Longitudinal association of vitamin B-6, folate, and vitamin B-12 with depressive symptoms among older adults over time

Association of serum total folate and serum vitamin D concentrations with W-shape in depressed older adults with cognitive dysfunction: A cross-sectional observational study

BACKGROUND

Depression and cognitive dysfunction are prevalent in the elderly population and have a serious impact on patients' quality of life and social functioning. Nutritional factors play a key role in the prevention and management of these disorders, particularly folate and vitamin D. The aim of this study was to elucidate the association between serum total folate and serum vitamin D concentrations and depressive symptoms and cognitive dysfunction in older adults.

METHODS

Using data from the National Health and Nutrition Examination Survey (NHANES) 2011-2014, 2042 participants aged 60 years and older were analyzed. Depressive symptoms were assessed by the Patient Health Questionnaire (PHQ-9) and cognitive function was assessed by the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Animal Fluency test and the Digit Symbol Substitution Test (DSST). Associations between serum total folate and vitamin D concentrations and depression with cognitive dysfunction were analyzed using multivariate logistic regression models, incorporating stratification and sensitivity analyses.

RESULTS

For every 1 nmol/L increase in serum vitamin D concentration, there was a 1 % reduction in the risk of depression in older adults (OR = 0.99 95 % CI 0.98-0.99). Serum total folate showed a significant W-shaped association with depression with cognitive dysfunction: when serum total folate concentration was below 33.00 nmol/L, the risk of depression was reduced by 7.6 % for every 1 nmol/L increase in its concentration (OR = 0.924 95 % CI 0.89-0.959); this association was not significant when the concentration was above 33.00 nmol/L (OR = 1.006 95 % CI 0.998-1.013).

CONCLUSIONS

Adequate levels of vitamin D and folate may help prevent and manage depression and cognitive dysfunction in older adults. The W-shaped association between serum total folate and these conditions suggests that folic acid supplementation could be effective within a specific range, warranting further exploration and validation through clinical studies.

Religious Involvement, Vegetarian Diet, and Mental Well-Being Among Seventh-day Adventists in Peru

Mental well-being is conditioned by several factors, including religious involvement and diet. However, this evidence does not exist among members of the Seventh-day Adventist Church (SDA) in Latin America, particularly Peru. This study evaluated the association between religious involvement and vegetarian diet with mental well-being in members of the SDA Church in Peru. In this cross-sectional study, the sample included 767 participants, aged 18 to 59 years. A face-to-face and online survey was administered that included information on the dietary regimen and sociodemographic characteristics. Religious involvement and mental well-being were measured using the 12-item version of the General Health Questionnaire (GHQ-12) and the Duke University Religion Index (DUREL), respectively. A multivariate analysis was conducted to investigate the factors associated with mental well-being. Being female (β = 1.80, p < 0.001), coming from the highland region (β = 1.98, p < 0.001), having a basic educational degree (β = 1.85, p < 0.001), a higher level of religious involvement (β = 0.34, p < 0.001), and being vegetarian (β = 1.21, p < 0.001) were associated with greater mental well-being. This evidence highlights the implication of religious participation and a vegetarian diet in mental health, not only among SDA church members but also in a broader context. However, it should be recognized that direct transfer of church-based health promotion interventions and strategies to the general population can present challenges; therefore, it is suggested that these strategies should be adapted and adjusted to consider differences in the community context.

Fueling the Firefighter and Tactical Athlete with Creatine: A Narrative Review of a Key Nutrient for Public Safety

Background/Objectives: Firefighters, tactical police officers, and warriors often engage in periodic, intermittent, high-intensity physical work in austere environmental conditions and have a heightened risk of premature mortality. In addition, tough decision-making challenges, routine sleep deprivation, and trauma exacerbate this risk. Therefore, identifying strategies to bolster these personnel's health and occupational performance is critical. Creatine monohydrate (CrM) supplementation may offer several benefits to firefighters and tactical athletes (e.g., police, security, and soldiers) due to its efficacy regarding physical performance, muscle, cardiovascular health, mental health, and cognitive performance. Methods: We conducted a narrative review of the literature with a focus on the benefits and application of creatine monohydrate among firefighters. Results: Recent evidence demonstrates that CrM can improve anaerobic exercise capacity and muscular fitness performance outcomes and aid in thermoregulation, decision-making, sleep, recovery from traumatic brain injuries (TBIs), and mental health. Emerging evidence also suggests that CrM may confer an antioxidant/anti-inflammatory effect, which may be particularly important for firefighters and those performing tactical occupations exposed to oxidative and physiological stress, which can elicit systemic inflammation and increase the risk of chronic diseases. Conclusions: This narrative review highlights the potential applications of CrM for related tactical occupations, with a particular focus on firefighters, and calls for further research into these populations.

Electrochemical sensing of vitamin B6 (pyridoxine) by adapted carbon paste electrode

The recent investigation targets to use adapted carbon paste (CP) with copper nanoparticles (CuNs) operating in a phosphate buffer (PBS) medium with a pH range of 5.0-8.0, to synthesize a novel, susceptible, and simple electrochemical sensor for the detection of one of the most important drugs, vitamin B6. Copper (Cu) is one of the most three common essential trace elements found in the bodies of both humans and animals, along with iron and zinc for all crucial physiological and biochemical functions. Its properties, which are assessed using a variety of methods including scanning electron microscopy (SEM), cyclic voltammetry (CV), differential pulse voltammetry (DPV), and electrochemical impedance spectroscopy (EIS), have also drawn a lot of attention recently. We considered the effects of pH, buffer, scan rate, interference, and calibration curve. The susceptible electrode's linear calibration curve encompassed concentration values between 8.88 and 1000.0 µM. The calculated limits of detection and quantification were 32.12 and 107.0 µM, respectively. Furthermore, this method was established in real human urine samples and drug validation which have been shown satisfactory results for vitamin B6 detection.

Development and validation of dietary depression index in Chinese adults

Objective: Previous studies have suggested diet was associated with depressive symptoms. We aimed to develop and validate Dietary Depression Index (DDI) based on dietary prediction of depression in a large Chinese cancer screening cohort.Methods: In the training set (n = 2729), we developed DDI by using intake of 20 food groups derived from a food frequency questionnaire to predict depression as assessed by Patient Health Questionnaire-9 based on the reduced rank regression method. Sensitivity, specificity, positive predictive value, and negative predictive value were used to assess the performance of DDI in evaluating depression in the validation dataset (n = 1176).Results: Receiver operating characteristic analysis was constructed to determine the best cut-off value of DDI in predicting depression. In the study population, the DDI ranged from -3.126 to 1.810. The discriminative ability of DDI in predicting depression was good with the AUC of 0.799 overall, 0.794 in males and 0.808 in females. The best cut-off values of DDI for depression prediction were 0.204 overall, 0.330 in males and 0.034 in females. DDI was a validated method to assess the effects of diet on depression.Conclusion: Among individual food components in DDI, fermented vegetables, fresh vegetables, whole grains and onions were inversely associated, whereas legumes, pickled vegetables and rice were positively associated with depressive symptoms.

The Role of Water-Soluble Vitamins and Vitamin D in Prevention and Treatment of Depression and Seasonal Affective Disorder in Adults

Depression is a major global health concern expected to worsen by 2030. In 2019, 28 million individuals were affected by depressive disorders. Dietary and supplemental vitamins show overall favorable preventative and therapeutic effects on depression. B vitamins are crucial for neurological function and mood regulation. Deficiencies in these vitamins are linked to depression. Studies on individual B vitamins show promise in improving depressive symptoms, particularly thiamin, riboflavin, niacin, and folate. Vitamin C deficiency may heighten depressive symptoms, but its exact role is not fully understood. Seasonal Affective Disorder (SAD) is associated with insufficient sunlight exposure and vitamin D deficiency. Vitamin D supplementation for SAD shows inconsistent results due to methodological variations. Further investigation is needed to understand the mechanisms of vitamins in depression treatment. Moreover, more research on SAD and light therapy's efficacy and underlying mechanisms involving photoreceptors, enzymes, and immune markers is needed. Although dietary and supplemental vitamins show overall favorable preventative and therapeutic effects on depression, dietitians treating psychiatric disorders face challenges due to diverse study designs, making direct comparisons difficult. Therefore, this article reviews the current literature to assess the role of dietary and supplemental vitamins in the prevention and treatment of depression. This review found that, although evidence supports the role of B vitamins and vitamins C and D in preventing and treating depression, further research is needed to clarify their mechanisms of action and determine the most effective intervention strategies.

Vitamin B12 Supplementation in Psychiatric Practice

PURPOSE OF REVIEW

Vitamin B12 (B12, cobalamin) deficiency has been associated with neuropsychiatric symptoms, suggesting a role for B12 supplementation both as a treatment for psychiatric symptoms due to B12 deficiency and as an augmentation strategy for pharmacological treatments of psychiatric disorders. This critical review discusses the major causes of B12 deficiency, the range of psychiatric and non-psychiatric manifestations of B12 deficiency, the indications for testing B12 levels, and the evidence for B12 supplementation for major psychiatric disorders.

RECENT FINDINGS

We find that high-quality evidence shows no benefit to routine B12 supplementation for mild depressive symptoms or to prevent depression. There is very limited evidence on the role of B12 supplementation to augment antidepressants. No high-quality evidence to date suggests a role for routine B12 supplementation in any other major psychiatric disorder. No formal guidelines indicate when clinicians should test B12 levels for common psychiatric symptoms, in the absence of major risk factors for deficiency or cardinal symptoms of deficiency. No robust evidence currently supports routine B12 supplementation for major psychiatric disorders. However, psychiatrists should be aware of the important risk factors for B12 deficiency and should be able to identify symptoms of B12 deficiency, which requires prompt testing, medical workup, and treatment. Testing for B12 deficiency should be considered for atypical or severe psychiatric presentations.

Association between Oral Health and Depressive Symptoms in Chinese Older Adults: The Mediating Role of Dietary Diversity

Diet is a modifiable factor in healthy population aging. Additionally, oral health and diet are important factors affecting depressive symptoms. To assess the mediating role of dietary diversity (DD) in oral health and depressive symptoms in older adults, we selected 8442 participants aged ≥ 65 years from the 2018 Chinese Longitudinal Health Longevity Survey (CLHLS) for a cross-sectional study. Depressive symptoms were determined based on scores on the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10). Dietary diversity scores (DDS) were established based on the frequency of intake of food groups. Oral health was measured by denture use and toothbrushing frequency. Stepwise multiple linear regression and PROCESS macros were used for mediated effects analysis and testing. The sample had a positive detection rate of 44.1% for depressive symptoms, 40.8% for denture use, and 41.9% for once-a-day toothbrushing. Denture use (ρ = -0.077, p < 0.01) and toothbrushing frequency (ρ = -0.115, p < 0.01) were negative predictors of depressive symptoms in older adults. DD significantly mediated the association between denture use (indirect effect -0.047; 95%CI: -0.068-0.028; p < 0.001), toothbrushing frequency (indirect effect -0.041; 95%CI: -0.054-0.030; p < 0.001), and depressive symptoms. Denture use and toothbrushing frequency not only directly reduce the risk of depressive symptoms in older adults, but also indirectly affect depressive symptoms through DD.

Epigenetics, Nutrition, and the Brain: Improving Mental Health through Diet

The relationship between nutrition and brain health is intricate. Studies suggest that nutrients during early life impact not only human physiology but also mental health. Although the exact molecular mechanisms that depict this relationship remain unclear, there are indications that environmental factors such as eating, lifestyle habits, stress, and physical activity, influence our genes and modulate their function by epigenetic mechanisms to shape mental health outcomes. Epigenetic mechanisms act as crucial link between genes and environmental influences, proving that non-genetic factors could have enduring effects on the epigenome and influence health trajectories. We review studies that demonstrated an epigenetic mechanism of action of nutrition on mental health, focusing on the role of specific micronutrients during critical stages of brain development. The methyl-donor micronutrients of the one-carbon metabolism, such as choline, betaine, methionine, folic acid, VitB6 and VitB12 play critical roles in various physiological processes, including DNA and histone methylation. These micronutrients have been shown to alter gene function and susceptibility to diseases including mental health and metabolic disorders. Understanding how micronutrients influence metabolic genes in humans can lead to the implementation of early nutritional interventions to reduce the risk of developing metabolic and mental health disorders later in life.

Understanding the Impact of Vitamin B Supplements on a Saudi Population

Introduction B vitamins help generate energy within cells. A significant portion of populations in developed countries suffer a deficiency in one or more B vitamins. This study assesses the use of vitamin B supplements and their effects. Methodology This cross-sectional study was conducted using public participants in Saudi Arabia. Participants from all over Saudi Arabia were recruited through self-conducted surveys to study the effects of using vitamin B supplements on appetite, BMI, energy, and sleep, and to identify any side effects in participants. Inclusion criteria included age (18 years or older) and use of vitamin B supplements. Children, pregnant women, adults who had never used vitamin B, and those not willing to participate in the study were excluded. Results In total, 1,521 adults were recruited. Most of the participants were young Saudi Females. While taking vitamin B supplements, a minority of participants complained of mild gastrointestinal upset, but a significant proportion experienced no side effects. In this study, a significant proportion of participants experienced an increase in appetite, which was associated with a significant increase in BMI after taking vitamin B supplements. This study also explored increases in energy, which were significant and associated with significant increases in sleeping time. Male participants in the present study noticed a significant increase in erectile dysfunction (ED). Conclusions This study found significant effects of vitamin B supplements on BMI, appetite, energy, and sleep, as well as an increase in ED in male participants. More studies are needed to further explore these findings.

The effect of Mediterranean diet instructions on depression, anxiety, stress, and anthropometric indices: A randomized, double-blind, controlled clinical trial

Evidence suggests that adopting a healthy diet, such as the Mediterranean Diet (MD), can positively affect mental health. To further explore this, a study was conducted to determine the impact of MD instruction over 12 weeks on depression, anxiety, stress, and anthropometric indices. The study is a randomized, double-blind, controlled clinical trial with sixty participants who reported stress, anxiety, and depression conducted in Tabriz, Iran (2022-2023). They were randomly assigned to either the intervention group (n = 30), which received MD instruction, or the control group (n = 30), which received standard healthy nutrition education. Both groups were asked to follow their respective nutrition education plans for 12 weeks. After 12 weeks, depression, anxiety, and stress levels were measured using the DASS-21 questionnaire, and anthropometric indices were assessed. Initially, the unadjusted DASS-21 scores for depression, anxiety, and stress did not show significant differences between the two groups. However, after adjusting for baseline variables (model 2), all scores decreased significantly (the P-value for all scores was < 0.001). There was no significant difference in weight and BMI between the intervention and control groups. However, after adjusting the results based on baseline values (Model 2) and adherence to the program (Model 3), weight and BMI were significantly reduced in the MD group (P-values for both cases and both models were < 0.001). Overall, despite some significant findings, the results were not noticeable from a clinical perspective. The study provides some indications that following the Mediterranean diet may lead to improvements in weight and mental well-being.

Associations of dietary methyl donor nutrients with common psychological conditions (depression, anxiety and stress) among reproductive-aged women in Kabul, Afghanistan

BACKGROUND

Higher levels of methyl donor nutrients may be associated with better psychological conditions. Little is known about the association of methyl donor nutrients with psychological conditions among women especially in Asian countries such as Afghanistan.

METHOD

This cross-sectional study was conducted in Kabul, Afghanistan to assess the association of methyl donor nutrients with common psychological conditions (depression, anxiety and stress) among reproductive-aged women using multistage random sampling to choose one health center from each municipality out of four cardinal directions. Finally a sample of 421 reproductive-aged women with a mean BMI of 23.3 ± 5.0 kg/m2 and an age range of 15-45 years were collected. All women's dietary intakes were obtained using a 24-recall questionnaire. Depression, Anxiety and Stress Scale - 21 Items (DASS-21) was used to assess psychological conditions. Chi-square tests and one-way ANOVAs were performed to assess general characteristics. Residual model test while adjusting for energy intake was used to assess nutrient intake of methyl donor nutrients and food groups. We fitted logistic regression models to assess risk for Common mental health problems (CMHPs) based on methyl donor tertiles.

RESULT

We observed that there is no significant association between methyl donor nutrients and psychological disorders in both crude and adjusted models (depression, OR = 0.95, CI: 0.48; 1.88; anxiety, OR = 0.88, CI: 0.43, 1.79; stress, OR = 0.73, CI: 0.38, 1.40), (p > 0.05).

CONCLUSION

Overall, we did not find any significant association between methyl donor nutrients and depression, anxiety and stress.

Adherence to the Mediterranean diet and depression, anxiety, and stress symptoms in Chilean university students: a cross-sectional study

This study aims to determine the association of adherence to the Mediterranean diet and its food groups with depressive symptoms in Chilean university students. The study design was cross-sectional. A total of 934 first-year students at a Chilean public university completed a self-report questionnaire. To assess adherence to Mediterranean diet, an index validated in Chile (Chilean-MDI) was used, and depression, anxiety, and stress symptoms were assessed using the Depression Anxiety and Stress Scale (DASS-21). Logistic regression models were used to analyze the association of adherence to Mediterranean diet and its food groups with depression, anxiety, and stress symptoms adjusted for the main confounders. Students with moderate and high adherence to Mediterranean diet showed lower odds of depression [DASS-21 > 5, odds ratio (OR) = 0.64; 95% confidence interval (95%CI): 0.47-0.88] than those with low adherence to Mediterranean diet. The consumption of 1-2 servings/day of vegetables (OR = 0.63; 95%CI: 0.43-0.92), > 2 servings/week of nuts (OR = 0.41; 95%CI: 0.21-0.80), 1-2 servings/day of fruits (OR = 0.60; 95%CI: 0.42-0.85), 1-2 servings/week of fish and seafood (OR = 0.67; 95%CI: 0.48-0.94), and 1/2-3 units/week of avocado (OR = 0.67; 95%CI: 0.48-0.93) showed low odds of depressive symptoms. The consumption of whole grains and cereals (> 2 servings/day) (OR = 1.63; 95%CI: 1.02-2.61) showed the opposite association. Adherence to Mediterranean diet and consumption of fruits, vegetables, nuts, avocado, fish, and seafood are associated with a lower likelihood of depression in Chilean university students. New policies and educational strategies are recommended to improve diet quality and the mental health of the entire university community.

Body mass index modifies the relationship between dietary iron intake and depressive symptoms among adults: A national population-based cohort

BACKGROUND

Research on the effects of dietary iron intake on depression is limited and controversial. The aim of this study was to explore the association between iron intake and the prevalence of depressive symptoms.

METHODS

The present study used cross-sectional data from people who participated in the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2016. Logistic regression models and restricted cubic spline models were applied to investigate the relationship between iron intake and depressive symptoms.

RESULTS

A total of 16,098 adults aged 20 years or older were included in this study. Compared with individuals with lowest iron intake Q1 (≤8.31 mg/day), the adjusted OR values for dietary iron intake and depression in Q2 (8.32-11.47 mg/day), Q3 (11.48-15.02 mg/day), Q4 (15.03-20.28 mg/day), and Q5 (≥20.29 mg/day) were 0.69 (95 % CI: 0.52-0.91), 0.68 (95 % CI: 0.50-0.94,), 0.59 (95 % CI: 0.42-0.82,), and 0.63 (95 % CI: 0.40-0.98), respectively. The relationship between iron intake and depressive symptoms exhibited a non-linear. Our findings suggested an interaction between body mass index (BMI) and iron intake (P = 0.03). Additionally, the relationship between dietary iron intake and depressive symptoms in adults with a BMI <25 kg/m2 was U-shaped. And the OR of developing depressive symptoms was 0.93 (95 % CI: 0.87-0.99) in individuals with iron intake ≤19.72 mg/day.

LIMITATIONS

Cross-sectional study and relevant data was based on self-reports.

CONCLUSION

A higher iron intake is significantly associated with a decreased prevalence of depressive symptoms, and different levels of BMI can modify the association between them.

The Effect of Rare-Earth Elements on the Morphological Aspect of Borate and Electrocatalytic Sensing of Biological Compounds

Adjusting the morphological characteristics of a material can result in improved electrocatalytic capabilities of the material itself. An example of this is the introduction of rare-earth elements into the borate structure, which gives a new perspective on the possibilities of this type of material in the field of (bio)sensing. In this paper, we present the preparation of borates including La, Nd and Dy and their application for the modification of a glassy carbon electrode, which is used for the non-enzymatic detection of a biologically relevant molecule, vitamin B6 (pyridoxine). Compared with the others, dysprosium borate has the best electrocatalytic performance, showing the highest current and the lowest impedance, respectively, as determined using cyclic voltammetry and impedance tests. Quantitative testing of B6 was performed in DPV mode in a Britton-Robinson buffer solution with a pH of 6 and an oxidation potential of about +0.8 V. The calibration graph for the evaluation of B6 has a linear range from 1 to 100 μM, with a correlation coefficient of 0.9985 and a detection limit of 0.051 μM. The DyBO3-modified electrode can be used repeatedly, retaining more than 90% of the initial signal level after six cycles. The satisfactory selectivity offered a potential practical application of the chosen method for the monitoring of pyridoxine in artificially prepared biological fluids with acceptable recovery. In light of all the obtained results, this paper shows an important approach for the successful design of electrocatalysts with tuned architecture and opens new strategies for the development of materials for the needs of electrochemical (bio)sensing.

Lower alanine aminotransferase levels are associated with increased all-cause and cardiovascular mortality in nonalcoholic fatty liver patients

BACKGROUND

Serum alanine aminotransferase (ALT) levels are often considered a marker to evaluate liver disease and its severity.

AIM

To investigate the association between ALT levels and all-cause and cause-specific mortality in patients with nonalcoholic fatty liver disease (NAFLD).

METHODS

The Third National Health and Nutrition Examination Survey (NHANES-III) from 1988 to 1994 and NHANES-III-related mortality data from 2019 onward were used to obtain the necessary data for the study. NAFLD was defined as hepatic steatosis, as diagnosed by ultrasound, with no other liver diseases. ALT levels were categorized into four groups according to the different recommended upper limits of normal (ULN) in men and women: < 0.5 ULN, 0.5-1 ULN, 1-2 ULN, and ≥ 2 ULN. The hazard ratios for all-cause mortality and cause-specific mortality were analyzed using the Cox proportional hazard model.

RESULTS

Multivariate logistic regression analysis demonstrated that the odds ratio of NAFLD correlated positively with increased serum ALT levels. In patients with NAFLD, all-cause mortality and cardiovascular mortality were the highest when ALT was < 0.5 ULN, yet cancer-related mortality was the highest when ALT was ≥ 2 ULN. The same results could be found in both men and women. Univariate analysis showed that severe NAFLD with normal ALT levels had the highest all-cause and cause-specific mortality, but the difference was not statistically significant after adjustment for age and multivariate factors.

CONCLUSION

The risk of NAFLD was positively correlated with ALT level, but all-cause and cardiovascular mortality were the highest when ALT was < 0.5 ULN. Regardless of the severity of NAFLD, normal or lower ALT levels were associated with higher mortality than elevated ALT levels. Clinicians should be aware that high ALT levels indicate liver injury, but low ALT levels are associated with a higher risk of death.

The Brain-Gut-Microbiota Interplay in Depression: a key to design innovative therapeutic approaches

Depression is the most prevalent mental disorder in the world associated with huge socio-economic consequences. While depressive-related symptoms are well known, the molecular mechanisms underlying disease pathophysiology and progression remain largely unknown. The gut microbiota (GM) is emerging as a key regulator of the central nervous system homeostasis by exerting fundamental immune and metabolic functions. In turn, the brain influences the intestinal microbial composition through neuroendocrine signals, within the so-called gut microbiota-brain axis. The balance of this bidirectional crosstalk is important to ensure neurogenesis, preserve the integrity of the blood-brain barrier and avoid neuroinflammation. Conversely, dysbiosis and gut permeability negatively affect brain development, behavior, and cognition. Furthermore, although not fully defined yet, changes in the GM composition in depressed patients are reported to influence the pharmacokinetics of common antidepressants by affecting their absorption, metabolism, and activity. Similarly, neuropsychiatric drugs may shape in turn the GM with an impact on the efficacy and toxicity of the pharmacological intervention itself. Consequently, strategies aimed at re-establishing the correct homeostatic gut balance (i.e., prebiotics, probiotics, fecal microbiota transplantation, and dietary interventions) represent an innovative approach to improve the pharmacotherapy of depression. Among these, probiotics and the Mediterranean diet, alone or in combination with the standard of care, hold promise for clinical application. Therefore, the disclosure of the intricate network between GM and depression will give precious insights for innovative diagnostic and therapeutic approaches towards depression, with profound implications for drug development and clinical practice.

How Soon Do Depression and Anxiety Symptoms Improve after Bariatric Surgery?

Depression and anxiety are prevalent among bariatric surgery candidates, yet little is known about the course of symptoms after surgery. This study aimed to identify how soon changes in depression and anxiety occur after surgery. A retrospective review of patients treated at a university hospital was conducted. Participants attended a presurgical psychological evaluation, completed surgery, and attended follow-up visits with bariatric medical providers (2 weeks, 6 weeks, 3 months, and 6 months postoperatively). Depression and anxiety symptoms were assessed at all time points by the Patient-Reported Outcomes Measurement Information System (PROMIS) Depression and Anxiety. Generalized estimating equations models with repeated measures by person over time were used to examine change in depression and anxiety symptoms across time. Among 27 patients, anxiety (incident rate ratio (IRR) = 0.81, p = 0.04) and depression (IRR = 0.78, p = 0.05) significantly improved both 6 weeks and 3–6 months after bariatric surgery, after controlling for education, marital status, surgery type, age, and baseline body mass index. This is the first known study to show faster improvement in anxiety compared to depression after bariatric surgery. Understanding reductions in anxiety and depression symptoms may be important for postoperative care and timing of weight maintenance interventions.

The Effect of Dairy Products and Nutrient Intake after Childbirth on the Risk of Postpartum Depression

Previous studies have shown an association between the intake of dairy products during pregnancy and reduced symptoms of postpartum depression (PPD). However, the effect of postpartum intake of dairy products on PPD is not fully understood. This study evaluates the effects of dairy products and nutrient intake after childbirth on the risk of PPD. A cross-sectional survey-based study was conducted asking participants to fill out a food frequency questionnaire (FFQ) to assess intake of dairy products and other nutrients. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen for PPD symptoms. Out of 530 participants, almost three-quarters subjectively reported PPD (N = 395, 74.11%). The risk of PPD was relatively high for a Q1 level of consumption of all four dairy products and other nutrients, and from Q2 to Q4 there appeared to be an increase in the risk of PPD as consumption increased. However, after adjustment for confounding factors, there was no significant association between postpartum intake of dairy products and other nutrients and PPD. The results indicate that the potential of dairy products and nutrient intake to reduce PPD are minimal. Further longitudinal and intervention studies of dairy products and other (particularly anti-depressants) nutrients are required to draw firm conclusions about their associations with the risk of PPD.

Vitamin B12, homocysteine, and folic acid in patients suffering from bipolar disorders: Relationship with suicide

OBJECTIVES

Vitamin B12, folic acid, and homocysteine play a key role in 'one-carbon metabolism', involved in different brain processes. Altered levels have been reported in mood disorders (MDs), particularly in major depression (MDD), while the information in bipolar disorders (BDs) is limited. The present study aimed at assessing vitamin B12, homocysteine, and folic acid in 69 bipolar inpatients.

METHODS

Twenty-seven patients were diagnosed with BDI, 15 BDII, 16 schizoaffective disorders, and 11 MDD, according to DSM-5 criteria. The clinical picture was assessed by the MINI, HRSD, YMRS, and CGI. The blood parameters were measured according to common clinical-chemical methods.

RESULTS

Thirty-four patients had significantly lower vitamin B12, and 14 higher homocysteine levels than normative values. Folic acid levels were normal in the majority of the sample. Patients with a family history of suicide showed significantly lower levels of vitamin B12.

CONCLUSIONS

Our results underline the utility of assessing vitamin B12, homocysteine, and folic acid in patients with BD. Although other studies are necessary, the present findings that lower levels of vitamin B12 seem typical of patients with a family history of suicide independently from the phase of illness suggest that they might constitute a possible predictor of suicide.

Nutrient deficiency profiles and depression: A latent class analysis study of American population

BACKGROUND

Research into the effects of nutrition on depression is often performed by examining the effects of singular nutrients and dietary styles (e.g.: vegan, Mediterranean). The present study is the first one to establish the effects of patterns of nutritional deficiency within the American population and examines their effects on depression.

METHODS

Data was drawn from National Health and Nutrition Examination Survey (NHANES). Latent class analysis was performed to identify homogeneous groups of nutrient deficiency. A 3-step analysis was performed to establish class-dependant differences in depression severity. BCH analysis revealed unique predictors of depression dependant on most probable class.

RESULTS

Analysis revealed 4 classes of nutrient deficiency. Magnesium and dietary fibre were the least endorsed. 'Nutrient deprived' individuals showed the highest depression severity (Mean = 4.137, SD = 0.337). Profiles were predicted by different socioeconomic and anthropogenic predictors with meeting minimum calories showing the strongest odds of not being nutrient deprived (OR between 5.44 and 11.11). Overall, age (β = -0.115, p ≤ 0.01) and income (β = -0.147, p ≤ 0.01) were the strongest protecting factors while being female (β = 0.128, p ≤ 0.01) and arthritis (β = 0.130, p ≤ 0.01) were the strongest risk factors.

LIMITATIONS

The study involved binary variables based on minimum daily intakes and did not account for positive effects of exceeding minimum recommended doses.

CONCLUSIONS

The study supports the notion of a negative relationship between good nutrition and depression. Finding unique risk factors for depression symptoms supports the utility of nutrient deficiency profiling.

Adherence to dietary approaches to stop hypertension (DASH) diet in relation to psychological function in recovered COVID-19 patients: a case–control study

Background

Follow-up of patients after recovery from coronavirus disease 2019 (COVID-19) and identifying the adverse effects of the disease in other organs is necessary. Psychiatric symptoms can persist after patients recover from the infection.

Aim

We aimed to examine the adherence to the dietary approach to stop hypertension (DASH) diet in relation to psychological function in individuals who have recovered from COVID-19.

Method

This case–control study was conducted on 246 eligible adults (123 cases and 123 controls). A valid and reliable food frequency questionnaire (FFQ) was used to determine dietary intake. Depression, anxiety and stress, insomnia, sleep quality, and quality of life of participants were evaluated using DASS, Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), and SF-36 questionnaires, respectively.

Results

There was a significant inverse correlation between total depression score with vegetables, depression, anxiety, and stress score and dietary intake of nuts, legumes, and whole grains (p < 0.05). There was a significant positive correlation between stress scores and the intake of red and processed meat (P < 0.05). In multivariate-adjusted regression model, a significant association was found between adherence to DASH diet and depression and stress only in case group (OR = 0.7863, 95% CI 0.746–0.997, p = 0.046 and OR = 0.876, 95% CI 0.771–0.995, p = 0.042, respectively).

Conclusion

Adherence to a DASH diet might be associated with depression and stress reduction in recovered COVID-19 patients.

Dietary methyl donor micronutrients intake in relation to psychological disorders in adults

Previous investigations have mostly studied an individual methyl donor nutrient in relation to psychological disorders and the findings were inconsistent. We investigated the association of methyl donor micronutrients (folate, B₆, B₁₂, choline, betaine and methionine) with psychological disorders in Iranian adults. In this cross-sectional study, dietary intakes of 3299 adults were collected using a validated food frequency questionnaire. Methyl donor micronutrient score (MDMS) was calculated based on energy-adjusted deciles of each nutrient. Hospital Anxiety and Depression Scale (HADS) and General Health Questionnaire (GHQ), validated for Iranians, have been applied to assess depression, anxiety and psychological distress. Participants had a mean age of 36·3 ± 7·9 years, of whom 58·5 % were women. After considering potential confounders, adults in the top quartile of MDMS, compared to the bottom one, had decreased odds of anxiety (OR: 0·53, 95 % CI: 0·37, 0·75), depression (OR: 0·75, 95 % CI: 0·58, 0·97) and psychological distress (OR: 0·61, 95 % CI: 0·46, 0·80). Among women, the top quartile of MDMS was protectively associated with anxiety (OR: 0·60, 95 % CI: 0·40, 0·90), depression (OR: 0·68, 95 % CI: 0·50, 0·93) and psychological distress (OR: 0·53, 95 % CI: 0·38, 0·74). Overweight and obese subjects in the highest quartile of MDMS had a 67 %, 35 % and 53 % lower odds of anxiety (95 % CI: 0·20, 0·56), depression (95 % CI: 0·44, 0·94) and psychological distress (95 % CI: 0·31, 0·70), respectively. We found that high consumption of methyl donor micronutrients was related to a reduced odds of psychological disorders, especially in women and overweight or obese individuals.

Dietary choline is inversely associated with depressive symptoms: A cross-sectional study of the National Health and Nutrition Examination Survey (NHANES) 2011 to 2018

BACKGROUND

Dietary choline has neuroprotective actions. However, the relationship between dietary choline and depression has been little studied.

METHODS

We conducted a cross-sectional study to explore the association between dietary choline and depressive symptoms in US adults, using data from the 2011 to 2018 National Health and Nutrition Examination Survey (NHANES). 12,906 individuals age ≥20 who had valid information on dietary choline and depressive symptoms were chosen. Depressive symptoms were defined as the score ≥10 of the Patient Health Questionnaire-9 (PHQ-9). Multivariable logistic regression and the restricted cubic splines were used in analyses.

RESULTS

In three models, compared with the bottom quintile, each quintile of dietary choline was significantly associated with a lower risk of depressive symptoms. After adjusted all selected confounding factors and covariates, the odds ratio with the 95% confidence interval of depressive symptoms was 0.57 (95% CI:0.38-0.85) for the highest quintile versus the lowest quintile of dietary choline intake. Statistical significance was also maintained in gender and age stratification studies. In the study of the dose-response relationship, an L-shaped relationship between dietary choline and depressive symptoms was found.

LIMITATIONS

Causality cannot be inferred in a cross-sectional study.

CONCLUSION

In this analysis of US adults, dietary choline intake is inversely associated with the risk of depressive symptoms. An L-shape dose-response relationship between those two was found. Further studies are needed to confirm our results.

The role of selenium in depression: a systematic review and meta-analysis of human observational and interventional studies

The results of human studies are inconsistent regarding selenium and depressive disorders. Therefore, we aimed to conduct a systematic review and meta-analysis of observational and interventional studies and provided an overview of the role of selenium in depression. Three databases including Medline, Scopus, and Web of Science were searched on June 30, 2020 and updated on April 12, 2021. Also, we searched in electronical databases of WHO Global Index Medicus and ClinicalTrials.gov. No time or language restrictions were used for the search. A random effects model was used to pool effect sizes. In total, 20 studies were included in the systematic review, and 15 studies were included in the meta-analysis. There were no significant differences in serum selenium levels between patients with depression and healthy subjects (WMD: 2.12 mg/L; 95% CI: - 0.11, 4.36; I2 = 98.0%, P < 0.001). Also, no significant correlation was found between serum levels of selenium and depression scores (r: - 0.12; 95% CI: - 0.33, 0.08; I2 = 73.5%, P = 0.010). Nevertheless, there was a significant negative association between high selenium intake and the risk of postpartum depression (OR: 0.97; 95% CI: 0.95, 0.99; I2 = 0.0%, P = 0.507). In addition, selenium supplementation significantly reduced depressive symptoms (WMD: - 0.37; 95% CI: - 0.56, - 0.18; I2 = 0.0%, P = 0.959). Taken these results together, selenium seems to have a protective role against postpartum depression and can be considered as a beneficial adjuvant therapy in patients with depression. Further studies are necessary to draw definitive conclusions.

Can Nutrients and Dietary Supplements Potentially Improve Cognitive Performance Also in Esports?

Factors influencing brain function and cognitive performance can be critical to athletic performance of esports athletes. This review aims to discuss the potential beneficial effects of micronutrients, i.e., vitamins, minerals and biologically active substances on cognitive functions of e-athletes. Minerals (iodine, zinc, iron, magnesium) and vitamins (B vitamins, vitamins E, D, and C) are significant factors that positively influence cognitive functions. Prevention of deficiencies of the listed ingredients and regular examinations can support cognitive processes. The beneficial effects of caffeine, creatine, and probiotics have been documented so far. There are many plant products, herbal extracts, or phytonutrients that have been shown to affect precognitive activity, but more research is needed. Beetroot juice and nootropics can also be essential nutrients for cognitive performance. For the sake of players’ eyesight, it would be useful to use lutein, which, in addition to improving vision and protecting against eye diseases, can also affect cognitive functions. In supporting the physical and mental abilities of e-athletes the base is a well-balanced diet with adequate hydration. There is a lack of sufficient evidence that has investigated the relationship between dietary effects and improved performance in esports. Therefore, there is a need for randomized controlled trials involving esports players.

Associations of depression and intake of antioxidants and vitamin B complex: Results of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

BACKGROUND

Optimum functioning of the central nervous system is dependent on a wide range of nutrients, so mental illness can be impacted by diet via several mechanisms. We aimed to investigate the associations of antioxidants (vitamin A, C and E, and selenium and zinc) and vitamin B complex (B6, folate and B12) intake with depression in 14,737 subjects of the Brazilian Longitudinal Study of Adult Health.

METHODS

Baseline cross-sectional data was analyzed. Micronutrients intake was measured using the Food Frequency Questionnaire, and depression was assessed using the Clinical Interview Schedule Revised. Logistic regression models were built using daily intake quintiles of micronutrients.

RESULTS

A significant inverse relationship was observed between depression and higher intake of selenium, zinc, vitamins B6 and B12 for the total sample. Among women, a similar pattern of associations was observed, in addition to the higher intake of vitamins A and C. Among men, a significant inverse relationship between depression was observed only with the intake of vitamins B12 and B6. Higher total antioxidant intake was significantly associated with lower odds of depression and an inverse dose-response effect between total antioxidant intake and clinical severity of depression was observed among women, in adjusted models.

LIMITATIONS

Recall bias in assessing diet. Misclassification bias regarding current depression.

CONCLUSIONS

Depression is associated with lower intake of antioxidants and B vitamins. Higher intake of selected micronutrients may contribute to reduce depression occurrence and severity.

Differential Effects of Sleep Disturbance and Malnutrition on Late-Life Depression Among Community-Dwelling Older Adults

BACKGROUND

Late-life depression is a complex phenomenon that cannot be fully understood simply as depression occurring in older adults, prompting researchers to suggest that it represents a component of geriatric syndrome. Given the inherent complexity and multifactorial nature of geriatric syndrome, understanding the interactions between the comorbid conditions involved is important for establishing appropriate preventive strategies. While sleep disturbance and malnutrition are common manifestations of geriatric syndrome, they have also been regarded as indicators of late-life depression. However, the differential effects of sleep disturbance and malnutrition on late-life depression and their interrelationships remain unclear.

OBJECTIVE

The objective of this study was to examine the effects of sleep disturbance and malnutrition on depression and the interactions between them among community-dwelling older adults.

METHODS

Sleep disturbance and malnutrition in 1,029 community-dwelling older adults from Suwon Geriatric Mental Health Center were assessed using the Pittsburgh Sleep Quality Index (PSQI) and Mini Nutritional Assessment (MNA), respectively. The Korean version of the Short Form of the Geriatric Depression Scale (SGDS-K) was used to evaluate depressive symptoms. Sociodemographic parameters were recorded. A multiple linear regression analysis was conducted to examine the effects of sleep and nutrition on depressive symptoms after adjusting for covariates. The effect size and conditional effects of sleep disturbance and malnutrition on late-life depression were assessed using Cohen's f² values and the Johnson-Neyman technique, respectively.

RESULTS

After possible confounders were adjusted, the SGDS-K score was positively associated with the PSQI score (standardized beta = 0.166, P < 0.001) and negatively associated with the MNA score (standardized beta = -0.480, P < 0.001). The local effect size of the associations was small for PSQI and medium for MNA. A significant interaction was observed between the PSQI and MNA scores. The result of the Johnson-Neyman technique indicated that the influence of PSQI on SGDS-K became weaker and insignificant as nutritional status worsened. However, the association between the MNA and SGDS-K scores was significant regardless of PSQI.

CONCLUSION

Both sleep disturbance and malnutrition were significantly associated with late-life depression, although malnutrition may be more critically associated with depression than sleep disturbance in community-dwelling older adults.

Can Vitamin B6 Help to Prevent Postpartum Depression? A Randomized Controlled Trial

Background

A low level of vitamin B6 may theoretically cause symptoms of depression.

Aims

To investigate the effect of vitamin B6 on the prevention of postpartum depression (PPD) among mothers at risk for PPD.

Methods

This single-blind, placebo-controlled clinical trial was conducted on 81 pregnant women who were at risk of PPD from February to July 2016 at six selected health centers in Isfahan, Iran. A simple random sampling method was adopted. Forty cases and 41 controls received 80 mg vitamin B6 and placebo, respectively from the 28^th week until the end of pregnancy. The risk of PPD was assessed as the main inclusion criteria using a structured clinical interview using hospital anxiety-depressive scale (HADS), social support appraisals scale (SS-A), and Holmes and Rahe life change and stress evaluation questionnaire (HRLCSEQ). The Edinburgh postpartum depression scale (EPDS) was used to assess the rate of depression prior to and 1.5 months after the intervention (end of pregnancy). Data were analyzed using SPSS 20 and statistical tests (Chi-square, independent t-test, Mann-Whitney's, and Exact Fisher Test).

Results

Forty-three subjects were assigned to each group and the final analysis comprised 81 subjects (40 in the case and 41 in the control groups), the mean age of the case and control groups being 5.8 ± 29.6 and 4.6 ± 28.2, respectively. The mean depression score was 10.4 ± 1.4 in the case and 9.3 ± 4.2 in control groups (P = 0.34) before and 4.2 ± 2.7 in the case and 10.4 ± 3.4 in control groups (P < 0.001) after intervention.

Conclusions

Vitamin B6 has a positive effect on reducing postpartum depression scores among mothers at risk for PPD. These may be clinically useful for preventing PPD in high-risk women.

Healthy diet, depression and quality of life: A narrative review of biological mechanisms and primary prevention opportunities

Unipolar depressive disorder (UDD) affects more than 264 million people worldwide and was projected well before the severe acute respiratory syndrome coronavirus 2 pandemic to be the leading cause of disability-adjusted life years lost in 2030. It is imperative for leading economies to implement preventive strategies targeted towards UDD, given consistent policies are currently lacking. Recently established similarities between the aetiological hypotheses of depression and cardiometabolic diseases are shifting paradigms within this field. It is believed that dietary practices could potentially reduce the incidence of depression; similar to their effects on metabolism. Thus, the aim of this review was to compile current evidence on healthy dietary patterns as suitable contributors towards primary prevention strategies against UDD. Most of the well-known biological mechanisms behind depression have been positively associated with healthful diets and dietary patterns to varying degrees. Interestingly, a common factor of UDD is the production and overall effects of inflammatory cytokines, such as interleukin-6, tumor necrosis factor-α, and C-reactive protein. These compounds have been associated with depressive symptoms, disturbances in neuroendocrine function, leaky gut, monoamine activity and brain function, while also being key factors in the development of cardiometabolic diseases. The Mediterranean diet (MD) in particular, is well supported by first-level evidence regarding its preventive qualities against metabolic and cardiovascular diseases and thus considered a model for healthy eating by various organizations. In one of the few clinical trials investigating these associations, the PREDIMED trial, individuals with diabetes assigned to a MD supplemented with mixed tree nuts experienced a 41% relative risk reduction for developing depression. Lastly, there is a need to include health related quality of life as an indicator of physical and mental well-being, considering its putative associations with depression and suicide risk. Going forward, focusing on clinical trials, using precise nutritional assessments, and identifying nutritional biomarkers which may be related to depression are needed to fully support the implementation of dietary recommendations in the field of psychiatry.

Eating alone and depressive symptoms among the Japanese working population: The Furukawa nutrition and health study

The aim of this study was to determine the cross-sectional associations between frequency of eating with others and depressive symptoms in Japanese employees while accounting for lifestyle and dietary factors. We also examined the relationship with stratification by living arrangement. Participants were 1876 workers aged 18-74 years who participated in a health survey at a periodic checkup. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression scale. Frequency of eating with others was categorized into ranges between daily and <1 day/week. Associations between frequency of eating with others and depressive symptoms were assessed using logistic regression analysis, with adjustment for lifestyle and dietary factors. The prevalence of depressive symptoms was 32.9%. The prevalence of depressive symptoms tended to increase with decreasing frequency of eating with others, with multivariate-adjusted odds ratios (95% confidence intervals) for the highest through lowest frequency groups of eating meals with others being 1.00 (reference), 1.27 (0.92-1.74), 1.56 (1.11-2.21), 1.86 (1.29-2.67), and 2.22 (1.53-3.22), respectively (P for trend<0.001). In analysis stratified by living arrangement, a significant association was found with those living with others but not those living alone (P for interaction <0.001). Lower frequency of eating with others may be associated with higher odds of depressive symptoms among Japanese workers living with others, even after controlling for lifestyle and dietary factors.

Hyperhomocysteinemia: Metabolic Role and Animal Studies with a Focus on Cognitive Performance and Decline-A Review

Disturbances in the one-carbon metabolism are often indicated by altered levels of the endogenous amino acid homocysteine (HCys), which is additionally discussed to causally contribute to diverse pathologies. In the first part of the present review, we profoundly and critically discuss the metabolic role and pathomechanisms of HCys, as well as its potential impact on different human disorders. The use of adequate animal models can aid in unravelling the complex pathological processes underlying the role of hyperhomocysteinemia (HHCys). Therefore, in the second part, we systematically searched PubMed/Medline for animal studies regarding HHCys and focused on the potential impact on cognitive performance and decline. The majority of reviewed studies reported a significant effect of HHCys on the investigated behavioral outcomes. Despite of persistent controversial discussions about equivocal findings, especially in clinical studies, the present evaluation of preclinical evidence indicates a causal link between HHCys and cognition-related- especially dementia-like disorders, and points out the further urge for large-scale, well-designed clinical studies in order to elucidate the normalization of HCys levels as a potential preventative or therapeutic approach in human pathologies.

The association between dairy products and psychological disorders in a large sample of Iranian adults

BACKGROUND

Dairy products contain certain nutrients that are useful in mental disorders. This study aimed to assess the associations between dairy products and psychological disorders in a large sample of Iran, a Middle Eastern country.

METHODS

This cross-sectional study was undertaken on 7387 adults. Data on dietary intakes were obtained using a validated Food Frequency Questionnaire. Psychological health was assessed by the Iranian validated version of depression, anxiety, and stress scale 21. Multivariable logistic regression analysis was performed to analyze the association between dairy intake and psychological disorders.

RESULTS

After adjustment for potential confounders, total milk consumption (OR for the highest vs. lowest tertile: 0.73, 0.58-0.92) and total yogurt consumption (0.78, 0.62-0.97) were associated with decreased odds of depression. An inverse relationship was found between total dairy (0.73, 95% CI 0.590.91), total milk (0.72; 0.58-0.88), kashk (0.79, 0.65-0.96), and yogurt drink (0.80, 95% CI 0.65-0.98) consumption and anxiety symptoms. Higher intake of cheese was related to greater odds of stress (1.52, 1.02-2.26). No association was found between the consumption of high-fat dairy, low-fat dairy, low-fat milk, low-fat yogurt, high-fat yogurt, cheese, kashk, yogurt drink, and depression. Also, there is no association between dairy products and stress symptoms. This association was significant among men and women and high-fat and low-fat products in the total adjusted stratified analysis models.

CONCLUSIONS

Findings of this study revealed that both high-fat and low-fat dairy products are associated with a reduced prevalence of psychological disorders. Still, more prospective studies are required to confirm these associations.

Associations between nutrition and the incidence of depression in middle-aged and older adults: A systematic review and meta-analysis of prospective observational population-based studies

AIM

To systematically examine the longitudinal observational evidence between diet and the incidence of depression in adults aged 45 years and older.

METHOD

Three electronic databases were searched for cohort studies published up to December 2020 that investigated the association between baseline dietary intake and incidence of depression in community-dwelling adults aged 45+years. Combined odds ratios (OR) and 95% confidence intervals (95%CI) were calculated. Random-effects models were used.

RESULTS

In total 33 articles were included, with 21 combined in meta-analyses. Both the Dietary Inflammatory Index and the Western diet were associated with an increased odds of incident depression (Dietary Inflammatory Index: OR 1.33; 95%CI 1.04, 1.70; P = 0.02; Western: OR 1.15 95%CI 1.04, 1.26; P = 0.005). Higher fruit and vegetable intakes were associated with a reduced risk of incident depression (vegetables: OR 0.91; 95%CI 0.87, 0.96; P < 0.001; fruit: OR 0.85; 95%CI 0.81, 0.90; P < 0.001). No association was observed between the Mediterranean diet, "healthy" diet, fish intake and incident depression.

CONCLUSIONS

Results suggest an association between higher consumption of pro-inflammatory diets and Western diets and increased incidence of depression, while higher intake of fruit and vegetables was associated with decreased incidence of depression. These results are limited by the observational nature of the evidence (results may reflect residual confounding) and the limited number of studies. More high-quality intervention and cohort studies are needed to confirm these associations and to extend this work to other food groups and dietary patterns.

Prospective study on the association between serum amino acid profiles and depressive symptoms among the Japanese working population

Objective

Accumulating evidence suggests that amino acids, particularly tryptophan and glutamate, play an important role in the pathology of depression, but prospective epidemiologic data on this issue is scarce. We examined the association between circulating amino acids and the risk of depressive symptoms in a Japanese working population.

Methods

Participants were 841 workers who were free from depressive symptoms and provided blood at baseline and completed 3-yr follow-up survey. 30 varieties of amino acid concentrations in serum were measured using liquid chromatography/mass spectrometry. Depressive symptoms were defined using the Center for Epidemiologic Studies Depression Scale. Logistic regression was used to calculate the odds ratios of depressive symptoms according to serum amino acids with adjustment for lifestyle factors.

Results

A total of 151 (18.0%) workers were newly identified as having depressive symptoms at the follow-up. Baseline tryptophan and glutamate concentrations in serum were not appreciably associated with the risk of depressive symptoms. Risk of depressive symptoms tended to increase with increasing arginine concentrations; the multivariable-adjusted odds ratio for the highest versus lowest tertile of serum arginine was 1.65 (95% confidence interval: 0.96–2.83; P for trend = 0.07). No clear association was found for other amino acids.

Conclusions

Results of the present study do not support a significant role of circulating amino acids in the development of depressive symptoms among Japanese.

Red and White Meat Intake in Relation to Mental Disorders in Iranian Adults

Background: The association between meat consumption and mental disorders is less investigated in Iranian population. We examined the association between meat consumption and prevalence of symptoms of depression, anxiety, and psychological distress in Iranian adults. Methods: This cross-sectional study included 3,362 participants aged 18-55 years old. A dish-based 106-item semiquantitative food frequency questionnaire (FFQ) was used to assess usual dietary intake of study population. Hospital Anxiety and Depression Scale (HADS) and General Health Questionnaire (GHQ), all validated in Iranian population, were applied to collect data on symptoms of anxiety, depression, and psychological distress, respectively. Results: The prevalence of symptoms of depression, anxiety, and psychological distress in the study population was 28.6, 13.6, and 22.6%, respectively. After considering potential confounders, individuals in the top quartile of red meat intake had 43% increased risk of depression symptoms [odds ratio (OR) = 1.43; 95% CI: 1.09-1.89] compared to those in the first quartile. No significant relation was observed between red meat intake and anxiety or psychological distress symptoms. White meat consumption was not associated with mental disorders. Stratified analysis by sex showed that male participants in the highest quartile of red meat intake had 92% greater risk of depression symptoms (95% CI: 1.17-3.15) than those individuals in the lowest category. Red and white meat intake was not associated with mental disorders in women. In overweight or obese individuals, despite lack of any association between red meat intake and mental disorders, high intake of white meat was associated with a lower odds of psychological distress symptoms (OR = 0.64; 95% CI: 0.42-0.99) and a lower risk of depression symptoms (OR = 0.68; 95% CI: 0.45-1.00). In normal-weight participants, those in the highest quartile of red meat intake had greater odds for depression symptoms than those in the lowest quartile (OR = 1.66; 95% CI: 1.14-2.42). Conclusions: We found that red meat consumption was associated with increased risk of depression symptoms, especially in men, and normal-weight participants. In overweight or obese participants, white meat intake was inversely associated with psychological distress symptoms.

The association between adherence to a dietary approaches to stop hypertension (DASH) diet and neuro-psychological function in young women

Background

The adherence to a Dietary Approaches to Stop Hypertension (DASH) diet may have a bidirectional relationship with mental wellbeing. We aimed to evaluate the association between compliance with a DASH diet and neuro-psychological function in young women.

Methods

In this cross-sectional study, a total of 181 girls aged between 18 and 25 years were recruited. The dietary intakes of study participants were evaluated using a valid and reliable food frequency questionnaire (FFQ) containing 65 food items. Neuropsychological function of participants was evaluated using standard questionnaires.

Results

As may be expected, individuals in the highest tertile (T3) of adherence to DASH diet (highest adherence) were found to consume more folate, fruits, vegetables, low fat dairy, nuts, legume, and seed, less sweetened beverage and sodium, compared to the participants in the lowest tertile (T1, lowest adherence). There was a significant negative correlation between cognitive function and consumption of red and processed meat (r = − 0.168; p < 0.05); quality of life score with dietary sodium (r = − 0.151; p < 0.01) and depression score with dietary vegetables (r = − 0.174; p < 0.05). In multivariate multinomial logistic regression analyses adjusted for age, BMI and energy intake, adherence to a DASH-style diet was associated with a lower stress score (OR = 0.70; 95%CI: 0.34–1.47, P = 0.067; T3 vs. T1) and difficulty with sleep initiation (OR = 0.46; 95%CI: 0.21–1.00, P = 0.017; T3 vs. T1).

Conclusion

Adherence to a DASH diet may be associated with reduced stress and difficulty with initiating sleep.

Depression and Vegetarians: Association between Dietary Vitamin B6, B12 and Folate Intake and Global and Subcortical Brain Volumes

Deficiency of vitamin B6 and vitamin B12, mostly in vegetarians, is found to be associated with depression and adverse neurological function. We investigated whether vitamin B6, B12, and folate have an effect on brain structure, especially among depressed people who follow a specific diet. The study sample comprised 9426 participants from the UK Biobank cohort with a mean age of 62.4 years. A generalized linear model controlling for age, sex, body mass index, ethnicity, town send deprivation index, educational qualification, smoking, and alcohol intake was used to test the association between study groups and structural brain volumes. Depression was more prevalent, and intake of vitamin B6 and B12 was lower among vegetarians, while non-vegetarians had a lower intake of folate. Overall, no significant association was observed between vitamin B6, B12, and folate intakes and both global and subcortical brain volumes among participants with depression. However, vitamin B12 intake was positively associated with right pallidum among non-depressed participants, and a significant interaction between vitamin B12 intake and depression status on the right pallidum was observed. Also, a significant interaction between folate intake and depression status on grey matter (GM) volume and left thalamus was observed. Upon diet stratification, folate intake is associated with total brain volume and GM volume among vegetarians with depression. Furthermore, no significant associations were observed for subcortical regions. Our findings suggest that dietary intake of vitamin B6 and B12 might have an effect on brain structure. Vegetarians, particularly those who suffer from depression may benefit from supplementing their diets with vitamins B6, B12, and folate to ensure brain health. Further studies, especially with a larger sample size and longitudinal design, are needed to confirm these findings.

Association of Selenium Intake and Development of Depression in Brazilian Farmers

Introduction: Depression and deficiency in the consumption of micronutrients are a public health problem, especially in the rural population. The deficiency in selenium consumption affects mental health, contributing to the development of major depressive disorders. Thus, this study aimed to evaluate selenium intake and its association with depressive symptoms in farmers in southeastern Brazil. Material and Methods: Epidemiological, cross-sectional, and analytical study with 736 farmers aged between 18 and 59. A semistructured questionnaire was used to collect sociodemographic, lifestyle and clinical condition data. For evaluation of food intake, three 24-h recalls were applied, and for identification of depressive episodes, the Mini-International Neuropsychiatric Interview was conducted. Results: A total of 16.1% (n = 119) of the farmers presented symptoms of major depressive episodes, 5.8% (n = 43) presented symptoms of current depressive episodes, and 10.3% (n = 76) presented symptoms of recurrent major depressive episodes. Sociodemographic factors associated with depression were gender (p < 0.001), marital status (p = 0.004), and socioeconomic class (p = 0.015). The consumption of high doses of selenium was associated with a reduction of ~54% in the chances of occurrence of depression (OR = 0.461; 95% CI = 0.236-0.901). Conclusion: High selenium intake is associated with a lower prevalence of depression even after adjusting for sociodemographic variables, lifestyle, and pesticide intoxication. The findings of this study contributed to highlighting the high prevalence of depression in rural areas and its relationship with selenium intake.

Gut microbiota-derived vitamins - underrated powers of a multipotent ally in psychiatric health and disease

Despite the well-established roles of B-vitamins and their deficiencies in health and disease, there is growing evidence indicating a key role of those nutrients in functions of the central nervous system and in psychopathology. Clinical data indicate the substantial role of B-vitamins in various psychiatric disorders, including major depression, bipolar disorder, schizophrenia, autism, and dementia, including Alzheimer's and Parkinson's diseases. As enzymatic cofactors, B-vitamins are involved in many physiological processes such as the metabolism of glucose, fatty acids and amino acids, metabolism of tryptophan in the kynurenine pathway, homocysteine metabolism, synthesis and metabolism of various neurotransmitters and neurohormones including serotonin, dopamine, adrenaline, acetylcholine, GABA, glutamate, D-serine, glycine, histamine and melatonin. Those vitamins are highly involved in brain energetic metabolism and respiration at the cellular level. They have a broad range of anti-inflammatory, immunomodulatory, antioxidant and neuroprotective properties. Furthermore, some of those vitamins are involved in the regulation of permeability of the intestinal and blood-brain barriers. Despite the fact that a substantial amount of the above vitamins is acquired from various dietary sources, deficiencies are not uncommon, and it is estimated that micronutrient deficiencies affect about two billion people worldwide. The majority of gut-resident microbes and the broad range of bacteria available in fermented food, express genetic machinery enabling the synthesis and metabolism of B-vitamins and, consequently, intestinal microbiota and fermented food rich in probiotic bacteria are essential sources of B-vitamins for humans. All in all, there is growing evidence that intestinal bacteria-derived vitamins play a significant role in physiology and that dysregulation of the "microbiota-vitamins frontier" is related to various disorders. In this review, we will discuss the role of vitamins in mental health and explore the perspectives and potential of how gut microbiota-derived vitamins could contribute to mental health and psychiatric treatment.

Dietary carotenoids intake and depressive symptoms in US adults, NHANES 2015-2016

BACKGROUND

The data for effect of dietary specific carotenoids on depression are limited and controversial. Thus, this study aimed to examine the relationship between dietary carotenoids intakes and the prevalence of depressive symptoms.

METHODS

In the 2015-2016 United States National Health and Nutrition Examination Survey, 4,105 adults with complete data of dietary intake and assessment of depressive symptoms are enrolled. Dietary intake was assessed through two 24-h dietary recall interviews. Depression symptoms were assessed using the nine-item Patient Health Questionnaire. We used logistic regression to assess the relationship between diet carotenoids intake and the prevalence of depressive symptoms, adjusting for the main potential confounders. In addition, daily dietary carotenoids intake was adjusted for daily total energy intake based on the nutrient density model.

RESULTS

We found a significant inverse association between dietary beta-cryptoxanthin intake and depressive symptoms, with lowest prevalence in the third tertile (OR: 0.65, 95% CI: 0.47-0.90, p for trend < 0.001). Dose-response analyses revealed that the prevalence of depressive symptoms decreased with increasing intakes of beta-cryptoxanthin when reached the point above 110 ug/1000 Kcal. No such association was found for alpha-carotene, beta-carotene, lycopene, and lutein/zeaxanthin.

CONCLUSIONS

Increase the intake of beta-cryptoxathin-rich foods might protect from depressive symptoms. Further prospective studies are requested before dietary recommendation.

Nutrition and behavioral health disorders: depression and anxiety

Suboptimal nutrition has been implicated in the underlying pathology of behavioral health disorders and may impede treatment and recovery. Thus, optimizing nutritional status should be a treatment for these disorders and is likely important for prevention. The purpose of this narrative review is to describe the global burden and features of depression and anxiety, and summarize recent evidence regarding the role of diet and nutrition in the prevention and management of depression and anxiety. Current evidence suggests that healthy eating patterns that meet food-based dietary recommendations and nutrient requirements may assist in the prevention and treatment of depression and anxiety. Randomized controlled trials are needed to better understand how diet and nutrition-related biological mechanisms affect behavioral health disorders, to assist with the development of effective evidence-based nutrition interventions, to reduce the impact of these disorders, and promote well-being for affected individuals.

Depressive Symptoms in Middle-Aged and Elderly Women Are Associated with a Low Intake of Vitamin B6: A Cross-Sectional Study

This study investigated the nutritional factors that are associated with anxiety and depressive symptoms in Japanese middle-aged and elderly women. We conducted a cross-sectional study with 289 study participants aged ≥40 years (mean age = 52.0 ± 6.9 years). Their dietary habits, menopausal status and symptoms, and varied background factors, such as body composition, lifestyle factors, and cardiovascular parameters, were assessed. Their anxiety and depressive symptoms were evaluated using the Hospital Anxiety and Depression Scale (HADS), where scores of 0–7 points, 8–10 points, and 11–21 points on either the anxiety or depression subscales were categorized as mild, moderate, and severe, respectively. The dietary consumption of nutrients was assessed using a brief self-administered diet history questionnaire. The relationships between the moderate-to-severe anxiety/depressive symptoms and the dietary intake of 43 major nutrients were investigated using multivariate logistic regression analyses. After adjusting for age, menopausal status, and the background factors that were significantly related to depressive symptoms, moderate and severe depression was significantly inversely associated with only vitamin B6 (adjusted odds ratio per 10 μg/MJ in vitamin B6 intake = 0.89, 95% confidence interval = 0.80–0.99). A higher intake of vitamin B6 could help relieve depressive symptoms for this population.

Vitamin B12 Supplementation: Preventing Onset and Improving Prognosis of Depression

Depression is a common mental health condition occurring across all ages, genders, and populations and is almost always multifaceted. It can manifest as a form of metabolic disorder, endocrine disorder, cardiovascular diseases, inflammatory disorders, deficiencies, or neurodegenerative disorders. Although there have been various treatment options available for the treatment of depression, it is still a sizable global health concern requiring more attention. This review article was produced by researching data and studies to prove a relationship between Vitamin B12 and depression. Numerous studies were reviewed, and based on these studies, it was concluded that supplementation of Vitamin B12 early enough can delay the onset of depression and improve the effect of anti-depressants when used in conjunction with Vitamin B12. Although other vitamins like Vitamin B6 and folate are known to have an impact on depression, we have primarily focused on Vitamin B12 in an attempt to offer the providers a foundation to address this concern with their patients prone to depression or have had a major depressive episode in their life.

Autoreceptor control of serotonin dynamics

BACKGROUND

Serotonin is a neurotransmitter that has been linked to a wide variety of behaviors including feeding and body-weight regulation, social hierarchies, aggression and suicidality, obsessive compulsive disorder, alcoholism, anxiety, and affective disorders. Full understanding involves genomics, neurochemistry, electrophysiology, and behavior. The scientific issues are daunting but important for human health because of the use of selective serotonin reuptake inhibitors and other pharmacological agents to treat disorders. This paper presents a new deterministic model of serotonin metabolism and a new systems population model that takes into account the large variation in enzyme and transporter expression levels, tryptophan input, and autoreceptor function.

RESULTS

We discuss the steady state of the model and the steady state distribution of extracellular serotonin under different hypotheses on the autoreceptors and we show the effect of tryptophan input on the steady state and the effect of meals. We use the deterministic model to interpret experimental data on the responses in the hippocampus of male and female mice, and to illustrate the short-time dynamics of the autoreceptors. We show there are likely two reuptake mechanisms for serotonin and that the autoreceptors have long-lasting influence and compare our results to measurements of serotonin dynamics in the substantia nigra pars reticulata. We also show how histamine affects serotonin dynamics. We examine experimental data that show very variable response curves in populations of mice and ask how much variation in parameters in the model is necessary to produce the observed variation in the data. Finally, we show how the systems population model can potentially be used to investigate specific biological and clinical questions.

CONCLUSIONS

We have shown that our new models can be used to investigate the effects of tryptophan input and meals and the behavior of experimental response curves in different brain nuclei. The systems population model incorporates individual variation and can be used to investigate clinical questions and the variation in drug efficacy. The codes for both the deterministic model and the systems population model are available from the authors and can be used by other researchers to investigate the serotonergic system.

Associations between dietary intake of B-vitamins and psychological disorders among Iranian women: a cross-sectional study

OBJECTIVE

B-vitamins affect brain function through multiple pathways. Given limited evidence on the relationship between dietary intake of these vitamins and psychological disorders, we examined dietary intake of vitamin B6-9-12 in relation to psychological disorders among Iranian women.

DESIGN

Cross-sectional study. Dietary intake was assessed using a valid and reliable FFQ. To assess psychological disorders, we used a version of the Depression Anxiety Stress Scale-21 validated in Iran.

SETTING

Ten public health centres in southern Tehran, Iran.

PARTICIPANTS

A total of 447 female participants aged 20-50 years.

RESULTS

The median values of vitamin B6 (pyridoxine), B9 (folate) and B12 (cobalamin) were 1·30 mg/d, 313·89 µg/d and 3·99 µg/d, respectively. After adjustment for potential confounders, dietary vitamin B6 intake was associated with lower odds of depression (OR: 0·54; 95 % CI: 0·31, 0·95; Ptrend: 0·03). However, there was a positive association between dietary vitamin B12 intake with the odds of depression (OR: 2·05; 95 % CI: 1·17, 3·60; Ptrend: 0·01) and psychological distress (OR: 2·00; 95 % CI: 1·17, 3·41; Ptrend: 0·01). No association was found between vitamin B9 with any psychological disorders.

CONCLUSIONS

Women with higher dietary intakes of vitamin B6 had lower likelihood of depression. However, women with higher dietary intake of vitamin B12 had higher odds of depression and psychological distress. Future prospective studies in different populations are needed to clarify whether B-vitamin deficiency is a cause or consequence of psychological disorders.

Dietary intake and risk of depression among male and female with HIV/AIDS

PURPOSE

Depression is the most common mental disorder among subjects with HIV. The present study was conducted to determine the relationship between dietary intake and depression among male and female with HIV/AIDS.

METHODS

335 HIV/AIDS subjects were evaluated who referred to Behavioral Disorders Counseling Center in Kermanshah, province in Iran. Depression was assessed using Beck questionnaire. Food frequency questionnaire was used to assess dietary intake.

RESULTS

Our findings indicated that 76.1% of the studied subjects had varying degrees of depression. The rate of depression in the men was significantly higher than in the women (P = 0.007). The mean of weight in the men with depression was significantly lower than of the men without depression (P = 0.01). Higher adhere to legume and vegetables in the men (OR 0.049, CI 95% 0.003-0.713 and OR 0.534, CI 95% 0.334-0.855, respectively) and dairy products in the women (OR 0.493, CI 95% 0.265-0.917) were associated with decrease risk of depression.

CONCLUSION

The results of this study were shown that the high prevalence of depression among these subjects. Higher intake of legume and vegetables and dairy products had a protective effect on the risk of depression.

LEVEL OF EVIDENCE

Level V, descriptive cross-sectional study.

Revised D-A-CH Reference Values for the Intake of Vitamin B6

BACKGROUND

The Nutrition Societies of Germany, Austria, and Switzerland as the joint editors of the "D-A-CH reference values for nutrient intake" have revised the reference values for vitamin B6 in summer 2019.

SUMMARY

For women, the average requirement (AR) for vitamin B6 intake was derived on the basis of balance studies using a pyridoxal-5'-phosphate (PLP) plasma concentration of ≥30 nmol/L as a biomarker of an adequate vitamin B6 status. The recommended intake (RI) was derived considering a coefficient of variation of 10%. The RIs of vitamin B6 for men, children, and adolescents were extrapolated from the vitamin B6 requirement for women considering differences in body weight, an allometric exponent, growth factors as appropriate, and a coefficient of variation. For infants aged 0 to under 4 months, an estimated value was set based on the vitamin B6 intake via breast feeding. The reference value for infants aged 4 to under 12 months was extrapolated from the estimated value for infants under 4 months of age and the average vitamin B6 requirement for adults. The reference values for pregnant and lactating women consider the requirements for the foetus and the loss via breast milk. Key Messages: According to the combined analysis of 5 balance studies, the AR for vitamin B6 to ensure a plasma PLP concentration of ≥30 nmol/L is 1.2 mg/day for adult females and the extrapolated AR for adult males is 1.3 mg/day. The corresponding RIs of vitamin B6 are 1.4 mg/day for adult females and 1.6 mg/day for adult males, independent of age. For infants, the estimated value is 0.1 mg/day and 0.3 mg/day, depending on age. The AR of vitamin B6 for children and adolescents ranges between 0.5 and 1.5 mg/day, and the RI is between 0.6 mg/day and 1.6 mg/day. During pregnancy, the AR is 1.3 mg/day in the first trimester and 1.5 mg/day in the second and third trimesters; the RI is 1.5 mg/day in the first trimester and 1.8 mg/day in the second and third trimesters. For lactating women, the AR is 1.3 mg/day and the RI is 1.6 mg/day.

Dietary fiber and its associations with depression and inflammation

Dietary fiber is a crucial component of a healthy diet, with benefits that can be attributed to processes in the gut microbiota and the resulting by-products. Observational studies support associations between dietary fiber intake and depression and inflammation, but the potential mechanisms are poorly understood. This review examines evidence of the effects of dietary fiber on depression and inflammation and considers plausible mechanisms linking dietary fiber and depression, including microbiota-driven modification of gene expression and increased production of neurotransmitters. Additionally, inflammation may mediate the relationship between dietary fiber intake and depression. A high-fiber diet potentially lowers inflammation by modifying both the pH and the permeability of the gut. The resultant reduction in inflammatory compounds may alter neurotransmitter concentrations to reduce symptoms of depression. Further research into the link between dietary fiber intake and inflammation and depression is essential, as findings could potentially provide guidance for improvement in or prevention of inflammatory and depressive disorders.