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Basso M, Zorzan I, Johnstone N, Barberis M, Cohen Kadosh K. Diet quality and anxiety: a critical overview with focus on the gut microbiome. Front Nutr 2024; 11:1346483. [PMID: 38812941 PMCID: PMC11133642 DOI: 10.3389/fnut.2024.1346483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 04/05/2024] [Indexed: 05/31/2024] Open
Abstract
Anxiety disorders disproportionally affect females and are frequently comorbid with eating disorders. With the emerging field of nutritional psychiatry, focus has been put on the impact of diet quality in anxiety pathophysiology and gut microbiome underlying mechanisms. While the relationship between diet and anxiety is bidirectional, improving dietary habits could better facilitate the actions of pharmacological and psychological therapies, or prevent their use. A better understanding of how gut bacteria mediate and moderate such relationship could further contribute to develop personalized programs and inform probiotics and prebiotics manufacturing. To date, studies that look simultaneously at diet, the gut microbiome, and anxiety are missing as only pairwise relationships among them have been investigated. Therefore, this study aims at summarizing and integrating the existing knowledge on the dietary effects on anxiety with focus on gut microbiome. Findings on the effects of diet on anxiety are critically summarized and reinterpreted in relation to findings on (i) the effects of diet on the gut microbiome composition, and (ii) the associations between the abundance of certain gut bacteria and anxiety. This novel interpretation suggests a theoretical model where the relationship between diet and anxiety is mediated and/or modulated by the gut microbiome through multiple mechanisms. In parallel, this study critically evaluates methodologies employed in the nutritional field to investigate the effects of diet on anxiety highlighting a lack of systematic operationalization and assessment strategies. Therefore, it ultimately proposes a novel evidence-based approach that can enhance studies validity, reliability, systematicity, and translation to clinical and community settings.
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Affiliation(s)
- Melissa Basso
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Irene Zorzan
- Molecular Systems Biology, School of Biosciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
- Centre for Mathematical and Computational Biology, CMCB, University of Surrey, Guildford, United Kingdom
| | - Nicola Johnstone
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Matteo Barberis
- Molecular Systems Biology, School of Biosciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
- Centre for Mathematical and Computational Biology, CMCB, University of Surrey, Guildford, United Kingdom
- Synthetic Systems Biology and Nuclear Organization, Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, Netherlands
| | - Kathrin Cohen Kadosh
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
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Zheng J, Liu M, Zhao L, Hébert JR, Steck SE, Wang H, Li X. Dietary Inflammatory Potential, Inflammation-Related Lifestyle Factors, and Incident Anxiety Disorders: A Prospective Cohort Study. Nutrients 2023; 16:121. [PMID: 38201952 PMCID: PMC10781140 DOI: 10.3390/nu16010121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 12/19/2023] [Accepted: 12/25/2023] [Indexed: 01/12/2024] Open
Abstract
It is unclear whether diet-associated inflammation is related to the development of anxiety disorders. We aimed to investigate the association between energy-adjusted dietary inflammatory index (E-DII) scores and the incidence of anxiety disorders, and explore the joint effects of E-DII scores with other inflammatory lifestyles in enhancing anxiety risk. In the UK Biobank Study of 96,679 participants, baseline E-DII scores were calculated from the average intake of at least two 24 h dietary recalls. Multivariable-adjusted Cox models were used to evaluate the associations between E-DII scores and the incidence of total anxiety disorders, and primary types and subtypes; additive and multiplicative interactions of a pro-inflammatory diet and seven inflammatory lifestyles were examined. After a median follow-up of 9.4 years, 2785 incident cases of anxiety disorders occurred. Consuming a pro-inflammatory diet was significantly associated with a higher risk of total anxiety disorders (HRQ4vsQ1 = 1.12, 95% CI = 1.00-1.25), and positive associations were consistently identified for primary types and subtypes of anxiety disorders, with HRs ranging from 1.08 to 1.52, and were present in women only. Both additive and multiplicative interactions of current smoking and a proinflammatory diet on total anxiety risk were identified. A proinflammatory diet was associated with a higher incidence of anxiety disorders, and current smoking may synergize with a proinflammatory diet to promote anxiety risk, particularly among women.
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Affiliation(s)
- Jiali Zheng
- Department of Epidemiology and Biostatistics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China;
| | - Mengdan Liu
- Department of Food Safety and Toxicology, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China;
| | - Longgang Zhao
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (L.Z.); (J.R.H.); (S.E.S.)
| | - James R. Hébert
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (L.Z.); (J.R.H.); (S.E.S.)
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Susan E. Steck
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (L.Z.); (J.R.H.); (S.E.S.)
| | - Hui Wang
- Department of Food Safety and Toxicology, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China;
| | - Xiaoguang Li
- Department of Food Safety and Toxicology, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China;
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Azarmanesh D, Pearlman J, Carbone ET, DiNatale JC, Bertone-Johnson ER. Construct Validation of the Dietary Inflammatory Index (DII) among Young College-Aged Women. Nutrients 2023; 15:4553. [PMID: 37960206 PMCID: PMC10647813 DOI: 10.3390/nu15214553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 10/20/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023] Open
Abstract
The Dietary Inflammatory Index (DII) is designed to assess the inflammatory potential of the diet. While previous research has utilized DII among college-aged women, no study to date has validated it in this population. We conducted a construct validation of DII among 393 healthy women aged 18-31 years against a robust panel of 14 inflammatory biomarkers, including CRP, IL-1β, IL-4, IL-6, IL-10, and TNF-α, which were used in the development of DII. Three linear regression models were constructed: (1) an age-adjusted model, (2) the most parsimonious model based on likelihood ratio tests, and (3) a fully adjusted model for age, race, body mass index, waist circumference, physical activity, smoking status, and nonsteroidal anti-inflammatory drug use. DII was derived from the Harvard food frequency questionnaire and categorized into quartiles. Consistent with our hypothesis, DII was negatively and significantly associated with back-transformed IL-10 levels, confirming that a more pro-inflammatory diet was associated with lower levels of an anti-inflammatory cytokine (Model 3: Q4 vs. Q1 β = 0.62; 95% CI: 0.42, 0.93; p-trend = 0.04). While validated in other populations, DII may not be a suitable tool for assessing the inflammatory potential of the diet among college-aged women.
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Affiliation(s)
- Deniz Azarmanesh
- Department of Human Nutrition and Hospitality Management, The University of Alabama, Tuscaloosa, AL 35487, USA;
| | - Jessica Pearlman
- Institute for Social Science Research, University of Massachusetts Amherst, Amherst, MA 01003, USA;
| | - Elena T. Carbone
- Department of Nutrition and Commonwealth Honors College, University of Massachusetts Amherst, Amherst, MA 01003, USA;
| | - Janie C. DiNatale
- Department of Human Nutrition and Hospitality Management, The University of Alabama, Tuscaloosa, AL 35487, USA;
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Solomou S, Logue J, Reilly S, Perez-Algorta G. A systematic review of the association of diet quality with the mental health of university students: implications in health education practice. HEALTH EDUCATION RESEARCH 2023; 38:28-68. [PMID: 36441584 PMCID: PMC9853940 DOI: 10.1093/her/cyac035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 10/13/2022] [Accepted: 10/31/2022] [Indexed: 06/16/2023]
Abstract
University students are at risk of experiencing mental health problems during the transition from home to university. This transition can also adversely affect their diet quality. This review aims to examine bidirectional associations from observational studies regarding the influence of diet quality on the mental health of university students, and vice versa. The databases PubMed, CINAHL, EMBASE, PsycINFO, The Cochrane Library and Web of Science were searched using relevant search terms. The searches were last updated on 15 July 2022. Majority of studies (36 out of 45) found that good diet quality of students was associated with better mental health in terms of depression, anxiety, stress and overall general mental well-being. Moreover, majority of studies (19 out of 23) found that stress and anxiety of students were associated with poorer diet quality. The effect sizes observed were generally small-moderate. Healthy diets of students have been associated with better mental health in terms of depression, anxiety, stress or other mental health issues. Stress experienced by university students has been associated with unhealthy diets. There are implications for health education research, as interventions to improve diet quality at the university level could reduce mental health issues; additionally, interventions to support students under stress may lead to healthier dietary habits when living on campuses. Randomized controlled trials and intervention studies are needed to further investigate these implications.
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Affiliation(s)
| | - Jennifer Logue
- Faculty of Health and Medicine, Lancaster University, Bailrigg, Lancaster LA1 4YW, UK
| | - Siobhan Reilly
- Faculty of Health and Medicine, Lancaster University, Bailrigg, Lancaster LA1 4YW, UK
- Faculty of Health Studies, University of Bradford, Richmond Road, Bradford, West Yorkshire BD7 1DP, UK
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Mansouri T, Ghanatios G, Hatzinger L, Barich R, Dampha E, Temple JL, Clemency BM, Hostler D. Eating Patterns among Emergency Medical Service Providers in the United States: A Qualitative Interview Study. Nutrients 2022; 14:nu14224884. [PMID: 36432571 PMCID: PMC9696925 DOI: 10.3390/nu14224884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 11/22/2022] Open
Abstract
Emergency medical service (EMS) providers experience demanding work conditions in addition to shift work, which increases risk for nutrition related chronic disease such as metabolic syndrome, diabetes, obesity, and cardiovascular disease. The high stress, emergent, and unpredictable nature of EMS may interfere with healthy eating patterns on and off shift, however little is known about how these conditions impact dietary patterns among EMS providers. This study aimed to understand factors impacting dietary patterns through semi-structured interviews with 40 EMS providers throughout the United States. Interviews were conducted virtually via Zoom video conference. Inductive coding was used to identify themes throughout the interviews. Salient factors mentioned in the interviews included hunger, fatigue, stress, coworker influence, ambulance posting, geographical location, agency policy, and culture. Factors were grouped into 4 domains: physiological factors, psychosocial factors, physical environment, and organizational environment, represented by an adapted version of the social ecological model of health behaviors to include factors influencing eating patterns specific to EMS, which may contribute to overall health. Various barriers to healthy eating exist within EMS, and future studies should explore interventions at each level of our proposed model to improve conditions and reduce nutrition related disease risk in this essential population.
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Affiliation(s)
- Tegan Mansouri
- Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, NY 14214, USA
- Correspondence: ; Tel.: +1-716-829-2941; Fax: +1-716-829-2428
| | - George Ghanatios
- Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, NY 14214, USA
| | - Lori Hatzinger
- Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, NY 14214, USA
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA 90007, USA
| | - Rachel Barich
- Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, NY 14214, USA
- Department of Foods and Nutrition, University of Prince Edward Island, Charlottetown, PE C1A 4P3, Canada
| | - Ebriama Dampha
- Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, NY 14214, USA
| | - Jennifer L. Temple
- Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, NY 14214, USA
| | - Brian M. Clemency
- Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, NY 14214, USA
- Department of Emergency Medicine, University at Buffalo, Buffalo, NY 14203, USA
| | - David Hostler
- Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, NY 14214, USA
- Department of Emergency Medicine, University at Buffalo, Buffalo, NY 14203, USA
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The Risk of T2DM in College Women: The Predictive Power of Financial versus Residential Status in a Cross-Sectional Pilot Study in Turkey. Behav Sci (Basel) 2022; 12:bs12090309. [PMID: 36135113 PMCID: PMC9495967 DOI: 10.3390/bs12090309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/21/2022] [Accepted: 08/24/2022] [Indexed: 11/17/2022] Open
Abstract
Aim: This study aimed to investigate the relationships between dietary habits, income levels and type 2 diabetes mellitus (T2DM) risk in Turkish female university students who are living with their family or in the dormitory. Materials and Methods: This work was a cross-sectional pilot study conducted during December 2016–January 2017 in Istanbul Yeni Yuzyıl University. A survey was administered to 100 female students, 60 living with their family and 40 in dormitories. Income level was determined based on TURKSTAT 2015 percentiles. T2DM risk was determined using the Finnish Diabetes Association Type 2 Diabetes Risk Assessment Form (FINDRISC). Food frequency questionnaire and 24 h dietary recall results were analyzed by the diet analysis software Beslenme Bilgi Sistemi (BeBiS), specially developed for Turkey. Results: Results indicated inadequacies and imbalanced nutrition among female college students overall. Notably, there was a statistically significant higher diet quality for the students living with their families compared to those living in dormitories. Income level was consistently positively associated with better nutritional outcomes, while negatively associated with T2DM risk, but interestingly, only in the case of students living in the dormitory and not for those living with family. Conclusions: Our findings indicated that financial status, rather than living in the dormitory versus with family, is positively associated with increased T2DM risk as assessed via FINDRISC among Turkish female college students. This study’s results indicate a potential need for educational programs and nutritional support for students, particularly those living away from family.
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