1
|
Aucoin M, LaChance L, van der Wurff I, McLaren M, Monteiro S, Miller S, Jenkins A, Sabri E, Cooley K. Dietary counseling plus omega-3 supplementation in the treatment of generalized anxiety disorder: results of a randomized wait-list controlled pilot trial (the 'EASe-GAD Trial'). Nutr Neurosci 2024:1-14. [PMID: 39316026 DOI: 10.1080/1028415x.2024.2403901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/25/2024]
Abstract
OBJECTIVES Clinical evidence suggests that nutrition interventions can significantly improve symptoms of major depressive disorder; however, the effect on clinical anxiety symptoms in individuals with anxiety disorders has not been studied. The primary objective of the present study was to assess the feasibility and acceptability of a nutrition intervention. The secondary objectives included assessing changes in anxiety symptom severity, diet quality, self-efficacy, mindful eating, quality of life, and biomarkers. METHODS This study was a randomized, wait-list controlled pilot trial delivering a 12-week, biweekly dietary counseling intervention and omega-3 supplementation to 50 adult women with generalized anxiety disorder. Questionnaires and blood work were completed at baseline, after the waiting period, and after the intervention. RESULTS 443 individuals expressed interest within eight months; 50 met the criteria for enrollment. The mean number of sessions attended was 6.4. Final questionnaires were completed by 46 participants. Eighty-four percent of participants strongly agreed with the statement 'My experience during this study was positive'. The mean anxiety symptom severity score in the intervention group was 26.2 (95% CI 22.94-29.48) at baseline and 11.0 (95% CI 8.05-13.87) at week 12. The mean diet quality score was 7.2 (95% CI 6.32-8.10) and 10.5 (95% CI 9.55-11.49) at baseline and week 12, respectively. Among the waitlist participants, the mean baseline anxiety score was 29.3 (95% CI 24.73-33.91) and 26.8 (95% CI 22.09-31.56) at week 12. DISCUSSION This study was feasible and acceptable. Participation in the intervention was associated with a decrease in anxiety symptoms. These findings lay the foundation for large-scale studies. Trial registration: ClinicalTrials.gov NCT05573672.
Collapse
Affiliation(s)
- Monique Aucoin
- Research and Clinical Epidemiology, Canadian College of Naturopathic Medicine, Toronto, Canada
- Human Health and Nutritional Sciences, University of Guelph, Guelph, Canada
| | - Laura LaChance
- Research and Clinical Epidemiology, Canadian College of Naturopathic Medicine, Toronto, Canada
- Department of Psychiatry, McGill University, Montreal, Canada
- Department of Psychiatry, St. Mary's Hospital, Montreal, Canada
| | - Inge van der Wurff
- Health Psychology, Faculty of Psychology, Open University of the Netherlands, Heerlen, The Netherlands
| | - Meagan McLaren
- Research and Clinical Epidemiology, Canadian College of Naturopathic Medicine, Toronto, Canada
| | - Sasha Monteiro
- Research and Clinical Epidemiology, Canadian College of Naturopathic Medicine, Toronto, Canada
| | | | | | - Elham Sabri
- Ottawa Hospital Research Institute, Ottawa, Canada
| | - Kieran Cooley
- Research and Clinical Epidemiology, Canadian College of Naturopathic Medicine, Toronto, Canada
- Southern Cross University, Lismore, Australia
- University of Technology Sydney, Sydney, Australia
- Human Biology, University of Toronto, Toronto, Canada
| |
Collapse
|
2
|
Xu QH, Yang T, Jiang KY, Liu JD, Guo HH, Xia EQ. The association between the number of food kinds and risk of depression in U.S. adults. BMC Public Health 2024; 24:2575. [PMID: 39304862 DOI: 10.1186/s12889-024-19344-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 07/02/2024] [Indexed: 09/22/2024] Open
Abstract
BACKGROUND The association between the number of food kinds and the risk of depression in adults was examined. METHODS According to the inclusion and exclusion criteria, a total of 4593 adults were included in the study. The number of food kinds was collected via 24‒hour dietary recalls. Depression was assessed using the Patient Health Questionnaire‒9. Logistic regression and restricted cubic spline models were applied to assess the association between the number of food kinds and the risk of depression. RESULTS This study included 4593 study participants, 451 of whom were diagnosed with depression. The revised advantage ratios (with corresponding confidence intervals) for the prevalence of depression among individuals in the fourth quartiles of the number of food kinds (Q4) in comparison to the lowest quartile (Q1) were determined to be 0.59 (0.36‒0.96), respectively. According to our subgroup analyses, the number of food kinds was negatively associated with the risk of depression in females, participants aged 18‒45 and 45‒65 years, and participants with a body mass index (BMI) of 25 to 24.9 kg/m2. According to our dose‒response analysis, the number of food kinds was linearly associated with the risk of depression (Pfor nonlinear=0.5896). CONCLUSION The risk of depression exhibited a linear and negative correlation with the number of food kinds. The results indicated that a diversified diet was an effective nonpharmacological approach that deserved further generalization.
Collapse
Affiliation(s)
- Qiu-Hui Xu
- School of Public Health, Shunde Women and Children's Hospital, Guangdong Medical University, Guangdong, 524003, China
| | - Ting Yang
- School of Public Health, Shunde Women and Children's Hospital, Guangdong Medical University, Guangdong, 524003, China
| | - Ke-Yu Jiang
- School of Public Health, Shunde Women and Children's Hospital, Guangdong Medical University, Guangdong, 524003, China
| | - Jin-Dong Liu
- School of Public Health, Shunde Women and Children's Hospital, Guangdong Medical University, Guangdong, 524003, China
| | - Hong-Hui Guo
- School of Public Health, Shunde Women and Children's Hospital, Guangdong Medical University, Guangdong, 524003, China
| | - En-Qin Xia
- School of Public Health, Shunde Women and Children's Hospital, Guangdong Medical University, Guangdong, 524003, China.
| |
Collapse
|
3
|
Wu Y, Chen M, Huang H, Jiang Q. Effect of dietary live microbe intake on the prevalence and mortality risks of depression and suicidal ideation in adults: Evidence from a nationwide population-based study. J Affect Disord 2024:S0165-0327(24)01616-1. [PMID: 39303884 DOI: 10.1016/j.jad.2024.09.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 09/16/2024] [Accepted: 09/17/2024] [Indexed: 09/22/2024]
Abstract
BACKGROUND Gut microbial dysbiosis has been implicated in the pathogenesis of depression. Dietary interventions offer promising microbial-targeted therapeutics for depression. However, limited evidence exists regarding the associations between dietary live microbe intake and the prevalence of depression, as well as its impact on mortality risks. METHODS This study included 28,133 participants from the U.S. National Health and Nutrition Examination Survey (2005-2018), and ascertained their underlying causes of death. Weighted logistic regression was utilized to assess the relationships between live microbe intake and risks of depression and suicidal ideation. Independent and joint associations between live microbe and mortality outcomes were evaluated using multivariable Cox regression and Kaplan-Meier survival curves to calculate relative risks. RESULTS In the fully adjusted model, participants with high dietary live microbe intake had a significantly lower prevalence of depression (OR = 0.727, 95%CI: 0.627,0.844) and suicidal ideation (OR = 0.778, 95%CI: 0.648,0.935) than those with low intake. The multivariable-adjusted HRs for individuals in the G1 were 1.217 (95%CI, 1.081, 1.370) for all-cause mortality and 1.307 (95%CI, 1.029,1.661) for cardiovascular disease mortality, compared to participants in the G3. Kaplan-Meier survival analysis revealed that cumulative hazard of cardiovascular mortality was progressively lower among participants with depression in the G3 than those without depression. CONCLUSIONS Higher live microbe intake was associated with a lower prevalence of depression and suicidal ideation, and was linked to significantly decreased risks of all-cause and cardiovascular mortality. Further larger prospective studies are essential to verify the health effects of live microbes, and personalized dietary recommendations are necessary.
Collapse
Affiliation(s)
- Yigao Wu
- Department of Medical Psychology, The First Affiliated Hospital of Wannan Medical College, No. 2 Zheshan West Road, Wuhu City 241001, China.
| | - Man Chen
- Department of Medical Psychology, The First Affiliated Hospital of Wannan Medical College, Wuhu 241001, China
| | - Huilan Huang
- Department of Medical Psychology, The First Affiliated Hospital of Wannan Medical College, Wuhu 241001, China
| | - Qin Jiang
- Department of Medical Psychology, The First Affiliated Hospital of Wannan Medical College, Wuhu 241001, China
| |
Collapse
|
4
|
Cabrera-Suárez BM, Hernández-Fleta JL, Molero P, González-Pinto A, Lahortiga F, Cabrera C, Chiclana-Actis C, Sánchez-Villegas A. Mediterranean diet-based intervention to improve depressive symptoms: analysis of the PREDIDEP randomized trial. Nutr Neurosci 2024; 27:951-961. [PMID: 37990906 DOI: 10.1080/1028415x.2023.2283290] [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] [Indexed: 11/23/2023]
Abstract
BACKGROUND The effect of an intervention based on Mediterranean diet on reducing recurrence risk or subsyndromal depressive symptoms in recovered depressed patients has not been explored. METHODS The PREDIDEP study was a two-year randomized trial designed to assess the effect of the Mediterranean Diet enriched with extra virgin olive oil on depression recurrence. At baseline and at four, eight, 16, 20, and 24 months of follow-up, depressive symptoms were evaluated through the Beck Depression inventory. Cox regression analysis was fitted to assess the role of dietary intervention on the risk of depression recurrence. Mixed effects linear models were used to assess changes in depressive subsyndromal symptoms according to the intervention. RESULTS After two years of intervention, the dietary intervention group (n = 103) compared to the control group (n = 93) showed no differences regarding depression recurrence risk as main outcome. As secondary outcomes, an improvement of depressive symptoms was yielded at four (-2.15; 95% CI = -4.00 to -0.29) and eight months (-2.42; 95% CI = -4.17 to -0.67) in the intervention group, with no changes in control group. Moreover, at 20 months, significant differences were found between groups (-3.35; 95% CI = -6.08 to -0.61). CONCLUSIONS An intervention with Mediterranean diet in patients with previous depressive episodes might contribute to the reduction of depressive subsyndromal symptoms.
Collapse
Affiliation(s)
- Beatriz M Cabrera-Suárez
- Psychiatry and Clinical Psychology Service, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Jose L Hernández-Fleta
- Psychiatry and Clinical Psychology Service, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Patricio Molero
- Department of Psychiatry and Clinical Psychology, Clínica Universidad de Navarra, Navarra, Spain
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, Navarra, Spain
| | - Ana González-Pinto
- Biomedical Research Center Network on Mental Health (CIBERSAM), Institute of Health Carlos III, Madrid, Spain
- BIOARABA, Hospital Universitario de Alava, UPV/EHU, Vitoria-Gasteiz, Spain
| | - Francisca Lahortiga
- Department of Psychiatry and Clinical Psychology, Clínica Universidad de Navarra, Navarra, Spain
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, Navarra, Spain
| | - Claudio Cabrera
- Psychiatry and Clinical Psychology Service, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | | | - Almudena Sánchez-Villegas
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, Navarra, Spain
- ISFOOD - Institute for Innovation & Sustainable Development in Food Chain, Universidad Pública de Navarra (UPNA), Navarra, Spain
- Biomedical Research Center Network on Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| |
Collapse
|
5
|
Lugon G, Hernáez Á, Jacka FN, Marrugat J, Ramos R, Garre-Olmo J, Elosua R, Lassale C. Association between different diet quality scores and depression risk: the REGICOR population-based cohort study. Eur J Nutr 2024:10.1007/s00394-024-03466-z. [PMID: 39180556 DOI: 10.1007/s00394-024-03466-z] [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: 02/21/2024] [Accepted: 07/08/2024] [Indexed: 08/26/2024]
Abstract
BACKGROUND Our aim was to determine the association between diet quality and depression incidence in the population-based REGICOR cohort study, Catalonia, Spain. METHODS Prospective observational study using participants' baseline (2003-2006), follow-up (2007-2013) and clinical records data. Five diet quality scores were derived from a food frequency questionnaire (FFQ) at baseline: the relative Mediterranean Diet Score (rMED), the Modified Mediterranean Diet Score (ModMDS), a Dietary Approaches to Stop Hypertension (DASH) score, a Healthful Plant-based Diet Index (HPDI) and the World Health Organization Healthy Diet Indicator (WHO-HDI). Participants using pharmacological antidepressant treatment were excluded as a proxy for presence of depression at baseline. At follow-up, the Patient Health Questionnaire (PHQ-9) was applied to assess depressive symptoms (≥ 10 defining depressive disorder). A secondary outcome was depression diagnosis assessed through clinical records. Logistic regression and Cox proportional hazards models were used. RESULTS Main analysis included 3046 adults (50.3% women) with a mean age of 54.7 (SD = 11.6) years. After 6-years follow-up, 184 (6.04%) cases of depressive disorder were identified. There was 16% lower odds of depressive disorder per 1SD increase of rMED (OR = 0.84; 95%CI = 0.71-0.98). Secondary outcome analysis (n = 4789) identified 261 (5.45%) incident cases of clinical depression diagnosis over 12 years follow-up, and 19% lower risk of clinical depression was observed with the WHO-HDI (HR = 0.81; 95%CI = 0.70-0.93). Adjusting for BMI did not attenuate the findings. CONCLUSIONS A significant inverse association between diet quality and depression incidence was found in this population-based cohort study, independent of sociodemographic, health and lifestyle. Adherence to a healthy diet could be a complementary intervention for the prevention of depression.
Collapse
Affiliation(s)
- Gabriela Lugon
- Epidemiology and Public Health Programme, Hospital del Mar Medical Research Institute, PRBB, Carrer Doctor Aiguader 88, Barcelona, 08003, Spain.
- Preventive Medicine and Public Health Training Unit PSMar-UPF-ASPB (Parc de Salut Mar - Pompeu Fabra University - Agència de Salut Pública de Barcelona), Barcelona, Spain.
- PhD Program in Biomedicine, Universitat Pompeu Fabra (UPF), Barcelona, Spain.
| | - Álvaro Hernáez
- Epidemiology and Public Health Programme, Hospital del Mar Medical Research Institute, PRBB, Carrer Doctor Aiguader 88, Barcelona, 08003, Spain
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- Facultat de Ciènces de la Salut Blanquerna, Universitat Ramon Llull, Barcelona, Spain
- Consortium for Biomedical Research - Cardiovascular Diseases (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
| | - Felice N Jacka
- School of Medicine, Food & Mood Centre, IMPACT Strategic Research Centre, Deakin University, Melbourne, VIC, Australia
| | - Jaume Marrugat
- Epidemiology and Public Health Programme, Hospital del Mar Medical Research Institute, PRBB, Carrer Doctor Aiguader 88, Barcelona, 08003, Spain
- Consortium for Biomedical Research - Cardiovascular Diseases (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
| | - Rafael Ramos
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Girona, Spain
- Girona Biomedical Research Institute (IdIBGi), Dr. Josep Trueta University Hospital, Girona, Spain
- Department of Medical Sciences, School of Medicine, University of Girona, Girona, Spain
| | - Josep Garre-Olmo
- Girona Biomedical Research Institute (IdIBGi), Dr. Josep Trueta University Hospital, Girona, Spain
- Serra-Húnter Professor Department of Nursing, University of Girona, Girona, Spain
| | - Roberto Elosua
- Epidemiology and Public Health Programme, Hospital del Mar Medical Research Institute, PRBB, Carrer Doctor Aiguader 88, Barcelona, 08003, Spain
- Consortium for Biomedical Research - Cardiovascular Diseases (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
- Faculty of Medicine, University of Vic - Central University of Catalunya, Vic, Spain
| | - Camille Lassale
- Epidemiology and Public Health Programme, Hospital del Mar Medical Research Institute, PRBB, Carrer Doctor Aiguader 88, Barcelona, 08003, Spain.
- Consortium for Biomedical Research - Pathophysiology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.
- ISGlobal, Barcelona, Spain.
- Universitat Pompeu Fabra (UPF), Barcelona, Spain.
| |
Collapse
|
6
|
Jiménez-López E, Mesas AE, Visier-Alfonso ME, Pascual-Morena C, Martínez-Vizcaíno V, Herrera-Gutiérrez E, López-Gil JF. Adherence to the Mediterranean diet and depressive, anxiety, and stress symptoms in Spanish adolescents: results from the EHDLA study. Eur Child Adolesc Psychiatry 2024; 33:2637-2646. [PMID: 38170283 DOI: 10.1007/s00787-023-02351-0] [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: 09/04/2023] [Accepted: 12/04/2023] [Indexed: 01/05/2024]
Abstract
Depression and anxiety are prevalent and disabling conditions among adolescents. The aim of this study was to examine the relationship between adherence to the Mediterranean diet (MD) and depressive, anxiety, and stress symptoms in adolescents. This cross-sectional study included a sample of 698 adolescent students from a region of Spain (mean age of 13.9 ± 1.5 years; 56.2% girls). Adherence to the MD was evaluated with the Mediterranean Diet Quality Index in children and adolescents (KIDMED). Mental health symptoms were measured with the Depression, Anxiety, and Stress Scale (DASS-21). Logistic regression models were performed, including a wide range of potential confounders. Compared to individuals with low adherence to the MD, those with moderate and high adherence had lower odds of experiencing depressive symptoms (odds ratio [OR] = 0.40, 95% confidence interval [CI] 0.24-0.65 and OR = 0.33, 95% CI 0.20-0.55, respectively), which were statistically significant even after adjustment. No significant associations were found regarding anxiety or stress symptoms. Therefore, according to our results, higher adherence to the MD is inversely related to having depressive symptoms among adolescents, regardless of socioeconomic, anthropometric, and lifestyle factors. Considering the deleterious effects of mental health problems in youths, further research on the role of nonpharmacological strategies for the prevention and treatment of depressive symptoms in adolescence is essential.
Collapse
Affiliation(s)
- Estela Jiménez-López
- Health and Social Research Center, Universidad de Castilla-La Mancha, Santa Teresa Jornet s/n, 16071, Cuenca, Spain
- Department of Psychiatry, Hospital Virgen de La Luz, Cuenca, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
| | - Arthur Eumann Mesas
- Health and Social Research Center, Universidad de Castilla-La Mancha, Santa Teresa Jornet s/n, 16071, Cuenca, Spain.
- Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina, Paraná, 86057-970, Brazil.
| | - María Eugenia Visier-Alfonso
- Health and Social Research Center, Universidad de Castilla-La Mancha, Santa Teresa Jornet s/n, 16071, Cuenca, Spain
| | - Carlos Pascual-Morena
- Health and Social Research Center, Universidad de Castilla-La Mancha, Santa Teresa Jornet s/n, 16071, Cuenca, Spain
| | - Vicente Martínez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Santa Teresa Jornet s/n, 16071, Cuenca, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, 1101, Talca, Chile
| | - Eva Herrera-Gutiérrez
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Murcia, Espinardo Campus, 30100, Murcia, Spain
| | | |
Collapse
|
7
|
Schneider E, O'Riordan KJ, Clarke G, Cryan JF. Feeding gut microbes to nourish the brain: unravelling the diet-microbiota-gut-brain axis. Nat Metab 2024; 6:1454-1478. [PMID: 39174768 DOI: 10.1038/s42255-024-01108-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 07/15/2024] [Indexed: 08/24/2024]
Abstract
The prevalence of brain disorders, including stress-related neuropsychiatric disorders and conditions with cognitive dysfunction, is rising. Poor dietary habits contribute substantially to this accelerating trend. Conversely, healthy dietary intake supports mood and cognitive performance. Recently, the communication between the microorganisms within the gastrointestinal tract and the brain along the gut-brain axis has gained prominence as a potential tractable target to modulate brain health. The composition and function of the gut microbiota is robustly influenced by dietary factors to alter gut-brain signalling. To reflect this interconnection between diet, gut microbiota and brain functioning, we propose that a diet-microbiota-gut-brain axis exists that underpins health and well-being. In this Review, we provide a comprehensive overview of the interplay between diet and gut microbiota composition and function and the implications for cognition and emotional functioning. Important diet-induced effects on the gut microbiota for the development, prevention and maintenance of neuropsychiatric disorders are described. The diet-microbiota-gut-brain axis represents an uncharted frontier for brain health diagnostics and therapeutics across the lifespan.
Collapse
Affiliation(s)
| | | | - Gerard Clarke
- APC Microbiome Ireland, University College Cork, Cork, Ireland
- Department of Psychiatry and Neurobehavioural Science, 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.
| |
Collapse
|
8
|
Haghighatdoost F, Feizi A, Hajihashemi P, Shahoon H, Ani A, Roohafza H, Adibi P. The association of the Prime Diet Quality Score (PDQS) with depression and anxiety symptoms: the Isfahan functional disorders (ISFUN) cohort study. Nutr Neurosci 2024:1-10. [PMID: 38985816 DOI: 10.1080/1028415x.2024.2372190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2024]
Abstract
Background: Due to scarce epidemiologic data regarding the Prime Diet Quality Score (PDQS) and mental health disorders, this study aimed to investigate the association of PDQS with depression and anxiety symptoms in Iranian adults.Methods: This cross-sectional analysis was performed using the baseline data collected for the Isfahan functional disorders (ISFUN) cohort study. ISFUN was established in 2017 and enrolled apparently healthy adults, aged 18-65 years in Isfahan, Iran. Information on usual dietary intakes was collected using a validated Dish-based, 106-item food frequency questionnaire. The severity of depression and anxiety was assessed using a validated Iranian version of the Hospital Anxiety and Depression Scale.Results: A total number of1892 participants were enrolled in the present study. In total, 54.50% of subjects were female. In the fully adjusted model, participants with PDQS lower than median compared with those with PDQS higher than median had higher risk of depression (OR = 1.62; 95% CI: 1.11, 2.37) and anxiety (OR: 1.57; 95% CI: 1.08, 2.27). In stratified analysis by sex, males with PDQS lower than median compared with those with PDQS higher than median had greater risk for depressive (OR: 1.57) and anxiety symptoms (OR = 1.52). However, in females, no significant association was found between PDQS and odds of depression, and anxiety in the fully adjusted model.Conclusion: We found evidence indicating a significant inverse association between PDQS and depression and anxiety symptoms among Iranian adults. Further studies, in particular with prospective design, are required to confirm these findings.
Collapse
Affiliation(s)
- Fahimeh Haghighatdoost
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parisa Hajihashemi
- Isfahan Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hassan Shahoon
- Isfahan Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Ani
- Department of Bioinformatics, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamidreza Roohafza
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Peyman Adibi
- Isfahan Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
9
|
Zhou J, Wang H, Pao C, Zhou J, Zou Z. Association between 29 food groups of diet quality questionnaire and perceived stress in Chinese adults: a prospective study from China health and nutrition survey. BMC Public Health 2024; 24:1832. [PMID: 38982411 PMCID: PMC11234725 DOI: 10.1186/s12889-024-19308-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 06/28/2024] [Indexed: 07/11/2024] Open
Abstract
PURPOSE Diet plays a fundamental role in promoting resilience against stress-related disorders. We aimed to examine the overall and sex-specific association between food groups and perceived stress in adults. METHODS We analyzed the prospective data of 7,434 adults who completed both the 2011 and 2015 surveys of the China Health and Nutrition Survey (CHNS). The Diet Quality Questionnaire (DQQ) was used to code all the food items of 2011 dietary intake into 29 food groups, and perceived stress in 2015 was measured using a 14-item perceived stress scale (PSS-14). Univariate analysis and logistic regression models were used to examine the relationship between food groups and perceived stress. RESULTS People who perceived a higher level of stress (PSS-14 total score > 25) made up 41.5% and 45.1% of the male and female groups, respectively (χ2 = 9.605, p = 0.002). Individuals with increased intake of food groups such as legumes, other vegetables, other fruits, yogurt, poultry, fish & seafood, fluid milk, and fruit juice were less likely to experience a higher level of psychological stress (OR range: 0.544-0.892, p < 0.05). Additionally, we found sex-specific associations between food groups and perceived stress. The difference in the proportion of food groups, such as fluid milk and fish & seafood, between the two stress groups in men was statistically significant (p < 0.025). In the female group, the distribution of eight food groups, like legumes and nuts & seeds, between the two stress groups was statistically significant (p < 0.025). CONCLUSION This study indicated that food groups were differentially associated with perceived stress.
Collapse
Affiliation(s)
- Jia Zhou
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Huan Wang
- Institute of Child and Adolescent Health, Peking University School of Public Health/National Health Commission Key Laboratory of Reproductive Health, the People's Republic of China, Beijing, China
| | - Christine Pao
- Mental Health and Behavioral Science Service, Bruce W. Carter VA Medical Center, Miami, FL, USA
| | - Jingjing Zhou
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
| | - Zhiyong Zou
- Institute of Child and Adolescent Health, Peking University School of Public Health/National Health Commission Key Laboratory of Reproductive Health, the People's Republic of China, Beijing, China.
| |
Collapse
|
10
|
Linsmayer D, Eckert GP, Reiff J, Braus DF. [Nutrition, metabolism, brain and mental health]. DER NERVENARZT 2024; 95:667-680. [PMID: 38884643 PMCID: PMC11222242 DOI: 10.1007/s00115-024-01678-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/08/2024] [Indexed: 06/18/2024]
Abstract
This review article explores the intricate relationship between nutrition, metabolism, brain function and mental health. It highlights two key complementary models: the energy balance model and the more comprehensive carbohydrate-insulin model, to understand the development of obesity and metabolic dysfunctions. It particularly focuses on the role of dopamine in dietary regulation and insulin in the brain, both of which are crucial in the pathogenesis of neurodegenerative and stress-associated mental disorders. Additionally, the significance of sleep and dietary habits, such as medically assisted calorie restriction for mental health and the concept of "brain food" are described. These findings emphasize the importance of nutritional medicine in psychiatry and psychotherapy and the consideration of metabolic states for the prevention and treatment of mental and neurodegenerative diseases.
Collapse
Affiliation(s)
- Denise Linsmayer
- Vitos Klinikum Rheingau, Kloster-Eberbach-Straße 4, 65346, Eltville, Deutschland
| | - Gunter P Eckert
- Institut für Ernährungswissenschaft, Justus-Liebig-Universität Gießen, Wilhelmstraße 20, 35392, Gießen, Deutschland
| | - Julia Reiff
- Vitos Klinikum Rheingau, Kloster-Eberbach-Straße 4, 65346, Eltville, Deutschland
| | - Dieter F Braus
- Vitos Klinikum Rheingau, Kloster-Eberbach-Straße 4, 65346, Eltville, Deutschland.
| |
Collapse
|
11
|
Logan AC, D'Adamo CR, Pizzorno JE, Prescott SL. "Food faddists and pseudoscientists!": Reflections on the history of resistance to ultra-processed foods. Explore (NY) 2024; 20:470-476. [PMID: 38176973 DOI: 10.1016/j.explore.2023.12.014] [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: 08/13/2023] [Revised: 12/10/2023] [Accepted: 12/20/2023] [Indexed: 01/06/2024]
Abstract
The term 'ultra-processed food' emerged in the 1980s, mostly used in reference to highly-processed convenience foods and snacks, often energy-dense, poor in nutrients, and inclusive of various synthetic additives such as emulsifiers, colors, artificial sweeteners, and/or flavor enhancers. Concern over such foods was part of the growing holistic and environmental health movements of the 1970-80s; yet, those who raised alarm about the encroachment of ultra-processed foods were often labeled, especially by industry and their powerful allies, as 'food faddists' and 'pseudoscientists'. Today, the topic of ultra-processed foods is generating massive personal, public, and planetary health interest. However, other than discussing the history of the NOVA food classification system, a useful tool that has allowed researchers to more accurately separate foods based on processing, most lay media and academic articles are ahistorical. That is, there is a tendency to present the term ultra-processed food(s) as a relatively new entrance into the lexicon, and by default, the idea that health-related pushback on ultra-processed foods is a relatively new phenomenon. This omission overlooks decades of determined advocacy and clinical work, much of it by pioneers within the holistic medicine (now integrative, functional, and lifestyle medicine) movement. Here in this reflection paper, the authors will use historical research and reporting to fill in the historical gap and articulate the saliency of why it matters.
Collapse
Affiliation(s)
- Alan C Logan
- Nova Institute for Health, Baltimore, MD 21231, USA.
| | - Christopher R D'Adamo
- Nova Institute for Health, Baltimore, MD 21231, USA; Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | | | - Susan L Prescott
- Nova Institute for Health, Baltimore, MD 21231, USA; Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA; Medical School, University of Western Australia, Nedlands, WA 6009, Australia; The ORIGINS Project, Telethon Kids Institute, Nedlands, WA 6009, Australia
| |
Collapse
|
12
|
Caamaño-Navarrete F, Del-Cuerpo I, Arriagada-Hernández C, Alvarez C, Gaya AR, Reuter CP, Delgado-Floody P. Association between Active Commuting and Lifestyle Parameters with Mental Health Problems in Chilean Children and Adolescent. Behav Sci (Basel) 2024; 14:554. [PMID: 39062377 PMCID: PMC11273756 DOI: 10.3390/bs14070554] [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: 04/30/2024] [Revised: 06/25/2024] [Accepted: 06/26/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Little is known about the association between active commuting (i.e., walking or cycling to school) with lifestyle parameters and mental health in youths. The objective of the present study was to investigate the association between mental health problems and symptoms of depression, anxiety, and stress with lifestyle (i.e., food habits, screen time, physical activity, and sleep quality), active commuting, and gender. METHODS A total of 511 children and adolescents (boys, n = 249; girls, n = 262) aged 10 to 17 years participated in the study. Lifestyle parameters and mental health were evaluated using the Depression Anxiety and Stress Scale (DASS-21). RESULTS Girls reported higher levels of anxiety (p = 0.001), depression (p = 0.001), and stress (p = 0.001). Mental health problems showed a positive association with gender (girls, β = 3.06, p < 0.001) and a negative association with food habits (β = -0.65, p = 0.019). Anxiety was positively associated with gender (β = 7.88, p < 0.001) and negatively associated with food habits (β = -0.23, p = 0.019). Gender (girls) and food habits were also associated with symptoms of depression (β = 2.29, p < 0.001 and β = -0.27, p = 0.005, respectively). Finally, active commuting was inversely associated with stress (β = -1.24, p = 0.008), and stress was positively linked to gender (β = 2.53, p < 0.001). CONCLUSIONS Active commuting, lifestyle parameters, and gender were associated with mental health in children and adolescents. Moreover, girls reported higher levels of anxiety, symptoms of depression, and stress.
Collapse
Affiliation(s)
- Felipe Caamaño-Navarrete
- Physical Education Career, Universidad Autónoma de Chile, Temuco 4780000, Chile; (F.C.-N.); (C.A.-H.)
| | - Indya Del-Cuerpo
- Department of Physical Education and Sports, Faculty of Sports Sciences, University of Granada, 18010 Granada, Spain;
- Strength & Conditioning Laboratory, CTS-642 Research Group, Department Physical Education and Sports, Faculty of Sports Sciences, University of Granada, 18010 Granada, Spain
| | - Carlos Arriagada-Hernández
- Physical Education Career, Universidad Autónoma de Chile, Temuco 4780000, Chile; (F.C.-N.); (C.A.-H.)
- Grupo de Investigación Colaborativa para el Desarrollo Escolar (GICDE), Temuco 4780000, Chile
| | - Cristian Alvarez
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, Chile;
| | - Anelise Reis Gaya
- Graduate Program in Human Movement Sciences, Federal University of Rio Grande do Sul, Porto Alegre 90690-200, Brazil;
| | - Cézane Priscila Reuter
- Graduate Program in Health Promotion, University of Santa Cruz do Sul, Independência Av.2293-Universitário, Santa Cruz do Sul 96815-900, Brazil;
| | - Pedro Delgado-Floody
- Department of Physical Education, Sport and Recreation, Universidad de La Frontera, Temuco 4811230, Chile
| |
Collapse
|
13
|
Jiang X, Wang X, Zhang M, Yu L, He J, Wu S, Yan J, Zheng Y, Zhou Y, Chen Y. Associations between specific dietary patterns, gut microbiome composition, and incident subthreshold depression in Chinese young adults. J Adv Res 2024:S2090-1232(24)00221-2. [PMID: 38879123 DOI: 10.1016/j.jare.2024.05.030] [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: 03/18/2024] [Revised: 04/25/2024] [Accepted: 05/29/2024] [Indexed: 06/20/2024] Open
Abstract
INTRODUCTION The interplay between influential factors and the incidence of subthreshold depression (SD) in young adults remains poorly understood. OBJECTIVES This study sought to understand the dietary habits, gut microbiota composition, etc. among individuals with SD in young adults and to investigate their association with SD occurrence. METHODS Employing a cross-sectional approach, 178 individuals with SD, aged 18-32 years, were matched with 114 healthy counterparts. SD status was evaluated using the Zung Self-rating Depression Scale (SDS), Zung Self-rating Anxiety Scale (SAS), Beck Depression Inventory 2nd version (BDI-II), the 17-item Hamilton Rating Scales of Depression (HAMD-17), and Pittsburgh Sleep Quality Index (PSQI). Metagenomic sequencing was utilized to identify fecal microbial profiles. Dietary patterns were discerned via factor analysis of a 25-item food frequency questionnaire (FFQ). Logistic regression analysis and mediation analysis were performed to explore the potential links between gut microbiota, dietary patterns, and incident SD. RESULTS Data on dietary habits were available for 292 participants (mean [SD] age, 22.1 [2.9] years; 216 [73.9 %] female). Logistic regression analysis revealed that dietary patterns Ⅰ (odds ratio [OR], 0.34; 95 % CI, 0.15-0.75) and IV (OR, 0.39; 95 % CI, 0.17-0.86 and OR, 0.39; 95 % CI, 0.18-0.84) were associated with reduced risk of SD. Distinct microbial profiles were observed in young adults with SD, marked by increased microbial diversity and taxonomic alterations. Moreover, mediation analysis suggested Veillonella atypica as a potential mediator linking SDS or BDI-II scores with a healthy dietary pattern rich in bean products, coarse grains, nuts, fruits, mushrooms, and potatoes (β = 0.25, 95 % CI: 0.02-0.78 and β = 0.18, 95 % CI: 0.01-0.54). CONCLUSIONS Our findings highlight the complex interplay between dietary patterns, gut microbiota, and the risk of developing SD in young adults, underscoring the potential for dietary interventions and microbiome modulation in mental health promotion.
Collapse
Affiliation(s)
- Xiumin Jiang
- Institute of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine, Jinan, China; South China Research Center for Acupuncture and Moxibustion, Clinical Medical College of Acupuncture, Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaotong Wang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China; South China Research Center for Acupuncture and Moxibustion, Clinical Medical College of Acupuncture, Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Meng Zhang
- Institute of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Lin Yu
- Department of Traditional Chinese Medicine, the Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Sleep Research Institute of Integrative Medicine, the Affiliated TCM Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jun He
- Rehabilitation Center, Counseling Department, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shengwei Wu
- Department of Traditional Chinese Medicine, the Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jinglan Yan
- Institute of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yuanjia Zheng
- Institute of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yuanyuan Zhou
- Institute of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yongjun Chen
- Institute of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine, Jinan, China; South China Research Center for Acupuncture and Moxibustion, Clinical Medical College of Acupuncture, Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China; Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, Guangzhou, China.
| |
Collapse
|
14
|
Velichkov M, Bezur Z, van Reekum CM, Williams CM. A biphasic response to blueberry supplementation on depressive symptoms in emerging adults: a double-blind randomized controlled trial. Eur J Nutr 2024; 63:1071-1088. [PMID: 38300292 PMCID: PMC11139700 DOI: 10.1007/s00394-023-03311-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 12/18/2023] [Indexed: 02/02/2024]
Abstract
PURPOSE The aim of the present study was to examine the acute and chronic effects of wild blueberry supplementation on mood, executive function, and serum biomarkers of neuroplasticity, inflammation, and oxidative stress in emerging adults with moderate-to-severe depressive symptoms. METHODS In this double-blind trial, 60 emerging adults (Mage = 20.0 years, 32% male) with self-reported depressive symptoms were randomly assigned to receive a single blueberry drink (acute phase), followed by 6 weeks of daily blueberry supplementation (chronic phase), or a matched placebo drink. The primary outcome was Beck Depression Inventory-II (BDI-II) scores at 6-week follow-up. Further measures included momentary affect (PANAS-X) and accuracy on an executive function task. The data were analyzed using ANCOVAs adjusted for baseline values, sex, and habitual fruit and vegetable intake. Estimated marginal means were calculated to compare the treatment arms. RESULTS The blueberry drink significantly improved positive affect (p = 0.026) and executive function (p = 0.025) at 2 h post-ingestion, with change scores being positively correlated in the blueberry group (r = 0.424, p = 0.017). However, after six weeks of supplementation the reduction in BDI-II scores was greater in the placebo group by 5.8 points (95% CI: 0.8-10.7, p = 0.023). Generalized anxiety and anhedonia also decreased significantly more in the placebo group. No significant differences were found for any of the biomarkers. CONCLUSIONS Six weeks of wild blueberry supplementation were inferior to placebo in reducing depressive symptoms. Nevertheless, the correlated improvements in positive affect and executive function after a single dose of blueberries point to a beneficial, albeit transient, psychological effect. These contrasting results suggest a biphasic, hormetic-like response that warrants further investigation. TRIAL REGISTRATION NCT04647019, dated 30 November, 2020.
Collapse
Affiliation(s)
- Martin Velichkov
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Zsofia Bezur
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Carien M van Reekum
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Claire M Williams
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK.
| |
Collapse
|
15
|
Shema A, Nouha T, Nesrine K, Asma M, Emna BM, Leila M, Radhouene D. Adherence and barriers to Mediterranean diet in Tunisian patients with nonalcoholic fatty liver disease. Future Sci OA 2024; 10:FSO919. [PMID: 38817356 PMCID: PMC11137804 DOI: 10.2144/fsoa-2023-0140] [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: 07/27/2023] [Accepted: 10/05/2023] [Indexed: 06/01/2024] Open
Abstract
Aim: The burden of non alcoolic fatty liver disease (NAFLD) is globally increasing. While crucial for management, NAFLD patient adherence to the Mediterranean diet (MD) is underexplored, especially in Mediterranean countries such as Tunisia. Materials & methods: A prospective study (Nov 2022-Feb 2023) supervised MD introduction by a nutritionist, evaluated adherence with MEDAS scores (≥10 for good compliance), and explored barriers to good adherence. Results: Among 41 patients (11 male/30 female, mean age 56 [29-70]), 63% had low education and 51% had metabolic syndrome. Good MD adherence stood at 14.6%. Poor adherence tied to diet-induced higher costs (p = 0.021) and difficulty to new-diet adoption (p = 0.026). Conclusion: Tunisian NAFLD patients had low MD adherence due to financial constraints and dietary adaptation challenges.
Collapse
Affiliation(s)
- Ayadi Shema
- Gastroenterology Department, Charles Nicolle Hospital, Faculty of Medicine of Tunis, University Tunis El Manar Tunis, Tunisia
| | - Trad Nouha
- Gastroenterology Department, Charles Nicolle Hospital, Faculty of Medicine of Tunis, University Tunis El Manar Tunis, Tunisia
| | - Krifa Nesrine
- Gastroenterology Department, Charles Nicolle Hospital, Faculty of Medicine of Tunis, University Tunis El Manar Tunis, Tunisia
| | - Mensi Asma
- Gastroenterology Department, Charles Nicolle Hospital, Faculty of Medicine of Tunis, University Tunis El Manar Tunis, Tunisia
| | - Belhadj Mabrouk Emna
- Gastroenterology Department, Charles Nicolle Hospital, Faculty of Medicine of Tunis, University Tunis El Manar Tunis, Tunisia
| | - Mouelhi Leila
- Gastroenterology Department, Charles Nicolle Hospital, Faculty of Medicine of Tunis, University Tunis El Manar Tunis, Tunisia
| | - Dabbeche Radhouene
- Gastroenterology Department, Charles Nicolle Hospital, Faculty of Medicine of Tunis, University Tunis El Manar Tunis, Tunisia
| |
Collapse
|
16
|
Camprodon-Boadas P, Gil-Dominguez A, De la Serna E, Sugranyes G, Lázaro I, Baeza I. Mediterranean Diet and Mental Health in Children and Adolescents: A Systematic Review. Nutr Rev 2024:nuae053. [PMID: 38758659 DOI: 10.1093/nutrit/nuae053] [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] [Indexed: 05/19/2024] Open
Abstract
CONTEXT Childhood and adolescence are periods of critical importance in the development of mental health disorders. The Mediterranean diet (MD) has been linked to multiple positive health outcomes, including reduced incidence of mental health disorders and fewer psychiatric symptoms. OBJECTIVE This study aimed to investigate the association between adherence to an MD and mental health outcomes in children and adolescents. METHODS A systematic literature review was conducted of original research that explored the relationship between psychiatric symptoms or disorders and adherence to an MD. The literature search was conducted on PubMed, Scopus, Web of Science, MEDES, Dialnet, and Latindex from inception to November 2022, and the Newcastle-Ottawa Scale was used to evaluate the quality of studies. RESULTS A total of 13 studies (6 cross-sectional, 4 case-control, 2 randomized clinical trials, and 1 longitudinal cohort) out of 450 met the inclusion criteria. A total of 3058 children or adolescents with a mean age range from 8.6 to 16.2 years were included. Among the reviewed studies, 5 (71.42%) of those looking at attention-deficit/hyperactivity disorder, 4 (80%) examining depression, and 2 (50%) assessing anxiety found a significant protective association. Seven articles (53.84%) were found to be of high quality and 6 (46.15%) of moderate quality. CONCLUSION Adherence to an MD could be a protective factor for mental health in child and adolescent populations. This suggests that promoting an MD could help prevent the onset of clinical psychiatric symptoms, reduce symptom severity, and improve prognosis in young patients. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42021276316.
Collapse
Affiliation(s)
- Patricia Camprodon-Boadas
- Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Institut Clinic de Neurociències, Hospital Clínic Universitari, Barcelona, 08036, Spain
- Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, 08036, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, 28029, Spain
- Department of Medicine, Institute of Neurosciences, Universitat de Barcelona, Barcelona, 08036, Spain
| | - Aitana Gil-Dominguez
- Department of Medicine, Institute of Neurosciences, Universitat de Barcelona, Barcelona, 08036, Spain
| | - Elena De la Serna
- Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Institut Clinic de Neurociències, Hospital Clínic Universitari, Barcelona, 08036, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, 28029, Spain
| | - Gisela Sugranyes
- Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Institut Clinic de Neurociències, Hospital Clínic Universitari, Barcelona, 08036, Spain
- Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, 08036, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, 28029, Spain
| | - Iolanda Lázaro
- Cardiovascular Risk and Nutrition, Hospital del Mar Medical Research Institute (IMIM), Barcelona, 08003, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, 28029, Spain
| | - Immaculada Baeza
- Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Institut Clinic de Neurociències, Hospital Clínic Universitari, Barcelona, 08036, Spain
- Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, 08036, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, 28029, Spain
- Department of Medicine, Institute of Neurosciences, Universitat de Barcelona, Barcelona, 08036, Spain
| |
Collapse
|
17
|
Werneck AO, Steele EM, Delpino FM, Lane MM, Marx W, Jacka FN, Stubbs B, Touvier M, Srour B, Louzada ML, Levy RB, Monteiro CA. Adherence to the ultra-processed dietary pattern and risk of depressive outcomes: Findings from the NutriNet Brasil cohort study and an updated systematic review and meta-analysis. Clin Nutr 2024; 43:1190-1199. [PMID: 38613906 DOI: 10.1016/j.clnu.2024.03.028] [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: 12/21/2023] [Revised: 02/24/2024] [Accepted: 03/24/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND & AIMS We aimed to analyze the prospective association between adherence to the ultra-processed dietary pattern and risk of depressive outcomes using original data from the NutriNet Brasil cohort and via a systematic review and meta-analysis of observational studies that have investigated the same association. METHODS In our original research analysis, we used data from 15,960 adults (≥18 y) participating in the NutriNet Brasil cohort study, free of depression or depressive symptoms during the baseline (77.5% women, 45.8 ± 13.0 y). The mean dietary share of ultra-processed foods (%Kcal/d), calculated from two baseline 24-h dietary recalls, was used to measure the adherence to the ultra-processed dietary pattern. New cases of depressive symptoms were assessed using the Patient Health Questionnaire-9 over the follow-up period (mean: 18.3 months). Cox proportional hazards models were used for the main analyses. In our systematic review and meta-analysis, we incorporated effect estimates from six prospective cohort studies that have examined the same association, including ours. RESULTS In the adjusted model, each 10% increase in the dietary share of ultra-processed foods was associated with a 10% increase in the hazard of incident cases of depressive symptoms (HR:1.10; 95%CI: 1.07-1.14). This association was slightly attenuated in the models including potential mediators. In our meta-analysis of six prospective studies, high versus low exposure to ultra-processed foods was associated with a summary hazard ratio of depressive outcomes of 1.32; 95%CI: 1.19-1.46; I2: 71%. CONCLUSION A higher adherence to the ultra-processed dietary pattern was associated with a higher risk of developing depressive outcomes in the NutriNet Brasil cohort and in the meta-analysis.
Collapse
Affiliation(s)
- André O Werneck
- Center for Epidemiological Research in Nutrition and Health, Department of Nutrition, School of Public Health, University of São Paulo (USP), São Paulo, SP, Brazil
| | - Euridice M Steele
- Center for Epidemiological Research in Nutrition and Health, Department of Nutrition, School of Public Health, University of São Paulo (USP), São Paulo, SP, Brazil
| | - Felipe M Delpino
- Postgraduate in Nursing, Federal University of Pelotas (UFPel), Pelotas, Rio Grande do Sul, Brazil
| | - Melissa M Lane
- Deakin University, IMPACT (the Institute for Mental and Physical Health and Clinical Translation), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Wolfgang Marx
- Deakin University, IMPACT (the Institute for Mental and Physical Health and Clinical Translation), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Felice N Jacka
- Deakin University, IMPACT (the Institute for Mental and Physical Health and Clinical Translation), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Mathilde Touvier
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Villetaneuse, France
| | - Bernard Srour
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Villetaneuse, France
| | - Maria Lc Louzada
- Center for Epidemiological Research in Nutrition and Health, Department of Nutrition, School of Public Health, University of São Paulo (USP), São Paulo, SP, Brazil
| | - Renata B Levy
- Center for Epidemiological Research in Nutrition and Health, Department of Nutrition, School of Public Health, University of São Paulo (USP), São Paulo, SP, Brazil
| | - Carlos A Monteiro
- Center for Epidemiological Research in Nutrition and Health, Department of Nutrition, School of Public Health, University of São Paulo (USP), São Paulo, SP, Brazil.
| |
Collapse
|
18
|
O'Brien L, Kasti A, Halmos EP, Tuck C, Varney J. Evolution, adaptation, and new applications of the FODMAP diet. JGH Open 2024; 8:e13066. [PMID: 38770353 PMCID: PMC11103764 DOI: 10.1002/jgh3.13066] [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: 02/11/2024] [Accepted: 04/03/2024] [Indexed: 05/22/2024]
Abstract
The FODMAP diet has been a treatment of irritable bowel syndrome (IBS) for many years. Rigorous scientific evaluation and clinical application of the FODMAP diet have generated deep understanding regarding clinical efficacy, mechanisms of action, and potential adverse effects of this dietary approach. In turn, this knowledge has allowed fine-tuning of the diet to optimize treatment benefits and minimize risks, in the form of the traditional three-phase diet; the FODMAP-gentle approach, which is a less restrictive iteration; and a proposed FODMAP-modified, Mediterranean-style diet which endeavours to optimise both gastrointestinal symptoms and other health parameters. Furthermore, recognition that IBS-like symptoms feature in other conditions has seen the FODMAP diet tested in non-IBS populations, including in older adults with diarrhea and women with endometriosis. These areas represent new frontiers for the FODMAP diet and a space to watch as future research evaluates the validity of these novel clinical applications.
Collapse
Affiliation(s)
- Leigh O'Brien
- Department of MedicineUniversity of OtagoChristchurchNew Zealand
| | - Arezina Kasti
- Department of Nutrition and DieteticsATTIKON University General HospitalAthensGreece
| | - Emma P. Halmos
- Department of GastroenterologyMonash University and Alfred HealthMelbourneVictoriaAustralia
| | - Caroline Tuck
- Department of Nursing and Allied HealthSwinburne UniversityMelbourneVictoriaAustralia
| | - Jane Varney
- Department of GastroenterologyMonash University and Alfred HealthMelbourneVictoriaAustralia
| |
Collapse
|
19
|
Deligiannidou GE, Philippou E, Vasiari E, de Andrade VL, Massaro M, Chervenkov M, Ivanova T, Jorge R, Dimitrova D, Ruskovska T, Miloseva L, Maksimova V, Smilkov K, Gjorgieva Ackova D, García-Conesa MT, Pinto P, Kontogiorgis CA. Exploring the Relationship between Mediterranean Diet Adherence and Subjective Well-Being among Greek and Cypriot Adults. Nutrients 2024; 16:1238. [PMID: 38674928 PMCID: PMC11054782 DOI: 10.3390/nu16081238] [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: 03/01/2024] [Revised: 04/11/2024] [Accepted: 04/18/2024] [Indexed: 04/28/2024] Open
Abstract
Associations between subjective well-being (SWB) and dietary habits, employment status, and habitual activities are increasingly capturing the focus of researchers as well as policymakers worldwide. This study aimed to explore these associations in a sample of the population in Greece and Cyprus via an online survey. In total, 936 questionnaires (470: Cyprus, 466: Greece) were analyzed to study the associations between the Mediterranean Diet (MD) (using the 14-item MEDAS score, (14-MEDAS)), subjective well-being (SWB), and several socioeconomic factors. Key remarks of this survey highlight the positive impact of MD adherence on some well-being items. Namely, statistically significant differences were found on the following items: Satisfied with life (p < 0.001), Life worthwhile (p < 0.001), Feeling happy (p < 0.001), worried (p = 0.005), and depressed (p = 0.001), when comparing Low MD adherence (14-MEDAS < 5) to High MD adherence (14-MEDAS > 10). Other lifestyle habits such as spending time with friends and family, spending time in nature, and habitual physical activity were associated with aspects of SWB such as Life satisfaction, Life worthwhile, Feeling happy, and energetic. The findings support adherence to the MD, since it is associated with higher life satisfaction and self-reported happiness in this sample and should be considered when developing health policies on well-being.
Collapse
Affiliation(s)
- Georgia-Eirini Deligiannidou
- Laboratory of Hygiene and Environmental Protection, School of Medicine, Democritus University of Thrace, Dragana, 68100 Alexandroupolis, Greece; (G.-E.D.); (E.V.)
| | - Elena Philippou
- Department of Life Sciences, School of Sciences, University of Nicosia, Nicosia 1700, Cyprus
- Department of Nutritional Sciences, King’s College London, London SE1 9NH, UK
| | - Eirini Vasiari
- Laboratory of Hygiene and Environmental Protection, School of Medicine, Democritus University of Thrace, Dragana, 68100 Alexandroupolis, Greece; (G.-E.D.); (E.V.)
| | - Vanda Lopes de Andrade
- Agriculture School, Polytechnic University of Santarém, 2001-904 Santarem, Portugal; (V.L.d.A.); (P.P.)
- Research Centre for Natural Resources, Environment and Society (CERNAS), 3045-601 Coimbra, Portugal
- Life Quality Research Centre (CIEQV), 2040-413 Rio Maior, Portugal
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, 1649-003 Lisboa, Portugal
| | - Marika Massaro
- Institute of Clinical Physiology, National Research Council (CNR), 73100 Lecce, Italy;
| | - Mihail Chervenkov
- Faculty of Veterinary Medicine, University of Forestry, 1797 Sofia, Bulgaria;
- Slow Food in Bulgaria, 9 Pierre De Geytre St. bl. 3, 1113 Sofia, Bulgaria;
- Department of Plant and Fungal Diversity and Resources, Institute of Biodiversity and Ecosystem Research, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria;
| | - Teodora Ivanova
- Department of Plant and Fungal Diversity and Resources, Institute of Biodiversity and Ecosystem Research, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria;
| | - Rui Jorge
- School of Health Sciences, Polytechnic University of Leiria, 2411-901 Leiria, Portugal;
- Center for Innovative Care and Health Technology (ciTechcare), Polytechnic of Leiria, 2411-901 Leiria, Portugal
- Sport Sciences School of Rio Maior, Polytechnic University of Santarém, 2040-413 Rio Maior, Portugal
| | - Dessislava Dimitrova
- Slow Food in Bulgaria, 9 Pierre De Geytre St. bl. 3, 1113 Sofia, Bulgaria;
- Department of Plant and Fungal Diversity and Resources, Institute of Biodiversity and Ecosystem Research, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria;
| | - Tatjana Ruskovska
- Faculty of Medical Sciences, Goce Delcev University, Stip, Str. Krste Misirkov, No. 10A, POB 201, 2000 Stip, North Macedonia; (T.R.); (L.M.); (V.M.); (K.S.); (D.G.A.)
| | - Lence Miloseva
- Faculty of Medical Sciences, Goce Delcev University, Stip, Str. Krste Misirkov, No. 10A, POB 201, 2000 Stip, North Macedonia; (T.R.); (L.M.); (V.M.); (K.S.); (D.G.A.)
| | - Viktorija Maksimova
- Faculty of Medical Sciences, Goce Delcev University, Stip, Str. Krste Misirkov, No. 10A, POB 201, 2000 Stip, North Macedonia; (T.R.); (L.M.); (V.M.); (K.S.); (D.G.A.)
| | - Katarina Smilkov
- Faculty of Medical Sciences, Goce Delcev University, Stip, Str. Krste Misirkov, No. 10A, POB 201, 2000 Stip, North Macedonia; (T.R.); (L.M.); (V.M.); (K.S.); (D.G.A.)
| | - Darinka Gjorgieva Ackova
- Faculty of Medical Sciences, Goce Delcev University, Stip, Str. Krste Misirkov, No. 10A, POB 201, 2000 Stip, North Macedonia; (T.R.); (L.M.); (V.M.); (K.S.); (D.G.A.)
| | - María-Teresa García-Conesa
- Research Group on Quality, Safety and Bioactivity of Plant Foods, Centro de Edafología y Biología Aplicada del Segura-Consejo Superior de Investigaciones Científicas (CEBAS-CSIC), Campus de Espinardo, P.O. Box 164, 30100 Murcia, Spain;
| | - Paula Pinto
- Agriculture School, Polytechnic University of Santarém, 2001-904 Santarem, Portugal; (V.L.d.A.); (P.P.)
- Research Centre for Natural Resources, Environment and Society (CERNAS), 3045-601 Coimbra, Portugal
- Life Quality Research Centre (CIEQV), 2040-413 Rio Maior, Portugal
| | - Christos A. Kontogiorgis
- Laboratory of Hygiene and Environmental Protection, School of Medicine, Democritus University of Thrace, Dragana, 68100 Alexandroupolis, Greece; (G.-E.D.); (E.V.)
| |
Collapse
|
20
|
Warren A. The relationship between gender differences in dietary habits, neuroinflammation, and Alzheimer's disease. Front Aging Neurosci 2024; 16:1395825. [PMID: 38694261 PMCID: PMC11061392 DOI: 10.3389/fnagi.2024.1395825] [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: 03/04/2024] [Accepted: 04/03/2024] [Indexed: 05/04/2024] Open
Abstract
Neurocognitive decline is one of the foremost dire issues in medicine today. The mechanisms by which dementia pathogenesis ensues are complicated and multifactorial, particularly in the case of Alzheimer's disease (AD). One irrefutable, yet unexplained factor is the gender disparity in AD, in which women are disproportionately affected by AD, both in the rate and severity of the disease. Examining the multifaceted contributing causes along with unique gender dynamics in modifiable risk factors, such as diet, may lend some insight into why this disparity exists and potential paths forward. The aim of this brief narrative review is to summarize the current literature of gender differences in dietary habits and how they may relate to neuroinflammatory states that contribute to AD pathogenesis. As such, the interplay between diet, hormones, and inflammation will be discussed, along with potential interventions to inform care practices.
Collapse
Affiliation(s)
- Alison Warren
- The Department of Clinical Research and Leadership, George Washington University School of Medicine and Health Sciences, Washington, DC, United States
| |
Collapse
|
21
|
Alnabulsi M, Imam AA, Alawlaqi AA, Alhawaj FH, Jamjoom GF, Alsaeidi LD, Hassan FES, Ansari SA. Adherence to the Mediterranean Diet in Saudi Arabia and Its Association with Socioeconomic Status and Depression. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:642. [PMID: 38674290 PMCID: PMC11051785 DOI: 10.3390/medicina60040642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/02/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024]
Abstract
Background and Objectives: Several RCTs have reported significant reductions in depression symptoms with the Mediterranean diet (MedDiet), but observational studies have reported inconsistent findings. Moreover, studies have rarely investigated the mediating role of socioeconomic status (SES), including objective material status, in adherence to the MedDiet and its impact on depressive symptoms in the same population. Therefore, this cross-sectional study investigated the relationship between adherence to the MedDiet, socioeconomic factors, and depression severity. Materials and Methods: A cross-sectional online survey was conducted between June and December 2022 across Saudia Arabia. The snowball sampling technique was used to recruit participants aged ≥18 years. Mediterranean diet adherence screener (MEDAS) and Patient Health Questionnaire-9 (PHQ-9) were used to assess adherence to the MedDiet and depression severity. An SES index, validated in the Saudi Arabian context, was used to assess SES. The data were analyzed using the Chi-square and Pearson's correlation tests. Results: Only 21% of our study population (n = 467) was MedDiet adherent. Adherence was significantly associated with education (p = 0.014) but not employment status among traditional SES indicators. Similarly, only television ownership (p = 0.009) was associated with MedDiet adherence among the 20 objective material possessions investigated. Nonetheless, the MedDiet-adherent group had a significantly lower PHQ-9 score than the non-adherent group (6.16 ± 0.68 vs. 8.35 ± 0.31, p = 0.002). A moderate but significantly negative correlation between MEDAS and PHQ-9 scores (r = -0.16, p = 0.001) was noted. Conclusions: MedDiet adherence was associated with lower depression severity scores. In addition to education and television ownership, adherence was not associated with any objective indicators of SES.
Collapse
Affiliation(s)
- Majed Alnabulsi
- Department of Internal Medicine, General Medicine Practice Program, Batterjee Medical College, Jeddah 21442, Saudi Arabia;
| | - Ahmad Abdullah Imam
- Internal Medicine Department, College of Medicine, Umm Al-Qura University, Makkah 24382, Saudi Arabia;
| | - Atheer Ahmed Alawlaqi
- General Medicine Practice Program, Batterjee Medical College, Jeddah 21442, Saudi Arabia; (A.A.A.); (F.H.A.); (G.F.J.); (L.D.A.)
| | - Fatimah Hussain Alhawaj
- General Medicine Practice Program, Batterjee Medical College, Jeddah 21442, Saudi Arabia; (A.A.A.); (F.H.A.); (G.F.J.); (L.D.A.)
| | - Ghazal Fareed Jamjoom
- General Medicine Practice Program, Batterjee Medical College, Jeddah 21442, Saudi Arabia; (A.A.A.); (F.H.A.); (G.F.J.); (L.D.A.)
| | - Lina Dakhil Alsaeidi
- General Medicine Practice Program, Batterjee Medical College, Jeddah 21442, Saudi Arabia; (A.A.A.); (F.H.A.); (G.F.J.); (L.D.A.)
| | - Fatma El-Sayed Hassan
- Medical Physiology Department, Kasr Alainy, Faculty of Medicine, Cairo University, Giza 11562, Egypt;
- General Medicine Practice Program, Department of Physiology, Batterjee Medical College, Jeddah 21442, Saudi Arabia
| | - Shakeel Ahmed Ansari
- General Medicine Practice Program, Batterjee Medical College, Jeddah 21442, Saudi Arabia; (A.A.A.); (F.H.A.); (G.F.J.); (L.D.A.)
| |
Collapse
|
22
|
Dong X, Wang Y, Kang Y, Zhou X, Li J, Cao H, Li Y, Li Y, Yang P, Duan Y, Xie J. Protein-enriched and anti-inflammatory dietary patterns, healthy lifestyle index and depressive symptoms: A cross-sectional study of 287,945 adults in China. J Affect Disord 2024; 351:863-869. [PMID: 38342321 DOI: 10.1016/j.jad.2024.02.028] [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: 02/24/2023] [Revised: 01/18/2024] [Accepted: 02/08/2024] [Indexed: 02/13/2024]
Abstract
OBJECTIVES Depressive symptoms have a considerable negative impact on mental health. This study aimed to understand the relationship between the protein-enriched and anti-inflammatory dietary index scores, modified healthy lifestyle index scores (Modified HLIS), and depressive symptoms. METHODS This study used convenience sampling to conduct a single-center cross-sectional survey. From January 1, 2015 to December 31, 2020, a total of 287,945 Chinese adults from a health management center of a general hospital completed an online self-reported health questionnaire, which included demographic characteristics, the Dietary Diversity Scale, the Modified Healthy Lifestyle Index Scores and the Patient Health Questionnaire-9. RESULTS The higher anti-inflammatory dietary index scores (POR = 0.87; 95 % CI: 0.86-0.87; p < 0.001), moderate modified healthy lifestyle index scores (POR = 0.76; 95 % CI: 0.75-0.78; p < 0.001) and sufficient modified healthy lifestyle index scores (POR = 0.53; 95 % CI: 0.52-0.54; p < 0.001) were negatively associated with depressive symptoms, while the higher protein-enriched dietary index scores (POR = 1.01; 95 % CI: 1.01-1.02; p < 0.001) was positively correlated with depressive symptoms. CONCLUSIONS This study demonstrated that protein-enriched and anti-inflammatory dietary index scores, and multiple healthy lifestyles are associated depressive symptoms in adults.
Collapse
Affiliation(s)
- Xiaoqian Dong
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha 410000, China; Xiangya Nursing School, Central South University, Changsha 410000, China.
| | - Yaqin Wang
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha 410000, China.
| | - Yue Kang
- Xiangya Nursing School, Central South University, Changsha 410000, China.
| | - Xing Zhou
- Xiangya Nursing School, Central South University, Changsha 410000, China
| | - Jing Li
- Xiangya Nursing School, Central South University, Changsha 410000, China
| | - Huan Cao
- Xiangya Nursing School, Central South University, Changsha 410000, China
| | - Yuxuan Li
- Xiangya Nursing School, Central South University, Changsha 410000, China.
| | - Ying Li
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha 410000, China.
| | - Pingting Yang
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha 410000, China
| | - Yinglong Duan
- Nursing Department, The Third Xiangya Hospital, Central South University, Changsha 410000, China.
| | - Jianfei Xie
- Nursing Department, The Third Xiangya Hospital, Central South University, Changsha 410000, China.
| |
Collapse
|
23
|
Hu J, He K, Yang Y, Huang C, Dou Y, Wang H, Zhang G, Wang J, Niu C, Bi G, Zhang L, Zhu S. Amino acid formula induces microbiota dysbiosis and depressive-like behavior in mice. Cell Rep 2024; 43:113817. [PMID: 38412095 DOI: 10.1016/j.celrep.2024.113817] [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: 07/31/2023] [Revised: 11/24/2023] [Accepted: 02/01/2024] [Indexed: 02/29/2024] Open
Abstract
Amino acid formula (AAF) is increasingly consumed in infants with cow's milk protein allergy; however, the long-term influences on health are less described. In this study, we established a mouse model by subjecting neonatal mice to an amino acid diet (AAD) to mimic the feeding regimen of infants on AAF. Surprisingly, AAD-fed mice exhibited dysbiotic microbiota and increased neuronal activity in both the intestine and brain, as well as gastrointestinal peristalsis disorders and depressive-like behavior. Furthermore, fecal microbiota transplantation from AAD-fed mice or AAF-fed infants to recipient mice led to elevated neuronal activations and exacerbated depressive-like behaviors compared to that from normal chow-fed mice or cow's-milk-formula-fed infants, respectively. Our findings highlight the necessity to avoid the excessive use of AAF, which may influence the neuronal development and mental health of children.
Collapse
Affiliation(s)
- Ji Hu
- Key Laboratory of Immune Response and Immunotherapy, Center for Advanced Interdisciplinary Science and Biomedicine of IHM, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China
| | - Kaixin He
- Key Laboratory of Immune Response and Immunotherapy, Center for Advanced Interdisciplinary Science and Biomedicine of IHM, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China
| | - Yifei Yang
- School of Data Science, University of Science and Technology of China, Hefei, China
| | - Chuan Huang
- Key Laboratory of Immune Response and Immunotherapy, Center for Advanced Interdisciplinary Science and Biomedicine of IHM, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Yiping Dou
- Key Laboratory of Immune Response and Immunotherapy, Center for Advanced Interdisciplinary Science and Biomedicine of IHM, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Hao Wang
- Key Laboratory of Immune Response and Immunotherapy, Center for Advanced Interdisciplinary Science and Biomedicine of IHM, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Guorong Zhang
- Key Laboratory of Immune Response and Immunotherapy, Center for Advanced Interdisciplinary Science and Biomedicine of IHM, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China
| | - Jingyuan Wang
- Key Laboratory of Immune Response and Immunotherapy, Center for Advanced Interdisciplinary Science and Biomedicine of IHM, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Chaoshi Niu
- The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China
| | - Guoqiang Bi
- Key Laboratory of Immune Response and Immunotherapy, Center for Advanced Interdisciplinary Science and Biomedicine of IHM, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Lan Zhang
- The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China.
| | - Shu Zhu
- Key Laboratory of Immune Response and Immunotherapy, Center for Advanced Interdisciplinary Science and Biomedicine of IHM, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China; School of Data Science, University of Science and Technology of China, Hefei, China.
| |
Collapse
|
24
|
Warren M, O'Connor C, Lee JE, Burton J, Walton D, Keathley J, Wammes M, Osuch E. Predispose, precipitate, perpetuate, and protect: how diet and the gut influence mental health in emerging adulthood. Front Nutr 2024; 11:1339269. [PMID: 38505265 PMCID: PMC10948435 DOI: 10.3389/fnut.2024.1339269] [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: 11/15/2023] [Accepted: 02/02/2024] [Indexed: 03/21/2024] Open
Abstract
Medicine often employs the 4Ps of predisposing, precipitating, perpetuating, and protective factors to identify salient influences on illness states, and to help guide patient care. Mental illness is a significant cause of morbidity and mortality worldwide. Mental health is a complex combination of biological, psychological, environmental, and social factors. There is growing interest in the gut-brain-microbiome (GBM) axis and its impact on mental health. We use the medical model of the 4Ps to explore factors involving the connection between nutrition and the GBM axis and their associated risks with mental health problems in emerging adults (EAs), a life stage when mental illness onset is the most common. We review the impact of current dietary trends on the GBM and on mental health, and the role that gut microbiome-based interventions can have in modulating the GBM axis of EAs. We discuss the implications of gut health on the GBM and areas for clinical intervention.
Collapse
Affiliation(s)
- Michael Warren
- Department of Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Colleen O'Connor
- School of Food and Nutritional Sciences, Brescia University College, London, ON, Canada
| | - Ju Eun Lee
- Geriatrics, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Jeremy Burton
- Department of Surgery, Microbiology and Immunology, Lawson Health Research Institute, Western University, London, ON, Canada
| | - David Walton
- School of Physical Therapy, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Justine Keathley
- Department of Human Health and Nutritional Sciences, College of Biological Science, University of Guelph, Guelph, ON, Canada
| | - Michael Wammes
- Department of Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Elizabeth Osuch
- Department of Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
- London Health Sciences Centre, Lawson Health Research Institute, London, ON, Canada
- First Episode Mood and Anxiety Program, London Health Sciences Centre, London, ON, Canada
| |
Collapse
|
25
|
Cheng J, Hu H, Ju Y, Liu J, Wang M, Liu B, Zhang Y. Gut microbiota-derived short-chain fatty acids and depression: deep insight into biological mechanisms and potential applications. Gen Psychiatr 2024; 37:e101374. [PMID: 38390241 PMCID: PMC10882305 DOI: 10.1136/gpsych-2023-101374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 12/25/2023] [Indexed: 02/24/2024] Open
Abstract
The gut microbiota is a complex and dynamic ecosystem known as the 'second brain'. Composing the microbiota-gut-brain axis, the gut microbiota and its metabolites regulate the central nervous system through neural, endocrine and immune pathways to ensure the normal functioning of the organism, tuning individuals' health and disease status. Short-chain fatty acids (SCFAs), the main bioactive metabolites of the gut microbiota, are involved in several neuropsychiatric disorders, including depression. SCFAs have essential effects on each component of the microbiota-gut-brain axis in depression. In the present review, the roles of major SCFAs (acetate, propionate and butyrate) in the pathophysiology of depression are summarised with respect to chronic cerebral hypoperfusion, neuroinflammation, host epigenome and neuroendocrine alterations. Concluding remarks on the biological mechanisms related to gut microbiota will hopefully address the clinical value of microbiota-related treatments for depression.
Collapse
Affiliation(s)
- Junzhe Cheng
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- Clinical Medicine Eight-Year Program, Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Hongkun Hu
- Clinical Medicine Eight-Year Program, Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Yumeng Ju
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha, Hunan, China
| | - Jin Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha, Hunan, China
| | - Mi Wang
- Department of Mental Health Center, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Bangshan Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha, Hunan, China
| | - Yan Zhang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha, Hunan, China
| |
Collapse
|
26
|
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.
Collapse
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
| |
Collapse
|
27
|
Ross FC, Mayer DE, Gupta A, Gill CIR, Del Rio D, Cryan JF, Lavelle A, Ross RP, Stanton C, Mayer EA. Existing and Future Strategies to Manipulate the Gut Microbiota With Diet as a Potential Adjuvant Treatment for Psychiatric Disorders. Biol Psychiatry 2024; 95:348-360. [PMID: 37918459 DOI: 10.1016/j.biopsych.2023.10.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 09/20/2023] [Accepted: 10/23/2023] [Indexed: 11/04/2023]
Abstract
Nutrition and diet quality play key roles in preventing and slowing cognitive decline and have been linked to multiple brain disorders. This review compiles available evidence from preclinical studies and clinical trials on the impact of nutrition and interventions regarding major psychiatric conditions and some neurological disorders. We emphasize the potential role of diet-related microbiome alterations in these effects and highlight commonalities between various brain disorders related to the microbiome. Despite numerous studies shedding light on these findings, there are still gaps in our understanding due to the limited availability of definitive human trial data firmly establishing a causal link between a specific diet and microbially mediated brain functions and symptoms. The positive impact of certain diets on the microbiome and cognitive function is frequently ascribed with the anti-inflammatory effects of certain microbial metabolites or a reduction of proinflammatory microbial products. We also critically review recent research on pro- and prebiotics and nondietary interventions, particularly fecal microbiota transplantation. The recent focus on diet in relation to brain disorders could lead to improved treatment outcomes with combined dietary, pharmacological, and behavioral interventions.
Collapse
Affiliation(s)
- Fiona C Ross
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland; APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Dylan E Mayer
- Institute of Human Nutrition, Columbia University, New York, New York
| | - Arpana Gupta
- Goodman-Luskin Microbiome Center, G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Chris I R Gill
- Nutrition Innovation Centre for Food and Health, Ulster University, Coleraine, United Kingdom
| | - Daniele Del Rio
- Department of Food and Drugs, University of Parma, Parma, Italy
| | - John F Cryan
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland; APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Aonghus Lavelle
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland; APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - R Paul Ross
- APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Catherine Stanton
- APC Microbiome Ireland, University College Cork, Cork, Ireland; Teagasc Moorepark Food Research Centre, Fermoy, Cork, Ireland.
| | - Emeran A Mayer
- Goodman-Luskin Microbiome Center, G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.
| |
Collapse
|
28
|
Zhang X, Zhou W, Wang H, Bai Y, Zhang F, Lu W. Association between healthy eating and depression symptoms among Chinese older adults: A cross-sectional study based on the Chinese Longitudinal Healthy Longevity survey. Prev Med Rep 2024; 38:102616. [PMID: 38298821 PMCID: PMC10828603 DOI: 10.1016/j.pmedr.2024.102616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/12/2024] [Accepted: 01/14/2024] [Indexed: 02/02/2024] Open
Abstract
Introduction This study aimed to assess the relationship between the healthy eating index (HEI) and depression symptoms in an older adult population using the Chinese Longevity Health Survey. Methods The HEI was constructed based on the frequency of intake of 13 dietary variables, with higher scores indicating better diet quality. Depression symptoms was assessed by the Center for Epidemiologic Studies Depression-10 scale. We used multivariate binary logistic regression to explore the association between the HEI and depression symptoms and reported as odds ratio (OR) and 95 % confidence interval (95 % CI). Results A total of 12,078 older adults were included. The average HEI for this group of older adults was 26.4 ± 7.1. After adjusting for covariates, compared with participants in the lowest quartile of a healthy eating index, those in the second to the fourth quartile group had a 0.93- (95 % CI: 0.83 to 1.03), 0.84- (95 % CI: 0.75 to 0.95) and 0.69- (95 % CI: 0.62 to 0.77) fold risk of depression symptoms, respectively. Restricted cubic spline curves showed that the risk of depression symptoms decreased with increasing HEI, especially above 26, and for each unit increase in the HEI, the risk of depression symptoms in older adults decreased by 3 % (OR = 0.97; 95 % CI: 0.96 to 0.99). Conclusions This study found an association between higher levels of the HEI and reduced risk of depression symptoms in older Chinese adults. This result emphasizes the need to focus on dietary diversity in older adults to promote healthy aging.
Collapse
Affiliation(s)
- Xinyue Zhang
- Department of Oncology, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wenqin Zhou
- Department of Nursing, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hui Wang
- Department of Anorectology, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yan Bai
- Department of Nephrology A, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Fan Zhang
- Department of Nephrology A, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wei Lu
- Department of Nursing, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| |
Collapse
|
29
|
Staudacher HM, Mahoney S, Canale K, Opie RS, Loughman A, So D, Beswick L, Hair C, Jacka FN. Clinical trial: A Mediterranean diet is feasible and improves gastrointestinal and psychological symptoms in irritable bowel syndrome. Aliment Pharmacol Ther 2024; 59:492-503. [PMID: 37969059 DOI: 10.1111/apt.17791] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/17/2023] [Accepted: 10/20/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND Diet is fundamental to the care of irritable bowel syndrome (IBS). However, some approaches are not appropriate for individuals experiencing psychological symptoms. AIMS To assess feasibility of a Mediterranean diet in IBS and its impact on gastrointestinal and psychological symptoms. METHODS We recruited adults with Rome IV IBS and mild or moderate anxiety and/or depressive symptoms to an unblinded 6-week randomised controlled trial. Patients were randomised to Mediterranean diet counselling or habitual diet. We collected gastrointestinal and psychological symptom data, dietary data and stool samples for metagenomic sequencing. RESULTS We randomised 59 individuals (29 Mediterranean diet, 30 control); 48 completed the study. The Mediterranean Diet Adherence Screener score was higher in the Mediterranean diet group than controls at week 6 (7.5 [95% CI: 6.9-8.0] vs. 5.7 [5.2-6.3], p < 0.001), and there was a greater score increase than controls (2.1 [95% CI: 1.3-2.9] vs. 0.5 [95% CI: 0.1-1.0], p = 0.004), demonstrating Mediterranean diet feasibility. There was a greater proportion of gastrointestinal symptom responders in the Mediterranean diet group than controls (24/29, 83% vs. 11/30, 37%, p < 0.001) and depression responders (15/29, 52% vs. 6/30 20%, p = 0.015). There was no difference in FODMAP intake at week 6 (p = 0.51). Gastrointestinal adverse events were similar (p = 0.588). There were no differences in change in microbiome parameters between groups. CONCLUSIONS A Mediterranean diet is feasible in IBS and leads to improvement in gastrointestinal and psychological symptoms. Although this study was unblinded, these findings together with the broader benefits of the Mediterranean diet, provide strong impetus for future research in IBS. Australia New Zealand Clinical Trials Registry: ACTRN12620001362987.
Collapse
Affiliation(s)
- Heidi M Staudacher
- Food & Mood Centre, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine and Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Sophie Mahoney
- Food & Mood Centre, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine and Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Kim Canale
- Food & Mood Centre, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine and Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Rachelle S Opie
- Food & Mood Centre, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine and Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Amy Loughman
- Food & Mood Centre, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine and Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Daniel So
- Food & Mood Centre, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine and Barwon Health, Deakin University, Geelong, Victoria, Australia
- Department of Nutritional Sciences, King's College London, London, UK
| | - Lauren Beswick
- Department of Gastroenterology, Barwon Health, Geelong, Victoria, Australia
- School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Chris Hair
- Department of Gastroenterology, Barwon Health, Geelong, Victoria, Australia
- School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Felice N Jacka
- Food & Mood Centre, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine and Barwon Health, Deakin University, Geelong, Victoria, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| |
Collapse
|
30
|
Bayes J, Schloss J, Sibbritt D. The use of diet for preventing and treating depression in young men: current evidence and existing challenges. Br J Nutr 2024; 131:214-218. [PMID: 37519245 PMCID: PMC10751942 DOI: 10.1017/s000711452300168x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 07/12/2023] [Accepted: 07/25/2023] [Indexed: 08/01/2023]
Abstract
Emerging evidence suggests that diet therapy (nutrients, foods and dietary patterns) could be effective as a potential adjunctive treatment option for major depressive disorder. Numerous mechanisms have been proposed, including the role inflammation, oxidative stress, brain-derived neurotrophic factor, the gastrointestinal tract microbiome and tryptophan/serotonin metabolism. Despite known differences in depression characteristics and treatment responses between males and females, there are limited sex-specific studies examining the role of diet in young men specifically. This is important as young men are often reluctant to seek mental health support, so finding treatment strategies which appeal to this demographic is crucial. This brief report provides an overview of the most recent advances in the use of diet for preventing and treating depression in young men, highlighting existing challenges and opportunities for future research. We recommend that clinicians discuss the role of diet with depressed young men, so that diet may be used alongside current treatment options.
Collapse
Affiliation(s)
- Jessica Bayes
- National Centre for Naturopathic Medicine, Southern Cross University, Lismore, NSW2480, Australia
| | - Janet Schloss
- National Centre for Naturopathic Medicine, Southern Cross University, Lismore, NSW2480, Australia
| | - David Sibbritt
- School of Public Health, University of Technology Sydney, Ultimo, NSW2007, Australia
| |
Collapse
|
31
|
Prescott SL, Logan AC, D’Adamo CR, Holton KF, Lowry CA, Marks J, Moodie R, Poland B. Nutritional Criminology: Why the Emerging Research on Ultra-Processed Food Matters to Health and Justice. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:120. [PMID: 38397611 PMCID: PMC10888116 DOI: 10.3390/ijerph21020120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/17/2024] [Accepted: 01/22/2024] [Indexed: 02/25/2024]
Abstract
There is mounting concern over the potential harms associated with ultra-processed foods, including poor mental health and antisocial behavior. Cutting-edge research provides an enhanced understanding of biophysiological mechanisms, including microbiome pathways, and invites a historical reexamination of earlier work that investigated the relationship between nutrition and criminal behavior. Here, in this perspective article, we explore how this emergent research casts new light and greater significance on previous key observations. Despite expanding interest in the field dubbed 'nutritional psychiatry', there has been relatively little attention paid to its relevancy within criminology and the criminal justice system. Since public health practitioners, allied mental health professionals, and policymakers play key roles throughout criminal justice systems, a holistic perspective on both historical and emergent research is critical. While there are many questions to be resolved, the available evidence suggests that nutrition might be an underappreciated factor in prevention and treatment along the criminal justice spectrum. The intersection of nutrition and biopsychosocial health requires transdisciplinary discussions of power structures, industry influence, and marketing issues associated with widespread food and social inequalities. Some of these discussions are already occurring under the banner of 'food crime'. Given the vast societal implications, it is our contention that the subject of nutrition in the multidisciplinary field of criminology-referred to here as nutritional criminology-deserves increased scrutiny. Through combining historical findings and cutting-edge research, we aim to increase awareness of this topic among the broad readership of the journal, with the hopes of generating new hypotheses and collaborations.
Collapse
Affiliation(s)
- Susan L. Prescott
- School of Medicine, University of Western Australia, Perth, WA 6009, Australia;
- Nova Institute for Health, Baltimore, MD 21231, USA;
- Department of Family and Community Medicine, School of Medicine, University of Maryland, Baltimore, MD 21201, USA
- The ORIGINS Project, Telethon Kids Institute, Perth, WA 6009, Australia
| | - Alan C. Logan
- Nova Institute for Health, Baltimore, MD 21231, USA;
| | - Christopher R. D’Adamo
- Nova Institute for Health, Baltimore, MD 21231, USA;
- Department of Family and Community Medicine, School of Medicine, University of Maryland, Baltimore, MD 21201, USA
| | - Kathleen F. Holton
- Departments of Health Studies and Neuroscience, Center for Neuroscience and Behavior, American University, Washington, DC 20016, USA;
| | - Christopher A. Lowry
- Department of Psychology and Neuroscience, Center for Neuroscience and Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO 80309, USA;
| | - John Marks
- Department of Criminal Justice, Louisiana State University of Alexandria, Alexandria, LA 71302, USA;
| | - Rob Moodie
- School of Population and Global Health (MSPGH), University of Melbourne, Melbourne, VIC 3052, Australia;
| | - Blake Poland
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5R 0A3, Canada;
| |
Collapse
|
32
|
Bizzozero-Peroni B, Martínez-Vizcaíno V, Fernández-Rodríguez R, Jiménez-López E, Núñez de Arenas-Arroyo S, Saz-Lara A, Díaz-Goñi V, Mesas AE. The impact of the Mediterranean diet on alleviating depressive symptoms in adults: a systematic review and meta-analysis of randomized controlled trials. Nutr Rev 2024:nuad176. [PMID: 38219230 DOI: 10.1093/nutrit/nuad176] [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] [Indexed: 01/16/2024] Open
Abstract
CONTEXT High adherence to the Mediterranean diet (MD) has been associated with a reduced risk of depression in prospective cohort studies, but whether MD interventions are effective among adults with depression is uncertain. OBJECTIVE This study aimed to synthesize findings on the effects of MD interventions on the severity of depressive symptoms in adults with depression. DATA SOURCES PubMed, Cochrane CENTRAL, PsycINFO, Scopus, and Web of Science were systematically searched from database inception to March 2023. The Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines and the Cochrane recommendations were followed. We included randomized controlled trials (RCTs) comparing outcomes after MD interventions with outcomes for control conditions in adults with depressive disorders or depressive symptoms. DATA EXTRACTION Two authors extracted the data independently. The Sidik-Jonkman estimator, the I2 metric, and the prediction interval were used to estimate between-study heterogeneity. To determine the risk of bias and the certainty of evidence from RCTs, we used the Cochrane Collaboration's Risk of Bias 2 and Grades of Recommendation, Assessment, Development, and Evaluation tools, respectively. DATA ANALYSIS In total, 1507 participants (mean age range: 22.0 years-53.3 years) with depression were initially included in the 5 RCTs of this review. Compared with control conditions, MD interventions significantly reduced depressive symptoms among young and middle-aged adults with major depression or mild to moderate depressive symptoms (standardized mean difference: -0.53; 95% confidence interval: -0.90 to -0.16; I2 = 87.1%). The prediction interval ranged from -1.86 to 0.81. The overall risk of bias was within the range of "some concerns" to "high," while the certainty of evidence was low. CONCLUSION MD interventions appear to have substantial potential for alleviating depressive symptoms in people experiencing major or mild depression. However, to establish robust recommendations, there remains a need for high-quality, large-scale, and long-term RCTs. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42022341895.
Collapse
Affiliation(s)
- Bruno Bizzozero-Peroni
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Department of Physical Education and Health, Higher Institute of Physical Education, Universidad de la República, Rivera, Uruguay
| | - Vicente Martínez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Grupo de Investigación en Educación Física, Salud y Calidad de Vida, Facultad de Educación, Universidad Autónoma de Chile, Temuco, Chile
| | | | - Estela Jiménez-López
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Department of Psychiatry, Hospital Virgen de La Luz, Cuenca, Spain
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | | | - Alicia Saz-Lara
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Valentina Díaz-Goñi
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Arthur Eumann Mesas
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| |
Collapse
|
33
|
Thomson-Casey C, McIntyre E, Rogers K, Adams J. Practice recommendations and referrals, perceptions of efficacy and risk, and self-rated knowledge regarding complementary medicine: a survey of Australian psychologists. BMC Complement Med Ther 2024; 24:13. [PMID: 38166841 PMCID: PMC10759583 DOI: 10.1186/s12906-023-04288-y] [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: 07/22/2023] [Accepted: 11/29/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Many people with mental health problems use a range of complementary medicine (CM), including over the counter products, practices, and utilise the services of CM practitioners. Psychologists are likely to consult with clients using CM, in some form, as part of their broader mental health care. The aim of this research was to determine the number of types of CM products, practices, and practitioners are recommended and/or referred by Australian psychologists as part of their clinical practice, as well as explore the relationship between psychologists' perspectives on the risk and relevance of engaging with CM in psychology. METHODS Survey data was collected from psychologists in clinical practice who self-selected to participate in the study via an online 79-item questionnaire exploring core aspects of CM engagement in psychology clinical practice. RESULTS Amongst the 201 psychologists, 5% reported not recommending any type of CM, with 63% recommending four or more types of CM. Further, 25% had not referred to a CM practitioner, while 33% had referred to four or more types of CM practitioner. Psychologists are recommending and referring to CM even when they perceive their knowledge of CM to be poor, and that engaging with CM was a risk. CONCLUSION This study provides insights into psychologist perceptions of CM within psychology practice and how these perceptions are associated with rates of recommending and referring to CM as part of their clinical practice. These findings may inform the development of CM relevant education and guidelines for psychologists.
Collapse
Affiliation(s)
- Carrie Thomson-Casey
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia.
- Faculty of Health, Southern Cross University, Gold Coast, Australia.
| | - Erica McIntyre
- Institute for Sustainable Futures, University of Technology Sydney, Sydney, Australia
| | - Kris Rogers
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Jon Adams
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| |
Collapse
|
34
|
Lachmansingh DA, Lavelle A, Cryan JF, Clarke G. Microbiota-Gut-Brain Axis and Antidepressant Treatment. Curr Top Behav Neurosci 2024; 66:175-216. [PMID: 37962812 DOI: 10.1007/7854_2023_449] [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] [Indexed: 11/15/2023]
Abstract
In the treatment of depressive disorders, conventional antidepressant therapy has been the mainstay of clinical management, along with well-established nonpharmacological interventions such as various kinds of psychotherapy. Over the last 2 decades, there has been considerable interest in the role of the gastrointestinal system and its microbiota on brain function, behavior, and mental health. Components of what is referred to as the microbiota-gut-brain axis have been uncovered, and further research has elicited functional capabilities such as "gut-brain modules." Some studies have found associations with compositional alterations of gut microbiota in patients with depressive disorders and individuals experiencing symptoms of depression. Regarding the pathogenesis and neurobiology of depression itself, there appears to be a multifactorial contribution, in addition to the theories involving deficits in catecholaminergic and monoamine neurotransmission. Interestingly, there is evidence to suggest that antidepressants may play a role in modulating the gut microbiota, thereby possibly having an impact on the microbiota-gut-brain axis in this manner. The development of prebiotics, probiotics, and synbiotics has led to studies investigating not only their impact on the microbiota but also their therapeutic value in mental health. These psychobiotics have the potential to be used as therapeutic adjuncts in the treatment of depression. Regarding future directions, and in an attempt to further understand the role of the microbiota-gut-brain axis in depression, more studies such as those involving fecal microbiota transplantation will be required. In addition to recent findings, it is also suggested that more research will have to be undertaken to elicit whether specific strains of gut organisms are linked to depression. In terms of further investigation of the therapeutic potential of prebiotics, probiotics, and synbiotics as adjuncts to antidepressant treatment, we also expect there to be more research targeting specific microorganisms, as well as a strong focus on the effects of specific prebiotic fibers from an individualized (personalized) point of view.
Collapse
Affiliation(s)
- David Antoine Lachmansingh
- APC Microbiome Ireland, University College Cork, Cork, Ireland
- Department of Psychiatry and Neurobehavioural Science, University College Cork, Cork, Ireland
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - Aonghus Lavelle
- APC Microbiome Ireland, University College Cork, Cork, Ireland
- Department of Anatomy and Neuroscience, 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
| |
Collapse
|
35
|
Evrensel A. Probiotics and Fecal Microbiota Transplantation in Major Depression: Doxa or Episteme? ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1456:67-83. [PMID: 39261424 DOI: 10.1007/978-981-97-4402-2_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/13/2024]
Abstract
In the human body, eukaryotic somatic cells and prokaryotic microorganisms live together. In this state, the body can be viewed as a "superorganism." Symbiotic life with commensal microorganisms can be observed in almost every part of the body. Intestinal microbiota plays an important role in health and disease, and in shaping and regulating neuronal functions from the intrauterine period to the end of life. Microbiota-based treatment opportunities are becoming more evident in both understanding the etiopathogenesis and treatment of neuropsychiatric disorders, especially depression. Antidepressant drugs, which are the first choice in the treatment of depression, also have antimicrobial and immunomodulatory mechanisms of action. From these perspectives, direct probiotics and fecal microbiota transplantation are treatment options to modulate microbiota composition. There are few preclinical and clinical studies on the effectiveness and safety of these applications in depression. The information obtained from these studies may still be at a doxa level. However, the probability that this information will become episteme in the future seems to be increasing.
Collapse
Affiliation(s)
- Alper Evrensel
- Department of Psychiatry, Uskudar University, Istanbul, Turkey.
- NP Brain Hospital, Istanbul, Turkey.
| |
Collapse
|
36
|
Khiroya K, Sekyere E, McEwen B, Bayes J. Nutritional considerations in major depressive disorder: current evidence and functional testing for clinical practice. Nutr Res Rev 2023:1-12. [PMID: 37964733 DOI: 10.1017/s0954422423000276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
Depression is a multifaceted condition with diverse underlying causes. Several contributing and inter-related factors such as genetic, nutritional, neurological, physiological, gut-brain-axis, metabolic and psychological stress factors play a role in the pathophysiology of depression. This review aims to highlight the role that nutritional factors play in the aetiology of depression. Secondly, we discuss the biomedical and functional pathology tests which measure these factors, and the current evidence supporting their use. Lastly, we make recommendations on how practitioners can incorporate the latest evidence-based research findings into clinical practice. This review highlights that diet and nutrition greatly affect the pathophysiology of depression. Nutrients influence gene expression, with folate and vitamin B12 playing vital roles in methylation reactions and homocysteine regulation. Nutrients are also involved in the tryptophan/kynurenine pathway and the expression of brain-derived neurotrophic factor (BDNF). Additionally, diet influences the hypothalamic-pituitary-adrenal (HPA) response and the composition and diversity of the gut microbiome, both of which have been implicated in depression. A comprehensive dietary assessment, combined with appropriate evaluation of biochemistry and blood pathology, may help uncover contributing factors to depressive symptoms. By employing such an approach, a more targeted and personalised treatment strategy can be devised, ultimately leading to improved patient outcomes.
Collapse
Affiliation(s)
- Kathryn Khiroya
- Endeavour College of Natural Health, Haymarket, NSW, Australia
| | - Eric Sekyere
- Endeavour College of Natural Health, Haymarket, NSW, Australia
| | - Bradley McEwen
- Faculty of Health, Southern Cross University, East Lismore, NSW, Australia
| | - Jessica Bayes
- National Centre for Naturopathic Medicine, Southern Cross University, East Lismore, NSW, Australia
| |
Collapse
|
37
|
Aucoin M, LaChance L, van der Wurff I, Miller S, Naidoo U, Jenkins A, Cooley K. Dietary counselling plus omega-3 supplementation in the treatment of generalized anxiety disorder: protocol for a randomized wait-list controlled pilot trial (the "EASe-GAD Trial"). Pilot Feasibility Stud 2023; 9:186. [PMID: 37950301 PMCID: PMC10636887 DOI: 10.1186/s40814-023-01414-y] [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: 02/02/2023] [Accepted: 10/25/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Anxiety disorders are prevalent and disabling conditions involving excessive worry and tension. Generalized anxiety disorder (GAD), the most common anxiety disorder, affects 5% of individuals from high-income countries and many individuals report that treatment options are not accessible, effective, or tolerable. Clinical evidence suggests that nutrition interventions, based on the Mediterranean diet and supplementation of omega-3 fatty acids, can significantly improve symptoms of depression; however, the effect of nutrition interventions on anxiety symptoms has not been studied in a clinical population. The primary objective of the present study is to assess the feasibility and acceptability of a dietary counselling and omega-3 fatty acid supplementation intervention delivered to adult women with GAD. The secondary objectives include assessing changes in anxiety symptom severity, assessing changes in quality of life, assessing changes in biomarkers, and evaluating the components of the program. METHODS This study is a randomized, wait-list controlled pilot trial delivering a 12-week, dietary counselling intervention and omega-3 supplementation to 50 adult women with GAD. Participants will complete seven individual counselling sessions which include education, personalized recommendations, mindful eating techniques, motivational interviewing, and goal setting. They will be provided with recipes, instructional videos, and food items. The intervention is designed based on the Social Cognitive Theory and previous research that has been done by the author team to identify dietary constituents with the most evidence to support their use in the treatment of anxiety disorders. Questionnaires and blood work will be completed at baseline, after the waiting period (for those in the waitlist group), and after the intervention. DISCUSSION Results from this study will lay the foundation for future large-scale studies in this area and may provide preliminary evidence of the role of diet counselling and omega-3 supplementation in the management of GAD. Research on the role of nutrition in psychiatric care has been identified as a priority by a number of international organizations. The present trial directly addresses the call for the research that is most needed to advance the field. TRIAL REGISTRATION This protocol was registered at ClinicalTrials.gov on October 10, 2022; NCT05573672 . Trial sponsor: The Canadian College of Naturopathic Medicine, 1255 Sheppard Ave E, Toronto, ON M2K 1E2, 416-498-1255. Steering committee: Composed of MA, LL, KC, IvdW, SM, UN, AJ. The committee meets monthly to oversee the trial. Protocol identifier: CCNM_EASe-GADCT_2201v4.
Collapse
Affiliation(s)
- Monique Aucoin
- Canadian College of Naturopathic Medicine, Toronto, Canada.
- University of Guelph, Guelph, Canada.
| | - Laura LaChance
- McGill University, Montreal, Canada
- St. Mary's Hospital, Montreal, Canada
| | - Inge van der Wurff
- Health Psychology, Faculty of Psychology, Open University of the Netherlands, Utrecht, Netherlands
| | | | - Umadevi Naidoo
- Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, USA
| | | | - Kieran Cooley
- Canadian College of Naturopathic Medicine, Toronto, Canada
- Southern Cross University, Lismore, Australia
- University of Technology Sydney, Ultimo, Australia
- Pacific College of Health and Science, San Diego, USA
| |
Collapse
|
38
|
Murta L, Seixas D, Harada L, Damiano RF, Zanetti M. Intermittent Fasting as a Potential Therapeutic Instrument for Major Depression Disorder: A Systematic Review of Clinical and Preclinical Studies. Int J Mol Sci 2023; 24:15551. [PMID: 37958535 PMCID: PMC10647529 DOI: 10.3390/ijms242115551] [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: 09/29/2023] [Revised: 10/20/2023] [Accepted: 10/23/2023] [Indexed: 11/15/2023] Open
Abstract
Recent studies have reported positive effects of Intermittent Fasting (IF) on metabolic parameters, cognition, and mood. However, regarding depressive symptoms, the effect of IF is not clear. The purpose of this review was to assess the available evidence on IF interventions for depression in both clinical and preclinical studies. Of the 23 included studies, 15 were performed on humans and 8 on animal models. The studies on rodents suggested that IF acts as a circadian regulator, improving neurotransmitter availability and increasing the levels of neurotrophic factors in the brain. However, the investigations on humans mainly evaluated healthy volunteers and showed a great heterogeneity regarding both the IF regimen studied and the observed effects on mood. Most available clinical trials have specific limitations, such as small sample sizes and uncontrolled designs. A comprehensive systematic review was conducted on five databases, PubMed, Cochrane, the Central Register of Controlled Trials, Web of Science databases, BVS and Scopus, identifying 23 relevant studies up to 6 October 2022. IF has potentially relevant physiological effects for the treatment of mood disorders, but better designed studies and controlled evaluations are needed to evaluate its efficiency in the treatment of major depression.
Collapse
Affiliation(s)
- Laís Murta
- Hospital Sírio-Libanês, Sao Paulo 01308-050, Brazil; (L.H.); (M.Z.)
| | - Daniela Seixas
- Faculdade de Medicina, Universidade de São Paulo, Sao Paulo 01246-903, Brazil; (D.S.); (R.F.D.)
| | - Luana Harada
- Hospital Sírio-Libanês, Sao Paulo 01308-050, Brazil; (L.H.); (M.Z.)
| | - Rodolfo Furlan Damiano
- Faculdade de Medicina, Universidade de São Paulo, Sao Paulo 01246-903, Brazil; (D.S.); (R.F.D.)
| | - Marcus Zanetti
- Hospital Sírio-Libanês, Sao Paulo 01308-050, Brazil; (L.H.); (M.Z.)
| |
Collapse
|
39
|
Bahari H, Seifi N, Foroumandi E, Kourepaz F, Shahabi HE, Ervin K, Khabari N, Ferns GA, Ghayour-Mobarhan M. Dietary acid load, depression, and anxiety: results of a population-based study. BMC Psychiatry 2023; 23:679. [PMID: 37723484 PMCID: PMC10506201 DOI: 10.1186/s12888-023-05163-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 09/04/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND Dietary acid load seems to be associated with psychological disorders through several mechanisms, and may barricade their treatment and recovery. The aim of current study was to evaluate the relationship between dietary acid load, using potential renal acid load (PRAL) and dietary acid load (DAL) scores, with the severity of depression and anxiety among Iranian adults. METHODS A total of 6531 participants aged 35-65 years were recruited in this cross-sectional study. A validated food frequency questionnaire (FFQ) was used to assess dietary intakes of participants. DAL was estimated using PRAL and DAL scores. Depression and anxiety were screened using Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). RESULTS In the fully adjusted model, women with the highest DAL or PRAL had higher odds of more severe depression compared to those in the lowest category (OR = 1.20; 95% CI = 1.03-1.42 and OR = 1.20; 95% CI = 1.03-1.39, respectively). No significant association was observed between DAL and PRAL and depression severity in men and in the population as a whole. Regarding the association between PRAL and anxiety severity, there was no significant association when separated by sex. However, in the fully adjusted model for the whole population, participants in the highest tertile of PRAL had 13% greater odds of more severe anxiety than the lowest tertile (OR: 1.13, 95% CI: 1.01-1.13). No significant association was observed between DAL and anxiety severity in women, men or in the whole population. CONCLUSION Women, but not men, with higher dietary acid load had significantly higher odds of having more severe depression. A significant positive association was also observed between dietary acid load and anxiety in the whole population.
Collapse
Affiliation(s)
- Hossein Bahari
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Najmeh Seifi
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Elahe Foroumandi
- Non-Communicable Diseases Research Center, Department of Nutrition and Biochemistry, Faculty of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | | | - Hediye Erfaniyan Shahabi
- Department of Biology, Faculty of Sciences, Mashhad Branch of Islamic Azad University, Mashhad, Iran
| | - Kimia Ervin
- Department of Biology, Faculty of Sciences, Mashhad Branch of Islamic Azad University, Mashhad, Iran
| | - Nahid Khabari
- Department of Biology, Faculty of Sciences, Mashhad Branch of Islamic Azad University, Mashhad, Iran
| | - Gordon A Ferns
- Division of Medical Education, Brighton and Sussex Medical School, Falmer, Brighton, Sussex, UK
| | - Majid Ghayour-Mobarhan
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran.
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, 99199-91766, Iran.
| |
Collapse
|
40
|
Staudacher HM, Black CJ, Teasdale SB, Mikocka-Walus A, Keefer L. Irritable bowel syndrome and mental health comorbidity - approach to multidisciplinary management. Nat Rev Gastroenterol Hepatol 2023; 20:582-596. [PMID: 37268741 PMCID: PMC10237074 DOI: 10.1038/s41575-023-00794-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/02/2023] [Indexed: 06/04/2023]
Abstract
Irritable bowel syndrome (IBS) affects 5-10% of the global population. Up to one-third of people with IBS also experience anxiety or depression. Gastrointestinal and psychological symptoms both drive health-care use in people with IBS, but psychological comorbidity seems to be more important for long-term quality of life. An integrated care approach that addresses gastrointestinal symptoms with nutrition and brain-gut behaviour therapies is considered the gold standard. However, best practice for the treatment of individuals with IBS who have a comorbid psychological condition is unclear. Given the rising prevalence of mental health disorders, discussion of the challenges of implementing therapy for people with IBS and anxiety and depression is critical. In this Review, we draw upon our expertise in gastroenterology, nutrition science and psychology to highlight common challenges that arise when managing patients with IBS and co-occurring anxiety and depression, and provide recommendations for tailoring clinical assessment and treatment. We provide best practice recommendations, including dietary and behavioural interventions that could be applied by non-specialists and clinicians working outside an integrated care model.
Collapse
Affiliation(s)
- Heidi M Staudacher
- Food & Mood Centre, IMPACT Institute, Deakin University Geelong, Melbourne, Victoria, Australia.
| | - Christopher J Black
- Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK
- Leeds Gastroenterology Institute, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Scott B Teasdale
- Psychiatry and Mental Health, University of New South Wales, Sydney, New South Wales, Australia
| | | | - Laurie Keefer
- Department of Medicine and Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| |
Collapse
|
41
|
Li Y, Shi DD, Wang Z. Adolescent nonpharmacological interventions for early-life stress and their mechanisms. Behav Brain Res 2023; 452:114580. [PMID: 37453516 DOI: 10.1016/j.bbr.2023.114580] [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: 04/18/2023] [Revised: 07/08/2023] [Accepted: 07/11/2023] [Indexed: 07/18/2023]
Abstract
Those with a negative experience of psychosocial stress during the early stage of life not only have a high susceptibility of the psychiatric disorder in all phases of their life span, but they also demonstrate more severe symptoms and poorer response to treatment compared to those without a history of early-life stress. The interventions targeted to early-life stress may improve the effectiveness of treating and preventing psychiatric disorders. Brain regions associated with mood and cognition develop rapidly and own heightened plasticity during adolescence. So, manipulating nonpharmacological interventions in fewer side effects and higher acceptance during adolescence, which is a probable window of opportunity, may ameliorate or even reverse the constantly deteriorating impact of early-life stress. The present article reviews animal and people studies about adolescent nonpharmacological interventions for early-life stress. We aim to discuss whether those adolescent nonpharmacological interventions can promote individuals' psychological health who expose to early-life stress.
Collapse
Affiliation(s)
- Yi Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dong-Dong Shi
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhen Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Institute of Psychological and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China.
| |
Collapse
|
42
|
Pathare NN, Fayet-Moore F, Fogarty JA, Jacka FN, Strandwitz P, Strangman GE, Donoviel DB. Nourishing the brain on deep space missions: nutritional psychiatry in promoting resilience. Front Neural Circuits 2023; 17:1170395. [PMID: 37663891 PMCID: PMC10469890 DOI: 10.3389/fncir.2023.1170395] [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: 02/20/2023] [Accepted: 07/31/2023] [Indexed: 09/05/2023] Open
Abstract
The grueling psychological demands of a journey into deep space coupled with ever-increasing distances away from home pose a unique problem: how can we best take advantage of the benefits of fresh foods in a place that has none? Here, we consider the biggest challenges associated with our current spaceflight food system, highlight the importance of supporting optimal brain health on missions into deep space, and discuss evidence about food components that impact brain health. We propose a future food system that leverages the gut microbiota that can be individually tailored to best support the brain and mental health of crews on deep space long-duration missions. Working toward this goal, we will also be making investments in sustainable means to nourish the crew that remains here on spaceship Earth.
Collapse
Affiliation(s)
- Nihar N. Pathare
- Center for Space Medicine, Baylor College of Medicine, Houston, TX, United States
| | | | - Jennifer A. Fogarty
- Center for Space Medicine, Baylor College of Medicine, Houston, TX, United States
- Department of Medicine, Baylor College of Medicine, Houston, TX, United States
- Translational Research Institute for Space Health (TRISH), Houston, TX, United States
| | - Felice N. Jacka
- Food and Mood Centre, Institute for Mental and Physical Health and Clinical Translation (IMPACT) Strategic Research Centre, Deakin University, Geelong, VIC, Australia
- Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
| | | | - Gary E. Strangman
- Neural Systems Group, Division of Health Sciences and Technology, Massachusetts General Hospital, Harvard Medical School and Harvard-MIT, Charlestown, MA, United States
- Department of Psychology, Harvard University, Cambridge, MA, United States
| | - Dorit B. Donoviel
- Center for Space Medicine, Baylor College of Medicine, Houston, TX, United States
- Translational Research Institute for Space Health (TRISH), Houston, TX, United States
- Department of Pharmacology and Chemical Biology, Baylor College of Medicine, Houston, TX, United States
| |
Collapse
|
43
|
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.
Collapse
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
| |
Collapse
|
44
|
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: 19] [Impact Index Per Article: 19.0] [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.
Collapse
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.
| |
Collapse
|
45
|
Gamage E, Orr R, Travica N, Lane MM, Jacka F, Dissanayaka T, Kim JH, Grosso G, Godos J, Marx W. Polyphenols as novel interventions for depression: exploring the efficacy, mechanisms of action, and implications for future research. Neurosci Biobehav Rev 2023; 151:105225. [PMID: 37164045 DOI: 10.1016/j.neubiorev.2023.105225] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 04/29/2023] [Accepted: 05/06/2023] [Indexed: 05/12/2023]
Abstract
Numerous animal and human studies have assessed the relationship between polyphenols and outcomes related to depression. However, no comprehensive synthesis of the main findings has been conducted. The aim of this manuscript was to systematically review the available evidence from animal and human studies on the association and the effects of dietary polyphenols on depression and provide recommendations for future research. We based our review on 163 preclinical animal, 16 observational and 44 intervention articles assessing the relationship between polyphenols and outcomes related to depression. Most animal studies demonstrated that exposure to polyphenols alleviated behaviours reported to be associated with depression. However, human studies are less clear, with some studies reporting and inverse relationship between the intake of some polyphenols, and polyphenol rich foods and depression risk and symptoms, while others reporting no association or effect. Hence, while there has been extensive research conducted in animals and there is some supporting evidence in humans, further human studies are required, particularly in younger and clinical populations.
Collapse
Affiliation(s)
- Elizabeth Gamage
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Rebecca Orr
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Nikolaj Travica
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Melissa M Lane
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Felice Jacka
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Thusharika Dissanayaka
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Jee H Kim
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Giuseppe Grosso
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Justyna Godos
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Wolfgang Marx
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| |
Collapse
|
46
|
Mantzorou M, Mentzelou M, Vasios GK, Kontogiorgis C, Antasouras G, Vadikolias K, Psara E, Vorvolakos T, Poulios E, Serdari A, Papadopoulou SK, Giaginis C. Mediterranean Diet Adherence Is Associated with Favorable Health-Related Quality of Life, Physical Activity, and Sleep Quality in a Community-Dwelling Greek Older Population. Antioxidants (Basel) 2023; 12:antiox12050983. [PMID: 37237849 DOI: 10.3390/antiox12050983] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 04/16/2023] [Accepted: 04/21/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND The Mediterranean diet (MD) is a beneficial dietary pattern with strong antioxidant and anti-inflammatory properties that can promote mental and physical human health. This study aims to assess the impact of MD adherence on health-related quality of life, physical activity levels, and sleep quality in a representative Greek elderly population. METHODS This is a cross-sectional study. A total of 3254 persons ≥65 years from 14 different Greek regions, urban, rural and islands participated in this study, of which 48.4% were female and 51.6% were male. Health-Related Quality of Life (HRQOL) was evaluated utilizing a short form healthy survey, physical activity was determined by the International Physical Activity Questionnaire (IPAQ), sleep quality was assessed utilizing the Pittsburgh Sleep Quality Index (PSQI) and MD adherence was assessed via the Mediterranean Diet Score (MedDietScore). RESULTS Moderate adherence to the MD and an increased prevalence of poor quality of life, low physical activity levels and inadequate sleep quality among the elderly population were recorded. High MD adherence was independently associated with better quality of life (OR: 2.31, 95% CI: 2.06-2.68, p = 0.0008), higher physical activity (OR: 1.89, 95% CI: 1.47-2.35, p = 0.0141) and adequate sleep quality (OR: 2.11, 95%: 1.79-2.44, p = 0.0018), female sex (OR: 1.36, 95% CI: 1.02-1.68, p = 0.0032) and living with others (OR: 1.24, 95% CI: 0.81-1.76, p = 0.0375), after adjustment for potential confounding factors. In unadjusted analysis, participants' age (p < 0.0001), anthropometric characteristics (p < 0.005), educational (p = 0.0026) and financial status (p = 0.0005) and smoking habits (p = 0.0031) were also identified as indicators of MD adherence; however, their impact on MD adherence was considerably attenuated after adjusting for confounding factors (p > 0.05). CONCLUSION High MD adherence was correlated with favorable quality of life, higher levels of physical activity, and a more adequate sleep quality score. Strategies and public health policies that facilitate MD adherence and physical activity in older adults may improve sleep and quality of life, impacting overall wellbeing in this age group.
Collapse
Affiliation(s)
- Maria Mantzorou
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Lemnos, Greece
| | - Maria Mentzelou
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Lemnos, Greece
| | - Georgios K Vasios
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Lemnos, Greece
| | - Christos Kontogiorgis
- Laboratory of Hygiene and Environmental Protection, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Georgios Antasouras
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Lemnos, Greece
| | - Konstantinos Vadikolias
- Department of Neurology, School of Medicine, Democritus University of Thrace, 68100 Alexadroupolis, Greece
| | - Evmorfia Psara
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Lemnos, Greece
| | - Theofanis Vorvolakos
- Department of Geriatric Psychiatry, School of Medicine, Democritus University of Thrace, 68100 Alexadroupolis, Greece
| | - Efthymios Poulios
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Lemnos, Greece
| | - Aspasia Serdari
- Department of Psychiatry and Child Psychiatry, School of Medicine, Democritus University of Thrace, 68100 Alexadroupolis, Greece
| | - Sousana K Papadopoulou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Lemnos, Greece
| |
Collapse
|
47
|
Dietch DM, Kerr-Gaffney J, Hockey M, Marx W, Ruusunen A, Young AH, Berk M, Mondelli V. Efficacy of low carbohydrate and ketogenic diets in treating mood and anxiety disorders: systematic review and implications for clinical practice. BJPsych Open 2023; 9:e70. [PMID: 37066662 PMCID: PMC10134254 DOI: 10.1192/bjo.2023.36] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 02/01/2023] [Accepted: 02/16/2023] [Indexed: 04/18/2023] Open
Abstract
BACKGROUND There is mounting interest in the potential efficacy of low carbohydrate and very low carbohydrate ketogenic diets in various neurological and psychiatric disorders. AIMS To conduct a systematic review and narrative synthesis of low carbohydrate and ketogenic diets (LC/KD) in adults with mood and anxiety disorders. METHOD MEDLINE, Embase, PsycINFO and Cochrane databases were systematically searched for articles from inception to 6 September 2022. Studies that included adults with any mood or anxiety disorder treated with a low carbohydrate or ketogenic intervention, reporting effects on mood or anxiety symptoms were eligible for inclusion. PROSPERO registration CRD42019116367. RESULTS The search yielded 1377 articles, of which 48 were assessed for full-text eligibility. Twelve heterogeneous studies (stated as ketogenic interventions, albeit with incomplete carbohydrate reporting and measurements of ketosis; diet duration: 2 weeks to 3 years; n = 389; age range 19 to 75 years) were included in the final analysis. This included nine case reports, two cohort studies and one observational study. Data quality was variable, with no high-quality evidence identified. Efficacy, adverse effects and discontinuation rates were not systematically reported. There was some evidence for efficacy of ketogenic diets in those with bipolar disorder, schizoaffective disorder and possibly unipolar depression/anxiety. Relapse after discontinuation of the diet was reported in some individuals. CONCLUSIONS Although there is no high-quality evidence of LC/KD efficacy in mood or anxiety disorders, several uncontrolled studies suggest possible beneficial effects. Robust studies are now needed to demonstrate efficacy, to identify clinical groups who may benefit and whether a ketogenic diet (beyond low carbohydrate) is required and to characterise adverse effects and the risk of relapse after diet discontinuation.
Collapse
Affiliation(s)
- Daniel M. Dietch
- Lonsdale Medical Centre, London, UK; and Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Jess Kerr-Gaffney
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Meghan Hockey
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Australia
| | - Wolfgang Marx
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Australia
| | - Anu Ruusunen
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Australia; Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland; and Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Allan H. Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Michael Berk
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Australia
| | - Valeria Mondelli
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; and National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, King's College London, London, UK
| |
Collapse
|
48
|
Dominguez LJ, Veronese N, Di Bella G, Cusumano C, Parisi A, Tagliaferri F, Ciriminna S, Barbagallo M. Mediterranean diet in the management and prevention of obesity. Exp Gerontol 2023; 174:112121. [PMID: 36792040 DOI: 10.1016/j.exger.2023.112121] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 02/06/2023] [Accepted: 02/12/2023] [Indexed: 02/17/2023]
Abstract
The current pandemic of obesity represents a major global public health problem, mainly due to its association with chronic non-communicable disabling conditions and with increased mortality. Population aging increases the chances of non-communicable chronic diseases allowing a longer exposure to risk factors for these disabling conditions. Obesity is a major risk factor contributing to pathological aging. Numerous epidemiological studies have shown that the risk of death due to cardiovascular disease and cancer increases progressively as overweight and obesity rise. Nutrition research is now focused on the effects of combinations of foods in dietary patterns instead of those of single nutrients or foods. The dietary model with the largest body of evidence of health benefit is that traditionally followed by inhabitants of some Mediterranean countries. There is evidence confirming the inverse association of adhering to Mediterranean diet with overweight and obesity. Four meta-analyses of randomized controlled trials, including up to 16 trials, have shown a greater reduction of body weight and BMI with MedDiet compared to other diets, while a meta-analysis of 7 prospective cohort studies, found a reduced risk of becoming obese and gaining weight over time associated with a higher adherence to MedDiet. This narrative review examines studies reporting inverse associations of a higher adherence to the MedDiet with overweight/obesity and with age-associated chronic diseases related to obesity.
Collapse
Affiliation(s)
- Ligia J Dominguez
- Faculty of Medicine and Surgery, "Kore" University of Enna, Enna, Italy; Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy.
| | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Giovanna Di Bella
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Claudia Cusumano
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Angela Parisi
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Federica Tagliaferri
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Stefano Ciriminna
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Mario Barbagallo
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| |
Collapse
|
49
|
Liu L, Wang H, Chen X, Zhang Y, Zhang H, Xie P. Gut microbiota and its metabolites in depression: from pathogenesis to treatment. EBioMedicine 2023; 90:104527. [PMID: 36963238 PMCID: PMC10051028 DOI: 10.1016/j.ebiom.2023.104527] [Citation(s) in RCA: 107] [Impact Index Per Article: 107.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 02/13/2023] [Accepted: 03/02/2023] [Indexed: 03/26/2023] Open
Abstract
Major depressive disorder is one of the most disabling mental disorders worldwide. Increasing preclinical and clinical studies have highlighted that compositional and functional (e.g., metabolite) changes in gut microbiota, known as dysbiosis, are associated with the onset and progression of depression via regulating the gut-brain axis. However, the gut microbiota and their metabolites present a double-edged sword in depression. Dysbiosis is involved in the pathogenesis of depression while, at the same time, offering a novel therapeutic target. In this review, we describe the association between dysbiosis and depression, drug-microbiota interactions in antidepressant treatment, and the potential health benefits of microbial-targeted therapeutics in depression, including dietary interventions, fecal microbiota transplantation, probiotics, prebiotics, synbiotics, and postbiotics. With the emergence of microbial research, we describe a new direction for future research and clinical treatment of depression.
Collapse
Affiliation(s)
- Lanxiang Liu
- Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China; NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China; Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Haiyang Wang
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China; College of Stomatology and Affiliated Stomatological Hospital of Chongqing Medical University, 401147, China
| | - Xueyi Chen
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Yangdong Zhang
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China; Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Hanping Zhang
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China; Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Peng Xie
- Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China; NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China; Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China; College of Stomatology and Affiliated Stomatological Hospital of Chongqing Medical University, 401147, China.
| |
Collapse
|
50
|
Bayes J, Schloss J, Sibbritt D. A Mediterranean diet intervention for young men with depression: patient experiences, challenges and benefits (the "AMMEND study") - A cross-sectional study. Clin Nutr ESPEN 2023; 53:159-164. [PMID: 36657908 DOI: 10.1016/j.clnesp.2022.12.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 12/03/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Recent research has highlighted the beneficial effects of following a Mediterranean diet (MD) for depression. Unfortunately, adherence to specific diets presents many challenges and while previous research has aimed to understand these challenges, the focus has primarily been on weight-loss interventions in patients with obesity or cardiovascular disease. The aim of this study was to understand the experiences and challenges expressed by young men with clinical depression who completed a 12-week Mediterranean diet intervention. METHODS An online questionnaire was used to collect data from 36 young Australian men aged between 18 and 25 with diagnosed depression who participated in the Mediterranean Diet arm of the Mediterranean Diet for Men with Depression (AMMEND) study. Descriptive analyses were undertaken for each variable with results reported as percentages and frequencies. RESULTS Positive aspects highlighted by participants included enjoying the taste of foods, being highly motivated to continue with the diet and a perceived benefit to their depressive symptoms. The main challenges included increased cost and time commitment, and the negative attitudes of their friends and family towards the diet. CONCLUSION We recommend that the influence of friends and family attitudes towards the diet and the impact this has on following a Mediterranean diet in young men be explored further, as this posed a challenge for many of our participants. These results may assist clinicians when promoting a Mediterranean diet to this specific demographic.
Collapse
Affiliation(s)
- Jessica Bayes
- Faculty of Health, University of Technology Sydney, 35 Jones Street, Ultimo, NSW, 2007, Australia.
| | - Janet Schloss
- Faculty of Health, University of Technology Sydney, 35 Jones Street, Ultimo, NSW, 2007, Australia; National Centre for Naturopathic Medicine, Southern Cross University, Lismore, NSW, 2480, Australia.
| | - David Sibbritt
- Faculty of Health, University of Technology Sydney, 35 Jones Street, Ultimo, NSW, 2007, Australia.
| |
Collapse
|