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Shavit Y, Tepper S, Teodorescu K. Exploring culinary diversity to enhance Mediterranean diet adherence: A randomized controlled trial. Appetite 2024; 201:107597. [PMID: 38972638 DOI: 10.1016/j.appet.2024.107597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 07/03/2024] [Accepted: 07/03/2024] [Indexed: 07/09/2024]
Abstract
We Investigated how promoting diverse, healthy food options affects long-term dietary choices. We hypothesized that encouraging exploration of nutritious plant-based foods would lead to lasting improvements in diet. Participants (N = 211) were randomly assigned into two groups for a 6-week intervention: The fixed menu group was given the same large menu every week, while the changing menu group received a new small menu each week. At the end of the intervention both groups were exposed to the same menu suggestions. Food diversity evaluation was based on weekly reports collected during the intervention. Self-reported adherence to Mediterranean diet components was assessed using the I-MEDAS screener. The proportion of plant-based foods in participants' diets was estimated using a 0-100% scale based on self-report. Both items were evaluated using online questionnaires given to participants at baseline, at the end of the intervention, as well as three and six months after the intervention concluded. Results mean(SD) demonstrated that participants in fixed menu group explored a significantly wider array of items 26.33(11.64) than those in the changing menus group [19.79(10.29), t(202) = 4.25, p < 0.001, Cohen's d = 0.60]. A repeated measures analysis of covariance rmANCOVA revealed that short-term increase in I-MEDAS and PBD score were noted in both groups; however, only participants with the fixed menu sustained this increase at months follow-up [diff = 1.50, t(132) = 4.50, p < 0.001 Our findings suggest that manipulating the rate of exposure to food suggestions may affect overall dietary variety. It seems that early presentation with options may increase overall dietary variety and may even support longer-term habits. This study contributes to developing effective interventions and highlights the challenge of promoting exploratory behavior in nutrition.
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Affiliation(s)
- Yael Shavit
- Technion - Israel Institute of Technology, Israel.
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2
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Farrugia F, Refalo D, Bonello D, Cuschieri S. The impact of the COVID-19 pandemic on Mediterranean diet adherence: A narrative systematic review. Nutr Health 2024; 30:215-233. [PMID: 37439029 PMCID: PMC10345400 DOI: 10.1177/02601060231187511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Abstract
BACKGROUND The COVID-19 pandemic upended many aspects of daily life. For some individuals, this was an opportunity to re-evaluate their life and make better choices, while others were overwhelmed with stressors, leading to a deterioration in mental and physical health. AIM The aim of this narrative systematic review is to explore the effects of the COVID-19 pandemic on Mediterranean diet adherence. METHODS A systematic literature search was carried out on PubMed, Scopus and Web of Science electronic databases utilising the search terms 'Mediterranean diet' AND 'COVID-19'. This yielded 73 articles that fulfilled the inclusion criteria. RESULTS The data suggests that a substantial proportion of individuals adhered less to the Mediterranean diet during the COVID-19 lockdown period. However, individuals receiving some form of lifestyle intervention had better adherence to the Mediterranean diet than their unassisted counterparts. CONCLUSION This emphasises the importance of professional support during times of crisis to avoid deterioration of a population's health.
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Affiliation(s)
- Francesca Farrugia
- Department of Physiology and Biochemistry, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Daniel Refalo
- Department of Physiology and Biochemistry, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - David Bonello
- Department of Physiology and Biochemistry, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Sarah Cuschieri
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
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3
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Camprodon-Boadas P, Gil-Dominguez A, De la Serna E, Sugranyes G, Lázaro I, Baeza I. Mediterranean Diet and Mental Health in Children and Adolescents: A Systematic Review. Nutr Rev 2024:nuae053. [PMID: 38758659 DOI: 10.1093/nutrit/nuae053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2024] Open
Abstract
CONTEXT Childhood and adolescence are periods of critical importance in the development of mental health disorders. The Mediterranean diet (MD) has been linked to multiple positive health outcomes, including reduced incidence of mental health disorders and fewer psychiatric symptoms. OBJECTIVE This study aimed to investigate the association between adherence to an MD and mental health outcomes in children and adolescents. METHODS A systematic literature review was conducted of original research that explored the relationship between psychiatric symptoms or disorders and adherence to an MD. The literature search was conducted on PubMed, Scopus, Web of Science, MEDES, Dialnet, and Latindex from inception to November 2022, and the Newcastle-Ottawa Scale was used to evaluate the quality of studies. RESULTS A total of 13 studies (6 cross-sectional, 4 case-control, 2 randomized clinical trials, and 1 longitudinal cohort) out of 450 met the inclusion criteria. A total of 3058 children or adolescents with a mean age range from 8.6 to 16.2 years were included. Among the reviewed studies, 5 (71.42%) of those looking at attention-deficit/hyperactivity disorder, 4 (80%) examining depression, and 2 (50%) assessing anxiety found a significant protective association. Seven articles (53.84%) were found to be of high quality and 6 (46.15%) of moderate quality. CONCLUSION Adherence to an MD could be a protective factor for mental health in child and adolescent populations. This suggests that promoting an MD could help prevent the onset of clinical psychiatric symptoms, reduce symptom severity, and improve prognosis in young patients. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42021276316.
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Affiliation(s)
- Patricia Camprodon-Boadas
- Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Institut Clinic de Neurociències, Hospital Clínic Universitari, Barcelona, 08036, Spain
- Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, 08036, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, 28029, Spain
- Department of Medicine, Institute of Neurosciences, Universitat de Barcelona, Barcelona, 08036, Spain
| | - Aitana Gil-Dominguez
- Department of Medicine, Institute of Neurosciences, Universitat de Barcelona, Barcelona, 08036, Spain
| | - Elena De la Serna
- Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Institut Clinic de Neurociències, Hospital Clínic Universitari, Barcelona, 08036, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, 28029, Spain
| | - Gisela Sugranyes
- Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Institut Clinic de Neurociències, Hospital Clínic Universitari, Barcelona, 08036, Spain
- Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, 08036, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, 28029, Spain
| | - Iolanda Lázaro
- Cardiovascular Risk and Nutrition, Hospital del Mar Medical Research Institute (IMIM), Barcelona, 08003, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, 28029, Spain
| | - Immaculada Baeza
- Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Institut Clinic de Neurociències, Hospital Clínic Universitari, Barcelona, 08036, Spain
- Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, 08036, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, 28029, Spain
- Department of Medicine, Institute of Neurosciences, Universitat de Barcelona, Barcelona, 08036, Spain
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4
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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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5
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Movva N, Reichert H, Hooda N, Bylsma LC, Mitchell M, Cohen SS. Dietary eating patterns, dairy consumption, and anxiety: A systematic literature review. PLoS One 2023; 18:e0295975. [PMID: 38153944 PMCID: PMC10754443 DOI: 10.1371/journal.pone.0295975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 12/02/2023] [Indexed: 12/30/2023] Open
Abstract
BACKGROUND Nutrition affects both physical and mental health but evidence is mixed regarding potential associations between anxiety and diet, particularly dairy consumption. We conducted a systematic literature review (SLR) of dairy consumption and/or various dietary patterns and risk of anxiety. METHODS Literature searches were conducted in PubMed and Embase. All study designs except case reports, small case series, and SLRs were considered for inclusion. Reference lists of previously published SLRs were reviewed for any relevant additional studies. Studies of populations without dairy sensitivities exploring the association between dietary patterns and/or dairy consumption and anxiety published through May 2022 were identified using predefined eligibility criteria. Study quality was determined using the Academy of Nutrition and Dietetics Quality Criteria Checklist. RESULTS For this SLR, 132 studies were included; 80 were cross-sectional. Studies examined different dietary patterns (e.g., Mediterranean, gluten-free) and anxiety using various anxiety scales, with 19 studies specifically reporting on whole dairy consumption and anxiety. Dairy consumption was significantly associated with a lower risk of anxiety in 7 studies, while the remaining 12 studies showed no significant associations. Evidence was mixed for the association between various dietary patterns and anxiety, but more studies observed a lower risk of anxiety with greater adherence to "healthy" diets (e.g., Mediterranean, diet quality score, vegetarian/vegan) than a higher risk. Notable heterogeneity in study populations, time periods, geographical locations, dietary assessment methods, and anxiety scales was observed. CONCLUSIONS The results of this SLR suggest a potential link between diet including diary consumption and anxiety, but future studies, especially with longitudinal designs that measure diet and anxiety at several timepoints and comprehensively adjust for confounders, are needed to fully understand the relationship between diet and anxiety.
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Affiliation(s)
- Naimisha Movva
- EpidStrategies, A Division of ToxStrategies, LLC, Katy, Texas, United States of America
| | - Heidi Reichert
- EpidStrategies, A Division of ToxStrategies, LLC, Katy, Texas, United States of America
| | - Naushin Hooda
- EpidStrategies, A Division of ToxStrategies, LLC, Katy, Texas, United States of America
| | - Lauren C. Bylsma
- EpidStrategies, A Division of ToxStrategies, LLC, Katy, Texas, United States of America
| | - Meghan Mitchell
- EpidStrategies, A Division of ToxStrategies, LLC, Katy, Texas, United States of America
| | - Sarah S. Cohen
- EpidStrategies, A Division of ToxStrategies, LLC, Katy, Texas, United States of America
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6
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Galarza-Delgado DA, Azpiri-Lopez JR, Colunga-Pedraza IJ, Cardenas-de la Garza JA, Gonzalez-Gonzalez V, Beltran-Aguilar VM, Arias-Peralta AG, De Avila-Gonzalez N, Guajardo-Jauregui N. Cardiovascular health worsening in patients with autoimmune rheumatological diseases during the COVID-19 pandemic. Clin Rheumatol 2023; 42:2677-2690. [PMID: 36627529 PMCID: PMC9838353 DOI: 10.1007/s10067-022-06486-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 12/10/2022] [Accepted: 12/12/2022] [Indexed: 01/12/2023]
Abstract
Rheumatic autoimmune diseases are associated with a myriad of comorbidities. Of particular importance due to their morbimortality are cardiovascular diseases. COVID-19 greatly impacted the world population in many different areas. Patients with rheumatic diseases had to face changes in their healthcare, in addition to unemployment, a decrease in physical activity, social isolation, and lack of access to certain medications. This review summarizes the impact of COVID-19 pandemic on cardiovascular risk factors, comorbidities, and unhealthy behaviors in patients with rheumatic inflammatory autoimmune diseases, particularly focused on rheumatoid arthritis and systemic lupus erythematosus. Searches were carried out in MEDLINE/PubMed and Scopus from August to December 2022. Four reviewers screened the title and abstract of retrieved records. Potentially eligible reports were then reviewed in full text. Differences were reconciled by either consensus or discussion with an external reviewer. During the COVID-19 pandemic, patients with rheumatic diseases showed an increase in the prevalence of mental health disorders (43.2-57.7%), reduced physical activity (56.8%), and a worsening in eating behaviors. Alcohol intake increased (18.2%), especially in early phases of the pandemic. Smoking prevalence decreased (28.2%). Dyslipidemia and hypertension showed no changes. The pandemic and lockdown affected rheumatic patients not only in disease-related characteristics but in the prevalence of their cardiovascular comorbidities and risk factors. Lifestyle changes, such as healthy eating, physical activity, and optimal management of their rheumatic diseases and comorbidities, are essential to manage the long-lasting consequences of the COVID-19 outbreak. Key Points • During the COVID-19 pandemic, anxiety, depression, sedentarism, obesity, and a worsening in eating behaviors increased. •Patients with rheumatic diseases and comorbidities have worse clinical outcomes and a higher cardiovascular disease burden than those without them. •Comparative studies are necessary to precisely elucidate the pandemic's impact on the prevalence of cardiovascular disease, risk factors, and comorbidities in patients with rheumatoid arthritis and systemic lupus erythematosus.
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Affiliation(s)
- Dionicio A Galarza-Delgado
- Division of Rheumatology, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
| | - Jose R Azpiri-Lopez
- Division of Cardiology, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Francisco I. Madero y Gonzalitos S/N, 64460, Monterrey, Nuevo León, Mexico.
| | - Iris J Colunga-Pedraza
- Division of Rheumatology, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
| | - Jesus Alberto Cardenas-de la Garza
- Division of Rheumatology, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
| | - Valeria Gonzalez-Gonzalez
- Division of Rheumatology, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
| | - Victor M Beltran-Aguilar
- Division of Rheumatology, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
| | - Angel G Arias-Peralta
- Division of Cardiology, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Francisco I. Madero y Gonzalitos S/N, 64460, Monterrey, Nuevo León, Mexico
| | - Natalia De Avila-Gonzalez
- Division of Rheumatology, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
| | - Natalia Guajardo-Jauregui
- Internal Medicine Department, Hospital Universitario "Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
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7
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Pavlidou E, Papadopoulou SK, Mentzelou M, Dakanalis A, Vorvolakos T, Antasouras G, Spanoudaki M, Pandi AL, Serdari A, Chrysafi M, Dimoliani S, Giaginis C. Association of Mediterranean Diet Adherence with Sociodemographic, Anthropometric, and Lifestyle Factors during the COVID-19 Pandemic: A Cross-Sectional Study in Greece. Nutrients 2023; 15:4123. [PMID: 37836406 PMCID: PMC10574046 DOI: 10.3390/nu15194123] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/20/2023] [Accepted: 09/21/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has negatively affected several aspects of people's lifestyle worldwide. Healthy dietary patterns and their bioactive components may improve or even co-treat the negative impacts of the COVID-19 pandemic in several aspects of people's lifestyle and mental health in daily life. The aim of this survey is to evaluate the potential effect of Mediterranean diet (MD) adherence against COVID-19-induced complications. METHODS This is a cross-sectional survey performed on 3721 adults aged between 18 and 65 years old, which aims to evaluate the potential association of MD adherence with multiple sociodemographic, anthropometric, and lifestyle factors during the COVID-19 pandemic period. RESULTS This study has supported evidence that elevated MD compliance was independently related to female gender, better economic status, no smoking, increased risk of abdominal obesity, higher physical activity levels, greater prevalence of adequate sleep quality, better quality of life, and reduced probability of anxiety and depression during the COVID-19 pandemic by adjusting for multiple confounders. CONCLUSIONS MD compliance may improve or even co-treat the negative impacts of the COVID-19 pandemic in several aspect of people's lifestyle in daily life. Further research is strongly recommended exploring the possible beneficial effects of the MD against COVID-19 lifestyle complications in daily life.
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Affiliation(s)
- Eleni Pavlidou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece
| | - Sousana K Papadopoulou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece
| | - Maria Mentzelou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece
| | - Antonios Dakanalis
- Department of Mental Health, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
| | - Theofanis Vorvolakos
- Department of Geriatric Psychiatry, School of Health Sciences, University General Hospital of Alexandroupolis, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Georgios Antasouras
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece
| | - Maria Spanoudaki
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece
| | - Aimilia-Lynn Pandi
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece
| | - Aspasia Serdari
- Department of Psychiatry and Child Psychiatry, School of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Maria Chrysafi
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece
| | - Sofia Dimoliani
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece
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Castro A, Gili M, Visser M, Penninx BWJH, Brouwer IA, Montaño JJ, Pérez-Ara MÁ, García-Toro M, Watkins E, Owens M, Hegerl U, Kohls E, Bot M, Roca M. Soft Drinks and Symptoms of Depression and Anxiety in Overweight Subjects: A Longitudinal Analysis of an European Cohort. Nutrients 2023; 15:3865. [PMID: 37764652 PMCID: PMC10536294 DOI: 10.3390/nu15183865] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/11/2023] [Accepted: 08/31/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Studies about the association of carbonated/soft drinks, coffee, and tea with depression and anxiety are scarce and inconclusive and little is known about this association in European adults. Our aim was to examine the association between the consumption of these beverages and depressive and anxiety symptom severity. METHODS A total of 941 European overweight adults (mean age, 46.8 years) with subsyndromal depression that participated in the MooDFOOD depression prevention randomized controlled trial (Clinical Trials.gov identifier: NCT2529423; date of the study: from 2014 to 2018) were analyzed. Depressive and anxiety symptom severity and beverage consumption were assessed using multilevel mixed-effects ordinal logistic regression models for each beverage consumption (carbonated/soft drink with sugar, carbonated/soft drink with non-nutritive sweeteners, coffee, and tea) with the three repeated measures of follow-up (baseline and 6 and 12 months). A case report form for participants' sociodemographic and clinical characteristics, the Food Frequency Questionnaire, the Patient Health Questionnaire-9, the Generalized Anxiety Disorder 7-Item Scale, the MINI International Neuropsychiatric Interview 5.0, the Short Questionnaire to Assess Health-Enhancing Psychical Activity, and the Alcohol Use Disorders Identification Test were the research tools used. RESULTS Daily consumption of carbonated/soft drinks with sugar was associated with a higher level of anxiety. Trends towards significance were found for associations between both daily consumption of carbonated/soft drinks with sugar and non-nutritive sweeteners and a higher level of depression. No relationship was found between coffee and tea consumption and the level of depression and anxiety. CONCLUSIONS The high and regular consumption of carbonated/soft drink with sugar (amount of consumption: ≥1 unit (200 mL)/day) tended to be associated with higher level of anxiety in a multicountry sample of overweight subjects with subsyndromal depressive symptoms. It is important to point out that further research in this area is essential to provide valuable information about the intake patterns of non-alcoholic beverages and their relationship with affective disorders in the European adult population.
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Affiliation(s)
- Adoración Castro
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), 07122 Palma de Mallorca, Spain; (M.G.); (M.Á.P.-A.); (M.G.-T.); (M.R.)
- Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Edificio S, 07120 Palma de Mallorca, Spain;
- Department of Psychology, University of the Balearic Islands (UIB), 07122 Palma de Mallorca, Spain
| | - Margalida Gili
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), 07122 Palma de Mallorca, Spain; (M.G.); (M.Á.P.-A.); (M.G.-T.); (M.R.)
- Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Edificio S, 07120 Palma de Mallorca, Spain;
- Department of Psychology, University of the Balearic Islands (UIB), 07122 Palma de Mallorca, Spain
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands; (M.V.); (I.A.B.)
| | - Brenda W. J. H. Penninx
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands; (B.W.J.H.P.); (M.B.)
| | - Ingeborg A. Brouwer
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands; (M.V.); (I.A.B.)
| | - Juan José Montaño
- Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Edificio S, 07120 Palma de Mallorca, Spain;
- Department of Psychology, University of the Balearic Islands (UIB), 07122 Palma de Mallorca, Spain
| | - María Ángeles Pérez-Ara
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), 07122 Palma de Mallorca, Spain; (M.G.); (M.Á.P.-A.); (M.G.-T.); (M.R.)
| | - Mauro García-Toro
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), 07122 Palma de Mallorca, Spain; (M.G.); (M.Á.P.-A.); (M.G.-T.); (M.R.)
- Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Edificio S, 07120 Palma de Mallorca, Spain;
- Department of Medicine, University of the Balearic Islands (UIB), 07122 Palma de Mallorca, Spain
| | - Ed Watkins
- Department of Psychology, University of Exeter, Exeter EX4 4PY, UK; (E.W.); (M.O.)
| | - Matt Owens
- Department of Psychology, University of Exeter, Exeter EX4 4PY, UK; (E.W.); (M.O.)
| | - Ulrich Hegerl
- Department of Psychiatry, Psychosomatics and Psychotherapy, Goethe Universität Frankfurt am Main, 60528 Frankfurt am Main, Germany;
| | - Elisabeth Kohls
- Department of Psychiatry and Psychotherapy, Medical Faculty, University Leipzig, 04109 Leipzig, Germany;
| | - Mariska Bot
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands; (B.W.J.H.P.); (M.B.)
| | - Miquel Roca
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), 07122 Palma de Mallorca, Spain; (M.G.); (M.Á.P.-A.); (M.G.-T.); (M.R.)
- Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Edificio S, 07120 Palma de Mallorca, Spain;
- Department of Medicine, University of the Balearic Islands (UIB), 07122 Palma de Mallorca, Spain
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Li Y, Hou T, Cheng M, Miao Y, Yeerjang Y, Sheng CS, Xue K, Wu C, Zhang S, Yan Q, Pei J, Yang Q, Tian J, Xu W, Shi Y. Anxiety prevalence and its association with physical activity in patients with non-communicable diseases during COVID-19 lockdown: a cross-sectional study in Shanghai, China. BMC Public Health 2023; 23:317. [PMID: 36782166 PMCID: PMC9924212 DOI: 10.1186/s12889-022-14369-1] [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: 06/29/2022] [Accepted: 10/17/2022] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Quarantine due to the COVID-19 pandemic may have created great psychological stress among vulnerable populations. We aimed to investigate the prevalence of anxiety and explore the association between physical activities (PA) and anxiety risk in people with non-communicable diseases during the period of COVID-19 lockdown. METHODS We conducted a cross-sectional telephone survey from February 25 to April 20, 2020, the period of COVID-19 lockdown in Shanghai. Up to 8000 patients with type 2 diabetes and/or hypertension were selected using multi-stage cluster random sampling. PA level was measured based on the International Physical Activity Questionnaire using Metabolic Equivalent for Task scores, while symptoms of anxiety were assessed by the 7-item Generalized Anxiety Disorder scale. Multiple logistic regression analyses were performed to evaluate the associations of type and level of PA with the risk of anxiety. RESULTS Of a total 4877 eligible patients, 2602 (53.4%) reported with anxiety, and 2463 (50.5%), 123 (2.5%) and 16 (0.3%) reported with mild, moderate, and severe anxiety. The prevalence of anxiety was higher in the females, the elders, non-smokers, non-drinkers, and patients with diabetes, and the associations of anxiety with sex, age, smoking, drinking and diagnosis of diabetes were significant. A significant negative association was observed for housework activities (OR 0.53, 95%CI: [0.45, 0.63], p < 0.001) and trip activities (OR 0.55, 95%CI: [0.48, 0.63], p < 0.001) with anxiety, but no significant was found for exercise activities (OR 1.06, 95%CI: [0.94, 1.20], p = 0.321). Compared with patients with a low PA level, those with a moderate (OR 0.53, 95%CI: [0.44, 0.64], p < 0.001) or a high PA level (OR 0.51, 95%CI: [0.43, 0.51], p < 0.001) had a lower prevalence of anxiety. CONCLUSION This study demonstrates a higher prevalence of anxiety in patients with hypertension, diabetes, or both during the COVID-19 lockdown. The negative associations of housework and trip activities with anxiety highlight the potential benefit of PA among patients with non-communicable diseases.
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Affiliation(s)
- Yanyun Li
- grid.430328.eShanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Tianzhichao Hou
- grid.16821.3c0000 0004 0368 8293Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Minna Cheng
- grid.430328.eShanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Ya Miao
- grid.16821.3c0000 0004 0368 8293Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yeerzati Yeerjang
- grid.8547.e0000 0001 0125 2443Key Lab of Health Technology Assessment (National Health Commission), School of Public Health, Fudan University, Shanghai, China ,grid.8547.e0000 0001 0125 2443School of Public Health, Fudan University, Shanghai, China
| | - Chang-sheng Sheng
- grid.16821.3c0000 0004 0368 8293Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluation, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Kun Xue
- grid.8547.e0000 0001 0125 2443School of Public Health, Fudan University, Shanghai, China
| | - Cui Wu
- Center for Disease Control and Prevention of Baoshan District, Shanghai, China
| | - Sheng Zhang
- grid.430328.eShanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Qinghua Yan
- grid.430328.eShanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Jianfeng Pei
- grid.8547.e0000 0001 0125 2443Key Lab of Health Technology Assessment (National Health Commission), School of Public Health, Fudan University, Shanghai, China ,grid.8547.e0000 0001 0125 2443School of Public Health, Fudan University, Shanghai, China
| | - Qinping Yang
- grid.430328.eShanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Jingyan Tian
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. .,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical GenomicsRuijin HospitalShanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
| | - Wanghong Xu
- Key Lab of Health Technology Assessment (National Health Commission), School of Public Health, Fudan University, Shanghai, China. .,School of Public Health, Fudan University, Shanghai, China.
| | - Yan Shi
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China. .,National Clinical Research Center for Aging and Medicine, Shanghai, China.
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Marakis G, Kontopoulou L, Konstantinidis G, Papathanasiou IV, Karpetas G, Mirkopoulou D, Walker AF, Vasara E. The Use of Dietary Supplements and Their Association with COVID-19-Related Anxiety among Non-Institutionalized Elderly in Northern Greece. J Diet Suppl 2023; 20:199-217. [PMID: 36476207 DOI: 10.1080/19390211.2022.2151677] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The elderly constitute a vulnerable group for increased anxiety and poor diet during the COVID-19 pandemic. There is limited research on the levels of COVID-19-related anxiety and dietary habits including dietary supplementation practices among the elderly and very elderly in Greece. A cross-sectional survey was conducted in 364 non-institutionalized elderly (65-74 y) and very elderly (≥75 y) living in northern Greece, with the aim to investigate the use of dietary supplements and their association with other factors, particularly the COVID-19-related anxiety. Levels of anxiety were assessed with the use of the Coronavirus Anxiety Scale (CAS-5). The percentage of dietary supplement users was 62.6%. The most popular dietary supplements used were vitamin D followed by vitamin C and multivitamin and mineral supplements. Multivariate analysis showed that the very elderly and overweight individuals were less likely to consume vitamin D supplements. Approximately a third of the participants (33.8%) exhibited signs of COVID-19-related anxiety but only 8% showed dysfunctional levels of anxiety. Regression analysis indicated that women, former smokers, and people exhibiting any sign of COVID-19 anxiety were approximately two times more likely to consume dietary supplements of any kind (Gender: OR 2.34, 95% CI 1.30-4.19; Smoking: OR 2.15, 95% CI: 1.08-4.26; COVID-19 anxiety: OR 2.16, 95 % CI: 1.20-3.91). Our results provide useful insights into the current practices of dietary supplement use in this population group and could be used by dietetic and medical associations as well as public authorities in the formulation of targeted, safe, and effective interventions for the protection of public health.
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Affiliation(s)
- Georgios Marakis
- Nutrition and Food Standards Unit, Hellenic Food Authority, Athens, Greece
| | | | | | | | | | - Daphne Mirkopoulou
- 1st Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Eleni Vasara
- School of Biology, Aristotle University of Thessaloniki, Thessaloniki, Greece
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