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Aslam H, Lotfaliany M, So D, Berding K, Berk M, Rocks T, Hockey M, Jacka FN, Marx W, Cryan JF, Staudacher HM. Fiber intake and fiber intervention in depression and anxiety: a systematic review and meta-analysis of observational studies and randomized controlled trials. Nutr Rev 2023:nuad143. [PMID: 38007616 DOI: 10.1093/nutrit/nuad143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2023] Open
Abstract
CONTEXT Dietary fibers hold potential to influence depressive and anxiety outcomes by modulating the microbiota-gut-brain axis, which is increasingly recognized as an underlying factor in mental health maintenance. OBJECTIVE Evidence for the effects of fibers on depressive and anxiety outcomes remains unclear. To this end, a systematic literature review and a meta-analysis were conducted that included observational studies and randomized controlled trials (RCTs). DATA SOURCES The PubMed, Embase, CENTRAL, CINAHL, and PsychINFO databases were searched for eligible studies. DATA EXTRACTION Study screening and risk-of-bias assessment were conducted by 2 independent reviewers. DATA ANALYSIS Meta-analyses via random effects models were performed to examine the (1) association between fiber intake and depressive and anxiety outcomes in observational studies, and (2) effect of fiber intervention on depressive and anxiety outcomes compared with placebo in RCTs. A total of 181 405 participants were included in 23 observational studies. In cross-sectional studies, an inverse association was observed between fiber intake and depressive (Cohen's d effect size [d]: -0.11; 95% confidence interval [CI]: -0.16, -0.05) and anxiety (d = -0.25; 95%CI, -0.38, -0.12) outcomes. In longitudinal studies, there was an inverse association between fiber intake and depressive outcomes (d = -0.07; 95%CI, -0.11, -0.04). In total, 740 participants were included in 10 RCTs, all of whom used fiber supplements. Of note, only 1 RCT included individuals with a clinical diagnosis of depression. No difference was found between fiber supplementation and placebo for depressive (d = -0.47; 95%CI, -1.26, 0.31) or anxiety (d = -0.30; 95%CI, -0.67, 0.07) outcomes. CONCLUSION Although observational data suggest a potential benefit for higher fiber intake for depressive and anxiety outcomes, evidence from current RCTs does not support fiber supplementation for improving depressive or anxiety outcomes. More research, including RCTs in clinical populations and using a broad range of fibers, is needed. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42021274898.
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Affiliation(s)
- Hajara Aslam
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine and Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Mojtaba Lotfaliany
- IMPACT, School of Medicine and Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Daniel So
- Department of Gastroenterology, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Kirsten Berding
- APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Michael Berk
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine and Barwon Health, Deakin University, Geelong, Victoria, Australia
- School of Medicine, Deakin University, Geelong, Victoria, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia
- Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia
- Department of Psychiatry, The University of Melbourne, Victoria, Australia
| | - Tetyana Rocks
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine and Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Meghan Hockey
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine and Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Felice N Jacka
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine and Barwon Health, Deakin University, Geelong, Victoria, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- College of Public Health, Medical & Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Wolfgang Marx
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine and Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - John F Cryan
- School of Medicine, Deakin University, Geelong, Victoria, Australia
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - Heidi M Staudacher
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine and Barwon Health, Deakin University, Geelong, Victoria, Australia
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Saghafian F, Hajishafiee M, Rouhani P, Saneei P. Dietary fiber intake, depression, and anxiety: a systematic review and meta-analysis of epidemiologic studies. Nutr Neurosci 2023; 26:108-126. [PMID: 36692989 DOI: 10.1080/1028415x.2021.2020403] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Findings of previous studies on relationship between dietary fiber intake and depression were inconsistent. We performed a meta-analysis on the association of dietary fiber intake with depression and anxiety in epidemiologic studies. METHODS We conducted a systematic search of electronic databases, up to May 2021. Data from 18 publications (12 cross-sectional, five cohort and one case-control studies) on dietary fiber consumption in relation to depression or anxiety were included. For depression, fifteen studies were conducted on adults and three others on adolescents. Anxiety was not included in the analysis, due to insufficient eligible studies. RESULTS Total dietary fiber intake was associated with a 10% lower odds of depression (OR = 0.90; 95% confidence interval [CI]: 0.86, 0.95) in adults and a 57% lower odds (OR = 0.43, 95% CI: 0.32, 0.59) in adolescents. Dose-response meta-analysis revealed an inverse linear association between total dietary fiber intake and odd of depression in adults; such that each 5-g increase in total dietary fiber intake was associated with a 5% reduction in risk of depression (OR = 0.95; 95% CI: 0.94, 0.97). An inverse significant association was observed between intake of fiber from vegetables (OR = 0.73; 95% CI: 0.66, 0.82) and soluble fiber (OR = 0.80, 95% CI: 0.71, 0.91) and odds of depression. However, cereal fiber, fiber from fruits and insoluble fiber were marginally associated with a reduction in having depression. CONCLUSIONS High intake of dietary fiber was protectively associated with depression in adults, in a dose-response fashion.
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Affiliation(s)
- Faezeh Saghafian
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, University of Medical Sciences, Tehran, Iran
| | - Maryam Hajishafiee
- Faculty of Health and Medical Sciences, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Parisa Rouhani
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parvane Saneei
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Associations of serum cystatin C with depressive symptoms and suicidal ideation in major depressive disorder. BMC Psychiatry 2021; 21:576. [PMID: 34789194 PMCID: PMC8596898 DOI: 10.1186/s12888-021-03509-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 09/24/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Individuals with major depressive disorder (MDD) have high suicidal ideation. There is evidence that serum cystatin C (Cys C) may be involved in the pathophysiology of MDD. The present study aimed to investigate Cys C concentration in patients with MDD and clarify its possible association with depressive symptoms and suicidal ideation. METHODS An online cross-sectional survey of 159 patients diagnosed with MDD was conducted. Serum Cys C levels were measured using ADVIA 2400 biochemical analyzer. The 24-item Hamilton Depression Scale (HAMD-24) was administered to evaluate the depressive symptoms. Generalized linear regression, logistic regression and restricted cubic spline models were used to examine the association of serum Cys C levels with depressive symptoms and suicidal ideation. RESULTS Serum Cys C levels were higher in MDD patients than in controls (p = 0.001) and were positively associated with scores on HAMD-24 in unadjusted (gender distribution, age, smoking, alcohol consumption, family history of depression and traumatic life events; (p = 0.003) and fully adjusted linear regression model (p = 0.005). The fully adjusted regression coefficient with 95% confidence intervals for serum Cys C levels and HAMD-24 score was 30.339 (9.602 to 51.077). The level of Cys C in the suicidal ideation (SI) group was significantly higher than that in the non-suicide ideation (non-SI) group (p = 0.001). Serum Cys C levels were positively associated with suicidal ideation in each logistic regression model (all p < 0.05). CONCLUSION Serum Cys C levels were elevated in MDD patients and appeared to be positively correlated with depressive symptoms and suicidal ideation. These findings suggest that the dysfunction of Cys C may be involved in the severity of depression and in the pathophysiological process of MDD. Thus, regulation of serum Cys C could potentially be an effective predictor of the severity of depression and potentially, play a role in reducing the risk of suicide in MDD patients.
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Inverse association between dietary fiber intake and depression in premenopausal women: a nationwide population-based survey. Menopause 2020; 28:150-156. [PMID: 33350672 DOI: 10.1097/gme.0000000000001711] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Depression is among the most common neuropsychiatric disorders, and its prevalence is twofold higher in women than in men. This study aimed to investigate the relationship between dietary fiber intake and depression in women by menopause status using data from a nationwide population-based survey conducted in Korea. METHODS We utilized the Korea National Health and Nutritional Examination Survey data for 2014, 2016, and 2018 with a complex sampling design. Dietary fiber intake was calculated according to the 24-hour recall method, and we used Patient Health Questionnaire-9 scores to assess depression. A t test based on the general linear model was used to compare mean dietary fiber intake according to the presence of depression by menopause status. A logistic regression analysis was conducted to compute the odds ratio for depression according to the gradually adjusted model. RESULTS This study included 5,807 women. Among the premenopausal women, dietary fiber intake was higher in the nondepression group than in the depression group (P < 0.001), while there was no significant difference among postmenopausal women. Accordingly, among the premenopausal women, a significantly inverse relationship was observed between a change in daily dietary fiber intake as 1 g/1,000 kcal and the prevalence of depression in the fully adjusted model with an odds ratio of 0.949 (95% confidence interval, 0.906-0.993; P = 0.03). However, among the postmenopausal women, this significant association was not observed. CONCLUSIONS Dietary fiber intake was inversely associated with depression in premenopausal but not postmenopausal women.
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