The relationship between plasma carotenoids and depressive symptoms in older persons

Serum carotenoid levels inversely correlate with depressive symptoms among adults: Insights from NHANES data

BACKGROUND

Carotenoids are a group of tetraterpenoid lipophilic pigments linked to depression, but studies on individual carotenoid components are lacking. We aimed to assess the association between each serum carotenoids and depressive symptoms in adults.

METHODS

This cross-sectional study included 7264 adults from the National Health and Nutrition Examination Survey (NHANES). Serum carotenoid levels (α-carotene, β-carotene, β-cryptoxanthin, lycopene, and lutein/zeaxanthin) were measured using high-performance liquid chromatography. Participants with a Patient Health Questionnaire score ≥ 10 were considered to have depressive symptoms. The association between each carotenoid and depressive symptoms was investigated using multivariable-adjusted logistic regression, restricted cubic spline, and weighted quantile sum regression models.

RESULTS

The participants' average age was 46.0 (interquartile range: 34.0-60.0) years (50.9 % females), and 545 participants (7.5 %) were diagnosed with depressive symptoms. The logistic regression model demonstrated that high serum α-carotene, β-carotene, β-cryptoxanthin, and lutein/zeaxanthin levels were associated with a lower likelihood of depressive symptoms. The restricted cubic spline model revealed that the significantly inverse relationships between serum carotenoid levels and the risk of depressive symptoms were nonlinear for α-carotene, β-carotene, β-cryptoxanthin, and lutein/zeaxanthin and were linear for lycopene. The threshold effect analysis further identified the inflection points were 12.1, 35.7, 5.9, and 7.7 μg/dL for α-carotene, β-carotene, β-cryptoxanthin, and lutein/zeaxanthin, respectively. The weighted quantile sum regression model revealed that β-cryptoxanthin (35.2 %) and α-carotene (34.5 %) were the top-weighted carotenoids correlated with depressive symptoms.

CONCLUSIONS

The present results suggested an association between higher levels of each serum carotenoids and a decreased risk of depressive symptoms in adults.

A mechanistic review on growing multiple therapeutic applications of lutein and its global market research

Lutein is a naturally occurring carotenoid synthesized by plants and algae that has a beneficial effect on several biological processes and associated ailments. Its immediate application is in ophthalmology, where it significantly lowers the incidences of age-related macular degeneration (AMD). It also has anti-inflammatory action, treatment of diabetic retinopathy, and cataracts, and enhancement of visual contrast. To critically assess lutein biosynthesis, therapeutic applicability, and market research literature. We have discussed its theoretical frameworks, experimental evidence, limitations, as well as clinical trial results, and future research prospects. The literature for this review article was mined and compiled by collecting and analyzing articles from several databases, including ScienceDirect, Google Scholar, PubMed, Wiley Online Library, Patentscope, and ClinicalTrials.gov published until March 30, 2022. Patent publications were identified using the search terms like IC:(C07C67/56) AND EN_AB:(lutein) OR EN_TI:(lutein) OR EN_AB:(extraction) OR EN_TI:(process). According to the literature, lutein is an essential nutrient given that it cannot be synthesized in the human body and acts as an antioxidant, affecting AMD, diabetic retinopathy, Rheumatic diseases, inflammation, and cancer. Due to inadequate production and laborious extraction, lutein is expensive despite its high demand and applicability. Market research predicts a 6.3% compound annual growth rate for lutein by 2032. Optimizing lutein extraction for high yield and purity is necessary. Lutein has proven applicability in various ailments as well as cosmetics that can be developed as a candidate drug for various diseases discussed in the review.

The association between dietary anti-oxidant quality score and psychological disorders among Iranian adults: a population-based study

OBJECTIVE

Evidence linking relation between dietary antioxidant quality score (DAQS) and psychological disorders is limited. Therefore, this study aimed to assess relationship between DAQSs and psychological disorders including depression, anxiety and stress among Iranian adults.

METHODS

This cross-sectional study used data on 7165 participants of the recruitment phase of Yazd Health Study (YaHS) and Taghzieh Mardom-e-Yazd Study (TAMYZ). Dietary intakes and psychological problems were evaluated using a validated semi-quantitative food frequency questionnaire and the validated Iranian version of depression, anxiety and stress scale questionnaire. DAQS was calculated for each person by summing up the assigned scores to a ratio between daily consuming each of the nutrients including vitamin A, C, E, selenium, manganese, zinc and their daily recommended intake (Score of 0 for a ratio of <2/3 and 1 for a ratio of >2/3). Eventually, association between DAQS and psychological disorders was assessed via logistic regression analysis.

RESULTS

Although no significant relationship was observed between DAQS and psychological disorders in general population, a protective role was found for DAQS against anxiety only in women after adjusting history of chronic disease; age; marital status; education level; smoking status; total energy intake and physical activity level (second tertile versus first tertile: OR: 0.63, 95% CI: 0.40-0.99). However, this finding was nonsignificant after further adjustment for body mass index.

CONCLUSION

Average levels of DAQS might be related to psychological distress especially among women. However, more studies are recommended to valid the findings.

Electroretinography and suicidal behaviors: a systematic review

BACKGROUND

Electroretinogram (ERG) is one of the tools used to investigate the electrophysiological underpinnings of mental health illnesses and major clinical phenomena (e.g., suicide) to improve their diagnosis and care. While multiple studies have reported specific ERG changes among individuals with suicidal behaviors, we know of no review that has been done to characterize their findings to inform future research.

METHODS

This review included available literature concerning ERG and suicidal behaviors. The paper's first section briefly overviews the theoretical basis of ERG and neurotransmitters involved in suicidal behaviors. The second section describes the findings of a review of studies reporting ERG findings among individuals with suicidal behaviors.

RESULTS

Most reviewed studies reported normal amplitude and implicit time of the a-waves, but the latency in individuals with suicidal behaviors was lower than normal. Additionally, the b-waves amplitude was reduced, but the implicit time and latency were increased. The b-a amplitude ratio and oscillatory potential were decreased.

CONCLUSION

Despite identifying certain ERG correlates with suicidal behaviors in the existing studies, there is a need for adequately powered and methodologically robust studies to advance clinical translation.

Plasma carotenoids and risk of depressive symptomatology in a population-based cohort of older adults

BACKGROUND

As part of a healthy diet, higher carotenoid intakes have been associated with a reduced risk of depression, mainly in adults, while prospective studies on plasma carotenoids in older adults are lacking. The aim of this study was to assess the prospective association between plasma carotenoids and the risk of Depressive Symptomatology (DS) in older adults.

METHODS

The study sample was based on the Three-City cohort of adults aged 65y+ free from DS at enrollment in 1999. Plasma carotenoids were measured at baseline. DS was assessed every 2-3 years over 17 years and defined by a Center for Epidemiologic Studies-Depression Scale score ≥ 16 and/or by antidepressant use. The association between plasma carotenoids or carotenoid/lipids (cholesterol and triglycerides) ratio and the risk for DS was assessed through multiple random-effect logistic regression.

RESULTS

The study sample was composed of 1010 participants (mean age 74 y (±4.9), 58 % of women) followed-up during a median time of 13.4 years. Plasma zeaxanthin and ratios of zeaxanthin/lipids, lutein+zeaxanthin/lipids and β-carotene/lipids were independently associated with a significant reduced risk of DS over time (Odds ratio (OR) = 0.81, 95 % Confidence Interval (CI) [0.67;0.99], OR = 0.79 [0.67;0.98], OR = 0.79 [0.64;0.94] and OR = 0.80 [0.66;0.97] for +1 standard deviation of each exposure respectively).

LIMITATIONS

Plasma carotenoids were only available at study baseline.

CONCLUSION

Focusing on circulating carotenoids and considering lipids levels, the present results suggested an association between higher levels of plasma zeaxanthin, combined lutein+zeaxanthin and β-carotene and a decreased risk of DS over time in older adults.

The impact of Pilates exercise for depression symptoms in female patients: A systematic review and meta-analysis

BACKGROUND

The Pilates exercise has recently become an increasingly popular way of exercise in female patients since it is an attractive and low-cost physical exercise modality. Pilates may be a beneficial method of exercise for female patients with depression and anxiety symptoms. However, to date, there has been no attempt to collate this literature. This review aims to systematically assess and meta-analyze the efficacy of Pilates exercise for female patients with depression and anxiety symptoms and inform evidence-based guidelines for exercise prescription.

METHODS

Five electronic databases (Scopus, MEDLINE/PubMed, Embase, Web of Science, and the Cochrane Library) were systematically searched up to January 2023 to examine randomized controlled trials (RCTs) focused on the effects of Pilates exercise for female patients with depressive disorders and individuals with elevated levels of depression were included. The primary outcomes were the severity of depression, and the secondary outcomes were anxiety. Statistical analyses were performed using Stata version 15.1 software with a 95% confidence interval (Registration number: CRD42023426522), and the PEDRO Scale was used to evaluate the risk of bias for RCT.

RESULTS

18 RCTs with 827 female patients were included. The methodological quality of the RCTs was considered an A level in 4 studies, B level in 13, studies, and C level in 1 study investigation. The meta-analysis showed that there was moderate evidence for the Pilates exercise significantly improved the severity of depression symptoms (SMD = -0.73; 95% CI -0.86 to -0.59; P < .01) and anxiety symptoms (SMD = -0.62; 95% CI -0.79 to -0.46; P < .01).

CONCLUSIONS

Pilates exercise could reduce levels of depression and anxiety in female patients with depression and anxiety symptoms. Pilates exercise can be used as a potential ancillary program to improve depression and anxiety symptoms for female patients.

Dietary Carotene Intake and Suicidal Ideation in Korean Females: Analysis of Data From the Korea National Health and Nutrition Examination Survey (2012, 2013, and 2015)

OBJECTIVE

The suicide rate in Korea was the highest among countries in the Organisation for Economic Co-operation and Development in 2019. In a previous study, higher intake of vegetables and fruits was associated with a lower risk of suicidal ideation, and carotene-rich fruits and vegetables lowered the risk of depression. This study aimed to examine the direct relationship between carotene intake and suicidal ideation, adjusting for the effect on depression.

METHODS

This study used data from the Korea National Health and Nutrition Examination Survey (KNHANES) conducted in 2012, 2013, and 2015. Carotene intake was assessed through a food intake frequency survey with a 24-hour recall. Suicidal ideation and depression were assessed using the mental health section of the KNHANES. We applied logistic regression to assess the relationship between carotene intake and suicidal ideation, adjusting for potential confounders.

RESULTS

A total of 5,480 females aged 19-64 years were included in this study. Carotene intake was significantly lower in the suicidal ideation group (3,034.5±1,756.4 μg/day) than in the nonsuicidal ideation group (3,225.4±1,795.1 μg/day) (p=0.015). We found a significant inverse association between carotene intake and the risk of suicidal ideation after adjusting for potential confounders (odds ratio=0.934, 95% confidence interval=0.873-0.999).

CONCLUSION

These results suggest that carotene intake may be inversely associated with the risk of suicidal ideation. Our findings may inform the development of new nutritional interventions to prevent increases in the risk of suicide worldwide.

Prognostic Factors Associated With Sleep Duration: Serum Pro-Oxidant/Antioxidant Balance and Superoxide Dismutase 1 as Oxidative Stress Markers and Anxiety/Depression

Objectives: Sleep is a conserved vital behavior in humans, and insufficient sleep is associated with several disorders. Recent studies have investigated the association of sleep duration, oxidative stress markers, anxiety, and depression. Therefore, we aim to assess the relationship between sleep duration, serum pro-oxidant/antioxidant balance (PAB) and superoxide dismutase 1 (SOD1) levels as markers of oxidative stress, anxiety, and depression. Methods: Participants included in our cross-sectional analysis were recruited as part of the MASHAD study (n = 9,184). Nocturnal sleep duration was identified using a self-reported questionnaire, and serum pro-oxidant/antioxidant balance (PAB) and superoxide dismutase 1 (SOD1) levels were assessed using methods that have been previously reported. Results: Serum PAB, depression, and anxiety scores were found significantly higher in subjects with very short sleep duration. In an adjusted model using MANOVA regression analysis, serum PAB was significantly higher in the subjects with a very short sleep duration (p: 0.016 in depression and p: 0.002 in anxiety). Conclusion: The present cross-sectional study demonstrates a relationship between sleep duration, oxidative balance, and depression/anxiety, especially in anxiety subjects that might predict each other.

Antioxidant and Anti-Inflammatory Effects of Carotenoids in Mood Disorders: An Overview

Depression has a multifactorial etiology comprising family history and unemployment. This review aims to summarize the evidence available for the antioxidant and anti-inflammatory effects of carotenoids in mood disorders. This review article’s methodologies were based on a search of the PubMed database for all linked published papers. Epidemiological studies indicate that a diet rich in vegetables, fruits, nuts, fish, and olive oil may prevent the development of depression. Antioxidant supplementation has been found to combat various stress-induced psychiatric disorders, including depression and anxiety. A growing body of evidence indicates that carotenoids have both antioxidant and anti-inflammatory. Studies also suggest that poor dietary intake, particularly low intakes of fruit and vegetables and high intakes of fast food and other convenience foods, may increase the risk of developing depression. Thus, dietary interventions have the potential to help mitigate the risk of mental health decline in both the general population and those with mood disorders. Considering that carotenoids have both antioxidant and anti-inflammatory effects, it is expected that they might exert a promising antidepressant effect. Nevertheless, further studies (including interventional and mechanistic studies) assessing the effect of carotenoids on preventing and alleviating depression symptoms are needed.

Associations of dietary Provitamin A carotenoid intake with depressive symptoms in midlife women: Results from the study of Women's Health Across the Nation

BACKGROUND

To study the association of Provitamin A (pro-A) carotenoid intake from diet with depressive symptoms in midlife women.

METHODS

Data for this cross-sectional study were retrieved from baseline assessment of the Study of Women's Health Across the Nation (SWAN). Logistic regression and restricted cubic spline models were performed to examine the association pro-A carotenoid intake with depressive symptoms.

RESULTS

A total of 3054 midlife women aged 42-52 years were included in the present study. In overall midlife women, pro-A carotenoid intake was inversely associated with depressive symptoms (CES-D score ≥16). In premenopausal women, pro-A carotenoid intake was inversely associated with depressive symptoms after adjustment for age, race/ethnicity, total family income, education, physical activity, BMI, use of antidepressant, dietary total caloric, protein, carbohydrate, fat, vitamin C, vitamin E and pro-A carotenes in model 1. In fully adjusted model, after additional adjustment for day of cycle, FSH and SHBG, this association remained statistically significant. The fully adjusted odds ratios (ORs) with 95 % CI of depressive symptoms were 0.685 (0.450-1.043) in quartile 4 compared with quartile 1 for pro-A carotenoid intake. However, in early perimenopausal women, no statistically significant difference was observed between pro-A carotenoid intake and depressive symptoms after adjustment for confounders.

LIMITATIONS

This was a cross-sectional study, limiting causal inferences. Assessment of CES-D was based on a self-report scale.

CONCLUSION

Pro-A carotenoid intake may be inversely associated with depression symptoms in premenopausal women, but not in early perimenopausal women.

Dietary Intake of Carotenoids and Risk of Depressive Symptoms: A Systematic Review and Meta-Analysis

Given the important role of oxidative stress in the pathogenesis of depression, the potential role of dietary antioxidant supplementation in the prevention of depression has attracted considerable attention. Most studies suggest that dietary carotenoids may play a role in maintaining depressive symptoms due to their antioxidant activity, but some studies concluded the contrary. This study conducted a meta-analysis of observational studies to test the relationship between carotenoid supplements and depressive symptoms. After a comprehensive search of the Cochrane Library, PubMed, Embase Scopus, and Web of Science databases from their inception to 28 July 2022, 12 publications met the inclusion and exclusion criteria, of which 8 were cross-sectional studies, 3 were case−control studies, and 1 was a cohort study, involving a total of 33,466 participants. Pooled meta-analysis found that intake of total carotenoids (OR = 0.61, 95% CI [0.53, 0.71], p < 0.01), beta-carotene (OR = 0.61, 95% CI [0.52, 0.70], p < 0.01), alpha-carotene (OR = 0.71, 95% CI [0.60, 0.83], p < 0.01), lycopene (OR = 0.71, 95% CI [0.55, 0.90], p < 0.01), lutein, and/or corn xanthin (OR = 0.53, 95% CI [0.43, 0.66], p < 0.01) was significantly inversely associated with depressive symptoms, while beta-cryptoxanthin (OR = 1.07, 95% CI [0.52, 2.21], p = 0.86) had no significance. At the same time, this meta-analysis was free of publication bias and heterogeneity. Although further studies are needed to elucidate the causal relationship between carotenoids and depressive symptoms, and to further reveal the mechanism of their association, the results of our meta-analysis suggest that carotenoids are protective factors for depressive symptoms, and dietary intake may help in reducing the risk of depressive symptoms.

Higher intakes of nutrients are linked with a lower risk of cardiovascular diseases, type 2 diabetes mellitus, arthritis, and depression among Korean adults

Persons with underlying noncommunicable diseases (NCDs) are more likely to acquire severe coronavirus disease 2019 disease and to die from coronavirus disease 2019. An urgent need for potential therapy to prevent and control NCDs is critical. We hypothesized that higher intakes of multiple individual nutrients, fruits, or vegetables would be linked with a low risk of NCDs in the Korean population. Thus, we aim to explore the association between NCDs, including cardiovascular diseases, type 2 diabetes mellitus (T2DM), arthritis, depression, and dietary factors. A total of 56,462 adults aged 18 years (2009-2019) were included. Dietary factors, including intakes of multiple individual nutrients, fruits, and vegetables, were assessed. Multivariable-adjusted logistic regression models were used to explore the associations between dietary factors and NCDs. Interactions were found between intakes of multiple individual nutrients and sex for T2DM, hypertension, stroke, myocardial infarction, arthritis, and osteoarthritis. Only in women was a 2-fold increase in daily multiple individual nutrient intake (vitamins A, B1, B2, B3, C; potassium, protein; phosphorus; calcium; iron; monounsaturated fatty acid and polyunsaturated fatty acid; n-3 fatty acid and n-6 fatty acid; and water) associated with a lower prevalence of T2DM, hypertension, stroke, myocardial infarction, arthritis, and osteoarthritis. In both women and men, high fruit or vegetable consumption was linked with a lower risk of T2DM, hypertension, dyslipidemia, osteoarthritis, and depression than low consumption. Our findings found higher intakes of fruits, vegetables, and multiple individual nutrients are linked with a lower risk of NCDs in the Korean adult population. Further work is needed to identify whether interactions between intake of multiple individual nutrients, vegetables, and fruits affect the presence of NCDs.

Environmental science and pollution research role of heavy metal concentrations and vitamin intake from food in depression: a national cross-sectional study (2009-2017)

Little is known about associations between depression and serum heavy metal levels, dietary vitamin intakes. Thus, we sought to determine the nature of these associations and to predict risks of depression using marginal effects. A data set of 16,371 individuals aged ≥10 years that participated in Korea National Health and Nutrition Examination Surveys (KNHANES) conducted from 2009 to 2017 (excluding 2014 and 2015) was used to obtain information on sociodemographics, family histories, lifestyles, serum heavy metal levels, food intakes, and depression. Serum cadmium (Cd) and lead (Pb) levels were analyzed by graphite furnace atomic absorption spectrometry and mercury (Hg) levels using a mercury analyzer. Daily vitamin intakes were calculated by 24-h dietary recall. The results obtained showed that females are at higher risk of depression than males. A doubling of serum Cd was associated with a 21% increase in depression (AOR 1.21, 95% CI: 1.07-1.37, p = 0.002), whereas twofold increases in daily vitamin B1, B3 and vitamin A intakes reduced the risk of depression by 17% (0.83, 95% CI: 0.73-0.95, p = 0.005), 20% (0.80, 95% CI: 0.70-0.91, p = 0.001), and 8% (0.92, 95% CI: 0.85-0.99, p = 0.020), respectively. Interactions between heavy metals, vitamin intakes, and sex did not influence the risk of depression. The result shows that increased daily dietary vitamin intake might protect the public against depression. Further studies are needed to reduce the risks posed by heavy metals and to determine more comprehensively the effects of daily dietary vitamin intake on depression.

Dietary Intake of Flavonoids and Carotenoids Is Associated with Anti-Depressive Symptoms: Epidemiological Study and In Silico-Mechanism Analysis

Flavonoids and carotenoids are bioactive compounds that have protective effects against depressive symptoms. Flavonoids and carotenoids are the two main types of antioxidant phytochemicals. This study investigated the association between flavonoid and carotenoid intake and depressive symptoms in middle-aged Korean females. We analyzed the mechanism of these associations using an in silico method. Depressive symptoms were screened using the Beck Depression Inventory-II (BDI-II), and flavonoid and carotenoid intake were assessed using a semi-quantitative food frequency questionnaire. Using a multivariate logistic regression model, we found that flavones, anthocyanins, individual phenolic compounds, lycopene, and zeaxanthin were negatively associated with depressive symptoms. In silico analysis showed that most flavonoids have high docking scores for monoamine oxidase A (MAOA) and monoamine oxidase B (MAOB), which are two important drug targets in depression. The results of the docking of brain-derived neurotrophic factor (BDNF) and carotenoids suggested the possibility of allosteric activation of BDNF by carotenoids. These results suggest that dietary flavonoids and carotenoids can be utilized in the treatment of depressive symptoms.

Association between consumption of fruits and vegetables with suicidal ideation

OBJECTIVE

To investigate the association between fruit and vegetable (F&V) intake with suicidal ideation.

DESIGN

Cross-sectional study using a Korean Community Health Survey.

SETTING

F&V consumers were defined as individuals who had consumed fruits or vegetables more than once per day. Multivariable logistic regression models were used to identify factors associated with suicidal ideation including F&V consumption and to estimate the prevalence of having suicidal ideation after consideration of potential confounders.

PARTICIPANTS

221 081 Korea adults (nationally representative).

RESULTS

Approximately 55 % of participants were F&V consumers. They were more likely to be young, be women, attain high educational levels, be married and be healthier physically and psychologically than the F&V non-consumers. Non-consumers had an increased risk for suicidal ideation than consumers even when potential confounders were considered, and this trend was more remarkable with vegetable intake.

CONCLUSION

F&V intake is associated with low risk for suicidal ideation.

Association of dietary total antioxidant capacity with depression, anxiety, and sleep disorders: A systematic review of observational studies

BACKGROUND AND AIM

We aimed to systematically review observational studies that evaluated the potential association of the dietary total antioxidant capacity (dTAC) with common mental disorders (depression and anxiety) and sleep disorders.

METHODS

Studies with an observational design that evaluated the association between the dTAC and common mental disorders and sleep disorders were identified using the PubMed and Scopus databases. The meta-analysis guideline of observational studies in epidemiology and the preferred reporting items for systematic reviews and meta-analysis were used to conduct and report the data of this systematic review.

RESULTS

Of the 439 records, seven studies were included in this review. There was a sample variation of 41-3297 participants. We highlight that five of the studies analyzed were conducted in the Iranian population. Four studies analyzed only women, and three studies were conducted with postmenopausal or climacteric women. Four cross-sectional studies showed inverse associations between the dTAC and depression, anxiety, and sleep disorders in Iranians.

CONCLUSION

The consumption of a diet rich in antioxidants, characterized by high dTAC scores, seems to be inversely associated with depression, anxiety, and sleep disorders. However, further studies with different populations and designs are necessary for a better understand this relationship.

RELEVANCE TO PATIENTS

This review assesses the association of the dTAC with common mental disorders (depression and anxiety) with sleep disorders. This will help guide further studies on the relationship between diet and mental disorders and sleep disorders. Knowledge about these relationships is essential for the creation of non-pharmacological practices for the prevention of these disorders.

The association between carotenoid intake, mental health, and sleep quality among university students

BACKGROUND

The impact of carotenoid intake on the risk of mental disorders and poor sleep quality is unclear. Thus, we sought to examine the association between carotenoid intake, mental health, and sleep quality among university students.

METHODS

A total of 368 healthy university students (181 men, 49%), aged 18 to 43 years, volunteered for this study. Dietary intake, physical activity, sleep quality, mental health, and body mass index (BMI) were evaluated. A multivariable logistic regression analysis test was used to estimate the odds ratio (OR) and 95% confidence interval (CI).

RESULTS

The mean age of the participants was 22.9 ± 3.9 years and mean BMI was 23.1 ± 3.8 kg/m². The students in the highest quartile of carotenoid intake had a significantly lower risk of poor sleep quality (OR = 0.19, 95% CI: 0.09 to 0.40; P  < 0.001) and depression (OR = 0.27, 95% CI: 0.12 to 0.59; P = 0.001). In the sex-stratified subgroup analysis, the depression risk was significant for men (OR = 0.28, 95% CI: 0.07 to 0.59; P = 0.007), but not for women. Furthermore, we did not observe any specific relationship between carotenoid intake and the risk of anxiety or stress.

CONCLUSION

It appears that the students with higher carotenoid intake may have a better quality of sleep and lower risk of depression. More longitudinal and in-depth qualitative and quantitative research, with a longer-term follow-up, is needed to support the veracity of our findings.

Fruit and Vegetable Dietary Patterns and Mental Health in Women: A Systematic Review

CONTEXT

Mental health may be influenced by some dietary patterns. Among common elements of beneficial patterns is high fruit and vegetable intake. However, no systematic review has been conducted to date, to our knowledge, that has assessed the influence of fruit and vegetable dietary patterns on a broad spectrum of mental health.

OBJECTIVE

We conducted a systematic review, using the PRISMA guidelines, of the observational studies analyzing the association between the dietary pattern of fruit and vegetables and the broad aspects of mental health in adult women.

DATA SOURCES

The databases PubMed and Web of Science were searched, and additional manual search for observational peer-reviewed studies was conducted for studies published until June 2019.

DATA EXTRACTION

A total of 5911 studies were extracted and verified based on title and abstract for the inclusion criteria. All procedures were conducted independently by 2 researchers. The final number of included studies was 30. The review was structured around the type of observed outcome.

DATA ANALYSIS

The included studies had defined habitual intake associated with dietary patterns with the intake of specific fruit and/or vegetables, and/or fruit or vegetable products (eg, juices), as well as any aspect of the broad spectrum of general mental health. The Newcastle-Ottawa Scale was used to assess bias. The observed association was not stated in all the included studies; some of them revealed a reverse relationship, but only for the vegetarian/vegan diet. A vegetarian diet may be characterized by high consumption of fruits and vegetables, but it sometimes may not be properly balanced, due to excluded products. This may be the reason of observed situation.

CONCLUSIONS

A general positive influence was observed for the dietary patterns characterized by high consumption of fruit and vegetables and of fruit or vegetable products by women.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42019138148.

Dietary antioxidants and fibre intake and depressive symptoms in Iranian adolescent girls

OBJECTIVE

To investigate the cross-sectional association between dietary intakes of antioxidants and fibre and depressive symptoms among Iranian adolescent girls.

DESIGN

A cross-sectional population-based study.

SETTING

Primary schools in two different cities located in northeastern Iran (Mashhad and Sabzevar).

PARTICIPANTS

A total of 988 adolescent girls aged 12-18 years were included in the study.

RESULTS

Subjects with no or minimal depression symptoms had significantly higher dietary intakes of α-carotene (P = 0·01), β-carotene (P = 0·006), lutein (P = 0·03) and vitamin C (P = 0·04) when compared with subjects with mild-to-severe depression symptoms. Soluble dietary fibre and insoluble dietary fibre intakes were also significantly higher in healthy adolescents compared with those with depression symptoms (P < 0·001). In multivariate-adjusted model 2, the OR (95 % CI) of depressive symptoms were 0·61 (95 % CI 0·37, 1·01), 0·42 (95 % CI 0·26, 0·69), 0·50 (95 % CI 0·31, 0·79), 0·71 (95 % CI 0·44, 1·15), 0·51 (95 % CI 0·32, 0·82) and 0·42 (95 % CI 0·25, 0·68) for the highest v. lowest quartile of vitamin C, β-carotene, α-carotene, lutein, soluble dietary fibre and insoluble dietary fibre cereal intakes, respectively.

CONCLUSIONS

Dietary intake of some antioxidants and dietary fibre intake was inversely associated with depression symptoms among Iranian adolescent girls.

Antioxidant vitamin intakes and risk of depression, anxiety and stress among female adolescents

BACKGROUND AND AIM

The relation of some antioxidant nutrients with psychological disorders has been studied previously. The aim of this study was to examine the association between antioxidant vitamin intakes and the risk of depression, anxiety, and stress.

METHODS

This cross-sectional study was conducted on 263 Tehranian female adolescents. Dietary intakes of vitamin E, C, and β-Carotene were determined using a valid and reliable food-frequency questionnaire. Depression, anxiety, and stress scores were characterized by DASS-21 (Depression Anxiety Stress Score-21 items) questionnaire. The multivariable logistic regression models were used to determine the odds ratios (ORs) and 95% confidence intervals (95%CIs) of depression, anxiety, and stress across tertiles of antioxidant vitamin intakes.

RESULTS

The mean ± SD age of participants was 16.20 ± 0.97 years. Also, the mean ± SD depression, anxiety and stress scores of participants were 9.89 ± 4.15, 8.43 ± 4.39 and 14.00 ± 6.45, respectively. In the fully adjusted model, subjects in the highest tertile of β-Carotene had a lower prevalence of depression (OR:0.46, 95%CI:0.23-0.95), anxiety (OR:0.40, 95%CI:0.20-0.81), and stress (OR:0.35, 95%CI:0.17-0.73) compared to the lowest tertile (P for trend<0.05). Moreover, individuals in the top tertile of vitamin E had a lower prevalence of stress, in comparison to the bottom tertile (OR:0.34, 95% CI:0.13-0.89), (P for trend<0.05). However, no significant associations were found between the intakes of vitamin E and C and other psychological disorders.

CONCLUSION

In this study, higher intake of β-Carotene was associated with lower prevalence of depression, anxiety and stress. Also, we found an inverse relationship between vitamin E intake and the risk of stress.

Nutrient patterns and depressive symptoms among Australian adults

PURPOSE

Much of the current literature on the associations between diet and depression focus on single nutrients rather than nutrient patterns (NPs). We investigated the association between NPs and depressive symptoms (DepS) in an Australian adult population.

METHODS

DepS were examined at two different time points, in 2010 (Stage 3, n = 1743, 49.0% males) and 2015 [North West 2015 (NW15), n = 1,024, 46.6% males] of the North West Adelaide Health Study (NWAHS). Dietary habits were evaluated using a food frequency questionnaire (FFQ) at Stage 3. DepS were assessed using the Center for Epidemiological Studies Depression (CES-D) scale at Stage 3 and NW15. Principal component analysis was used to identify NPs as well as the factor structure of the CES-D. Log- and negative binomial regression analyses were used to assess the association between NPs and DepS scores. Ordinal logistic regression analysis was undertaken between the NPs and identified factors of the CES-D score.

RESULTS

Three NPs (from the FFQ) and two-factors (from the CES-D score) were obtained. After adjusting for known confounding variables, a 'plant-sourced' NP (β-carotene, fibre, vitamin C, potassium and α-carotene) was inversely associated with DepS at Stage 3 [prevalence ratio (PR)_Q4VsQ1, 0.78; 95% CI 0.66-0.92; p = 0.003], whereas an 'animal-sourced' (ω-3 fatty acid, monounsaturated fat, vitamin E and cholesterol) or 'mixed-source' (phosphorous, protein, vitamin B2, iodine and zinc) NP was not associated with DepS. There was an inverse relationship between the 'plant-sourced' NP and the '(absence of) positive-affect' factor from the CES-D in both stages.

CONCLUSION

The 'plant-sourced' NP is consistently and inversely associated with DepS; however, longitudinal studies are recommended to confirm these results.

Effect of astaxanthin-rich extract derived from Paracoccus carotinifaciens on the status of stress and sleep in adults

This study investigated the effect of a dietary supplement containing astaxanthin-rich extract derived from Paracoccus carotinifaciens (astaxanthin supplement) on the status of stress and sleep in individuals aged 20-64 years. Twenty-five subjects orally administered 12 mg astaxanthin/day of astaxanthin supplement for 8 weeks (astaxanthin group) and 29 subjects given a placebo (placebo group) were evaluated with Profile of Mood States 2nd Edition for stress and Oguri-Shirakawa-Azumi Sleep Inventory for Middle-aged and Aged version for sleep. We did not observe any significant intergroup differences in the stress and sleep. A subgroup analysis was performed after dividing the subjects into two groups: those who scored >65 and those who scored ≤65 in the "Depression-Dejection" dimension of Profile of Mood States 2nd Edition. The sleep of subjects who scored >65 ("Depression-Dejection") showed significant improvement in the astaxanthin group compared with the placebo group, whereas no significant improvement was observed in stress and the other subjects. Our results indicate that people who tend to be strongly depressed may experience improved sleep after ingesting astaxanthin supplement. On the basis of the parameters tested, administration of astaxanthin supplement was not associated with any problems related to safety. Clinical registration: This study has been registered at the University Hospital Medical Information Network (https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000038619) on August 24, 2018 as "A study to evaluate the effect of intake of astaxanthin on the status of stress and sleep in adults," Identification No. UMIN000033863.

Prospective study on the association between dietary non-enzymatic antioxidant capacity and depressive symptoms

BACKGROUND & AIMS

Oxidative stress has been suggested to play an important role in the pathophysiology of depression, and a diet high in antioxidants may improve mood. However, studies addressing this issue are scarce. The aim of this cohort study was to investigate the prospective association between dietary non-enzymatic antioxidant capacity (NEAC) in overall diet and depressive symptoms in Japanese employees. Additionally, we examined the association separated by dietary NEAC sources.

METHOD

Participants were 911 workers without depressive symptoms at baseline and participated in 3-y follow-up survey. Dietary NEAC was determined from a database of NEAC measurements obtained by ferric reducing antioxidant power (FRAP) and oxygen radical absorbance capacity (ORAC). Dietary NEAC was calculated by multiplying the estimated NEAC values with the consumed amount and summing up those values. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. Logistic regression was used to estimate odds ratios of depressive symptoms according to overall NEAC and separately from foods and beverages.

RESULTS

At 3-y follow-up, 153 (16.8%) workers were newly identified as having depressive symptom. No significant associations were found between higher level of overall dietary NEAC and decreased risk of depressive symptoms after adjustment for potential confounders (overall: FRAP, P for trend = 0.19 and ORAC, P for trend = 0.20). Likewise, neither higher dietary NEAC from foods nor beverages were related with lower depressive symptoms.

CONCLUSION

Our findings did not support an inverse association between dietary NEAC and the risk of depressive symptoms in Japanese workers.

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

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

Dietary total antioxidant capacity is inversely associated with depression, anxiety and some oxidative stress biomarkers in postmenopausal women: a cross-sectional study

BACKGROUND

Postmenopausal women are at higher risk of mental disorders. Oxidative stress has implication in the development of these disorders. Dietary total antioxidant capacity (DTAC) has been proposed as a tool for assessing dietary antioxidants intake. The relationship between DTAC with depression, anxiety and stress has not been investigated in postmenopausal women. Thus, we aimed to assess the association between DTAC and depression, stress and anxiety as well as oxidative stress biomarkers.

METHODS

This cross-sectional study was carried out on 175 postmenopausal women. Data on dietary intake and mental health were collected by 147-item semi-quantitative food frequency questionnaires (FFQ) and Depression Anxiety Stress Scales (DASS-42), respectively. Dietary and serum total antioxidant capacity (TAC), malondialdehyde (MDA), oxidized-LDL, and superoxide dismutase (SOD) were measured. ANOVA test was applied to compare the mean of variables across the tertiles of DTAC. The relationship between DTAC and oxidative stress biomarkers was determined through ANCOVA method. Simple and multivariate linear regression tests were performed to measure the relationship between DTAC and mental health.

RESULTS

Serum MDA level was significantly lower in the subjects at the highest tertiles of DTAC (P-value < 0.001). In addition, serum TAC level was significantly higher in subjects at the second tertile of DTAC (P-value = 0.04). DTAC was inversely and independently related to depression (β = - 0.16, P-value = 0.03) and anxiety scores (β = - 0.21, P-value = 0.007). There was no significant association between DTAC and stress score (β = - 0.10, P-value = 0.1).

CONCLUSION

An inverse relationship was found between DTAC with depression, anxiety scores and some oxidative stress biomarkers in postmenopausal women. These findings indicate DTAC may be used for developing effective dietary measures for reducing depression and anxiety in these women.

Fruit and vegetable consumption and health outcomes: an umbrella review of observational studies

The aim of this study was to provide a comprehensive evaluation of current evidence on fruit and vegetable consumption and health outcomes. A systematic search for quantitative syntheses was performed. Several criteria, including study design, dose-response relationship, heterogeneity and agreement of results over time, and identification of potential confounding factors, were used to assess the level of evidence. The strongest (probable) evidence was found for cardiovascular disease protection; possible evidence for decreased risk of colon cancer, depression and pancreatic diseases was found for fruit intake; and colon and rectal cancer, hip fracture, stroke, depression and pancreatic diseases was found for vegetable intake. Suggestive and rather limited associations with other outcomes have been found. Evidence of potential confounding by sex and geographical localisation has been reported. Despite findings are consistent enough for hypothesising causation (at least for cardiovascular-related outcomes), further studies are needed to clarify the role of potential confounding factors.

Consumption of fruit and vegetables in relation with psychological disorders in Iranian adults

OBJECTIVE

Findings from observational studies on the relationship between fruit and vegetables consumption and risk of mental disorders are contradictory. We aimed to examine the association between fruit and vegetables intake and prevalence of depression, anxiety, and psychological distress in a large group of Iranian adults.

METHODS

This cross-sectional study was conducted on 3362 people of Iranian adults working in 50 health centers. Dietary data were collected using a validated dish-based 106-item semi-quantitative food frequency questionnaire (FFQ). The Iranian-validated version of Hospital Anxiety and Depression Scale (HADS) was used to screen for anxiety and depression. The General Health Questionnaire (GHQ) was used to assess psychological distress.

RESULTS

The prevalence of depression, anxiety, and high psychological distress among the study population was 30.0, 15.2, and 25.0%, respectively. Women in the top quintile of fruit intake, compared with those in the bottom quintile, had 57, 50, and 60% lower odds of depression, anxiety, and psychological distress. Consumption of vegetables was significantly associated with lower odds of depression (OR 0.65; 95% CI 0.46, 0.93) in women and lower odds of anxiety (OR 0.43; 95% CI 0.22, 0.87) in men. In addition, after adjustment for potential confounders, women in the highest quintile of fruit and vegetables intake, compared with those in the bottom quintile, had significantly lower odds of depression (OR 0.55; 95% CI 0.37, 0.80) and psychological distress (OR 0.60; 95% CI 0.40, 0.90). Furthermore, high intake of total fruit and vegetables was associated with lower odds of psychological distress (OR 0.42; 95% CI 0.21, 0.81) in men.

CONCLUSION

We found significant inverse associations between high intake of fruit with depression, anxiety, and psychological distress in Iranian women. High consumption of vegetables was also associated with lower risk of depression and anxiety, respectively, in women and men. In addition, high intake of total fruit and vegetable was associated with lower odds of depression and psychological distress in women and men.

Oxidative stress, anti-oxidants and the cross-sectional and longitudinal association with depressive symptoms: results from the CARDIA study

Depression may be accompanied by increased oxidative stress and decreased circulating anti-oxidants. This study examines the association between depressive symptoms, F2-isoprostanes and carotenoids in a US community sample. The study includes 3009 participants (mean age 40.3, 54.2% female) from CARDIA (Coronary Artery Risk Development in Young Adults). Cross-sectional analyses were performed on data from the year 15 examination (2000-2001) including subjects whose depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale (CES-D) and had measurements of plasma F2-isoprostanes (gas chromatography/mass spectrometry) or serum carotenoids (high-performance liquid chromatography). Carotenoids zeaxanthin/lutein, β-cryptoxanthin, lycopene, α-carotene, β-carotene were standardized and summed. Longitudinal analyses were conducted using the data from other examinations at 5-year intervals. Cross-lagged analyses investigated whether CES-D predicted F2-isoprostanes or carotenoids at the following exam, and vice versa. Regression analyses were controlled for sociodemographics, health and lifestyle factors. F2-isoprostanes were higher in subjects with depressive symptoms (CES-D ⩾ 16) after adjustment for sociodemographics (55.7 vs 52.0 pg ml(-1); Cohen's d = 0.14, P < 0.001). There was no difference in F2-isoprostanes after further adjustment for health and lifestyle factors. Carotenoids were lower in those with CES-D scores ⩾ 16, even after adjustment for health and lifestyle factors (standardized sum 238.7 vs 244.0, Cohen's d = -0.16, P < 0.001). Longitudinal analyses confirmed that depression predicts subsequent F2-isoprostane and carotenoid levels. Neither F2-isoprostanes nor carotenoids predicted subsequent depression. In conclusion, depressive symptoms were cross-sectionally and longitudinally associated with increased F2-isoprostanes and decreased carotenoids. The association with F2-isoprostanes can largely be explained by lifestyle factors, but lower carotenoids were independently associated with depressive symptoms.

Associations between fruit and vegetable consumption and psychological distress: results from a population-based study

BACKGROUND

Several studies observed associations of various aspects of diet with mental health, but little is known about the relationship between following the 5-a-day recommendation for fruit and vegetables consumption and mental health. Thus, we examined the associations of the Swiss daily recommended fruit and vegetable intake with psychological distress.

METHODS

Data from 20,220 individuals aged 15+ years from the 2012 Swiss Health Survey were analyzed. The recommended portions of fruit and vegetables per day were defined as 5-a-day (at least 2 portions of fruit and 3 of vegetables). The outcome was perceived psychological distress over the previous 4 weeks (measured by the 5-item mental health index [MHI-5]). High distress (MHI-5 score ≤ 52), moderate distress (MHI-5 > 52 and ≤ 72) and low distress (MHI-5 > 72 and ≤ 100) were differentiated and multinomial logistic regression analyses adjusted for known confounding factors were performed.

RESULTS

The 5-a-day recommendation was met by 11.6 % of the participants with low distress, 9.3 % of those with moderate distress, and 6.2 % of those with high distress. Consumers fulfilling the 5-a-day recommendation had lower odds of being highly or moderately distressed than individuals consuming less fruit and vegetables (moderate vs. low distress: OR = 0.82, 95 % confidence interval [CI] 0.69-0.97; high vs. low distress: OR = 0.55, 95 % CI 0.41-0.75).

CONCLUSIONS

Daily intake of 5 servings of fruit and vegetable was associated with lower psychological distress. Longitudinal studies are needed to further determine the causal nature of this relationship.

Intake of Lutein-Rich Vegetables Is Associated with Higher Levels of Physical Activity

Levels of physical inactivity, a major contributor to burden of disease, are high in many countries. Some preliminary research suggests that circulating lutein concentrations are associated with high levels of physical activity (PA). We aimed to assess whether the intake of lutein-containing foods, including vegetables and eggs, is associated with levels of PA in two studies conducted in different countries. Dietary data and PA data collected from participants in two cross-sectional studies: the Maine-Syracuse Longitudinal Study (MSLS), conducted in Central New York, USA (n = 972), and the Observation of Cardiovascular Risk Factors in Luxembourg Study (ORISCAV-LUX) (n = 1331) were analyzed. Higher intakes of lutein containing foods, including green leafy vegetables, were associated with higher levels of PA in both study sites. Increasing the consumption of lutein-rich foods may have the potential to impact positively on levels of PA. This needs to be further explored in randomized controlled trials.

Loss of Weight in Obese Older Adults: A Biomarker of Impending Expansion of Multimorbidity?

OBJECTIVES

To determine whether weight loss in older adults may be a marker of impending burden of multimorbidity regardless of initial weight, testing the hypotheses that obesity but not overweight in elderly adults is associated with greater number of diseases than normal weight and that obese older adults who lose weight over time have the greatest burden of multimorbidity.

DESIGN

Longitudinal cohort study (Invecchiare in Chianti Study).

SETTING

Community.

PARTICIPANTS

Individuals aged 60 and older at baseline followed for an average of 4 years (N = 1,025).

MEASUREMENTS

Multimorbidity was measured as number of diagnosed diseases. Baseline body mass index (BMI) was categorized as normal weight (<25.0 kg/m(2)), overweight (25.0-29.9 kg/m(2)), and obese (≥30.0 kg/m(2)). Loss of weight was defined as decrease over time in BMI of at least 0.15 kg/m(2) per year. Age, sex, and education were covariates.

RESULTS

Baseline obesity was cross-sectionally associated with high multimorbidity and greater longitudinal increase of multimorbidity than normal weight (P = .005) and overweight (P < .001). Moreover, obese participants who lost weight over follow-up had a significantly greater increase in multimorbidity than other participants, including obese participants who maintained or gained weight over time (P = .005). In nonobese participants, changes in weight had no effect on changes in multimorbidity over time. Sensitivity analyses confirmed that one specific disease did not drive the association and that competing mortality did not bias the association.

CONCLUSION

Loss of weight in obese older persons is a strong biomarker of impending expansion of multimorbidity. Older obese individuals who lose weight should receive thoughtful medical attention.

Gene polymorphisms and gene scores linked to low serum carotenoid status and their associations with metabolic disturbance and depressive symptoms in African-American adults

Gene polymorphisms provide a means to obtain unconfounded associations between carotenoids and various health outcomes. In the present study, we tested whether gene polymorphisms and gene scores linked to low serum carotenoid status are related to metabolic disturbance and depressive symptoms in African-American adults residing in Baltimore city, MD, using cross-sectional data from the Healthy Aging in Neighborhoods of Diversity across the Life Span study (age range 30-64 years, n 873-994). We examined twenty-four SNP of various gene loci that were previously shown to be associated with low serum carotenoid status (SNPlcar). Gene risk scores were created: five low specific-carotenoid risk scores (LSCRS: α-carotene, β-carotene, lutein+zeaxanthin, β-cryptoxanthin and lycopene) and one low total-carotenoid risk score (LTCRS: total carotenoids). SNPlcar, LSCRS and LTCRS were entered as predictors for a number of health outcomes. These included obesity, National Cholesterol Education Program Adult Treatment Panel III metabolic syndrome and its components, elevated homeostatic model assessment of insulin resistance, C-reactive protein, hyperuricaemia and elevated depressive symptoms (EDS, Center for Epidemiologic Studies-Depression score ≥ 16). Among the key findings, SNPlcar were not associated with the main outcomes after correction for multiple testing. However, an inverse association was found between the LTCRS and HDL-cholesterol (HDL-C) dyslipidaemia. Specifically, the α-carotene and β-cryptoxanthin LSCRS were associated with a lower odds of HDL-C dyslipidaemia. However, the β-cryptoxanthin LSCRS was linked to a higher odds of EDS, with a linear dose-response relationship. In summary, gene risk scores linked to low serum carotenoids had mixed effects on HDL-C dyslipidaemia and EDS. Further studies using larger African-American population samples are needed.

Vegans report less stress and anxiety than omnivores

OBJECTIVE

Studies investigating mood in vegetarian diets have yielded conflicting results, either demonstrating risk for mental disorders or mood protection. Our objective was to investigate mood, as well as factors that potentially impact mood in vegans (VG), vegetarians (VEG), and omnivores (OMN).

METHODS

We surveyed mood, diet, and lifestyle factors in a broad geographic online sample of adult VG (n = 283), VEG (n = 109), and OMN (n = 228) who were recruited via diet-related social networks. Mood was measured with the Depression Anxiety Stress Scale-21 (DASS-21).

RESULTS

The sample was mostly female (78.5%), and age was inversely correlated with all DASS scores (p < 0.05). Mean DASS-A (anxiety) and DASS-S (stress) scores differed by group (F(2,616) = 4.73, p = 0.009, η(2) = 0.015, and F(2, 615) = 8.23, p < 0.001, η(2) = 0.026, respectively), with VG scores lower than OMN scores, indicating less mood disturbance. Analyses of covariance were conducted by gender, adjusting for age. Anxiety scores were different in males only (F(2,128) = 5.39, p = 0.006, η(p)(2) = 0.078) and lower anxiety in males was related to a vegan diet and daily fruit and vegetable intake. Mean stress scores were different in females only (F(2,476) = 3.82, p = 0.023, η(p)(2) = 0.016) and lower stress in females was related to a vegan diet and lower daily intake of sweets.

DISCUSSION

A strict plant-based diet does not appear to negatively impact mood, in fact, reduction of animal food intake may have mood benefits. The improved mood domains were not consistent with those found in other studies, which may be due to methodological differences.

Aging and the burden of multimorbidity: associations with inflammatory and anabolic hormonal biomarkers

BACKGROUND

Multimorbidity increases with aging, but risk factors beyond age are unknown.

OBJECTIVE

To investigate the association of inflammatory and anabolic hormonal biomarkers with presence and prospective development of multimorbidity.

METHODS

Nine-year longitudinal study of 1018 participants aged 60 years or older (InCHIANTI Study). Multimorbidity was evaluated at baseline and follow-up visits as number of diagnosed diseases from a predefined list of 15 candidate chronic conditions, defined according to standard clinical criteria. Linear mixed models were used to test cross-sectional and longitudinal associations between candidate biomarkers and multimorbidity.

RESULTS

At baseline, multimorbidity was significantly higher in older participants (p < .001) and higher IL-6, IL-1ra, TNF-α receptor II (TNFAR2), and lower dehydroepiandrosterone sulfate were associated with higher number of diseases, independent of age, sex, body mass index, and education. The rate of longitudinal increase in number of chronic diseases was significantly steeper in participants who were older at baseline (p < .001). In addition, higher baseline IL-6 and steeper increase of IL-6 levels were significantly and independently associated with a steeper increase in multimorbidity over time (p < .001 and p = .003, respectively). Sensitivity analyses, performed using 15 different models obtained by removing each of 15 conditions included in the original list of candidate diseases, confirmed that results were not driven by any specific condition.

CONCLUSIONS

Accumulation of chronic diseases accelerates at older ages and in persons with higher baseline levels and steeper increase over time of IL-6. High IL-6 and increase in IL-6 may serve as early warning sign to better target interventions aimed at reducing the burden of multimorbidity.

Mood improvement in young adult males following supplementation with gold kiwifruit, a high-vitamin C food

Enhanced intakes of fruit and vegetables have been associated with improved psychological well-being. We investigated the potential mood-enhancing effects of kiwifruit, a fruit rich in vitamin C and a number of other important micronutrients. Young adult males (n 35) were supplemented with either half or two kiwifruit/d for 6 weeks. Profile of Mood States questionnaires were completed at baseline and following the intervention. No effect on overall mood was observed in the half a kiwifruit/d group; however, a 35 % (P = 0·06) trend towards a decrease in total mood disturbance and a 32 % (P = 0·063) trend towards a decrease in depression were observed in the two kiwifruit/d group. Subgroup analysis indicated that participants with higher baseline mood disturbance exhibited a significant 38 % (P = 0·029) decrease in total mood disturbance, as well as a 38 % (P = 0·048) decrease in fatigue, 31 % (P = 0·024) increase in vigour and a 34 % (P = 0·075) trend towards a decrease in depression, following supplementation with two kiwifruit/d. There was no effect of two kiwifruit/d on the mood scores of participants with lower baseline mood disturbance. Dietary intakes and body status of specific micronutrients indicated a significant increase in the participants' vitamin C intakes and corresponding plasma levels of the vitamin. The results indicate that enhanced intake of kiwifruit by individuals with moderate mood disturbance can improve overall mood.

Lipid peroxidation and depressed mood in community-dwelling older men and women

It has been hypothesized that cellular damage caused by oxidative stress is associated with late-life depression but epidemiological evidence is limited. In the present study we evaluated the association between urinary 8-iso-prostaglandin F_2α (8-iso-PGF_2α), a biomarker of lipid peroxidation, and depressed mood in a large sample of community-dwelling older adults. Participants were selected from the Health, Aging and Body Composition study, a community-based longitudinal study of older persons (aged 70–79 years). The present analyses was based on a subsample of 1027 men and 948 women free of mobility disability. Urinary concentration of 8-iso-PGF_2α was measured by radioimmunoassay methods and adjusted for urinary creatinine. Depressed mood was defined as a score greater than 5 on the 15-item Geriatric Depression Scale and/or use of antidepressant medications. Depressed mood was present in 3.0% of men and 5.5% of women. Depressed men presented higher urinary concentrations of 8-iso-PGF_2α than non-depressed men even after adjustment for multiple sociodemographic, lifestyle and health factors (p = 0.03, Cohen’s d = 0.30). This association was not present in women (depressed status-by-sex interaction p = 0.04). Our study showed that oxidative damage may be linked to depression in older men from a large sample of the general population. Further studies are needed to explore whether the modulation of oxidative stress may break down the link between late-life depression and its deleterious health consequences.

Antioxidant status and its association with elevated depressive symptoms among US adults: National Health and Nutrition Examination Surveys 2005-6

We examined the relationship of elevated depressive symptoms with antioxidant status. Cross-sectional data from the National Health and Nutrition Examination Surveys 2005–6 on US adults aged 20–85 years were analysed. Depressive symptoms were measured using the Patient Health Questionnaire with a score cut-off point of 10 to define ‘elevated depressive symptoms’. Serum antioxidant status was measured by serum levels of carotenoids, retinol (free and retinyl esters), vitamin C and vitamin E. The main analyses consisted of multiple logistic and zero-inflated Poisson regression models, taking into account sampling design complexity. The final sample consisted of 1798 US adults with complete data. A higher total serum carotenoid level was associated with a lower likelihood of elevated depressive symptoms with a reduction in the odds by 37 % overall with each sd increase in exposure, and by 34 % among women (P< 0·05). A dose–response relationship was observed when total serum carotenoids were expressed as quartiles (Q4 (1·62–10·1 μmol/l) v. Q1 (0·06–0·86 μmol/l): OR 0·41; 95 % CI 0·23, 0·76, P< 0·001; P for trend = 0·035), though no significant associations were found with the other antioxidant levels. Among carotenoids, β-carotene (men and women combined) and lutein+zeaxanthins (women only, after control for dietary lutein+zeaxanthin intake and supplement use) had an independent inverse association with elevated depressive symptoms among US adults. None of the other serum antioxidants had a significant association with depressive symptoms, independently of total carotenoids and other covariates. In conclusion, total carotenoids (mainly β-carotene and lutein+zeaxanthins) in serum were associated with reduced levels of depressive symptoms among community-dwelling US adults.

Fruit, vegetable, and antioxidant intakes are lower in older adults with depression

Studies have shown an association between depression and both antioxidant levels and oxidant stress, but generally have not included intakes of antioxidants and antioxidant-rich fruits and vegetables. This study examined the cross-sectional associations between clinically diagnosed depression and intakes of antioxidants, fruits, and vegetables in a cohort of older adults. Antioxidant, fruit, and vegetable intakes were assessed in 278 elderly participants (144 with depression, 134 without depression) using a Block 1998 food frequency questionnaire that was administered between 1999 and 2007. All participants were aged 60 years or older. Vitamin C, lutein, and beta cryptoxanthin intakes were significantly lower among individuals with depression than in comparison participants (P<0.05). In addition, fruit and vegetable consumption, a primary determinant of antioxidant intake, was lower in individuals with depression. In multivariable models controlling for age, sex, education, vascular comorbidity score, body mass index, total dietary fat, and alcohol; vitamin C, beta cryptoxanthin, fruits, and vegetables remained significant. Antioxidants from dietary supplements were not associated with depression. Antioxidant, fruit, and vegetable intakes were lower in individuals with late-life depression than in comparison participants. These associations may partially explain the elevated risk of cardiovascular disease among older individuals with depression. In addition, these findings point to the importance of antioxidant food sources rather than dietary supplements.