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Zhao W, Zhu DM, Shen Y, Zhang Y, Chen T, Cai H, Zhu J, Yu Y. The protective effect of vitamin D supplementation as adjunctive therapy to antidepressants on brain structural and functional connectivity of patients with major depressive disorder: a randomized controlled trial. Psychol Med 2024; 54:2403-2413. [PMID: 38482853 DOI: 10.1017/s0033291724000539] [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] [Indexed: 10/10/2024]
Abstract
BACKGROUND Growing evidence points to the pivotal role of vitamin D in the pathophysiology and treatment of major depressive disorder (MDD). However, there is a paucity of longitudinal research investigating the effects of vitamin D supplementation on the brain of MDD patients. METHODS We conducted a double-blind randomized controlled trial in 46 MDD patients, who were randomly allocated into either VD (antidepressant medication + vitamin D supplementation) or NVD (antidepressant medication + placebos) groups. Data from diffusion tensor imaging, resting-state functional MRI, serum vitamin D concentration, and clinical symptoms were obtained at baseline and after an average of 7 months of intervention. RESULTS Both VD and NVD groups showed significant improvement in depression and anxiety symptoms but with no significant differences between the two groups. However, a greater increase in serum vitamin D concentration was found to be associated with greater improvement in depression and anxiety symptoms in VD group. More importantly, neuroimaging data demonstrated disrupted white matter integrity of right inferior fronto-occipital fasciculus along with decreased functional connectivity between right frontoparietal and medial visual networks after intervention in NVD group, but no changes in VD group. CONCLUSIONS These findings suggest that vitamin D supplementation as adjunctive therapy to antidepressants may not only contribute to improvement in clinical symptoms but also help preserve brain structural and functional connectivity in MDD patients.
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Affiliation(s)
- Wenming Zhao
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
- Research Center of Clinical Medical Imaging, Anhui Province, Hefei 230032, China
- Anhui Provincial Institute of Translational Medicine, Hefei 230032, China
- Anhui Provincial Key Laboratory for Brain Bank Construction and Resource Utilization, Hefei 230032, China
| | - Dao-Min Zhu
- Department of Sleep Disorders, Affiliated Psychological Hospital of Anhui Medical University, Hefei 230022, China
- Hefei Fourth People's Hospital, Hefei 230022, China
- Anhui Mental Health Center, Hefei 230022, China
| | - Yuhao Shen
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
- Research Center of Clinical Medical Imaging, Anhui Province, Hefei 230032, China
- Anhui Provincial Institute of Translational Medicine, Hefei 230032, China
- Anhui Provincial Key Laboratory for Brain Bank Construction and Resource Utilization, Hefei 230032, China
| | - Yu Zhang
- Department of Sleep Disorders, Affiliated Psychological Hospital of Anhui Medical University, Hefei 230022, China
- Hefei Fourth People's Hospital, Hefei 230022, China
- Anhui Mental Health Center, Hefei 230022, China
| | - Tao Chen
- Department of Sleep Disorders, Affiliated Psychological Hospital of Anhui Medical University, Hefei 230022, China
- Hefei Fourth People's Hospital, Hefei 230022, China
- Anhui Mental Health Center, Hefei 230022, China
| | - Huanhuan Cai
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
- Research Center of Clinical Medical Imaging, Anhui Province, Hefei 230032, China
- Anhui Provincial Institute of Translational Medicine, Hefei 230032, China
- Anhui Provincial Key Laboratory for Brain Bank Construction and Resource Utilization, Hefei 230032, China
| | - Jiajia Zhu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
- Research Center of Clinical Medical Imaging, Anhui Province, Hefei 230032, China
- Anhui Provincial Institute of Translational Medicine, Hefei 230032, China
- Anhui Provincial Key Laboratory for Brain Bank Construction and Resource Utilization, Hefei 230032, China
| | - Yongqiang Yu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
- Research Center of Clinical Medical Imaging, Anhui Province, Hefei 230032, China
- Anhui Provincial Institute of Translational Medicine, Hefei 230032, China
- Anhui Provincial Key Laboratory for Brain Bank Construction and Resource Utilization, Hefei 230032, China
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Ji L, Ren Z, Chen J, Zhao H, Zhang X, Xue B, Zhang D. Associations of vegetable and fruit intake, physical activity, and school bullying with depressive symptoms in secondary school students: the mediating role of internet addiction. BMC Psychiatry 2024; 24:419. [PMID: 38834943 DOI: 10.1186/s12888-024-05867-0] [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: 12/25/2023] [Accepted: 05/26/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND Few studies have simultaneously focused on the associations of vegetable and fruit intake, physical activity, school bullying, and Internet addiction (IA) with depressive symptoms. This study aimed to explore the direct and indirect effects of the above factors on depressive symptoms in adolescents by constructing a structural equation model (SEM). METHODS This study was conducted in Qingdao from September to November 2021. A total of 6195 secondary school students aged 10-19 years were included in the analysis. Information on all variables was assessed using a self-administered questionnaire. An SEM was constructed with depressive symptoms as the endogenous latent variable, IA as the mediating variable, and vegetable and fruit intake, physical activity, and school bullying as the exogenous latent variables. The standardized path coefficients (β) were the direct effects between the latent variables, and the indirect effects were obtained by the product of direct effects between relevant latent variables. RESULTS The median value with the interquartile range of depressive symptom scores was 7 (3,12). Vegetable and fruit intake (β=-0.100, P<0.001) and physical activity (β=-0.140, P<0.001) were directly negatively related to depressive symptoms. While school bullying (β=0.138, P<0.001) and IA (β=0.452, P<0.001) were directly positively related to depressive symptoms. IA had the greatest impact on depressive symptoms. Vegetable and fruit intake, physical activity, and school bullying could not only directly affect depressive symptoms, but also indirectly affect depressive symptoms through the mediating effect of IA, the indirect effects and 95% confidence intervals (CIs) were -0.028 (-0.051, -0.007), -0.114 (-0.148, -0.089) and 0.095 (0.060, 0.157), respectively. The results of the multi-group analysis showed that the SEM we constructed still fit in boy and girl groups. CONCLUSIONS The results indicated that vegetable and fruit intake, physical activity, school bullying, and IA had a significant direct impact on depressive symptoms, among which IA had the greatest impact. In addition, both vegetable and fruit intake, school bullying, and physical activity indirectly affected depressive symptoms through the mediating effect of IA. The impact of IA on depressive symptoms should be given extra attention by schools and parents. This study provides a scientific and effective basis for the prevention and control of adolescent depressive symptoms.
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Affiliation(s)
- Lujun Ji
- Department of Epidemiology and Health Statistics, The School of Public Health of Qingdao University, 308 Ningxia Road, Qingdao, 266071, China
| | - Zhisheng Ren
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao Institute of Preventive Medicine, Qingdao, China
| | - Jian Chen
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao Institute of Preventive Medicine, Qingdao, China
| | - Hui Zhao
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao Institute of Preventive Medicine, Qingdao, China
| | - Xiaofei Zhang
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao Institute of Preventive Medicine, Qingdao, China
| | - Bai Xue
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao Institute of Preventive Medicine, Qingdao, China.
| | - Dongfeng Zhang
- Department of Epidemiology and Health Statistics, The School of Public Health of Qingdao University, 308 Ningxia Road, Qingdao, 266071, China.
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Slykerman R, Davies N, Fuad M, Dekker J. Milk Fat Globule Membranes for Mental Health across the Human Lifespan. Foods 2024; 13:1631. [PMID: 38890860 PMCID: PMC11171857 DOI: 10.3390/foods13111631] [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: 04/26/2024] [Revised: 05/17/2024] [Accepted: 05/22/2024] [Indexed: 06/20/2024] Open
Abstract
The milk fat globule membrane (MFGM) contains bioactive proteins, carbohydrates, and lipids. Polar lipids found in the MFGM play a critical role in maintaining cell membrane integrity and neuronal signalling capacity, thereby supporting brain health. This review summarises the literature on the MFGM and its phospholipid constituents for improvement of mental health across three key stages of the human lifespan, i.e., infancy, adulthood, and older age. MFGM supplementation may improve mental health by reducing neuroinflammation and supporting neurotransmitter synthesis through the gut-brain axis. Fortification of infant formula with MFGMs is designed to mimic the composition of breastmilk and optimise early gut and central nervous system development. Early behavioural and emotional development sets the stage for future mental health. In adults, promising results suggest that MFGMs can reduce the negative consequences of situational stress. Preclinical models of age-related cognitive decline suggest a role for the MFGM in supporting brain health in older age and reducing depressive symptoms. While there is preclinical and clinical evidence to support the use of MFGM supplementation for improved mental health, human studies with mental health as the primary target outcome are sparce. Further high-quality clinical trials examining the potential of the MFGM for psychological health improvement are important.
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Affiliation(s)
- Rebecca Slykerman
- Department of Psychological Medicine, The University of Auckland, Auckland 1023, New Zealand;
| | - Naomi Davies
- Department of Psychological Medicine, The University of Auckland, Auckland 1023, New Zealand;
| | - Maher Fuad
- Fonterra Cooperative Group Limited, Palmerston North 4472, New Zealand; (M.F.); (J.D.)
| | - James Dekker
- Fonterra Cooperative Group Limited, Palmerston North 4472, New Zealand; (M.F.); (J.D.)
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Ghanbarzadeh E, Dorosty Motlagh AR, Abbasi B. Association of healthy eating index (2015) with depression and anxiety symptoms among Iranian adolescent girls. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:44. [PMID: 38566258 PMCID: PMC10988820 DOI: 10.1186/s41043-024-00529-z] [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: 07/17/2022] [Accepted: 02/16/2024] [Indexed: 04/04/2024]
Abstract
Adolescence is a period of rapid growth, with changes in body composition and cognitive and psychosocial development. Teenagers who eat properly and participate in daily physical activities have a healthy lifestyle. Healthy living promotes optimal growth and performance at school and in the workplace and minimizes the risk of chronic nutrient-related diseases. Therefore, the present study was conducted to determine the relationship between the healthy eating index (2015) (HEI-2015) and depression and anxiety among Iranian adolescent girls. This cross-sectional study was designed based on the updated version of HEI-2015. The study population consisted of 412 high school girls aged 12-17 years old. Data were collected about the diet, sociodemographic, and anthropometric characteristics of the participants. HEI and anthropometric characteristics of the participants were measured. The depression, anxiety, and stress scale 42 (DASS-42) questionnaire was used to detect adolescents suffering from depression and anxiety. The relationships of the HEI and anthropometric measures with depression and anxiety were also assessed. The results showed that the HEI is inversely correlated with depression and anxiety in Iranian adolescent girls. HEI was greater in the healthy participants than in those suffering from depression and anxiety (P < 0.0001).
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Affiliation(s)
- Elham Ghanbarzadeh
- Department of Nutrition, Electronic Health and Statistics Surveillance Research Center, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Ahmad Reza Dorosty Motlagh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Behnood Abbasi
- Department of Nutrition, Electronic Health and Statistics Surveillance Research Center, Science and Research Branch, Islamic Azad University, Tehran, Iran.
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Beigrezaei S, Darabi Z, Davies IG, Mazidi M, Ghayour-Mobarhan M, Khayyatzadeh SS. Higher global diet quality score is related to lower prevalence of depression and poor quality of life among adolescent girls. BMC Psychiatry 2023; 23:886. [PMID: 38017405 PMCID: PMC10683251 DOI: 10.1186/s12888-023-05313-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 10/26/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Adolescence is a key time for the development of depression symptoms and the diet quality may be associated with mental health conditions. The present study examined the association between depression and quality of life (QoL) and the global diet quality score (GDQS) as a simple and standardized metric diet quality in Iranian adolescents. METHODS This cross-sectional study was conducted on 733 adolescent girls recruited using a random cluster sampling method. A 147-item food frequency questionnaire (FFQ) was used for dietary intake assessment. The GDQS is gained by summing points of all the 25 food groups, ranged from 0 to 49. Depression symptoms were assessed using a Persian version of the Beck Depression Inventory (BDI). For assessment of health-related QoL, the Short Form 12 Survey-version 2 (SF-12v2) questionnaire was employed. Multivariable logistic regression examined the association of depression and QoL with GDQS in crude and adjusted models. RESULTS Adolescent girls in the highest tertile of GDQS score compared with the lowest tertile had a 41% lower odds of depressive symptoms (OR: 0.59; 95% CI: 0.39-0.90, P = 0.01). The participants in the third tertile of GDQS score had lower odds of poor QoL compared with the first tertile (OR: 0.56; 95% CI: 0.37-0.85, P < 0.01). These associations remained significant (both P = 0.01) after adjustment for age, energy intake, body mass index (BMI), physical activity, and menstruation (depressive symptoms: OR: 0.59; 95% CI: 0.38-0.92; QoL: OR: 0.59; 95% CI: 0.38-0.91, P = 0.01). CONCLUSION We found that adolescent girls with a higher score of the GDQS had lower odds of depression and poor QoL Prospective and interventional investigations are needed to reach a clear vision.
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Affiliation(s)
- Sara Beigrezaei
- Research Center for Food Hygiene and Safety, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Zahra Darabi
- Research Center for Food Hygiene and Safety, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Ian G Davies
- Research Institute of Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
| | - Mohsen Mazidi
- Medical Research Council Population Health Research Unit, University of Oxford, Oxford, UK
- Nuffield Department of Population Health, Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), University of Oxford, Oxford, UK
- Department of Twin Research and Genetic Epidemiology, King's College London, South Wing St Thomas', London, UK
| | - Majid Ghayour-Mobarhan
- International UNESCO center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sayyed Saeid Khayyatzadeh
- Research Center for Food Hygiene and Safety, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Shohadaye gomnam BLD. ALEM square, Yazd, Iran.
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Schellekens H, Ribeiro G, Cuesta-Marti C, Cryan JF. The microbiome-gut-brain axis in nutritional neuroscience. Nutr Neurosci 2023; 26:1159-1171. [PMID: 36222323 DOI: 10.1080/1028415x.2022.2128007] [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: 12/02/2022]
Abstract
Emerging evidence is highlighting the microbiome as a key regulator of the effect of nutrition on gut-brain axis signaling. Nevertheless, it is not yet clear whether the impact of nutrition is moderating the microbiota-gut-brain interaction or if diet has a mediating role on microbiota composition and function to influence central nervous system function, brain phenotypes and behavior. Mechanistic evidence from cell-based in vitro studies, animal models and preclinical intervention studies are linking the gut microbiota to the effects of diet on brain function, but they have had limited translation to human intervention studies. While increasing evidence demonstrates the triangulating relationship between diet, microbiota, and brain function across the lifespan, future mechanistic and translational studies in the field of microbiota and nutritional neuroscience are warranted to inform potential strategies for prevention and management of several neurological, neurodevelopmental, neurodegenerative, and psychiatric disorders. This brief primer provides an overview of the most recent advances in the nutritional neuroscience - microbiome field, highlighting significant opportunities for future research.
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Affiliation(s)
- Harriët Schellekens
- APC Microbiome Ireland, University College Cork, Cork, Ireland
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | | | - Cristina Cuesta-Marti
- 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
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Adepalli N, Cumby J, Campbell N, Pavlova B, Alda M, Cahill LE, Uher R. Developmental Trajectory of Body Weight in Youths at Risk for Major Mood Disorders. JAMA Netw Open 2023; 6:e2338540. [PMID: 37856119 PMCID: PMC10587790 DOI: 10.1001/jamanetworkopen.2023.38540] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 09/06/2023] [Indexed: 10/20/2023] Open
Abstract
Importance Mood disorders are associated with increased body weight, especially in females, but it remains unknown when the weight increase starts. Objectives To examine sex-specific weight trajectories associated with familial mood disorder risk and determine the age at which youth at familial risk for mood disorders begin to diverge in weight from controls. Design, Setting, and Participants This community-based, single-center, acceleration cohort study of youth at familial risk for mood disorders and controls with yearly follow-ups (mean [SD], 5 [2.1] years) from January 1, 2014, to December 31, 2022, assessed 394 unaffected female and male offspring (aged 3 to 20 years) of parents with or without a mood disorder. Parents with mood (depressive or bipolar) disorders were recruited through adult mental health services. Parents of control participants were matched on age and socioeconomic factors and recruited through acquaintance referrals or schools. Exposures The youth in the familial mood risk group had at least 1 parent with a major mood disorder, whereas control youth did not have a parent with a mood disorder. Main Outcomes and Measures Body mass indexes (BMIs) were calculated as weight in kilograms divided by height in meters squared from measured weight and height at annual assessments and then converted to age- and sex-adjusted z scores (zBMIs). Repeated-measure regressions examined the association between zBMI and age in youth at familial risk of mood disorders and controls while accounting for sex. Sensitivity analyses accounted for socioeconomic status, prematurity, and birth weight. Results Of 394 participants (mean [SD] age, 11.5 [3.6] years; 203 [51.5%] female), youths at familial risk for mood disorders showed overall no difference in body weight (β = 0.12; 95% CI, 0.01-0.24) from controls. A sex-specific difference was detected, with females at familial risk showing a rapid peripubertal increase in body weight, leading to significantly increased zBMIs at 12 years and older compared with controls (β = 0.57; 95% CI, 0.31-0.82) independent of socioeconomic status, prematurity, or birth weight. Males did not differ from controls at any age. Conclusions and Relevance In this cohort study, females with a family history of mood disorders were prone to weight gain starting around puberty and predating mood disorder onset. Early interventions aiming to prevent adverse mental and physical outcomes in this vulnerable group need to start in childhood.
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Affiliation(s)
- Nitya Adepalli
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Jill Cumby
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Niamh Campbell
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Barbara Pavlova
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Leah E. Cahill
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Rudolf Uher
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
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Gerber M, Jakowski S, Kellmann M, Cody R, Gygax B, Ludyga S, Müller C, Ramseyer S, Beckmann J. Macronutrient intake as a prospective predictor of depressive symptom severity: An exploratory study with adolescent elite athletes. PSYCHOLOGY OF SPORT AND EXERCISE 2023; 66:102387. [PMID: 37665852 DOI: 10.1016/j.psychsport.2023.102387] [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: 06/16/2022] [Revised: 11/22/2022] [Accepted: 01/08/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND Appropriate availability of macro- and micronutrients has an important impact on cognitive performance, mood and mental health. Although the critical role of nutrition for elite athletes' performance was recognized early on, little is known about whether consumption of specific macronutrients (carbohydrates, proteins, fat) predict the development of future depressive symptoms in adolescent elite athletes. METHODS Participants were recruited from three Swiss Olympic Partner Schools (SOPS) in the Northwestern German speaking part of Switzerland. A total of 97 adolescent elite athletes (38% girls, Mage = 16.35 ± 1.19) participated in the study. Depressive symptoms (PHQ9) were assessed at baseline and after 10 months follow-up. A 3-day food recall was completed three months after the baseline assessment. Linear regression analyses were used to examine whether macronutrients predict depression symptom severity after controlling for covariates and baseline depressive symptoms. RESULTS Higher protein consumption in athletes was a prospective predictor of lower depressive symptom severity at follow-up (β = -35, p < .05). Several deviations from recommended nutritional standards were observed in elite athletes. CONCLUSIONS The findings of this exploratory study support the notion that dietary behaviour may be prospectively associated with athletes' mental health. However, more research is required with larger samples and more in-depth assessment techniques. Future research should also examine whether nutrition education and dietary modification can be used to prevent depressive symptoms among adolescent elite athletes.
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Affiliation(s)
- Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Switzerland.
| | - Sarah Jakowski
- Faculty of Sport Science, Ruhr-University Bochum, Germany
| | - Michael Kellmann
- Faculty of Sport Science, Ruhr-University Bochum, Germany; School of Human Movement and Nutrition Sciences, University of Queensland, Australia
| | - Robyn Cody
- Department of Sport, Exercise and Health, University of Basel, Switzerland
| | - Basil Gygax
- Department of Sport, Exercise and Health, University of Basel, Switzerland
| | - Sebastian Ludyga
- Department of Sport, Exercise and Health, University of Basel, Switzerland
| | - Caspar Müller
- Department of Sport, Exercise and Health, University of Basel, Switzerland
| | - Sven Ramseyer
- Department of Sport, Exercise and Health, University of Basel, Switzerland
| | - Johanna Beckmann
- Department of Sport, Exercise and Health, University of Basel, Switzerland
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Moriarity DP, Slavich GM, Alloy LB, Olino TM. Hierarchical Inflammatory Phenotypes of Depression: A Novel Approach Across Five Independent Samples and 27,730 Adults. Biol Psychiatry 2023; 93:253-259. [PMID: 36802275 PMCID: PMC10014190 DOI: 10.1016/j.biopsych.2022.08.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 07/16/2022] [Accepted: 08/03/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND Although characterizing associations between inflammation and depression may prove critical for informing theory, research, and treatment decisions, extant research has been limited by ignoring the possibility that inflammation may be simultaneously associated with depression broadly and with a subset of symptoms. This lack of direct comparison has hampered attempts to understand inflammatory phenotypes of depression and critically fails to consider that inflammation might be uniquely associated with both depression broadly and individual symptoms. METHODS We used moderated nonlinear factor analysis in 5 NHANES (National Health and Nutrition Examination Survey) cohorts (N = 27,730, 51% female, mean age = 46 years). RESULTS C-reactive protein (CRP) is simultaneously associated with latent depression, appetite, and fatigue. Specifically, CRP was associated with latent depression in all 5 samples (rs: 0.044-0.089; ps: < .001-.002) and was associated with both appetite (significant rs: 0.031-0.049, significant ps: .001-.007) and fatigue (significant rs: 0.030-0.054, significant ps: < .001-.029) in 4 samples. These results were largely robust to covariates. CONCLUSIONS Methodologically, these models indicate that the Patient Health Questionnaire-9 is scalar noninvariant as a function of CRP (i.e., identical Patient Health Questionnaire-9 scores may represent different constructs in those with high vs. low CRP levels). Therefore, mean comparisons of depression total scores and CRP might be misleading without accounting for symptom-specific associations. Conceptually, these findings indicate that studies investigating inflammatory phenotypes of depression should examine how inflammation is simultaneously related both to depression broadly and to specific symptoms, and whether these relations function via different mechanisms. This has the potential to yield new theoretical insights and may lead to the development of novel therapies for reducing inflammation-related symptoms of depression.
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Affiliation(s)
- Daniel P Moriarity
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California.
| | - George M Slavich
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California
| | - Lauren B Alloy
- Department of Psychology, Temple University, Philadelphia, Pennsylvania
| | - Thomas M Olino
- Department of Psychology, Temple University, Philadelphia, Pennsylvania
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Alsarrani A, Hunter RF, Dunne L, Garcia L. Association between friendship quality and subjective wellbeing among adolescents: a systematic review. BMC Public Health 2022; 22:2420. [PMID: 36564745 PMCID: PMC9784006 DOI: 10.1186/s12889-022-14776-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 10/17/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Social integration with friends has an important role in shaping adolescents' behavior and determining their wellbeing. Friendship features such as companionship, trust, closeness, intimacy, and conflicts all form the concept of friendship quality. The quality of friendships can either enhance or impede mental development during adolescence. Therefore, this systematic review was conducted to understand the association between friendship quality and adolescents' mental wellbeing. METHODS In November 2020 and later in August 2022, the search for evidence was conducted on five databases (Medline, Embase, ProQuest, Scopus, and PsycINFO). Only peer-reviewed quantitative studies published from January 2000 to August 2022 that investigated friendship quality as their exposure variable in relation to six constructs of subjective wellbeing (mood, loneliness, life satisfaction, happiness, self-esteem, and subjective wellbeing) were included. After screening for eligibility, two reviewers independently extracted the data based on population characteristics, study design, exposure and outcome variables, outcome measures used, and results. Risk of bias assessment was performed utilizing the NIH Quality Assessment Tool. Narrative evidence synthesis was performed based on the constructs of subjective wellbeing. RESULTS Forty-three articles out of 21,585 records were included in the review. The relationship between friendship quality and depression has been investigated extensively in the literature and negative (beneficial) associations were found in eighteen studies out of twenty-three. Poor peer relationship was associated with loneliness in nine studies out of ten. All seven studies on life satisfaction and quality of peer connection found a positive association. In five studies, better peer relationship was found to be associated with happiness. A positive association between friendship quality and self-esteem was observed in five out of six applicable studies. Friendship quality was found to be positively associated with subjective well-being in all of five included studies. CONCLUSIONS Although majority of the included studies were cross-sectional in nature, this review demonstrates the paramount value of promoting healthy friendship to adolescents' subjective wellbeing constructs. Interventions that aim to promote subjective wellbeing among adolescents should consider the development and maintenance of healthy friendships. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020219312.
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Affiliation(s)
- Abdullah Alsarrani
- grid.4777.30000 0004 0374 7521Center for Public Health, Institute of Clinical Sciences, Royal Victoria Hospital, School of Medicine, Dentistry, and Biomedical Sciences, Queen’s University Belfast, Belfast, BT12 6BA Northern Ireland, UK ,grid.412892.40000 0004 1754 9358College of Medicine, Taibah University, Medina, Saudi Arabia
| | - Ruth F. Hunter
- grid.4777.30000 0004 0374 7521Center for Public Health, Institute of Clinical Sciences, Royal Victoria Hospital, School of Medicine, Dentistry, and Biomedical Sciences, Queen’s University Belfast, Belfast, BT12 6BA Northern Ireland, UK
| | - Laura Dunne
- grid.4777.30000 0004 0374 7521School of Social Sciences, Education, and Social Work, Queen’s University Belfast, Belfast, Northern Ireland, UK
| | - Leandro Garcia
- grid.4777.30000 0004 0374 7521Center for Public Health, Institute of Clinical Sciences, Royal Victoria Hospital, School of Medicine, Dentistry, and Biomedical Sciences, Queen’s University Belfast, Belfast, BT12 6BA Northern Ireland, UK
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11
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Wang Y, Liu J, Compher C, Kral TV. Associations between dietary intake, diet quality and depressive symptoms in youth: A systematic review of observational studies. Health Promot Perspect 2022; 12:249-265. [PMID: 36686054 PMCID: PMC9808911 DOI: 10.34172/hpp.2022.32] [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: 03/03/2022] [Accepted: 07/17/2022] [Indexed: 01/15/2023] Open
Abstract
Background: Depression is the third leading cause of worldwide disease burden among youth, and nutrition- and diet-related behaviors have been considered as an effective strategy for reducing the risk of depressive symptoms. This systematic review aims to examine associations between dietary intake and diet quality with depressive symptoms among youth. Methods: In this systematic review, a search of scientific articles published between 2000 and 2021 was performed in four databases (CINAHL, Embase, PsycInfo, and PubMed) according to the PRISMA checklist. After applying inclusion and exclusion criteria, observational studies that focused on associations between micronutrient, macronutrient, food group intake, and diet quality and depressive symptoms among youth, ages 3 to 18, were selected for review. Results: Thirty-two articles met the review criteria. Dietary intake of magnesium, vitamin B12, fiber, fruits, vegetables, and fish were consistently inversely related to depressive symptoms. However, the evidence of associations between intake of vitamins B6, C, D, and E, iron, copper, zinc, omega-3 fatty acids, carbohydrate, and dietary fat and depressive symptoms was mixed. Dietary effects on decreased depressive symptoms were more pronounced in children than adolescents. Additionally, most studies failed to adjust for potential confounding variables. Conclusion: This review provides preliminary and comprehensive evidence for a relationship between dietary intake, diet quality, and depressive symptoms in youth. Although the results are heterogeneous and more research is needed, our findings indicate the importance of nutrition interventions for youth for decreasing depressive symptoms or for preventing further symptom exacerbation.
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Affiliation(s)
- Yiqi Wang
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA,University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA,Corresponding Author: Yiqi Wang,
| | - Jianghong Liu
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Charlene Compher
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Tanja V.E. Kral
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, PA, USA,Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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12
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Gong WJ, Fong DYT, Wang MP, Lam TH, Chung TWH, Ho SY. Skipping Breakfast and Eating Breakfast Away From Home Were Prospectively Associated With Emotional and Behavioral Problems in 115,217 Chinese Adolescents. J Epidemiol 2022; 32:551-558. [PMID: 34148915 PMCID: PMC9643789 DOI: 10.2188/jea.je20210081] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Breakfast is deemed the most important meal of the day. We examined the prospective associations of breakfast habits with emotional/behavioral problems in adolescents and potential effect modification. METHODS 115,217 Primary 6 students (United States Grade 6; mean age, 11.9; standard deviation [SD], 0.59 years) who attended the Student Health Service of Department of Health in Hong Kong in 2004/05, 2006/07, 2008/09 were followed till Secondary 6 (United States Grade 12). Emotional/behavioral problems were biennially examined using Youth Self-Report since Secondary 2 (United States Grade 8). Lifestyles were biennially examined using standardized questionnaires since Primary 6. Prospective associations of breakfast habit with emotional/behavioral problems and potential effect modification were examined using generalized estimating equations. RESULTS Compared with eating breakfast at home, eating breakfast away from home was significantly associated with total emotional/behavioral problems and seven syndromes, including withdrawal, somatic complaints, anxiety/depression, thought problems, attention problems, delinquent behaviors, and aggressive behaviors (adjusted odds ratios [AORs] 1.22-2.04), while skipping breakfast showed stronger associations with the above problems and social problems (AORs 1.34-2.29). Stronger associations were observed in younger students for total and attention problems (P < 0.03) and in those with lower weight status for delinquent behaviors (P = 0.005). CONCLUSION Eating breakfast away from home and especially skipping breakfast were prospectively associated with adolescent emotional/behavioral problems. The associations weakened with increasing age for total emotional/behavioral and attention problems, and weakened with higher weight status for delinquent behaviors, highlighting the vulnerability of younger and underweight children. If the associations are causal, increasing home breakfast may reduce adolescent emotional/behavioral problems and benefit psychosocial health.
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Affiliation(s)
- Wei-Jie Gong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China,School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Daniel Yee-Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Man-Ping Wang
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Tai-Hing Lam
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | | | - Sai-Yin Ho
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
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13
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Rucklidge JJ, Blampied FM, Manna L, Sherwin A, Bagshaw S, Mulder RT, Boden J. Protocol for a randomised placebo-controlled trial investigating the efficacy and safety of a vitamin-mineral formula targeting dysregulated emotions in teenagers: The balancing emotions of adolescents with micronutrients (BEAM) study. Contemp Clin Trials Commun 2022; 30:101027. [PMID: 36340698 PMCID: PMC9634271 DOI: 10.1016/j.conctc.2022.101027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 10/08/2022] [Accepted: 10/26/2022] [Indexed: 11/21/2022] Open
Abstract
Background Emotional dysregulation (ED) is a significant contributing factor to psychological distress in young people. ED is a transdiagnostic dimension characterized by an excessive reactivity to negative emotional stimuli with affective (anger) and behavioral (aggression) components, and is present across anxiety, mood and behavioral disorders. Due to early onset, high prevalence and persistence, ED in childhood is one of the most psychosocially impairing and cost-intensive mental health conditions, with not enough children improving with conventional treatments. Clinical trials have established preliminary efficacy of micronutrients (vitamins and minerals) in the treatment of ED. This project expands the research to examine micronutrient efficacy for teenagers with ED. Methods This study is the first double-blind (participant and investigators) 8 week randomized controlled trial (with 8 week open-label extension and one year follow-up) designed to explore the efficacy and safety of micronutrients compared with placebo in 150 medication-free emotionally dysregulated youth (12–17 years), referred via self-referral, delivered remotely throughout New Zealand, using a website for monitoring symptoms, with a psychologist available online via text, email and video for assessment and monitoring. The primary outcome measures will be the Clinical Global Impression (CGI-I), the reactivity subscale of the Emotion Dysregulation Inventory (EDI) and the Clinician Rated Temper and Irritability Scale (CL-ARI). Discussion Micronutrient intervention delivered alongside online assessment and monitoring has the potential to transform delivery of mental health care to young people who may not be willing or able to access traditional therapies. We also hope that this intervention shows acceptability across different ethnicities.
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Affiliation(s)
- Julia J. Rucklidge
- School of Psychology, Speech and Hearing, University of Canterbury, New Zealand
- Corresponding author. University of Canterbury, Christchurch, New Zealand.
| | | | - Leona Manna
- School of Psychology, Speech and Hearing, University of Canterbury, New Zealand
| | - Angela Sherwin
- School of Psychology, Speech and Hearing, University of Canterbury, New Zealand
| | - Sue Bagshaw
- Psychological Medicine, University of Otago, New Zealand
| | | | - Joseph Boden
- Psychological Medicine, University of Otago, New Zealand
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14
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Nguyen N, Morisseau C, Li D, Yang J, Lam E, Woodside DB, Hammock BD, Shih PAB. Soluble Epoxide Hydrolase Is Associated with Postprandial Anxiety Decrease in Healthy Adult Women. Int J Mol Sci 2022; 23:11798. [PMID: 36233100 PMCID: PMC9569757 DOI: 10.3390/ijms231911798] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 11/16/2022] Open
Abstract
The metabolism of bioactive oxylipins by soluble epoxide hydrolase (sEH) plays an important role in inflammation, and sEH may be a risk modifier in various human diseases and disorders. The relationships that sEH has with the risk factors of these diseases remain elusive. Herein, sEH protein expression and activity in white blood cells were characterized before and after a high-fat meal in healthy women (HW) and women with anorexia nervosa (AN). sEH expression and sEH activity were significantly correlated and increased in both groups two hours after consumption of the study meal. Fasting sEH expression and activity were positively associated with body mass index (BMI) in both groups, while an inverse association with age was found in AN only (p value < 0.05). sEH was not associated with anxiety or depression in either group at the fasting timepoint. While the anxiety score decreased after eating in both groups, a higher fasting sEH was associated with a lower postprandial anxiety decrease in HW (p value < 0.05). sEH characterization using direct measurements verified the relationship between the protein expression and in vivo activity of this important oxylipin modulator, while a well-controlled food challenge study design using HW and a clinical control group of women with disordered eating elucidated sEH’s role in the health of adult women.
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Affiliation(s)
- Nhien Nguyen
- Department of Psychiatry, University of California San Diego, San Diego, CA 92037, USA
| | - Christophe Morisseau
- Department of Entomology and Nematology and Comprehensive Cancer Center, University of California, Davis, CA 95616, USA
| | - Dongyang Li
- Department of Entomology and Nematology and Comprehensive Cancer Center, University of California, Davis, CA 95616, USA
| | - Jun Yang
- Department of Entomology and Nematology and Comprehensive Cancer Center, University of California, Davis, CA 95616, USA
| | - Eileen Lam
- Centre for Mental Health, University Health Network, Toronto, ON M5G 2C4, Canada
| | - D. Blake Woodside
- Centre for Mental Health, University Health Network, Toronto, ON M5G 2C4, Canada
| | - Bruce D. Hammock
- Department of Entomology and Nematology and Comprehensive Cancer Center, University of California, Davis, CA 95616, USA
| | - Pei-an Betty Shih
- Department of Psychiatry, University of California San Diego, San Diego, CA 92037, USA
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15
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Zhao W, Zhu DM, Li S, Cui S, Jiang P, Wang R, Zhang Y, Zhu J, Yu Y. The reduction of vitamin D in females with major depressive disorder is associated with worse cognition mediated by abnormal brain functional connectivity. Prog Neuropsychopharmacol Biol Psychiatry 2022; 118:110577. [PMID: 35605842 DOI: 10.1016/j.pnpbp.2022.110577] [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: 11/17/2021] [Revised: 05/01/2022] [Accepted: 05/17/2022] [Indexed: 11/26/2022]
Abstract
Low vitamin D is linked to major depressive disorder (MDD) through affecting the brain. Gender difference is apparent in MDD and vitamin D level. We aimed to examine the association between gender, vitamin D, clinical presentations, and brain functional connectivity in a large cohort of MDD patients and comparison subjects. Resting-state functional MRI data from 122 patients and 119 controls were collected to perform a combined analysis of functional connectivity density (FCD) and seed-based functional connectivity (FC). Peripheral venous blood samples were obtained to measure serum concentration of vitamin D (SCVD). Clinical presentations (symptoms profiles and cognition) were also assessed. We found an interaction of group and gender on SCVD in which MDD patients demonstrated lower SCVD than controls in females rather than males. Concurrently, lower SCVD was associated with worse cognitive performance (prospective memory and sustained attention). Compared with controls, female MDD patients showed reduced FCD and FC of the left middle frontal gyrus, which were related to lower SCVD. Importantly, these FCD and FC changes mediated the relationship between lower SCVD and cognitive dysfunction. Our findings suggest that functional connectivity abnormalities may serve as neural substrates underlying the associations between low vitamin D and cognitive impairments in female MDD patients, providing unique insight into treatment and prevention of MDD and its related cognitive dysfunction from the perspective of regulating circulating vitamin D.
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Affiliation(s)
- Wenming Zhao
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China; Research Center of Clinical Medical Imaging, Anhui Province, Hefei 230032, China; Anhui Provincial Institute of Translational Medicine, Hefei 230032, China
| | - Dao-Min Zhu
- Department of Sleep Disorders, Affiliated Psychological Hospital of Anhui Medical University, Hefei 230022, China; Hefei Fourth People's Hospital, Hefei 230022, China; Anhui Mental Health Center, Hefei 230022, China
| | - Shoubin Li
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China; Research Center of Clinical Medical Imaging, Anhui Province, Hefei 230032, China; Anhui Provincial Institute of Translational Medicine, Hefei 230032, China
| | - Shunshun Cui
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China; Research Center of Clinical Medical Imaging, Anhui Province, Hefei 230032, China; Anhui Provincial Institute of Translational Medicine, Hefei 230032, China
| | - Ping Jiang
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China; Research Center of Clinical Medical Imaging, Anhui Province, Hefei 230032, China; Anhui Provincial Institute of Translational Medicine, Hefei 230032, China
| | - Rui Wang
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China; Research Center of Clinical Medical Imaging, Anhui Province, Hefei 230032, China; Anhui Provincial Institute of Translational Medicine, Hefei 230032, China
| | - Yu Zhang
- Department of Sleep Disorders, Affiliated Psychological Hospital of Anhui Medical University, Hefei 230022, China; Hefei Fourth People's Hospital, Hefei 230022, China; Anhui Mental Health Center, Hefei 230022, China
| | - Jiajia Zhu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China; Research Center of Clinical Medical Imaging, Anhui Province, Hefei 230032, China; Anhui Provincial Institute of Translational Medicine, Hefei 230032, China.
| | - Yongqiang Yu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China; Research Center of Clinical Medical Imaging, Anhui Province, Hefei 230032, China; Anhui Provincial Institute of Translational Medicine, Hefei 230032, China.
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16
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Western diet associated with increased post-stroke depressive symptoms. J Nutr Sci 2022; 11:e44. [PMID: 35754983 PMCID: PMC9201874 DOI: 10.1017/jns.2022.38] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/02/2022] [Accepted: 05/05/2022] [Indexed: 11/07/2022] Open
Abstract
The present study examines the association of diet with depressive symptoms among stroke survivors from a community cohort of older adults. Depression is common after stroke. A healthy diet has previously been associated with fewer depressive symptoms in older individuals, but it is unknown if this effect is also seen in stroke survivors. Eighty-six participants from the Memory and Aging Project with a history of stroke at their study baseline enrolment, complete dietary data and two or more assessments for depression were included in this observational prospective cohort analysis. Depressive symptoms were assessed annually with a 10-item version of the Center for Epidemiologic Studies Depression scale. Diet was assessed using a validated food-frequency questionnaire administered at baseline. Diet scores were based on analysis of participants' reported intakes of 144 food items. A generalised estimating equation (GEE) model was applied to examine the association of diet score with depressive symptoms. The study participants had a mean age of 82 ± 7⋅17 years and 14⋅42 ± 2⋅61 years of education, and 82⋅56 % were female. Western diet score was positively associated with depressive symptoms over time (diet score tertile 3 v. tertile 1: β = 0⋅22, se = 0⋅09, P = 0⋅02; P for trend = 0⋅022). Interaction with sex suggested a stronger effect in females. A Western diet was associated with more post-stroke depressive symptoms, suggesting nutrition is important not only for reducing cerebrovascular risk, but for protecting post-stoke mental health as well.
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17
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Orlando L, Savel KA, Madigan S, Colasanto M, Korczak DJ. Dietary patterns and internalizing symptoms in children and adolescents: A meta-analysis. Aust N Z J Psychiatry 2022; 56:617-641. [PMID: 34313455 PMCID: PMC9131419 DOI: 10.1177/00048674211031486] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
CONTEXT Studies of child and adolescent internalizing symptoms and dietary pattern have produced mixed results. OBJECTIVES To quantify the association between dietary patterns and internalizing symptoms, including depression, in children and adolescents. DATA SOURCES Embase, PsycINFO, MEDLINE, Web of Science and Cochrane up to March 2021. STUDY SELECTION Observational studies and randomized controlled trials with mean age ⩽ 18 years, reporting associations between diet patterns and internalizing symptoms. DATA EXTRACTION Mean effect sizes and 95% confidence intervals were determined under a random-effects model. RESULTS Twenty-six studies were cross-sectional, 12 were prospective, and 1 used a case-control design. The total number of participants enrolled ranged from 73,726 to 116,546. Healthy dietary patterns were negatively associated with internalizing (r = -0.07, p < 0.001, 95% confidence interval [-0.12, 0.06]) and depressive symptoms (r = -0.10, p < 0.001, 95% confidence interval [-0.18, -0.08]). Effect sizes were larger for studies of healthy dietary patterns and internalizing and depressive symptoms using self-report versus parent-report measures, as well as in cross-sectional studies of healthy dietary patterns and depression compared to prospective studies. Unhealthy dietary patterns were positively associated with internalizing (r = 0.09, p < 0.001, 95% confidence interval [0.06, 0.14]) and depressive symptoms (r = 0.10, p < 0.01, 95% CI [0.05, 0.17]). Larger effect sizes were observed for studies of unhealthy dietary patterns and internalizing and depressive symptoms using self-report versus parent-report measures. LIMITATIONS A lack of studies including clinical samples and/or physician diagnosis, and a paucity of studies in which anxiety symptoms were the primary mental health outcome. CONCLUSION Greater depression and internalizing symptoms are associated with greater unhealthy dietary patterns and with lower healthy dietary intake among children and adolescents.
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Affiliation(s)
- Laura Orlando
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Katarina A Savel
- Department of Human Biology, University of Toronto, Toronto, ON, Canada
| | - Sheri Madigan
- Department of Psychology, Faculty of Arts, University of Calgary, Alberta Children’s Hospital Research Institute, Calgary, AB, Canada
| | - Marlena Colasanto
- Applied Psychology and Human Development, University of Toronto, Toronto, ON, Canada,Department of Neuroscience and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Daphne J Korczak
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada,Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada,Daphne J Korczak, Department of Psychiatry, The Hospital for Sick Children, 555 University Avenue, 1145 Burton Wing, Toronto, ON M5G 1X8, Canada.
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18
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Metri NJ, Ee C, Wardle J, Ng CH, Siskind D, Brakoulias V, Ho FYY, Wong VWH, Naidoo U, Eaton M, Firth J, Sarris J. Assessing dietary, exercise, and non-pharmacological modalities within psychiatric hospitals. Gen Hosp Psychiatry 2022; 76:31-35. [PMID: 35358900 DOI: 10.1016/j.genhosppsych.2022.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Najwa-Joelle Metri
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia.
| | - Carolyn Ee
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia
| | - Jon Wardle
- National Centre for Naturopathic Medicine, Southern Cross University, Lismore, NSW, Australia
| | - Chee H Ng
- Professorial Unit, The Melbourne Clinic, Department of Psychiatry, The University of Melbourne, Richmond, Victoria, Australia
| | - Dan Siskind
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Vlasios Brakoulias
- Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia; Western Sydney Local Health District Mental Health Services, Sydney, NSW, Australia
| | - Fiona Yan-Yee Ho
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong
| | | | - Uma Naidoo
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Melissa Eaton
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia; School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia
| | - Joseph Firth
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia; Division of Psychology & Mental Health, The University of Manchester, Manchester, UK
| | - Jerome Sarris
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia; Professorial Unit, The Melbourne Clinic, Department of Psychiatry, The University of Melbourne, Richmond, Victoria, Australia; Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia
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19
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Exploring the associations of depressive symptoms with healthy eating self-efficacy over time amongst women in the READI cohort study. Int J Behav Nutr Phys Act 2021; 18:161. [PMID: 34922558 PMCID: PMC8684166 DOI: 10.1186/s12966-021-01233-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 11/29/2021] [Indexed: 11/24/2022] Open
Abstract
Background There is growing evidence that diet is associated with both depressive symptoms and clinical depression, likely through biological mechanisms. However, it is also plausible that depression impacts diet, for example by impairing the personal drivers of healthy eating behaviors such as self-efficacy. This study is one of the first to explore the association of depressive symptoms with healthy eating self-efficacy over time. Methods Data was drawn from the Resilience for Eating and Activity Despite Inequality (READI) longitudinal study, a prospective cohort study of socioeconomically disadvantaged Australian women. This analysis includes a sub-sample of 1264 women. Linear mixed models, with random intercepts for suburb of residence, were performed to explore the relationships between total healthy eating self-efficacy at 5-years follow-up and depressive symptoms over time, whilst adjusting for potential confounders. To assess different trajectories of depressive symptoms over time, four categories were created; 1. no depressive symptoms (n = 667), 2. resolved depressive symptoms (n = 165), 3. new depressive symptoms (n = 189), and 4. persistent depressive symptoms (n = 243). Results There was very strong evidence of a difference in total healthy eating self-efficacy at follow-up between the four depressive symptoms trajectory categories (F(3,235) = 7.06,p < .0001), after adjusting for potential confounders. Pairwise comparisons indicated strong evidence of higher healthy eating self-efficacy among individuals with no depressive symptoms compared to individuals with persistent depressive symptoms (B = 1.97[95%CI: 0.60,3.33],p = .005). Similarly, there was evidence of higher healthy eating self-efficacy in individuals with resolved depressive symptoms than those with persistent depressive symptoms (B = 1.95[95%CI: 0.18,3.72],p = .031). Conclusions This study provides new insights demonstrating differences in total healthy eating self-efficacy at 5-year follow-up according to trajectory of depressive symptoms over time. Future interventions should focus on strategies that enhance self-efficacy among individuals with or at risk of depressive symptoms for supporting healthier dietary practices, which in turn, may contribute to reducing the highly burdensome mental health condition.
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20
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Bujtor M. Can dietary intake protect against low-grade inflammation in children and adolescents? Brain Behav Immun Health 2021; 18:100369. [PMID: 34825233 PMCID: PMC8604686 DOI: 10.1016/j.bbih.2021.100369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 02/08/2023] Open
Abstract
In children and adolescents, chronic low-grade inflammation has been implicated in the pathogenesis of co- and multi-morbid conditions to mental health disorders. Diet quality is a potential mechanism of action that can exacerbate or ameliorate low-grade inflammation; however, the exact way dietary intake can regulate the immune response in children and adolescents is still to be fully understood. In this review, I discuss the current observational and interventional evidence that supports a potential therapeutic role for dietary intake in the amelioration of low-grade inflammation and highlight the need to develop a better understanding of the biological mechanisms underlying and attenuating the associations between dietary intake and low-grade inflammation in children and adolescents.
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Affiliation(s)
- Melissa Bujtor
- Institute of Psychiatry, Psychology & Neuroscience Division of Psychological Medicine Kings College London and Institute for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Victoria, Australia
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21
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O’Brien KM, Barnes C, Yoong S, Campbell E, Wyse R, Delaney T, Brown A, Stacey F, Davies L, Lorien S, Hodder RK. School-Based Nutrition Interventions in Children Aged 6 to 18 Years: An Umbrella Review of Systematic Reviews. Nutrients 2021; 13:4113. [PMID: 34836368 PMCID: PMC8618558 DOI: 10.3390/nu13114113] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/12/2021] [Accepted: 11/15/2021] [Indexed: 01/08/2023] Open
Abstract
Schools are identified as a key setting to influence children's and adolescents' healthy eating. This umbrella review synthesised evidence from systematic reviews of school-based nutrition interventions designed to improve dietary intake outcomes in children aged 6 to 18 years. We undertook a systematic search of six electronic databases and grey literature to identify relevant reviews of randomized controlled trials. The review findings were categorised for synthesis by intervention type according to the World Health Organisation Health Promoting Schools (HPS) framework domains: nutrition education; food environment; all three HPS framework domains; or other (not aligned to HPS framework domain). Thirteen systematic reviews were included. Overall, the findings suggest that school-based nutrition interventions, including nutrition education, food environment, those based on all three domains of the HPS framework, and eHealth interventions, can have a positive effect on some dietary outcomes, including fruit, fruit and vegetables combined, and fat intake. These results should be interpreted with caution, however, as the quality of the reviews was poor. Though these results support continued public health investment in school-based nutrition interventions to improve child dietary intake, the limitations of this umbrella review also highlight the need for a comprehensive and high quality systematic review of primary studies.
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Affiliation(s)
- Kate M. O’Brien
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia; (C.B.); (S.Y.); (E.C.); (R.W.); (T.D.); (A.B.); (S.L.); (R.K.H.)
- Priority Research Centre in Health and Behaviour, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia;
- Hunter New England Population Health, Longworth Avenue Wallsend, Newcastle, NSW 2287, Australia;
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW 2305, Australia
- National Centre of Implementation Science, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia
| | - Courtney Barnes
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia; (C.B.); (S.Y.); (E.C.); (R.W.); (T.D.); (A.B.); (S.L.); (R.K.H.)
- Priority Research Centre in Health and Behaviour, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia;
- Hunter New England Population Health, Longworth Avenue Wallsend, Newcastle, NSW 2287, Australia;
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW 2305, Australia
| | - Serene Yoong
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia; (C.B.); (S.Y.); (E.C.); (R.W.); (T.D.); (A.B.); (S.L.); (R.K.H.)
- Priority Research Centre in Health and Behaviour, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia;
- Hunter New England Population Health, Longworth Avenue Wallsend, Newcastle, NSW 2287, Australia;
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW 2305, Australia
- National Centre of Implementation Science, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia
- Faculty of Health, Arts and Design, Swinburne University of Technology, John Street, Hawthorn, VIC 3122, Australia
| | - Elizabeth Campbell
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia; (C.B.); (S.Y.); (E.C.); (R.W.); (T.D.); (A.B.); (S.L.); (R.K.H.)
- Priority Research Centre in Health and Behaviour, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia;
- Hunter New England Population Health, Longworth Avenue Wallsend, Newcastle, NSW 2287, Australia;
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW 2305, Australia
| | - Rebecca Wyse
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia; (C.B.); (S.Y.); (E.C.); (R.W.); (T.D.); (A.B.); (S.L.); (R.K.H.)
- Priority Research Centre in Health and Behaviour, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia;
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW 2305, Australia
| | - Tessa Delaney
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia; (C.B.); (S.Y.); (E.C.); (R.W.); (T.D.); (A.B.); (S.L.); (R.K.H.)
- Priority Research Centre in Health and Behaviour, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia;
- Hunter New England Population Health, Longworth Avenue Wallsend, Newcastle, NSW 2287, Australia;
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW 2305, Australia
| | - Alison Brown
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia; (C.B.); (S.Y.); (E.C.); (R.W.); (T.D.); (A.B.); (S.L.); (R.K.H.)
- Priority Research Centre in Health and Behaviour, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia;
- Hunter New England Population Health, Longworth Avenue Wallsend, Newcastle, NSW 2287, Australia;
- National Centre of Implementation Science, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia
| | - Fiona Stacey
- Priority Research Centre in Health and Behaviour, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia;
- Hunter New England Population Health, Longworth Avenue Wallsend, Newcastle, NSW 2287, Australia;
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW 2305, Australia
| | - Lynda Davies
- Hunter New England Population Health, Longworth Avenue Wallsend, Newcastle, NSW 2287, Australia;
| | - Sasha Lorien
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia; (C.B.); (S.Y.); (E.C.); (R.W.); (T.D.); (A.B.); (S.L.); (R.K.H.)
- Priority Research Centre in Health and Behaviour, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia;
- Hunter New England Population Health, Longworth Avenue Wallsend, Newcastle, NSW 2287, Australia;
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW 2305, Australia
- National Centre of Implementation Science, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia
| | - Rebecca K. Hodder
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia; (C.B.); (S.Y.); (E.C.); (R.W.); (T.D.); (A.B.); (S.L.); (R.K.H.)
- Priority Research Centre in Health and Behaviour, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia;
- Hunter New England Population Health, Longworth Avenue Wallsend, Newcastle, NSW 2287, Australia;
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW 2305, Australia
- National Centre of Implementation Science, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia
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22
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Berding K, Vlckova K, Marx W, Schellekens H, Stanton C, Clarke G, Jacka F, Dinan TG, Cryan JF. Diet and the Microbiota-Gut-Brain Axis: Sowing the Seeds of Good Mental Health. Adv Nutr 2021; 12:1239-1285. [PMID: 33693453 PMCID: PMC8321864 DOI: 10.1093/advances/nmaa181] [Citation(s) in RCA: 129] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 12/18/2020] [Accepted: 12/21/2020] [Indexed: 02/06/2023] Open
Abstract
Over the past decade, the gut microbiota has emerged as a key component in regulating brain processes and behavior. Diet is one of the major factors involved in shaping the gut microbiota composition across the lifespan. However, whether and how diet can affect the brain via its effects on the microbiota is only now beginning to receive attention. Several mechanisms for gut-to-brain communication have been identified, including microbial metabolites, immune, neuronal, and metabolic pathways, some of which could be prone to dietary modulation. Animal studies investigating the potential of nutritional interventions on the microbiota-gut-brain axis have led to advancements in our understanding of the role of diet in this bidirectional communication. In this review, we summarize the current state of the literature triangulating diet, microbiota, and host behavior/brain processes and discuss potential underlying mechanisms. Additionally, determinants of the responsiveness to a dietary intervention and evidence for the microbiota as an underlying modulator of the effect of diet on brain health are outlined. In particular, we emphasize the understudied use of whole-dietary approaches in this endeavor and the need for greater evidence from clinical populations. While promising results are reported, additional data, specifically from clinical cohorts, are required to provide evidence-based recommendations for the development of microbiota-targeted, whole-dietary strategies to improve brain and mental health.
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Affiliation(s)
| | | | - Wolfgang Marx
- Deakin University, iMPACT – the Institute for Mental and Physical Health and Clinical Translation, Food & Mood Centre, School of Medicine, Barwon Health, Geelong, VIC,Australia
| | - Harriet Schellekens
- APC Microbiome Ireland, Cork, Ireland
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - Catherine Stanton
- APC Microbiome Ireland, Cork, Ireland
- Teagasc Food Research Centre, Moorepark, Fermoy, Cork, Ireland
| | - Gerard Clarke
- APC Microbiome Ireland, Cork, Ireland
- Department of Psychiatry and Neurobehavioural Sciences, University College Cork, Cork, Ireland
| | - Felice Jacka
- Deakin University, iMPACT – the Institute for Mental and Physical Health and Clinical Translation, Food & Mood Centre, School of Medicine, Barwon Health, Geelong, VIC,Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Black Dog Institute, Randwick, NSW, Australia
- College of Public Health, Medical & Veterinary Sciences, James Cook University, Douglas, QLD, Australia
| | - Timothy G Dinan
- APC Microbiome Ireland, Cork, Ireland
- Department of Psychiatry and Neurobehavioural Sciences, University College Cork, Cork, Ireland
| | - John F Cryan
- APC Microbiome Ireland, Cork, Ireland
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
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23
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Cherian L, Wang Y, Holland T, Agarwal P, Aggarwal N, Morris MC. DASH and Mediterranean-Dash Intervention for Neurodegenerative Delay (MIND) Diets Are Associated With Fewer Depressive Symptoms Over Time. J Gerontol A Biol Sci Med Sci 2021; 76:151-156. [PMID: 32080745 DOI: 10.1093/gerona/glaa044] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Depression is common in older adults and more prevalent in those with cognitive impairment, vascular risk factors, or stroke. Nonpharmacologic strategies to reduce depression, such as diet, may be effective; however, few studies have investigated the relation. METHODS A total of 709 participants (23.3% men, mean age 80.4), from an observational prospective cohort study were assessed annually for an average of 6.53 years of follow-up. Participants with missing or invalid baseline dietary evaluations or fewer than two depression assessments were excluded. Depressive symptoms were assessed with a 10-item version of the Center for Epidemiologic Studies Depression scale. High burden of depressive symptoms was defined as the presence of four or more depressive symptoms. Diet scores were computed using a validated food frequency questionnaire for the Dietary Approaches to Stop Hypertension (DASH) diet, Mediterranean diet, Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet, and Western diets. Diet scores were modeled in tertiles. A generalized estimating equation (GEE) model was performed for the longitudinal analysis of depression as a binary outcome. RESULTS Participants in the highest tertile of the DASH (β = -0.10, confidence interval [CI]: -0.20, -0.0064) and MIND (β = -0.12, CI: -0.23, -0.0092) diet scores had lower rates of depressive symptoms over time when compared to those in the respective lowest tertiles. The Western diet was positively associated with depressive symptoms over time (β = 0.093, p-trend = .05). CONCLUSIONS Diet may be effective in reducing depressive symptoms in older adults. A diet intervention trial may be needed to determine the optimal nutritional components for prevention of late onset depression.
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Affiliation(s)
- Laurel Cherian
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
| | - Yamin Wang
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
| | - Thomas Holland
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
| | - Puja Agarwal
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
| | - Neelum Aggarwal
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois.,Rush Alzheimer's Disease Center, Chicago, Illinois
| | - Martha Clare Morris
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
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24
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Gascoyne C, Scully M, Wakefield M, Morley B. Food and drink marketing on social media and dietary intake in Australian adolescents: Findings from a cross-sectional survey. Appetite 2021; 166:105431. [PMID: 34062174 DOI: 10.1016/j.appet.2021.105431] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 05/21/2021] [Accepted: 05/25/2021] [Indexed: 10/21/2022]
Abstract
Unhealthy food and drink marketing is prominent on social media and use of such platforms is widespread among adolescents. This study aims to examine the association between exposure to and engagement with food or drink advertisements on social media and unhealthy food and drink intake in Australian adolescents. In 2018, a representative sample of secondary school students aged 12-17 years (N = 8708) self-reported how frequently they saw food or drink advertisements on social media (exposure), 'liked' or 'shared' food or drink posts (engagement), and consumption of various unhealthy food and drinks. Multilevel logistic regression assessed the association between exposure to and engagement with food marketing on social media and high intake of unhealthy food and drinks. Fifty-five percent of students reported seeing a food or drink advertisement on social media at least weekly, while engagement was less frequent. Exposure to a food or drink advertisement on social media at least once in the last week was associated with a high intake of unhealthy drinks, while liking or sharing a food or drink post at least once in the last month was associated with a high intake of unhealthy food and drinks (all p < 0.01). As frequency of engagement with this type of marketing increased, so too did the likelihood of a high intake of unhealthy food and drinks. The association between exposure to and engagement with food or drink marketing and high unhealthy drink intake was driven by males, while all associations persisted irrespective of age. Holding manufacturers to higher standards in their digital marketing of unhealthy food and drink products through improved policy design and enforcement capability may be crucial in enabling young individuals to maintain a healthy diet.
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Affiliation(s)
- Claudia Gascoyne
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria, 3004, Australia.
| | - Maree Scully
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria, 3004, Australia.
| | - Melanie Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria, 3004, Australia; Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria, 3010, Australia.
| | - Belinda Morley
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria, 3004, Australia.
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25
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ÇAM C, ATAY E, AYGAR H, ÖCAL EE, GÖKTAŞ S, IŞIKLI B, ÖNSÜZ MF, METİNTAS S. Evaluation of Associated Factors with Nutrition Behavior and Dietary Self-efficacy for Healthy Food Choice among Primary School Students. KONURALP TIP DERGISI 2021. [DOI: 10.18521/ktd.869407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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26
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Korczak DJ, Perruzza S, Chandrapalan M, Cost K, Cleverley K, Birken CS, McCrindle BM. The association of diet and depression: an analysis of dietary measures in depressed, non-depressed, and healthy youth. Nutr Neurosci 2021; 25:1948-1955. [PMID: 33939946 DOI: 10.1080/1028415x.2021.1918981] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND The association of diet quality with depression among the pediatric age group has been inconsistent. This may be due, in part, to varying dietary assessment methods. The current study sought to examine this association, and its reliability, using four dietary measures previously studied in children and adolescents. METHODS Dietary habits among 139 children and adolescents (10-18 years, 66% female) with major depressive disorder [MDD (n = 77)], non-MDD psychiatric conditions (PSYCH; n = 31), or without psychiatric illness (healthy controls [HC]; n = 31) were examined. Using self-reported dietary intake, diet quality was characterized using the Youth Healthy Eating Index (YHEI), Dietary Questionnaire (DQ), Health Behaviour of Teenagers (HBT), and the Healthy Eating Habits Scale (HEHS). Multivariate Analysis of Covariances examined the association between depression status and dietary habits across measures controlling for participant age. RESULTS The multivariate effect was significant by diet measures, F (16, 256) = 1.9, p = .02, partial η2 = 0.12, with significant differences across groups on consumption of healthy dietary practices and minimal variability across measures. In subgroup analyses, MDD children had decreased consumption of healthy foods compared with PSYCH and HC children on three out of four measures. There was no difference in consumption of unhealthy foods across diagnostic groups. LIMITATIONS Cross-sectional design. CONCLUSIONS Children with MDD consume fewer healthy foods than non-MDD children, with little variation by dietary measure. Research examining the directionality of this association and specific dietary deficits among MDD youth is needed to elucidate potential preventative targets for intervention.
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Affiliation(s)
- Daphne J Korczak
- Neuroscience and Mental Health, SickKids' Research Institute, Toronto, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Stephanie Perruzza
- Neuroscience and Mental Health, SickKids' Research Institute, Toronto, Canada
| | | | - Katherine Cost
- Neuroscience and Mental Health, SickKids' Research Institute, Toronto, Canada
| | - Kristin Cleverley
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada.,Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada.,Margaret and Wallace McCain Centre for Child, Youth, and Family Mental Health, Centre for Addiction and Mental Health, Toronto, Canada
| | - Catherine S Birken
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Canada.,Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Brian M McCrindle
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Canada.,Division of Cardiology, Department of Pediatrics, Hospital for Sick Children, Toronto, Canada
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27
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A novel, complex systems approach to modelling risk of psychological distress in young adolescents. Sci Rep 2021; 11:9428. [PMID: 33941827 PMCID: PMC8093239 DOI: 10.1038/s41598-021-88932-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 04/12/2021] [Indexed: 11/08/2022] Open
Abstract
Adolescence is a period of significant anatomical and functional brain changes, and complex interactions occur between mental health risk factors. The Longitudinal Adolescent Brain Study commenced in 2018, to monitor environmental and psychosocial factors influencing mental health in 500 adolescents, for 5 years. Participants are recruited at age 12 from the community in Australia's Sunshine Coast region. In this baseline, cross-sectional study of N = 64 participants, we draw on the network perspective, conceptualising mental disorders as causal systems of interacting entities, to propose a Bayesian network (BN) model of lifestyle and psychosocial variables influencing chances of individuals being psychologically well or experiencing psychological distress. Sensitivity analysis of network priors revealed that psychological distress (Kessler-10) was most affected by eating behaviour. Unhealthy eating increased the chance of moderate psychological distress by 600%. Low social connectedness increased the chance of severe psychological disorder by 200%. Certainty for psychological wellness required 33% decrease in unhealthy eating behaviours, 11% decrease in low social connectedness, and 9% reduction in less physical activity. BN can augment clinician judgement in mental disorders as probabilistic decision support systems. The full potential of BN methodology in a complex systems approach to psychopathology has yet to be realised.
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28
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Converging vulnerability factors for compulsive food and drug use. Neuropharmacology 2021; 196:108556. [PMID: 33862029 DOI: 10.1016/j.neuropharm.2021.108556] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 03/29/2021] [Accepted: 04/03/2021] [Indexed: 12/12/2022]
Abstract
Highly palatable foods and substance of abuse have intersecting neurobiological, metabolic and behavioral effects relevant for understanding vulnerability to conditions related to food (e.g., obesity, binge eating disorder) and drug (e.g., substance use disorder) misuse. Here, we review data from animal models, clinical populations and epidemiological evidence in behavioral, genetic, pathophysiologic and therapeutic domains. Results suggest that consumption of highly palatable food and drugs of abuse both impact and conversely are regulated by metabolic hormones and metabolic status. Palatable foods high in fat and/or sugar can elicit adaptation in brain reward and withdrawal circuitry akin to substances of abuse. Intake of or withdrawal from palatable food can impact behavioral sensitivity to drugs of abuse and vice versa. A robust literature suggests common substrates and roles for negative reinforcement, negative affect, negative urgency, and impulse control deficits, with both highly palatable foods and substances of abuse. Candidate genetic risk loci shared by obesity and alcohol use disorders have been identified in molecules classically associated with both metabolic and motivational functions. Finally, certain drugs may have overlapping therapeutic potential to treat obesity, diabetes, binge-related eating disorders and substance use disorders. Taken together, data are consistent with the hypotheses that compulsive food and substance use share overlapping, interacting substrates at neurobiological and metabolic levels and that motivated behavior associated with feeding or substance use might constitute vulnerability factors for one another. This article is part of the special issue on 'Vulnerabilities to Substance Abuse'.
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29
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Bartonicek A, Wickham SR, Pat N, Conner TS. The value of Bayesian predictive projection for variable selection: an example of selecting lifestyle predictors of young adult well-being. BMC Public Health 2021; 21:695. [PMID: 33836714 PMCID: PMC8033696 DOI: 10.1186/s12889-021-10690-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 03/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Variable selection is an important issue in many fields such as public health and psychology. Researchers often gather data on many variables of interest and then are faced with two challenging goals: building an accurate model with few predictors, and making probabilistic statements (inference) about this model. Unfortunately, it is currently difficult to attain these goals with the two most popular methods for variable selection methods: stepwise selection and LASSO. The aim of the present study was to demonstrate the use predictive projection feature selection - a novel Bayesian variable selection method that delivers both predictive power and inference. We apply predictive projection to a sample of New Zealand young adults, use it to build a compact model for predicting well-being, and compare it to other variable selection methods. METHODS The sample consisted of 791 young adults (ages 18 to 25, 71.7% female) living in Dunedin, New Zealand who had taken part in the Daily Life Study in 2013-2014. Participants completed a 13-day online daily diary assessment of their well-being and a range of lifestyle variables (e.g., sleep, physical activity, diet variables). The participants' diary data was averaged across days and analyzed cross-sectionally to identify predictors of average flourishing. Predictive projection was used to select as few predictors as necessary to approximate the predictive accuracy of a reference model with all 28 predictors. Predictive projection was also compared to other variable selection methods, including stepwise selection and LASSO. RESULTS Three predictors were sufficient to approximate the predictions of the reference model: higher sleep quality, less trouble concentrating, and more servings of fruit. The performance of the projected submodel generalized well. Compared to other variable selection methods, predictive projection produced models with either matching or slightly worse performance; however, this performance was achieved with much fewer predictors. CONCLUSION Predictive projection was used to efficiently arrive at a compact model with good predictive accuracy. The predictors selected into the submodel - felt refreshed after waking up, had less trouble concentrating, and ate more servings of fruit - were all theoretically meaningful. Our findings showcase the utility of predictive projection in a practical variable selection problem.
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Affiliation(s)
- A Bartonicek
- Department of Psychology, University of Otago, Dunedin, New Zealand.
| | - S R Wickham
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | - N Pat
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | - T S Conner
- Department of Psychology, University of Otago, Dunedin, New Zealand
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30
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Fletcher BD, Flett JAM, Wickham SR, Pullar JM, Vissers MCM, Conner TS. Initial Evidence of Variation by Ethnicity in the Relationship between Vitamin C Status and Mental States in Young Adults. Nutrients 2021; 13:792. [PMID: 33673717 PMCID: PMC7997165 DOI: 10.3390/nu13030792] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 02/17/2021] [Accepted: 02/24/2021] [Indexed: 12/21/2022] Open
Abstract
Higher fruit and vegetable intake has been associated with improved mood, greater vitality, and lower stress. Although the nutrients driving these benefits are not specifically identified, one potentially important micronutrient is vitamin C, an important co-factor for the production of peptide hormones, carnitine and neurotransmitters that are involved in regulation of physical energy and mood. The aim of our study was to investigate the cross-sectional relationship between blood plasma vitamin C status and mood, vitality and perceived stress. A sample of 419 university students (aged 18 to 35; 67.8% female) of various ethnicities (49.2% European, 16.2% East Asian, 8.1% Southeast/Other Asian, 9.1% Māori/Pasifika, 11.5% Other) provided a fasting blood sample to determine vitamin C status and completed psychological measures consisting of the Profile of Mood States Short Form (POMS-SF), the vitality subscale of the Rand 36-Item Short Form (SF-36), and the Perceived Stress Scale (PSS). Participants were screened for prescription medication, smoking history, vitamin C supplementation, fruit/juice and vegetable consumption, kiwifruit allergies, excessive alcohol consumption and serious health issues, and provided age, gender, ethnicity, and socioeconomic status information, which served as covariates. There were no significant associations between vitamin C status and the psychological measures for the sample overall. However, associations varied by ethnicity. Among Māori/Pasifika participants, higher vitamin C was associated with greater vitality and lower stress, whereas among Southeast Asian participants, higher vitamin C was associated with greater confusion on the POMS-SF subscale. These novel findings demonstrate potential ethnicity-linked differences in the relationship between vitamin C and mental states. Further research is required to determine whether genetic variation or cultural factors are driving these ethnicity differences.
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Affiliation(s)
- Benjamin D. Fletcher
- Department of Psychology, University of Otago, Dunedin 9016, New Zealand; (B.D.F.); (S.-R.W.)
| | | | - Shay-Ruby Wickham
- Department of Psychology, University of Otago, Dunedin 9016, New Zealand; (B.D.F.); (S.-R.W.)
| | - Juliet M. Pullar
- Centre for Free Radical Research, Department of Pathology and Biomedical Science, University of Otago, Christchurch 8011, New Zealand; (J.M.P.); (M.C.M.V.)
| | - Margreet C. M. Vissers
- Centre for Free Radical Research, Department of Pathology and Biomedical Science, University of Otago, Christchurch 8011, New Zealand; (J.M.P.); (M.C.M.V.)
| | - Tamlin S. Conner
- Department of Psychology, University of Otago, Dunedin 9016, New Zealand; (B.D.F.); (S.-R.W.)
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31
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Bujtor M, Turner AI, Torres SJ, Esteban-Gonzalo L, Pariante CM, Borsini A. Associations of Dietary Intake on Biological Markers of Inflammation in Children and Adolescents: A Systematic Review. Nutrients 2021; 13:356. [PMID: 33503979 PMCID: PMC7911843 DOI: 10.3390/nu13020356] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 01/19/2021] [Accepted: 01/21/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND In children and adolescents, chronic low-grade inflammation has been implicated in the pathogenesis of co- and multi-morbid conditions to mental health disorders. Diet quality is a potential mechanism of action that can exacerbate or ameliorate low-grade inflammation; however, the exact way dietary intake can regulate the immune response in children and adolescents is still to be fully understood. METHODS Studies that measured dietary intake (patterns of diet, indices, food groups, nutrients) and any inflammatory biomarkers in children and adolescents aged 2 to19 years and published until November 2020 were included in this systematic review, and were selected in line with PRISMA guidelines through the following databases: Academic Search Complete, CINAHL, Global Health, Medline COMPLETE and Web of Science-Core Collection. A total of 53 articles were identified. RESULTS Results show that adequate adherence to healthful dietary patterns such as the Mediterranean diet, or food groups such as vegetables and fruit, or macro/micro nutrients such as fibre or vitamin C and E, are associated with decreased levels of pro-inflammatory biomarkers, mainly c-reactive protein (CRP), interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-α), whereas adherence to a Western dietary pattern, as well as intake of food groups such as added sugars, macro-nutrients such as saturated fatty acids or ultra-processed foods, is associated with higher levels of the same pro-inflammatory biomarkers. CONCLUSIONS This is the first systematic review examining dietary intake and biological markers of inflammation in both children and adolescents. A good quality diet, high in vegetable and fruit intake, wholegrains, fibre and healthy fats ameliorates low-grade inflammation, and therefore represents a promising therapeutic approach, as well as an important element for disease prevention in both children and adolescents.
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Affiliation(s)
- Melissa Bujtor
- Institute for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC 3125, Australia; (M.B.); (A.I.T.); (S.J.T.)
| | - Anne I. Turner
- Institute for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC 3125, Australia; (M.B.); (A.I.T.); (S.J.T.)
| | - Susan J. Torres
- Institute for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC 3125, Australia; (M.B.); (A.I.T.); (S.J.T.)
| | - Laura Esteban-Gonzalo
- Nursing Department, Faculty of Medicine, Autonomous University of Madrid, 28029 Madrid, Spain;
| | - Carmine M. Pariante
- Stress, Psychiatry and Immunology Laboratory, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College, London SE5 9RT, UK;
| | - Alessandra Borsini
- Stress, Psychiatry and Immunology Laboratory, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College, London SE5 9RT, UK;
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Challenges in researching the immune pathways between early life adversity and psychopathology. Dev Psychopathol 2021; 32:1597-1624. [DOI: 10.1017/s0954579420001157] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
AbstractExposure to childhood adversity is a critical risk factor for the development of psychopathology. A growing field of research examines how exposure to childhood adversity is translated into biological risk for psychopathology through alterations in immune system functioning, most notably heightened levels of inflammation biomarkers. Though our knowledge about how childhood adversity can instantiate biological risk for psychopathology is growing, there remain many challenges and gaps in the field to understand how inflammation from childhood adversity contributes to psychopathology. This paper reviews research on the inflammatory outcomes arising from childhood adversity and presents four major challenges that future research must address: (a) the measurement of childhood adversity, (b) the measurement of inflammation, (c) the identification of mediators between childhood adversity and inflammation, and (d) the identification of moderators of inflammatory outcomes following childhood adversity. We discuss synergies and inconsistencies in the literature to summarize the current understanding of the association between childhood adversity, a proinflammatory phenotype, and the biological risk for psychopathology. We discuss the clinical implications of the inflammatory links between childhood adversity and psychopathology, including possibilities for intervention. Finally, this review conclude by delineates future directions for research, including issues of how best to detect, prevent, and understand these “hidden wounds” of childhood adversity.
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Chopra C, Mandalika S, Kinger N. Does diet play a role in the prevention and management of depression among adolescents? A narrative review. Nutr Health 2021; 27:243-263. [PMID: 33416032 DOI: 10.1177/0260106020980532] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Depression is one of the major causes of illness and disability, while suicide is the second leading cause of death amongst adolescents. Although many factors determine the mental health of an individual, diet has been gaining popularity as a key modifiable factor in the prevention and management of depression. Nutritional Psychiatry is an emerging field where researchers suggest that the food we consume influences our mental well-being. AIM This review aims to explore the significance of diet, nutrient deficiencies, imbalances, and unhealthy dietary patterns in the prevention and management of unipolar depression or major depressive disorder among adolescents. METHODS Electronic databases such as PubMed, Scopus, Google Scholar, Science Direct, and MEDLINE were searched using keywords such as "mental health," "depression," "adolescents," "diet," "dietary pattern," and pertinent articles (N = 68) were retrieved and reviewed. RESULTS The Mediterranean and traditional diets rich in complex carbohydrates, omega-3 fatty acids, B-group vitamins and several amino acids have shown negative correlation with the incidence of depression. On the other hand, Western dietary patterns (sweetened beverages, processed/ junk food, and foods rich in saturated fatty acids), along with low consumption of fruits and vegetables have been linked to an increased risk of depression among adolescents. CONCLUSION Dietary modification can prove to be a cost-effective strategy for the prevention and treatment of depression among adolescents. Diet and nutrition need to be recognized as key modifiable targets for the prevention of mental disorders and nutritional medicine should be considered as an integral part of psychiatric treatment.
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Affiliation(s)
- Chandni Chopra
- Department of Foods, Nutrition and Dietetics, 271467College of Home Science, Nirmala Niketan (Affiliated to University of Mumbai), New Marine Lines, Maharashtra, India
| | - Subhadra Mandalika
- Department of Foods, Nutrition and Dietetics, 271467College of Home Science, Nirmala Niketan (Affiliated to University of Mumbai), New Marine Lines, Maharashtra, India
| | - Narendra Kinger
- 81727Sir H.N. Reliance Foundation Hospital and Research Centre, Girgaon, Maharashtra, India
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Wickham SR, Amarasekara NA, Bartonicek A, Conner TS. The Big Three Health Behaviors and Mental Health and Well-Being Among Young Adults: A Cross-Sectional Investigation of Sleep, Exercise, and Diet. Front Psychol 2020; 11:579205. [PMID: 33362643 PMCID: PMC7758199 DOI: 10.3389/fpsyg.2020.579205] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 11/05/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Sleep, physical activity, and diet have been associated with mental health and well-being individually in young adults. However, which of these "big three" health behaviors most strongly predicts mental health and well-being, and their higher-order relationships in predictive models, is less known. This study investigated the differential and higher-order associations between sleep, physical activity, and dietary factors as predictors of mental health and well-being in young adults. METHOD In a cross-sectional survey design, 1,111 young adults (28.4% men) ages 18-25 from New Zealand and the United States answered an online survey measuring typical sleep quantity and quality; physical activity; and consumption of raw and processed fruit and vegetables, fast food, sweets, and soda, along with extensive covariates (including demographics, socioeconomic status, body mass index, alcohol use, smoking, and health conditions) and the outcome measures of depressive symptoms [measured by the Center for Epidemiological Depression Scale (CES-D)] and well-being (measured by the Flourishing Scale). RESULTS Controlling for covariates, sleep quality was the strongest predictor of depressive symptoms and well-being, followed by sleep quantity and physical activity. Only one dietary factor-raw fruit and vegetable consumption-predicted greater well-being but not depressive symptoms when controlling for covariates. There were some higher-order interactions among health behaviors in predicting the outcomes, but these did not survive cross-validation. CONCLUSION Sleep quality is an important predictor of mental health and well-being in young adults, whereas physical activity and diet are secondary but still significant factors. Although strictly correlational, these patterns suggest that future interventions could prioritize sleep quality to maximize mental health and well-being in young adults.
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Affiliation(s)
| | | | | | - Tamlin S. Conner
- Department of Psychology, University of Otago, Dunedin, New Zealand
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Eckert KF, Asbridge M, Campbell LA, Stewart S, Bennett M, Loewen OK, Veugelers PJ, Cahill LE. Meal regularity is associated with self-esteem among grade 5 children. Am J Clin Nutr 2020; 113:467-475. [PMID: 33300041 PMCID: PMC7851821 DOI: 10.1093/ajcn/nqaa321] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 10/09/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Meal regularity is associated with many aspects of mental health. However, few studies have examined whether a relationship exists between meal regularity and self-esteem in children. OBJECTIVES The objective of this study was to determine whether an association exists between meal regularity and self-esteem in grade 5 children. METHODS Among 4009 grade 5 students (mean age = 11.0 years ± SEM = 0.006) from the 2011 Children's Lifestyle and School Performance Study (CLASS-II; Nova Scotia, Canada), cross-sectional meal regularity survey data (family supper, supper in front of the television, supper alone, skipping breakfast, and skipping lunch) were collected using the Harvard Youth/Adolescent Food Frequency Questionnaire and examined in relation to self-esteem. Multilevel mixed-effects logistic regression was used to determine the ORs and 95% CIs associated with low self-esteem. Analyses were stratified by sex and adjusted for sociodemographic and lifestyle covariates. RESULTS Compared to children who ate supper in front of the television or alone either never or less than once/week, children had greater odds of low self-esteem if 5 or more times/week they ate supper in front of the television (OR = 1.85; 95% CI, 1.40-2.43) or alone (OR = 4.23; 95% CI, 2.58-6.95). Compared to children who ate family supper 5 or more times/week, children who ate family supper never or less than once/week had greater odds of low self-esteem (OR: 1.97; 95% CI, 1.51-2.56). Skipping breakfast and skipping lunch were associated with greater odds of low self-esteem [OR = 2.92 (95% CI, 1.87-4.57) and OR = 4.82 (95% CI, 2.14-10.87) respectively]. CONCLUSIONS In our study of grade 5 children, all 5 indicators of meal regularity tested are significantly and consistently associated with self-esteem.
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Affiliation(s)
- Katherine F Eckert
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada,Department of Psychology & Neuroscience, Dalhousie University, Halifax, Canada
| | - Mark Asbridge
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada
| | - Leslie Anne Campbell
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada,School of Nursing, Dalhousie University, Halifax, Canada,Izaak Walton Killam Health Centre, Halifax,
Canada
| | - Sam Stewart
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada
| | - Mark Bennett
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada
| | - Olivia K Loewen
- Population Health Intervention Research Unit, School of Public Health, University of Alberta, Edmonton, Canada
| | - Paul J Veugelers
- Population Health Intervention Research Unit, School of Public Health, University of Alberta, Edmonton, Canada
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Dalwood P, Marshall S, Burrows TL, McIntosh A, Collins CE. Diet quality indices and their associations with health-related outcomes in children and adolescents: an updated systematic review. Nutr J 2020; 19:118. [PMID: 33099309 PMCID: PMC7585689 DOI: 10.1186/s12937-020-00632-x] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 09/30/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND To describe a-priori diet quality indices used in children and adolescents, appraise the validity and reliability of these indices, and synthesise evidence on the relationship between diet quality and physical and mental health, and growth-related outcomes. METHODS Five electronic databases were searched until January 2019. An a-priori diet quality index was included if it applied a scoring structure to rate child or adolescent (aged 0-18-years) dietary intakes relative to dietary or nutrient guidelines. Diagnostic accuracy studies and prospective cohort studies reporting health outcomes were appraised using the Academy of Nutrition and Dietetics Quality Criteria Checklist. RESULTS From 15,577 records screened, 128 unique paediatric diet quality indices were identified from 33 countries. Half of the indices' scores rated both food and nutrient intakes (n = 65 indices). Some indices were age specific: infant (< 24-months; n = 8 indices), child (2-12-years; n = 16), adolescent (13-18 years; n = 8), and child/adolescent (n = 14). Thirty-seven indices evaluated for validity and/or reliability. Eleven of the 15 indices which investigated associations with prospective health outcomes reported significant results, such as improved IQ, quality of life, blood pressure, body composition, and prevalence of metabolic syndrome. CONCLUSIONS Research utilising diet quality indices in paediatric populations is rapidly expanding internationally. However, few indices have been evaluated for validity, reliability, or association with health outcomes. Further research is needed to determine the validity, reliability, and association with health of frequently utilised diet quality indices to ensure data generated by an index is useful, applicable, and relevant. REGISTRATION PROSPERO number: CRD42018107630 .
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Affiliation(s)
- Phoebe Dalwood
- Bond University Nutrition & Dietetics Research Group, Faculty of Health Sciences & Medicine, Bond Universtiy, Robina, Queensland, 4226, Australia
| | - Skye Marshall
- Bond University Nutrition & Dietetics Research Group, Faculty of Health Sciences & Medicine, Bond Universtiy, Robina, Queensland, 4226, Australia.
- Nutrition Research Australia, Sydney, New South Wales, Australia.
| | - Tracy L Burrows
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, 2308, Australia
- Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Ashleigh McIntosh
- Bond University Nutrition & Dietetics Research Group, Faculty of Health Sciences & Medicine, Bond Universtiy, Robina, Queensland, 4226, Australia
| | - Clare E Collins
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, 2308, Australia
- Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW, 2308, Australia
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Healthy Lifestyle Behaviours Are Associated with Children's Psychological Health: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207509. [PMID: 33076407 PMCID: PMC7602583 DOI: 10.3390/ijerph17207509] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/09/2020] [Accepted: 10/13/2020] [Indexed: 12/17/2022]
Abstract
Protecting children’s mental health is important and studies have shown that diet and exercise can have a positive impact. There are limited data available, however, from representative populations of children on the relationship between regular healthy lifestyle behaviours and psychological health. Data were obtained from the New South Wales Child Population Health Survey, 2013–2014. Parents were asked about diet, physical activity and screen time behaviours and completed the Strengths and Difficulties Questionnaire (SDQ) for one child aged 5–15. Higher SDQ scores indicate poorer psychological health and risk for mental health problems. Multivariable linear and logistic regression examined the relationships among dietary consumption, physical activity, screen time and SDQ scores, adjusting for potential confounding. Meeting screen time recommendations was most strongly associated with a lower SDQ total difficulties score (5–10 years: −1.56 (−2.68, −0.44); 11–15 years: −2.12 (−3.11, −1.12)). Children and adolescents who met screen time recommendations were also significantly less likely to have any score in the at-risk range. Children and adolescents meeting vegetable intake guidelines had significantly lower total difficulties scores (5–10 years: −1.54 (−3.03, −0.05); 11–15 years: −1.19 (−3.60, −0.39)), as did adolescents meeting discretionary food guidelines (−1.16 (−2.14, −0.18)) and children consuming the recommended fruit intake (−1.26 (−2.42, −0.10)). Our findings indicate that more effective interventions to increase the proportion of young Australians who meet the guidelines for diet and screen time would contribute to protecting their mental health.
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Otsuka Y, Kaneita Y, Itani O, Jike M, Osaki Y, Higuchi S, Kanda H. Gender differences in dietary behaviors among Japanese adolescents. Prev Med Rep 2020; 20:101203. [PMID: 32995146 PMCID: PMC7509230 DOI: 10.1016/j.pmedr.2020.101203] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 09/04/2020] [Accepted: 09/05/2020] [Indexed: 11/30/2022] Open
Abstract
Few studies assessed a variety of adolescent dietary behaviours in Japan. The findings suggest that gender differences existed in dietary behaviors. Girls tended to adopt regular dietary behaviors as compared to boys. Schools support modeling and reinforcing healthy dietary behaviors.
Unhealthy dietary behaviors in adolescence are an important public health problem. Gender differences in dietary behaviors have already appeared during adolescence. However, few studies have assessed a variety of adolescent dietary behaviors in Japan. We aimed to clarify gender differences in unhealthy dietary behaviors among Japanese adolescents. The participants consisted of 84,988 participants from seventh to 12th grades. Unhealthy dietary behaviors were defined according to the National Health and Nutrition Survey. Multivariable logistic regression was used to analyze a nationally representative sample of Japanese adolescents from the 2014 to 2015 Lifestyle Survey. The effective response rate was 51.4%. The prevalence of unhealthy dietary behaviors (skipping breakfast, snacking, eating out, skipping meals, eating alone at dinner, and subjectively poor diet quality) among boys and girls was 14.2% versus 12.4%, 19.6% versus 14.1%, 10.6% versus 7.0%, 7.9% versus 5.6%, 13.3% versus 12.1%, and 12.3% versus 15.8%, respectively. Compared with boys, girls were more negatively associated with skipping breakfast [OR = 0.76 (95% CI 0.73–0.79)], snacking [OR = 0.67 (95% CI 0.65–0.70)], eating out [OR = 0.62 (95% CI 0.59–0.66)], skipping meals [OR = 0.61 (95% CI 0.58–0.65)], and eating alone at dinner [OR = 0.79 (95% CI 0.76–0.83)]. However, girls were more positively associated with subjectively poor diet quality [OR = 1.19 (95% CI 1.14.1.24)]. The findings suggest that gender differences existed in dietary behaviors. Gender differences in dietary behaviors suggest opportunities for tailoring interventions related to dietary education in schools.
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Affiliation(s)
- Yuichiro Otsuka
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Japan
| | - Yoshitaka Kaneita
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Japan
| | - Osamu Itani
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Japan
| | - Maki Jike
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Japan
| | - Yoneatsu Osaki
- Division of Environmental and Preventive Medicine, Department of Social Medicine, Faculty of Medicine, Japan
| | - Susumu Higuchi
- National Hospital Organization Kurihama Medical and Addiction Center, Japan
| | - Hideyuki Kanda
- Department of Public Health, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, University Faculty of Medicine, Japan
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Jacob L, Stubbs B, Firth J, Smith L, Haro JM, Koyanagi A. Fast food consumption and suicide attempts among adolescents aged 12-15 years from 32 countries. J Affect Disord 2020; 266:63-70. [PMID: 32056938 DOI: 10.1016/j.jad.2020.01.130] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 11/19/2019] [Accepted: 01/21/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND We examined the fast food consumption-suicide attempt relationship among 105,061 adolescents aged 12-15 years from 32 countries. METHODS This study was based on cross-sectional data from the Global School-based Student Health Survey (GSHS), and included 4 low-income, 13 lower middle-income, 9 upper middle-income, and 6 high-income countries. Data on past 7-day fast food consumption and 12-month suicide attempts were collected. The association between fast food consumption and suicide attempts was investigated with multivariable logistic regression and meta-analysis while adjusting for sex, age, food insecurity (proxy of socioeconomic status), alcohol consumption, smoking, physical activity, obesity, carbonated soft drink consumption, and fruit and vegetable consumption. RESULTS Overall, the prevalence of fast food consumption was high (53.5%) and the proportion of suicide attempts was higher among consumers of fast food compared to non-consumers (11.8% vs. 8.3%). Of the 32 countries included in the study, a positive association between fast food consumption and suicide attempts was found in 26 countries although this was not statistically significant in all countries. The pooled OR (95% CI) based on a meta-analysis was 1.31 (1.17-1.46). LIMITATIONS Since this was a cross-sectional study, it is not possible to draw any conclusions about causality or temporality in the associations assessed. CONCLUSIONS Fast food consumption is positively associated with suicide attempts in adolescents. Further research of longitudinal design is needed to confirm/refute our findings and explore the potential underlying mechanisms.
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Affiliation(s)
- Louis Jacob
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France; Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain.
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Positive Ageing Research Institute, Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, United Kingdom
| | - Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester, United Kingdom; NICM Health Research Institute, Western Sydney University, Westmead, Australia; Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Lee Smith
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain; ICREA, Pg. Lluis Companys 23, Barcelona, Spain
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Perry BI, Khandaker GM, Marwaha S, Thompson A, Zammit S, Singh SP, Upthegrove R. Insulin resistance and obesity, and their association with depression in relatively young people: findings from a large UK birth cohort. Psychol Med 2020; 50:556-565. [PMID: 30854996 PMCID: PMC7093318 DOI: 10.1017/s0033291719000308] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 11/30/2018] [Accepted: 02/05/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Depression frequently co-occurs with disorders of glucose and insulin homeostasis (DGIH) and obesity. Low-grade systemic inflammation and lifestyle factors in childhood may predispose to DGIH, obesity and depression. We aim to investigate the cross-sectional and longitudinal associations among DGIH, obesity and depression, and to examine the effect of demographics, lifestyle factors and antecedent low-grade inflammation on such associations in young people. METHODS Using the Avon Longitudinal Study of Parents and Children birth cohort, we used regression analyses to examine: (1) cross-sectional and (2) longitudinal associations between measures of DGIH [insulin resistance (IR); impaired glucose tolerance] and body mass index (BMI) at ages 9 and 18 years, and depression (depressive symptoms and depressive episode) at age 18 years and (3) whether sociodemographics, lifestyle factors or inflammation [interleukin-6 (IL-6) at age 9 years] confounded any such associations. RESULTS We included 3208 participants. At age 18 years, IR and BMI were positively associated with depression. These associations may be explained by sociodemographic and lifestyle factors. There were no longitudinal associations between DGIH/BMI and depression, and adjustment for IL-6 and C-reactive protein did not attenuate associations between IR/BMI and depression; however, the longitudinal analyses may have been underpowered. CONCLUSIONS Young people with depression show evidence of DGIH and raised BMI, which may be related to sociodemographic and lifestyle effects such as deprivation, smoking, ethnicity and gender. In future, studies with larger samples are required to confirm this. Preventative strategies for the poorer physical health outcomes associated with depression should focus on malleable lifestyle factors.
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Affiliation(s)
- B. I. Perry
- Department of Psychiatry, University of Cambridge, Cambridge, England
- Cambridgeshire and Peterborough National Health Service Foundation Trust, Cambridge, England
| | - G. M. Khandaker
- Department of Psychiatry, University of Cambridge, Cambridge, England
- Cambridgeshire and Peterborough National Health Service Foundation Trust, Cambridge, England
- National Institute for Health Research Cambridge Biomedical Research Centre, Cambridge, England
| | - S. Marwaha
- Institute for Mental Health, University of Birmingham, Birmingham, England
- Birmingham and Solihull Mental Health Foundation NHS Trust, Birmingham, England
| | - A. Thompson
- Coventry and Warwickshire Partnership NHS Trust, Coventry, England
- Unit of Mental Health and Wellbeing, University of Warwick, Coventry, England
| | - S. Zammit
- Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, England
- Institute of Psychological Medicine and Clinical Neurosciences, Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales
| | - S. P. Singh
- Coventry and Warwickshire Partnership NHS Trust, Coventry, England
- Unit of Mental Health and Wellbeing, University of Warwick, Coventry, England
| | - R. Upthegrove
- Institute for Mental Health, University of Birmingham, Birmingham, England
- Early Intervention Service, Birmingham Women's and Children's NHS Trust, Birmingham, UK
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Xu H, Guo J, Wan Y, Zhang S, Yang R, Xu H, Ding P, Tao F. Association Between Screen Time, Fast Foods, Sugar-Sweetened Beverages and Depressive Symptoms in Chinese Adolescents. Front Psychiatry 2020; 11:458. [PMID: 32528328 PMCID: PMC7264365 DOI: 10.3389/fpsyt.2020.00458] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 05/05/2020] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE Although previous studies have shown that screen time (ST), fast foods (FFs) and sugar-sweetened beverages (SSBs) consumption are associated with depressive symptoms in adolescents, research on these associations in Chinese adolescents is scarce. This study aimed to examine the association between ST, FFs, SSBs and depressive symptoms in Chinese adolescents, and explore the mediating effects of FFs and SSBs in the association between ST and depressive symptoms. METHODS This school-based nationwide survey was carried out among 14,500 students in four provinces of China. The Children's Depression Inventory was used to assess the participants' depressive symptoms. ST, FFs and SSBs consumption was measured by a self-reported questionnaire. The Bayesian multiple mediation model was used to analyze the mediation effect. RESULTS ST, FFs and SSBs, were more likely to be associated with depressive symptoms, and ORs (95%CI) was 1.075 (1.036-1.116), 1.062 (1.046-1.078) and 1.140 (1.115-1.166), after we adjusted for sociodemographic variables. Additionally, in Bayesian multiple mediation model, direct effect, mediating effect, total effect, the ratio of mediating effect to total effect was 0.125, 0.034, 0.159, and 0.214, respectively. All path coefficients of the three mediation paths are statistically significant (p < 0.05). CONCLUSIONS Our study demonstrates that ST, FFs and SSBs consumption are associated with depressive symptoms in Chinese adolescents. It is likely that FFs and SSBs partially mediate the association between ST and depressive symptoms by chain-mediating effects.
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Affiliation(s)
- Honglv Xu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,MOE Key Laboratory of Population Health Across Life Cycle Anhui Medical University, Hefei, China
| | - Jichang Guo
- School of Education Science, Yulin Normal University, Yulin, China
| | - Yuhui Wan
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,MOE Key Laboratory of Population Health Across Life Cycle Anhui Medical University, Hefei, China
| | - Shichen Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,MOE Key Laboratory of Population Health Across Life Cycle Anhui Medical University, Hefei, China
| | - Rong Yang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,MOE Key Laboratory of Population Health Across Life Cycle Anhui Medical University, Hefei, China
| | - Huiqiong Xu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,MOE Key Laboratory of Population Health Across Life Cycle Anhui Medical University, Hefei, China
| | - Peng Ding
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,MOE Key Laboratory of Population Health Across Life Cycle Anhui Medical University, Hefei, China
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,MOE Key Laboratory of Population Health Across Life Cycle Anhui Medical University, Hefei, China
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Shakya PR, Melaku YA, Page A, Gill TK. Association between dietary patterns and adult depression symptoms based on principal component analysis, reduced-rank regression and partial least-squares. Clin Nutr 2019; 39:2811-2823. [PMID: 32007317 DOI: 10.1016/j.clnu.2019.12.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 11/25/2019] [Accepted: 12/06/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND & AIMS There have been inconsistent findings on the association between dietary patterns and depressive symptoms (DepS). In addition, studies have used single analysis methods to identify dietary patterns. In the current study, we aimed to determine the association between dietary patterns, derived by principal component analysis (PCA), reduced-rank regressions (RRR) and partial least-squares (PLS), and DepS among adults using a cohort study in Australia. METHODS We examined a total of 1743 study participants (≥24 years, 48.9% males) using cross-sectional and longitudinal data from the North West Adelaide Health Study (NWAHS). The Center for Epidemiological Studies-Depression (CES-D) scale was used to assess DepS and a score ≥16 was considered as having depression. Dietary data were collected using a food frequency questionnaire. Eicosapentaenoic acid (EPA)/Docosahexaenoic acid (DHA), folate, magnesium (Mg) and zinc (Zn) densities were chosen as the response variables for RRR and PLS analyses. Dietary patterns were identified by PCA, RRR and PLS. Odds ratios (OR) and 95% confidence intervals (95% CI) were estimated across quartiles (Q) using log-binomial logistic regression to assess the association between dietary patterns and DepS. Sensitivity analyses, including a longitudinal association between dietary patterns and DepS among 859 participants, were performed. Multiple imputation was performed to investigate the effect of missing data on the estimates. RESULTS In this study, 16.9% (14.2% in men and 20.8% in women) of the participants had DepS. We retained two, four and four dietary patterns captured by PCA, RRR and PLS respectively. The 'prudent' pattern determined by PCA [ORQ4VsQ1 = 0.57; 95% CI: 0.35, 0.92] and PLS [ORQ4VsQ1 = 0.66; 95% CI: 0.43, 1.00] together with the 'typical Australian' pattern determined by RRR [ORQ4VsQ1 = 0.60; 95% CI: 0.40, 0.90] were inversely associated with DepS whereas the 'western' pattern derived by PCA [ORQ4VsQ1 = 2.04; 95% CI: 1.12, 3.68] and PLS [ORQ4VsQ1 = 1.62; 95% CI: 1.05, 2.50] was positively associated with DepS. In the longitudinal analysis, the 'prudent' pattern determined by PCA [ORQ4VsQ1 = 0.52; 95% CI: 0.25, 1.09] tended to be inversely associated with DepS whereas 'western' patterns determined by PCA [ORQ4VsQ1 = 3.47; 95% CI: 1.37, 8.78] and PLS [ORQ4VsQ1 = 2.47; 95% CI: 1.24, 4.91] were positively associated with DepS. We found that a dietary pattern characterized by high intakes of fruits, vegetables, medium fat dairy, nuts, legumes, and fish was inversely associated with DepS in this population-based study. Contrary to this, a dietary pattern characterized by high intakes of processed and red meat, fast foods (snacks and takeaway foods), soft drinks, white bread and high-fat dairy products were significantly associated with DepS. Multiple imputation and sensitivity analysis identified similar patterns of association between dietary pattern and DepS. CONCLUSIONS The findings indicate that the 'western' pattern was consistently associated with an increased risk, and the 'prudent' pattern tended to be associated with a reduced risk of DepS. This suggests that dietary interventions may assist with the treatment of DepS. However, current evidence on the impact of diet on DepS should be supported using further longitudinal studies with extended follow up, larger sample sizes and repeated measures.
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Affiliation(s)
- Prem Raj Shakya
- Vagal Afferent Research Group, University of Adelaide, Adelaide, South Australia, Australia; Nutrition, Diabetes and Metabolism, Lifelong Health, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia
| | - Yohannes Adama Melaku
- Adelaide Institute of Sleep Health, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia; Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - Amanda Page
- Vagal Afferent Research Group, University of Adelaide, Adelaide, South Australia, Australia; Nutrition, Diabetes and Metabolism, Lifelong Health, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia
| | - Tiffany K Gill
- Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia.
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Lassale C, Batty GD, Baghdadli A, Jacka F, Sánchez-Villegas A, Kivimäki M, Akbaraly T. Healthy dietary indices and risk of depressive outcomes: a systematic review and meta-analysis of observational studies. Mol Psychiatry 2019; 24:965-986. [PMID: 30254236 PMCID: PMC6755986 DOI: 10.1038/s41380-018-0237-8] [Citation(s) in RCA: 396] [Impact Index Per Article: 79.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 07/26/2018] [Accepted: 08/02/2018] [Indexed: 02/07/2023]
Abstract
With depression being the psychiatric disorder incurring the largest societal costs in developed countries, there is a need to gather evidence on the role of nutrition in depression, to help develop recommendations and guide future psychiatric health care. The aim of this systematic review was to synthesize the link between diet quality, measured using a range of predefined indices, and depressive outcomes. Medline, Embase and PsychInfo were searched up to 31st May 2018 for studies that examined adherence to a healthy diet in relation to depressive symptoms or clinical depression. Where possible, estimates were pooled using random effect meta-analysis with stratification by observational study design and dietary score. A total of 20 longitudinal and 21 cross-sectional studies were included. These studies utilized an array of dietary measures, including: different measures of adherence to the Mediterranean diet, the Healthy Eating Index (HEI) and Alternative HEI (AHEI), the Dietary Approaches to Stop Hypertension, and the Dietary Inflammatory Index. The most compelling evidence was found for the Mediterranean diet and incident depression, with a combined relative risk estimate of highest vs. lowest adherence category from four longitudinal studies of 0.67 (95% CI 0.55-0.82). A lower Dietary Inflammatory Index was also associated with lower depression incidence in four longitudinal studies (relative risk 0.76; 95% CI: 0.63-0.92). There were fewer longitudinal studies using other indices, but they and cross-sectional evidence also suggest an inverse association between healthy diet and depression (e.g., relative risk 0.65; 95% CI 0.50-0.84 for HEI/AHEI). To conclude, adhering to a healthy diet, in particular a traditional Mediterranean diet, or avoiding a pro-inflammatory diet appears to confer some protection against depression in observational studies. This provides a reasonable evidence base to assess the role of dietary interventions to prevent depression. This systematic review was registered in the PROSPERO International Prospective Register of Systematic Reviews under the number CRD42017080579.
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Affiliation(s)
- Camille Lassale
- Department of Epidemiology and Public Health, University College London, London, WC1E 6BT, United Kingdom.
- Department of Behavioural Science and Health, University College London, London, WC1E 6BT, United Kingdom.
| | - G David Batty
- Department of Epidemiology and Public Health, University College London, London, WC1E 6BT, United Kingdom
| | - Amaria Baghdadli
- Department of Psychiatry & Autism Resources Centre, University Hospital of Montpellier, CHRU de Montpellier, F-34000, France
- INSERM, U1018, Centre for Research in Epidemiology and Population Health, Hôpital Paul Brousse, Villejuif, France
| | - Felice Jacka
- Deakin University, Food & Mood Centre, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Almudena Sánchez-Villegas
- Nutrition Research Group, Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
- Ciber de Fisiopatología de la Obesidad y Nutrición (CIBER OBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, London, WC1E 6BT, United Kingdom
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Tasnime Akbaraly
- Department of Epidemiology and Public Health, University College London, London, WC1E 6BT, United Kingdom
- Department of Psychiatry & Autism Resources Centre, University Hospital of Montpellier, CHRU de Montpellier, F-34000, France
- MMDN, University of Montpellier, EPHE, INSERM, U1198, Montpellier, F-34095, France
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Tuck NJ, Farrow C, Thomas JM. Assessing the effects of vegetable consumption on the psychological health of healthy adults: a systematic review of prospective research. Am J Clin Nutr 2019; 110:196-211. [PMID: 31152539 DOI: 10.1093/ajcn/nqz080] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 04/11/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND To alleviate the immense health and economic burden of mental illness, modifiable targets to promote psychological health are required. Emerging evidence suggests that both fruit and vegetable (F&V) consumption may play an important role. However, the precise contribution of vegetable consumption, which may represent a more potent target than the consumption of fruit, has received little attention. OBJECTIVES This review aimed to synthesize and evaluate research investigating the effects of vegetable consumption on mental health and psychological well-being in nonclinical, healthy adult populations. We aimed to provide insight into the causal relation between vegetable consumption and these outcomes. METHODS Only studies with prospective or experimental data were included. The survey of the literature was last implemented on 1 February, 2019. RESULTS Ten eligible studies were identified, with a total sample size of n = 33,645, that measured vegetable intake separately from fruit, or combined this with fruit intake. Where studies explored the independent effects of fruit and vegetable consumption on psychological health (n = 3), 2 reported a preferential effect of vegetables (compared with fruit) on psychological well-being, whereas 1 reported a superior effect of fruit intake on odds reduction of symptoms of depression. More broadly, there was evidence that consuming the recommended amount of F&V (and exceeding this) was associated with increased psychological well-being. However, the effects of F&V consumption on mental health symptoms were inconsistent. CONCLUSIONS Increased F&V consumption has a positive effect on psychological well-being and there appears to be a preferential effect of vegetables (compared with fruit) from the limited data examined. The effect of F&V intake on mental health is less clear and, at present, there are no clear data to support a preferential effect of vegetable intake on mental health outcomes. Hence, additional research is warranted to investigate the influence of vegetables, compared with fruit, on psychological health in order to inform nutrition-based interventions. This review was registered at www.crd.york.ac.uk/prospero as CRD42017072880.
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Affiliation(s)
- Nicola-Jayne Tuck
- Department of Psychology, Aston University, Birmingham, United Kingdom
| | - Claire Farrow
- Department of Psychology, Aston University, Birmingham, United Kingdom
| | - Jason M Thomas
- Department of Psychology, Aston University, Birmingham, United Kingdom
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Okubo R, Matsuoka YJ, Sawada N, Mimura M, Kurotani K, Nozaki S, Shikimoto R, Tsugane S. Diet quality and depression risk in a Japanese population: the Japan Public Health Center (JPHC)-based Prospective Study. Sci Rep 2019; 9:7150. [PMID: 31073185 PMCID: PMC6509323 DOI: 10.1038/s41598-019-43085-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 04/16/2019] [Indexed: 12/11/2022] Open
Abstract
The association of overall diet quality based on the Japanese Food Guide Spinning Top with risk of depression is not known. This prospective cohort study aimed to determine whether higher adherence to the Japanese food guide reduced the risk of depression. Of 12,219 residents enrolled at baseline, we extracted 1,112 participants who completed a 5-year follow-up (1995) and participated in a mental health screening (2014–2015). Diet quality was scored based on adherence to the Japanese food guide and the ratio of white to red meat according to the Alternative Healthy Index and ranged from 0 (worst) to 80 (best). We calculated odds ratios and 95% confidence intervals for current psychiatrist-diagnosed depression per quartile of total score and of eight component scores with the lowest quartile as reference. Mean age of the participants was 73 years and 59% were women. Total diet quality score was not significantly associated with risk of depression 20 years after the baseline assessment. Among the eight components on the diet quality score, there was a significantly reduced risk for the highest quartile of the white to red meat ratio score. In conclusion, our results do not indicate that higher adherence to the Japanese food guide prevents depression.
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Affiliation(s)
- Ryo Okubo
- Division of Health Care Research, Center for Public Health Sciences, National Cancer Center Japan, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Yutaka J Matsuoka
- Division of Health Care Research, Center for Public Health Sciences, National Cancer Center Japan, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
| | - Norie Sawada
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center Japan, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kayo Kurotani
- Department of Nutritional Education, National Institute of Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8636, Japan
| | - Shoko Nozaki
- Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Ryo Shikimoto
- Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center Japan, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
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Wilson JE, Blizzard L, Gall SL, Magnussen CG, Oddy WH, Dwyer T, Venn AJ, Smith KJ. An age- and sex-specific dietary guidelines index is a valid measure of diet quality in an Australian cohort during youth and adulthood. Nutr Res 2019; 65:43-53. [DOI: 10.1016/j.nutres.2019.01.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 01/24/2019] [Accepted: 01/25/2019] [Indexed: 10/27/2022]
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Jesus M, Silva T, Cagigal C, Martins V, Silva C. Dietary Patterns: A New Therapeutic Approach for Depression? Curr Pharm Biotechnol 2019; 20:123-129. [DOI: 10.2174/1389201019666180925122116] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 07/19/2018] [Accepted: 07/30/2018] [Indexed: 12/22/2022]
Abstract
Introduction:
The field of nutritional psychiatry is a fast-growing one. Although initially, it
focused on the effects of vitamins and micronutrients in mental health, in the last decade, its focus also
extended to the dietary patterns. The possibility of a dietary cost-effective intervention in the most
common mental disorder, depression, cannot be overlooked due to its potential large-scale impact.
Method:
A classic review of the literature was conducted, and studies published between 2010 and
2018 focusing on the impact of dietary patterns in depression and depressive symptoms were included.
Results:
We found 10 studies that matched our criteria. Most studies showed an inverse association between
healthy dietary patterns, rich in fruits, vegetables, lean meats, nuts and whole grains, and with
low intake of processed and sugary foods, and depression and depressive symptoms throughout an array
of age groups, although some authors reported statistical significance only in women. While most
studies were of cross-sectional design, making it difficult to infer causality, a randomized controlled
trial presented similar results.
Discussion:
he association between dietary patterns and depression is now well-established, although
the exact etiological pathways are still unknown. Dietary intervention, with the implementation of
healthier dietary patterns, closer to the traditional ones, can play an important role in the prevention
and adjunctive therapy of depression and depressive symptoms.
Conclusion:
More large-scale randomized clinical trials need to be conducted, in order to confirm the
association between high-quality dietary patterns and lower risk of depression and depressive symptoms.
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Affiliation(s)
- Mariana Jesus
- Department of Psychiatry, Centro Hospitalar e Universitario de Coimbra, Coimbra, Portugal
| | - Tânia Silva
- Department of Psychiatry, Centro Hospitalar e Universitario de Coimbra, Coimbra, Portugal
| | - César Cagigal
- Department of Psychiatry, Centro Hospitalar e Universitario de Coimbra, Coimbra, Portugal
| | - Vera Martins
- Department of Psychiatry, Centro Hospitalar e Universitario de Coimbra, Coimbra, Portugal
| | - Carla Silva
- Department of Psychiatry, Centro Hospitalar e Universitario de Coimbra, Coimbra, Portugal
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Khanna P, Chattu VK, Aeri BT. Nutritional Aspects of Depression in Adolescents - A Systematic Review. Int J Prev Med 2019; 10:42. [PMID: 31057727 PMCID: PMC6484557 DOI: 10.4103/ijpvm.ijpvm_400_18] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 02/21/2019] [Indexed: 12/31/2022] Open
Abstract
Depression is defined as a cluster of specific symptoms with associated impairment affecting 7.4% of the adolescents globally. As part of the systematic review, around 1000 relevant articles published between January 1978 and December 2017 were identified by systematic online search from 6 electronic databases (PubMed, PsycInfo, Science Direct, MEDLINE, Scopus, and Google Scholar) and overall, 56 relevant studies were included in the current review as per the inclusion criteria. Findings highlight the potential importance of the relationship between healthy dietary patterns or quality and positive mental health throughout life span. Various nutrition and dietary compounds have been suggested to be involved in the onset maintenance and severity of depressive symptoms and disorders. Nutritional compounds might modulate depression associated biomarkers. In this context, several healthy foods such as olive oil, fish, nuts, legumes, dairy products, fruits, and vegetables have been inversely associated with the risk of depression and might also improve symptoms. In contrast western dietary patterns including the consumption of sweetened beverages, fried foods, processed meats, baked products have been shown to be associated with an increased risk of depression in longitudinal studies. Diet and nutrition offer key modifiable targets for the prevention of mental disorders. Evidence is steadily growing for the relation between nutrition deficiencies, diet quality and mental health and for the efficacy and use of nutritional supplements to address deficiencies or as augmentation therapies. We advocate recognition of diet and nutrition as crucial factors in prevention and management of mental disorders.
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Affiliation(s)
- Preeti Khanna
- Department of Food and Nutrition, Institute of Home Economics, University of Delhi, India
| | - Vijay K. Chattu
- Department of Food and Nutrition, Institute of Home Economics, University of Delhi, India
- Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago, Kerala, India
| | - Bani T. Aeri
- Department of Food and Nutrition, Institute of Home Economics, University of Delhi, India
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Dimov S, Mundy LK, Bayer JK, Jacka FN, Canterford L, Patton GC. Diet quality and mental health problems in late childhood. Nutr Neurosci 2019; 24:62-70. [PMID: 30890044 DOI: 10.1080/1028415x.2019.1592288] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Objectives: There is evidence that diet quality is associated with mental health problems in adults and adolescents. Yet the extent to which overall diet quality (not individual nutrients or dietary patterns) may be associated with mental health problems in pre-adolescent children, a common time for first onset of symptoms, remains unclear. This study examined associations between overall diet quality, using a brief measure, and mental health problems during late childhood, in a large community sample. Methods: Participants were 787 eight and nine-year-old children taking part in the Childhood to Adolescence Transition Study. Parents reported on their child's mental health problems using the Strengths and Difficulties Questionnaire and on their child's diet quality, using a six-item screening tool. Results: Regression analyses were conducted, adjusting for child age, sex, body mass index, and family socioeconomic status. Overall diet quality was significantly associated with children's mental health before (beta = -0.11, 95% CI -0.18 to -0.04, p = 0.004) and after adjustments for age, sex, body mass index and family socioeconomic status (beta = -0.10, 95% CI -0.18 to -0.03, p = 0.007). Conclusion: Concordant with previous literature, results indicate that better overall diet quality is related to more positive mental health in pre-adolescent children. Additionally, these results support the utility and efficacy of a brief (six-item) parent-report questionnaire as an indicator of overall diet quality.
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Affiliation(s)
- Stefanie Dimov
- Department of Psychology and Counselling, La Trobe University, Melbourne, Australia
| | - Lisa K Mundy
- Murdoch Children's Research Institute, Melbourne, Australia.,Centre for Adolescent Health, The Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Jordana K Bayer
- Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia.,School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Felice N Jacka
- Murdoch Children's Research Institute, Melbourne, Australia.,Centre for Adolescent Health, The Royal Children's Hospital, Melbourne, Australia.,Food & Mood Centre, Deakin University, Melbourne, Australia.,Black Dog Institute, Randwick, Australia
| | - Louise Canterford
- Murdoch Children's Research Institute, Melbourne, Australia.,Centre for Adolescent Health, The Royal Children's Hospital, Melbourne, Australia
| | - George C Patton
- Murdoch Children's Research Institute, Melbourne, Australia.,Centre for Adolescent Health, The Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia
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Takagi A, Toda M, Ikegawa A. [Dietary Patterns and Related Factors among Female University Students]. Nihon Eiseigaku Zasshi 2019; 74. [PMID: 30787255 DOI: 10.1265/jjh.18027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To investigate the associations between dietary patterns and mental health status of female university students. METHODS Self-administered questionnaires consisting of measures of food intake frequency and mental health status were completed by 320 female university students. Food intake frequency was assessed using the Food Frequency Questionnaire (FFQ). Then, dietary patterns were identified by cluster analysis. The 28-item General Health Questionnaire (GHQ-28) was used to evaluate students' mental health status. Relationships between the dietary patterns and the mental health status were analyzed. RESULTS We identified three dietary patterns. "The Japanese foods pattern in youth" was a representative food intake pattern of this generation. "The light eating pattern" had lower intakes of most items but higher intakes of soft drinks, and was not interested in nutrition balance. "The dairy products pattern" had higher intakes of dairy products and sweets, and were significantly associated with high scores of GHQ-28 subscale anxiety and insomnia. CONCLUSION The dietary patterns are associated with the mental health status of female university students.
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Affiliation(s)
- Arisa Takagi
- Graduate School of Human Life Sciences, Notre Dame Seishin University
| | - Masahiro Toda
- Graduate School of Human Life Sciences, Notre Dame Seishin University
| | - Akari Ikegawa
- Graduate School of Human Life Sciences, Notre Dame Seishin University
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