associated with Atypical and Melancholic Subtypes of Depression. Nutrients 2021; 13:nu13030768. [PMID: 33653007 PMCID: PMC7996872 DOI: 10.3390/nu13030768] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/05/2021] [Accepted: 02/24/2021] [Indexed: 01/05/2023] Open
Abstract
Diet has been associated with the risk of depression, whereas different subtypes of depression have been linked with different cardiovascular risk factors (CVRFs). In this study, our aims were to (1) identify dietary patterns with exploratory factor analysis, (2) assess cross-sectional associations between dietary patterns and depression subtypes, and (3) examine the potentially mediating effect of dietary patterns in the associations between CVRFs and depression subtypes. In the first follow-up of the population-based CoLaus|PsyCoLaus study (2009–2013, 3554 participants, 45.6% men, mean age 57.5 years), a food frequency questionnaire assessed dietary intake and a semi-structured interview allowed to characterize major depressive disorder into current or remitted atypical, melancholic, and unspecified subtypes. Three dietary patterns were identified: Western, Mediterranean, and Sweet-Dairy. Western diet was positively associated with current atypical depression, but negatively associated with current and remitted melancholic depression. Sweet-Dairy was positively associated with current melancholic depression. However, these dietary patterns did not mediate the associations between CVRFs and depression subtypes. Hence, although we could show that people with different subtypes of depression make different choices regarding their diet, it is unlikely that these differential dietary choices account for the well-established associations between depression subtypes and CVRFs.
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Nikolac Perkovic M, Sagud M, Tudor L, Konjevod M, Svob Strac D, Pivac N. A Load to Find Clinically Useful Biomarkers for Depression. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1305:175-202. [PMID: 33834401 DOI: 10.1007/978-981-33-6044-0_11] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Depression is heterogeneous and complex disease with diverse symptoms. Its neurobiological underpinning is still not completely understood. For now, there are still no validated, easy obtainable, clinically useful noninvasive biomarker(s) or biomarker panel that will be able to confirm a diagnosis of depression, its subtypes and improve diagnostic procedures. Future multimodal preclinical and clinical research that involves (epi)genetic, molecular, cellular, imaging, and other studies is necessary to advance our understanding of the role of monoamines, GABA, HPA axis, neurotrophins, metabolome, and glycome in the pathogenesis of depression and their potential as diagnostic, prognostic, and treatment response biomarkers. These studies should be focused to include the first-episode depression and antidepressant drug-naïve patients with large sample sizes to reduce variability in different biological and clinical parameters. At present, metabolomics study revealed with high precision that a neurometabolite panel consisting of plasma metabolite biomarkers (GABA, dopamine, tyramine, kynurenine) might represent clinically useful biomarkers of MDD.
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Affiliation(s)
- Matea Nikolac Perkovic
- Division of Molecular Medicine, Laboratory for Molecular Neuropsychiatry, Rudjer Boskovic Institute, Zagreb, Croatia
| | - Marina Sagud
- University of Zagreb School of Medicine, Zagreb, Croatia
- Department of Psychiatry, University Hospital Center Zagreb, Zagreb, Croatia
| | - Lucija Tudor
- Division of Molecular Medicine, Laboratory for Molecular Neuropsychiatry, Rudjer Boskovic Institute, Zagreb, Croatia
| | - Marcela Konjevod
- Division of Molecular Medicine, Laboratory for Molecular Neuropsychiatry, Rudjer Boskovic Institute, Zagreb, Croatia
| | - Dubravka Svob Strac
- Division of Molecular Medicine, Laboratory for Molecular Neuropsychiatry, Rudjer Boskovic Institute, Zagreb, Croatia
| | - Nela Pivac
- Division of Molecular Medicine, Laboratory for Molecular Neuropsychiatry, Rudjer Boskovic Institute, Zagreb, Croatia.
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Diet Quality and Sociodemographic, Lifestyle, and Health-Related Determinants among People with Depression in Spain: New Evidence from a Cross-Sectional Population-Based Study (2011-2017). Nutrients 2020; 13:nu13010106. [PMID: 33396825 PMCID: PMC7823268 DOI: 10.3390/nu13010106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 12/23/2020] [Accepted: 12/27/2020] [Indexed: 12/21/2022] Open
Abstract
The role of diet quality in depression is an emerging research area and it appears that diet quality could be an important modifying factor. The aims of this study were to report the prevalence of diet quality among individuals with and without a self-reported diagnosis of depression aged from 16 to 64 years old in Spain, to analyze the time trends of the frequency of food consumption and diet quality from 2011 to 2017 in individuals with a self-reported diagnosis of depression, and to explore the associations between poor/improvable diet quality and sociodemographic, lifestyle, and health-related factors. A nationwide cross-sectional study was conducted in 42,280 participants with and without a self-reported diagnosis of depression who had participated in the 2011/2012 and 2017 Spanish National Health Surveys and the 2014 European Health Survey in Spain. A logistic regression analysis was performed to identify the variables associated with diet quality. The overall prevalence of diet quality among depressive and non-depressive individuals revealed 65.71% and 70.27% were in need of improvement, respectively. Moreover, having a poor or improvable diet quality is associated with male gender, people aged 16-24 years old and 25-44 years old, separated or divorced, and also in smokers.
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Firth J, Solmi M, Wootton RE, Vancampfort D, Schuch FB, Hoare E, Gilbody S, Torous J, Teasdale SB, Jackson SE, Smith L, Eaton M, Jacka FN, Veronese N, Marx W, Ashdown-Franks G, Siskind D, Sarris J, Rosenbaum S, Carvalho AF, Stubbs B. A meta-review of "lifestyle psychiatry": the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders. World Psychiatry 2020; 19:360-380. [PMID: 32931092 PMCID: PMC7491615 DOI: 10.1002/wps.20773] [Citation(s) in RCA: 375] [Impact Index Per Article: 93.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
There is increasing academic and clinical interest in how "lifestyle factors" traditionally associated with physical health may also relate to mental health and psychological well-being. In response, international and national health bodies are producing guidelines to address health behaviors in the prevention and treatment of mental illness. However, the current evidence for the causal role of lifestyle factors in the onset and prognosis of mental disorders is unclear. We performed a systematic meta-review of the top-tier evidence examining how physical activity, sleep, dietary patterns and tobacco smoking impact on the risk and treatment outcomes across a range of mental disorders. Results from 29 meta-analyses of prospective/cohort studies, 12 Mendelian randomization studies, two meta-reviews, and two meta-analyses of randomized controlled trials were synthesized to generate overviews of the evidence for targeting each of the specific lifestyle factors in the prevention and treatment of depression, anxiety and stress-related disorders, schizophrenia, bipolar disorder, and attention-deficit/hyperactivity disorder. Standout findings include: a) convergent evidence indicating the use of physical activity in primary prevention and clinical treatment across a spectrum of mental disorders; b) emerging evidence implicating tobacco smoking as a causal factor in onset of both common and severe mental illness; c) the need to clearly establish causal relations between dietary patterns and risk of mental illness, and how diet should be best addressed within mental health care; and d) poor sleep as a risk factor for mental illness, although with further research required to understand the complex, bidirectional relations and the benefits of non-pharmacological sleep-focused interventions. The potentially shared neurobiological pathways between multiple lifestyle factors and mental health are discussed, along with directions for future research, and recommendations for the implementation of these findings at public health and clinical service levels.
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Affiliation(s)
- Joseph Firth
- Division of Psychology and Mental Health, Faculty of Biology, Medicine & Health, University of Manchester, Manchester, UK
- NICM Health Research Institute, Western -Sydney University, Westmead, NSW, Australia
| | - Marco Solmi
- Department of Neurosciences, University of Padua, Padua, Italy
| | - Robyn E Wootton
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
- University Psychiatric Centre KU Leuven, Kortenberg, Belgium
| | - Felipe B Schuch
- Department of Sports Methods and -Techniques, Federal University of Santa Maria, Santa Maria, Brazil
| | - Erin Hoare
- UKCRC Centre for Diet and Activity Research (CEDAR) and MRC Epidemiology Unit, University of -Cambridge, Cambridge, UK
| | - Simon Gilbody
- Mental Health and Addictions Research Group, Department of Health Sciences, University of York, York, UK
| | - John Torous
- Department of Psychiatry, Beth Israel Deaconess Medical Canter, Harvard Medical School, Boston, MA, USA
| | - Scott B Teasdale
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, -Australia
| | - Sarah E Jackson
- Department of Behavioural Science and Health, University College London, London, UK
| | - Lee Smith
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, -Cambridge, UK
| | - Melissa Eaton
- NICM Health Research Institute, Western -Sydney University, Westmead, NSW, Australia
| | - Felice N Jacka
- Food & Mood Centre, IMPACT - Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, VIC, Australia
| | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Wolfgang Marx
- Food & Mood Centre, IMPACT - Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, VIC, Australia
| | - Garcia Ashdown-Franks
- Department of Exercise Sciences, University of Toronto, Toronto, ON, Canada
- South London and Maudsley NHS Foundation Trust, London, UK
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Dan Siskind
- Metro South Addiction and Mental Health Service, Brisbane, QLD, Australia
- School of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Jerome Sarris
- NICM Health Research Institute, Western -Sydney University, Westmead, NSW, Australia
- Department of Psychiatry, University of Melbourne, The Melbourne Clinic, Melbourne, VIC, Australia
| | - Simon Rosenbaum
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, -Australia
| | - André F Carvalho
- Centre for Addiction & Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Brendon Stubbs
- South London and Maudsley NHS Foundation Trust, London, UK
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Thomas-Odenthal F, Molero P, van der Does W, Molendijk M. Impact of review method on the conclusions of clinical reviews: A systematic review on dietary interventions in depression as a case in point. PLoS One 2020; 15:e0238131. [PMID: 32936801 PMCID: PMC7494108 DOI: 10.1371/journal.pone.0238131] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 08/09/2020] [Indexed: 02/06/2023] Open
Abstract
Background The recommendations of experts who write review articles are a critical determinant of the adaptation of new treatments by clinicians. Several types of reviews exist (narrative, systematic, meta-analytic), and some of these are more vulnerable to researcher bias than others. Recently, the interest in nutritional interventions in psychiatry has increased and many experts, who are often active researchers on this topic, have come to strong conclusions about the benefits of a healthy diet on depression. In a young and active field of study, we aimed to investigate whether the strength of an author’s conclusion is associated with the type of review article they wrote. Methods Systematic searches were performed in PubMed, Web of Science, Cochrane Database of Systematic Reviews, and Google Scholar for narrative reviews and systematic reviews with and without meta-analyses on the effects of diet on depression (final search date: May 30th, 2020). Conclusions were extracted from the abstract and discussion section and rated as strong, moderate, or weak by independent raters who were blind to study type. A benchmark on legitimate conclusion strength was based on a GRADE assessment of the highest level of evidence. This systematic review was registered with PROSPERO, number CRD42020141372. Findings 24 narrative reviews, 12 systematic reviews, and 14 meta-analyses were included. In the abstract, 33% of narrative reviews and 8% of systematic reviews came to strong conclusions, whereas no meta-analysis did. Narrative reviews were 8.94 (95% CI: 2.17, 36.84) times more likely to report stronger conclusions in the abstract than systematic reviews with and without meta-analyses. These findings were similar for conclusions in the discussion section. Narrative reviews used 45.6% fewer input studies and were more likely to be written by authors with potential conflicts of interest. A study limitation is the subjective nature of the conclusion classification system despite high inter-rater agreements and its confirmation outside of the review team. Conclusions We have shown that narrative reviews come to stronger conclusions about the benefits of a healthy diet on depression despite inconclusive evidence. This finding empirically underscores the importance of a systematic method for summarizing the evidence of a field of study. Journal editors may want to reconsider publishing narrative reviews before meta-analytic reviews are available.
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Affiliation(s)
- Florian Thomas-Odenthal
- Clinical Psychology Department, Leiden University, Leiden, The Netherlands
- * E-mail: (FTO); (MM)
| | - Patricio Molero
- Department of Psychiatry and Medical Psychology, University of Navarra, Pamplona, Spain
| | - Willem van der Does
- Clinical Psychology Department, Leiden University, Leiden, The Netherlands
- Leiden University Treatment and Expertise Center LUBEC, Leiden, The Netherlands
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
- Leiden Institute of Brain and Cognition LIBC, Leiden University Medical Center, Leiden, The Netherlands
| | - Marc Molendijk
- Clinical Psychology Department, Leiden University, Leiden, The Netherlands
- Leiden Institute of Brain and Cognition LIBC, Leiden University Medical Center, Leiden, The Netherlands
- * E-mail: (FTO); (MM)
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Owens M, Watkins E, Bot M, Brouwer IA, Roca M, Kohls E, Penninx B, van Grootheest G, Cabout M, Hegerl U, Gili M, Visser M. Acceptability and feasibility of two interventions in the MooDFOOD Trial: a food-related depression prevention randomised controlled trial in overweight adults with subsyndromal symptoms of depression. BMJ Open 2020; 10:e034025. [PMID: 32933954 PMCID: PMC7493122 DOI: 10.1136/bmjopen-2019-034025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVES We report on the acceptability, feasibility, dose-response relationship and adherence of two nutritional strategies to improve mood (multinutrient supplements; food-related behavioural activation (F-BA)) studied in a randomised controlled depression prevention trial (the Multi-country cOllaborative project on the rOle of Diet, Food-related behaviour, and Obesity in the prevention of Depression (MooDFOOD) Trial). We also assessed baseline determinants of adherence and assessed whether better adherence resulted in lower depressive symptoms. DESIGN Randomised controlled trial with a 2×2 factorial design conducted between 2015 and 2017. SETTING Germany, the Netherlands, UK and Spain. PARTICIPANTS Community sample of 1025 overweight adults with elevated depressive symptoms without a current episode of major depressive disorder. Main eligibility criteria included age (18-75 years), being overweight or obese, and having at least mild depressive symptoms, shown by a Patient Health Questionnaire Score of ≥5. A total of 76% of the sample was retained at the 12-month follow-up. INTERVENTIONS Daily nutritional supplements versus pill placebo or an F-BA therapy, delivered in individual and group sessions versus no behavioural intervention over a 1-year period. PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcome: self-reported acceptability of the interventions. SECONDARY OUTCOMES adherence and self-reported depressive symptoms. RESULTS Most participants reported that the F-BA was acceptable (83.61%), feasible to do (65.91%) and would recommend it to a friend (84.57%). Individual F-BA sessions (88.10%) were significantly more often rated as positive than group F-BA sessions (70.17%) and supplements (28.59%). There were statistically significant reductions in depressive symptoms for those who both adhered to the F-BA intervention and had a history of depression (B=-0.08, SE=0.03, p=0.012) versus those who had no history of depression. Supplement intake had no effect on depressive symptoms irrespective of adherence. CONCLUSIONS F-BA may have scope for development as a depression prevention intervention and public health strategy but further refinement and testing are needed. TRIAL REGISTRATION NUMBER NCT02529423.
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Affiliation(s)
- Matthew Owens
- Department of Psychology, University of Exeter, Exeter, UK
| | - Edward Watkins
- Department of Psychology, University of Exeter, Exeter, UK
| | - Mariska Bot
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health research institute, GGZ in Geest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Ingeborg Annemarie Brouwer
- Department of Health Sciences, Faculty of Science and Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Miquel Roca
- Institut Universitari d' Investigació en Ciències de la Salut (IUNICS/IDISBA), Rediapp, University of Balearic Islands, Palma de Mallorca, Spain
| | - Elisabeth Kohls
- Department of Psychiatry and Psychotherapy, University Leipzig, Medical Faculty, Leipzig, Germany
| | - Brenda Penninx
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health research institute, GGZ in Geest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Gerard van Grootheest
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health research institute, GGZ in Geest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Mieke Cabout
- Department of Health Sciences, Faculty of Science and Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ulrich Hegerl
- Department of Psychiatry, Psychosomatics and Psychotherapy, Goethe-University Frankfurt, Frankfurt, Germany
| | - Margalida Gili
- Institut Universitari d' Investigació en Ciències de la Salut (IUNICS/IDISBA), Rediapp, University of Balearic Islands, Palma de Mallorca, Spain
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science and Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Diet Quality and Health Service Utilization for Depression: A Prospective Investigation of Adults in Alberta's Tomorrow Project. Nutrients 2020; 12:nu12082437. [PMID: 32823652 PMCID: PMC7468802 DOI: 10.3390/nu12082437] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/02/2020] [Accepted: 08/11/2020] [Indexed: 12/21/2022] Open
Abstract
Depression is a leading cause of disability and economic burden worldwide. Primary prevention strategies are urgently needed. We examined the association of diet quality with depression in a large provincial cohort of adults. A past year food frequency questionnaire was completed by Alberta’s Tomorrow Project (ATP) participants enrolled between 2000–2008 (n = 25,016; average age 50.4 years) and used to calculate Healthy Eating Index-Canada (HEI-C) 2015 scores. The number of physician visits for depression 2000–2015 was obtained via linkage with administrative health records. Negative binomial regression models assessed the relationship between HEI-C 2015 scores and physician visits for depression, adjusting for confounders. Every 10-unit increase in HEI-C 2015 scores was associated with 4.7% fewer physician visits for depression (rate ratio (RR): 0.95; 95% Confidence Interval (CI): 0.92–0.98). This relationship persisted when participants with physician visits for mental illness prior to cohort enrollment were excluded. Higher quality diets were associated with a lower number of physician visits for depression. Results highlight diet may be an important prevention strategy for reducing the burden of health service utilization for depression.
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Owens M, Watkins E, Bot M, Brouwer IA, Roca M, Kohls E, Penninx BWJH, Grootheest G, Hegerl U, Gili M, Visser M. Nutrition and depression: Summary of findings from the EU‐funded MooDFOOD depression prevention randomised controlled trial and a critical review of the literature. NUTR BULL 2020. [DOI: 10.1111/nbu.12447] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- M. Owens
- Department of Psychology University of Exeter Exeter UK
| | - E. Watkins
- Department of Psychology University of Exeter Exeter UK
| | - M. Bot
- Amsterdam UMC Vrije Universiteit, Psychiatry Amsterdam Public Health Research Institute GGZ in Geest Specialized Mental Health Care Amsterdam The Netherlands
| | - I. A. Brouwer
- Department of Health Sciences Faculty of Science Amsterdam Public Health Research Institute Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - M. Roca
- Institut Universitari d’ Investigació en Ciències de la Salut (IUNICS/IDISBA) Rediapp University of Balearic Islands Palma de Mallorca Spain
| | - E. Kohls
- Department of Psychiatry and Psychotherapy Medical Faculty University Leipzig Leipzig Germany
| | - B. W. J. H. Penninx
- Amsterdam UMC Vrije Universiteit, Psychiatry Amsterdam Public Health Research Institute GGZ in Geest Specialized Mental Health Care Amsterdam The Netherlands
| | - G. Grootheest
- Amsterdam UMC Vrije Universiteit, Psychiatry Amsterdam Public Health Research Institute GGZ in Geest Specialized Mental Health Care Amsterdam The Netherlands
| | - U. Hegerl
- Department of Psychiatry, Psychosomatics and Psychotherapy Goethe‐University Frankfurt Germany
| | - M. Gili
- Institut Universitari d’ Investigació en Ciències de la Salut (IUNICS/IDISBA) Rediapp University of Balearic Islands Palma de Mallorca Spain
| | - M. Visser
- Department of Health Sciences Faculty of Science Amsterdam Public Health Research Institute Vrije Universiteit Amsterdam Amsterdam The Netherlands
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Lopresti AL, Smith SJ, Metse AP, Foster T, Drummond PD. The Feasibility and Efficacy of a Brief Integrative Treatment for Adults With Depression and/or Anxiety: A Randomized Controlled Trial. J Evid Based Integr Med 2020; 25:2515690X20937997. [PMID: 32638615 PMCID: PMC7359645 DOI: 10.1177/2515690x20937997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
The aim of this study was to investigate the efficacy and suitability of a brief integrative intervention, Personalized Integrative Therapy (PI Therapy), for the treatment of adult depression and/or anxiety. In this 6-week, 3-arm, parallel-group, randomized trial, PI Therapy delivered alone or with nutritional supplements (PI Therapy + Supps) was compared to cognitive behavior therapy (CBT) in 48 adults with depression and/or anxiety. All treatments were delivered as a 1-day workshop plus 6 weeks of reminder phone text messages to reinforce topics and skills covered in the workshop. Affective symptoms decreased significantly and to the same extent in all 3 conditions. At the end of treatment, 33% to 58% of participants reported levels of depressive symptoms in the normal range, and 50% to 58% reported nonclinical levels of anxiety. Compared to CBT and PI Therapy, PI Therapy + Supps was associated with significantly greater improvements in sleep quality. These findings suggest that a brief integrative intervention with or without supplements was comparable to CBT in reducing affective symptoms in adults with depression and/or anxiety. However, sleep quality improved only in the PI Therapy + Supps condition. These findings will require replication with a larger cohort.
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Affiliation(s)
- Adrian L Lopresti
- Murdoch University, Perth, Western Australia, Australia.,Clinical Research Australia, Perth, Western Australia, Australia
| | - Stephen J Smith
- Murdoch University, Perth, Western Australia, Australia.,Clinical Research Australia, Perth, Western Australia, Australia
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Winkens LHH, Elstgeest LEM, van Strien T, Penninx BWJH, Visser M, Brouwer IA. Does food intake mediate the association between mindful eating and change in depressive symptoms? Public Health Nutr 2020; 23:1532-1542. [PMID: 31957621 PMCID: PMC10200545 DOI: 10.1017/s1368980019003732] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 07/30/2019] [Accepted: 08/19/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To examine mediation by (i) diet quality and (ii) diet quantity in the associations of mindful eating domains with 3-year change in depressive symptoms. DESIGN Depressive symptoms were measured with the Center for Epidemiologic Studies Depression scale at baseline and 3-year follow-up. Four mindful eating domains (Focused Eating; Eating in response to Hunger and Satiety Cues; Eating with Awareness; Eating without Distraction) were measured with the Mindful Eating Behavior Scale. Food intake was measured with a 238-item FFQ. Diet quality was defined as the Mediterranean Diet Score (MDS). Diet quantity was defined as total energy intake (kcal/d; 1 kcal = 4·184 kJ). Mediation analyses with percentile-corrected bootstrap confidence intervals were conducted to calculate indirect effects. SETTING Longitudinal Aging Study Amsterdam. PARTICIPANTS Adults aged 55 years or above (n 929). RESULTS Diet quality (MDS) did not mediate associations of any of the four mindful eating domains with change in depressive symptoms. In contrast, total energy intake did mediate the associations with change in depressive symptoms for the mindful eating domains Eating with Awareness (indirect effects fully adjusted models: B = -0·014, 95 % CI -0·037, -0·002) and Eating without Distraction (B = -0·013, 95 % CI -0·033, -0·001), but not for the other two domains. Post hoc multiple mediation analyses showed similar results. CONCLUSIONS Higher scores on two mindful eating domains were associated with a decrease in depressive symptoms through lower total energy intake. Diet quantity, but not diet quality, could be a possible underlying mechanism in the associations between mindful eating and change in depressive symptoms.
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Affiliation(s)
- LHH Winkens
- Consumption and Healthy Lifestyles Chair Group, Wageningen University & Research, Hollandseweg 1, 6706 KN Wageningen, The Netherlands
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - LEM Elstgeest
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - T van Strien
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - BWJH Penninx
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M Visser
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - IA Brouwer
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Evidence of the Importance of Dietary Habits Regarding Depressive Symptoms and Depression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051616. [PMID: 32131552 PMCID: PMC7084175 DOI: 10.3390/ijerph17051616] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 02/20/2020] [Accepted: 02/27/2020] [Indexed: 12/18/2022]
Abstract
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.
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Fanelli Kuczmarski M, Hossain S, Beydoun MA, Maldonando A, Evans MK, Zonderman AB. Association of DASH and Depressive Symptoms with BMI over Adulthood in Racially and Socioeconomically Diverse Adults Examined in the HANDLS Study. Nutrients 2019; 11:nu11122934. [PMID: 31816922 PMCID: PMC6950765 DOI: 10.3390/nu11122934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 11/25/2019] [Accepted: 11/26/2019] [Indexed: 11/16/2022] Open
Abstract
Adherence to the Dietary Approaches to Stop Hypertension (DASH) diet is linked to slower weight gain over time. Elevated depressive symptoms may lead to poor quality diets, potentially increasing Body Mass Index (BMI). This study explored these pathways using longitudinal data extracted from 1201-1458 Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study participants. DASH mean score was computed using four 24 h recalls [visits(v)1 + v2/2: 2004-2013] and depressive symptoms using the Center for Epidemiologic Studies Depression (CES-D) scale (v1 + v2/2: 2004-2013). BMI was measured at v2: 2009-2013 and v3: 2013-2017. Multiple linear mixed regression and mediation modeling were conducted, linking CES-D(mean) and DASH(mean) to BMI [v2 and annualized change ΔBMI (v3-v2)] and exploring mediation of the CES-D(mean)-BMI(v3) and DASH(mean)-BMI(v3) associations through DASH(mean) and CES-D(mean), respectively. Models were further stratified by sex, race and poverty status. Inverse cross-sectional and longitudinal relationships of DASH(mean) with BMI(v2) and ΔBMI were detected, mainly in women and <125% of poverty participants. CES-D(mean) was not associated with BMI(v3); no mediation was detected through DASH(mean) in all socio-demographic strata. Moreover, the inverse DASH(mean)-BMI(v3) total effect was not mediated through CES-D(mean). Future studies should explore other pathways aside from depressive symptoms by which DASH can have a preventive effect on weight status over time.
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Affiliation(s)
- Marie Fanelli Kuczmarski
- Department of Behavioral Health and Nutrition, University of Delaware, 206C McDowell Hall, Newark, DE 19716, USA
- Correspondence: ; Tel.: +1-302-831-8765
| | - Sharmin Hossain
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institute of Health, Baltimore, MD 21224, USA; (S.H.); (M.A.B.); (A.M.); (M.K.E.); (A.B.Z.)
| | - May A. Beydoun
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institute of Health, Baltimore, MD 21224, USA; (S.H.); (M.A.B.); (A.M.); (M.K.E.); (A.B.Z.)
| | - Ana Maldonando
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institute of Health, Baltimore, MD 21224, USA; (S.H.); (M.A.B.); (A.M.); (M.K.E.); (A.B.Z.)
| | - Michele K. Evans
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institute of Health, Baltimore, MD 21224, USA; (S.H.); (M.A.B.); (A.M.); (M.K.E.); (A.B.Z.)
| | - Alan B. Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institute of Health, Baltimore, MD 21224, USA; (S.H.); (M.A.B.); (A.M.); (M.K.E.); (A.B.Z.)
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Effect of food-related behavioral activation therapy on food intake and the environmental impact of the diet: results from the MooDFOOD prevention trial. Eur J Nutr 2019; 59:2579-2591. [PMID: 31642985 PMCID: PMC7413920 DOI: 10.1007/s00394-019-02106-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 10/04/2019] [Indexed: 01/04/2023]
Abstract
Purpose Food-based dietary guidelines are proposed to not only improve diet quality, but to also reduce the environmental impact of diets. The aim of our study was to investigate whether food-related behavioral activation therapy (F-BA) applying Mediterranean-style dietary guidelines altered food intake and the environmental impact of the diet in overweight adults with subsyndromal symptoms of depression. Methods In total 744 adults who either received the F-BA intervention (F-BA group) or no intervention (control group) for 12 months were included in this analysis. Food intake data were collected through a food frequency questionnaire at baseline and after 6 and 12 months. Greenhouse gas emissions (GHGE), land use (LU), and fossil energy use (FEU) estimates from life-cycle assessments and a weighted score of the three (pReCiPe score) were used to estimate the environmental impact of each individual diet at each timepoint. Results The F-BA group reported increased intakes of vegetables (19.7 g/day; 95% CI 7.8–31.6), fruit (23.0 g/day; 9.4–36.6), fish (7.6 g/day; 4.6–10.6), pulses/legumes (4.0 g/day; 1.6–6.5) and whole grains (12.7 g/day; 8.0–17.5), and decreased intake of sweets/extras (− 6.8 g/day; − 10.9 to − 2.8) relative to control group. This effect on food intake resulted in no change in GHGE, LU, and pReCiPe score, but a relative increase in FEU by 1.6 MJ/day (0.8, 2.4). Conclusions A shift towards a healthier Mediterranean-style diet does not necessarily result in a diet with reduced environmental impact in a real-life setting. Trial registration ClinicalTrials.gov. Number of identification: NCT02529423. August 2015. Electronic supplementary material The online version of this article (10.1007/s00394-019-02106-1) contains supplementary material, which is available to authorized users.
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