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ASSOCIATIONS BETWEEN WESTERN AND MEDITERRANEANTYPE DIETARY PATTERNS AND ANXIETY AND STRESS
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Purpose
To determine whether a plant-based nutrition program in a multicenter, corporate setting improves depression, anxiety, and productivity.
Design
A quasi-experimental study examined the impact of diet on emotional well-being and productivity.
Setting
The study was conducted in 10 corporate sites of a major U.S. insurance company.
Subjects
There were 292 participants (79.8% women, 20.2% men), with body mass index ≥25 kg/m² and/or previous diagnosis of type 2 diabetes.
Intervention
Either weekly instruction in following a vegan diet or no instruction was given for 18 weeks.
Measures
Depression and anxiety were measured using the Short Form-36 questionnaire. Work productivity was measured using the Work Productivity and Activity Impairment questionnaire.
Analysis
Baseline characteristics were examined by t-test for continuous variables and χ² test for categorical variables. Analysis of covariance models were adjusted for baseline covariates. Paired t-tests were used to determine within-group changes and t-tests for between-group differences.
Results
In an intention-to-treat analysis, improvements in impairment because of health (p < .001), overall work impairment because of health (p = .02), non-work-related activity impairment because of health (p < .001), depression (p = .02), anxiety (p = .04), fatigue (p < .001), emotional well-being (p = .01), daily functioning because of physical health (p = .01), and general health (p = 0.02) in the intervention group were significantly greater than in the control group. Results were similar for study completers.
Conclusion
A dietary intervention improves depression, anxiety, and productivity in a multicenter, corporate setting.
Use of complementary medicines and therapies (CAM) and modification of lifestyle factors such as physical activity, exercise, and diet are being increasingly considered as potential therapeutic options for anxiety disorders. The objective of this metareview was to examine evidence across a broad range of CAM and lifestyle interventions in the treatment of anxiety disorders. In early 2012 we conducted a literature search of PubMed, Scopus, CINAHL, Web of Science, PsycInfo, and the Cochrane Library, for key studies, systematic reviews, and metaanalyses in the area. Our paper found that in respect to treatment of generalized anxiety or specific disorders, CAM evidence revealed current support for the herbal medicine Kava. One isolated study shows benefit for naturopathic medicine, whereas acupuncture, yoga, and Tai chi have tentative supportive evidence, which is hampered by overall poor methodology. The breadth of evidence does not support homeopathy for treating anxiety. Strong support exists for lifestyle modifications including adoption of moderate exercise and mindfulness meditation, whereas dietary improvement, avoidance of caffeine, alcohol, and nicotine offer encouraging preliminary data. In conclusion, certain lifestyle modifications and some CAMs may provide a beneficial role in the treatment of anxiety disorders.
A growing body of literature links nutrition to mood, especially in epidemiological surveys, but there is little information characterizing food intake in people with diagnosed mood disorders.
Food intake obtained from 3-day food records was evaluated in 97 adults with mood disorders, whose diagnoses were confirmed in structured interviews. Information from a population nutrition survey, national guidelines for nutritional intakes (Eating Well with Canada's Food Guide) and North American dietary guidelines (Dietary Reference Intakes) was utilized to evaluate the quality of their food intake.
Compared to the regional nutrition survey data and national guidelines, a greater proportion of study participants consumed fewer of the recommended servings of grains (p < 0.001) and vegetables and fruits (p < 0.05), and less than the lower boundary of the Adequate Macronutrient Distribution Range (AMDR) for α-linolenic acid (p < 0.001). The study sample also had greater intakes of high-fat whole grain products (p < 0.01), processed meats (p < 0.00001), and higher sugar, fat or salty foods (p < 0.00001). Of the 1746 total meals and snacks consumed, 39% were from sources outside the home, suggesting a lack of time devoted to meal preparation. Finally, a subsample of 48 participants agreed to have blood tests: 44% had mild hypercholesterolemia (> 5.2 and ≤ 6.2 mmol/L) and 21% had hypercholesterolemia (> 6.2 mmol/L).
Much research has proposed multiple ways in which healthier diets may exert protective effects on mental health. The results of this study suggest that adults with mood disorders could benefit from nutritional interventions to improve diet quality.
Objective:
The study evaluated the association between consumption frequencies of the major food categories and the risk of new depression four years later in older Taiwanese.
Design:
A prospective cohort study with multistage random sampling. Logistic regression analysis evaluated the significance of the longitudinal associations of intake frequencies of the major food categories with future (4 years later) risk of new depression, controlled for possible confounding factors with or without adjustment for cognitive status.
Setting:
Population-based free-living elderly.
Subjects:
Men and women (n 1609) ≥65 years of age.
Results:
In a regression model that controlled for demographic, socio-economic, lifestyle and disease/health-related variables but not cognitive status, both fruits (OR = 0·66, 95 % CI 0·45, 0·98, P = 0·038) and vegetables (OR = 0·38, 95 % CI 0·17, 0·86, P = 0·021) were protective against depressive symptoms 4 years later. However, when the same regression model was also adjusted for cognitive status, only vegetables (OR = 0·40, 95 % CI 0·17, 0·95, P = 0·039) were protective against depressive symptoms. Higher consumption of eggs was close to being significant in both regression models (P = 0·087 and 0·069, respectively). Other food categories including meat/poultry, fish, seafood, dairy, legumes, grains and tea showed no significant associations.
Conclusions:
Results suggest that although confounding factors cannot be totally ruled out, more frequent consumption of vegetables seems to be protective against depressive symptoms in the elderly. Further studies are needed to elucidate the causal role and the mechanism of the association.
Recent evidence suggests a role for diet quality in the common mental disorders depression and anxiety. We aimed to investigate the association between diet quality, dietary patterns, and the common mental disorders in Norwegian adults.
This cross-sectional study included 5731 population-based men and women aged 46 to 49 and 70 to 74 years. Habitual diet was assessed using a validated food frequency questionnaire, and mental health was measured using the Hospital Anxiety and Depression Scale.
After adjustments for variables including age, education, income, physical activity, smoking, and alcohol consumption, an a priori healthy diet quality score was inversely related to depression (odds ratio [OR] = 0.71, 95% confidence interval [CI] = 0.59-0.84) and anxiety (OR = 0.77, 95% CI = 0.68-0.87) in women and to depression (OR = 0.83, 95% CI = 0.70-0.99) in men. Women scoring higher on a healthy dietary pattern were less likely to be depressed (OR = 0.68, 95% CI = 0.57-0.82) or anxious (OR = 0.87, 95% CI = 0.77-0.98), whereas men were more likely to be anxious (OR = 1.19, 95% CI = 1.03-1.38). A traditional Norwegian dietary pattern was also associated with reduced depression in women (OR = 0.77, 95% CI = 0.64-0.92) and anxiety in men (OR = 0.77, 95% CI = 0.61-0.96). A western-type diet was associated with increased anxiety in men (OR = 1.27, 95% CI = 1.14-1.42) and women (OR = 1.29, 95% CI = 1.17-1.43) before final adjustment for energy intake.
In this study, those with better quality diets were less likely to be depressed, whereas a higher intake of processed and unhealthy foods was associated with increased anxiety.
Vegetarian and vegan diets are effective in preventing and treating several chronic diseases. However, their acceptability outside a clinical trial setting has not been extensively studied. The aim of this study was to determine the acceptability of a worksite vegan nutrition program and its effects on health-related quality of life and work productivity.
Employees of a major insurance corporation with a body mass index > or =25 kg/m(2) and/or a previous diagnosis of type 2 diabetes received either weekly group instruction on a low-fat vegan diet (n = 68) or received no diet instruction (n = 45) for 22 weeks.
The vegan group reported improvements in general health (p = 0.002), physical functioning (p = 0.001), mental health (p = 0.03), vitality (p = 0.004), and overall diet satisfaction (p < 0.001) compared with the control group. The vegan group also reported a decrease in food costs (p = 0.003), and increased difficulty finding foods when eating out (p = 0.04) compared with the control group. The vegan group reported a 40-46% decrease in health-related productivity impairments at work (p = 0.03) and in regular daily activities (p = 0.004).
A worksite vegan nutrition program is well-accepted and can be implemented by employers to improve the health, quality of life, and work productivity of employees.
To examine the validity and reproducibility of food groups in the semi-quantitative food frequency questionnaire (FFQ) developed for the Tehran Lipid and Glucose Study (TLGS).
To evaluate the reproducibility of food groups included in the FFQ, 132 subjects (61 men and 71 women) aged 20 years or older twice completed a 168-item FFQ (FFQ1, FFQ2), with a 14-month interval between FFQ1 and FFQ2. Over the 1-year interval, 12 dietary recalls (DRs) were collected (1 each month) to assess the validity of the FFQ. Seventeen food groups were derived from the FFQ based on methods described in previous studies. Age-adjusted and deattenuated Spearman correlation coefficients were used to assess the validity of the FFQ.
The mean (SD) age and body mass index of subjects were 35.5 (16.8) years and 25.5 (5.2) kg/m(2), respectively. Validity correlation coefficients ranged from 0.03 (liquid oil) to 0.77 (simple sugars) in men (median, 0.44), and from 0.12 (snacks) to 0.79 (simple sugars) in women (median, 0.37). The energy-adjusted intraclass correlation coefficient, which reflects the reproducibility of the FFQ, was 0.51 in men and was highest for tea and coffee (0.91); in women it was 0.59 and was highest for simple sugars (0.74). The highest percentage of complete agreement and disagreement was observed for snacks and desserts (60.6%) and potatoes and dairy products (12.8%), respectively, in men, and tea and coffee (62.9%) and legumes (15.7%) in women.
The FFQ that was designed for the TLGS was found to be reliable and valid for assessing the intake of several food groups.
We provide an updated version of the Compendium of Physical Activities, a coding scheme that classifies specific physical activity (PA) by rate of energy expenditure. It was developed to enhance the comparability of results across studies using self-reports of PA. The Compendium coding scheme links a five-digit code that describes physical activities by major headings (e.g., occupation, transportation, etc.) and specific activities within each major heading with its intensity, defined as the ratio of work metabolic rate to a standard resting metabolic rate (MET). Energy expenditure in MET-minutes, MET-hours, kcal, or kcal per kilogram body weight can be estimated for specific activities by type or MET intensity. Additions to the Compendium were obtained from studies describing daily PA patterns of adults and studies measuring the energy cost of specific physical activities in field settings. The updated version includes two new major headings of volunteer and religious activities, extends the number of specific activities from 477 to 605, and provides updated MET intensity levels for selected activities.
Certain dietary components may play a role in the prevention of type 2 diabetes.
We examined prospectively the associations between whole- and refined-grain intake and the risk of type 2 diabetes in a large cohort of men.
Men from the Health Professionals Follow-up Study without a history of diabetes or cardiovascular disease in 1986 (n = 42898) were followed for </=12 y. Intakes of whole and refined grains, measured every 4 y by use of food-frequency questionnaires, were used to predict subsequent type 2 diabetes risk through multivariate analysis.
We ascertained 1197 cases of incident type 2 diabetes. After adjustment for age; physical activity; cigarette smoking; alcohol consumption; family history of diabetes; and fruit, vegetable, and energy intakes, the relative risk of type 2 diabetes was 0.58 (95% CI: 0.47, 0.70; P for trend < 0.0001) comparing the highest with the lowest quintile of whole-grain intake. The association was moderately attenuated when additionally adjusted for body mass index (relative risk: 0.70; 95% CI: 0.57, 0.85; P for trend = 0.0006). Intake of refined grains was not significantly associated with risk of type 2 diabetes. After further adjustment for magnesium intake, cereal fiber intake, and glycemic load, the association between whole grains and type 2 diabetes was attenuated and the trend no longer significant.
In men, a diet high in whole grains is associated with a reduced risk of type 2 diabetes in men that may be mediated by cereal fiber. Efforts should be made to replace refined-grain with whole-grain foods.
Studying the links between dietary patterns and obesity is especially relevant for Middle-Eastern populations because of their high prevalence of a particular type of obesity, the so-called Middle-Eastern pattern, and their diets' unique characteristics. Therefore, we wondered if major dietary patterns are related to the prevalence of general obesity and central adiposity among Iranian women. In this cross-sectional study of 486 women aged 40-60 y, usual dietary intakes were evaluated using a FFQ and anthropometric measurements. By the use of factor analysis, we extracted 3 major dietary patterns: healthy dietary pattern, western dietary pattern, and Iranian dietary pattern. Individuals in the upper category of the healthy pattern score were less likely to be generally (OR = 0.28; 95% CI = 0.14-0.53) and centrally obese (OR = 0.30; 95% CI = 0.16-0.55), whereas those in the upper quintile of western pattern had greater odds (for general obesity: 2.73; 95% CI = 1.46-5.08 and for central obesity: 5.74; 95% CI =2.99-10.99). Controlling for potential confounders attenuated the associations, but even after adjusting for energy intake, the associations were significant for both general and central obesity. Although the Iranian dietary pattern and general obesity were not significantly associated, subjects in the highest quintile had greater odds of being centrally obese, either before (OR = 2.15; 95% CI = 1.18-3.90) or after (OR = 2.08; 95% CI = 1.09-3.65) control for confounders. This study indicates significant associations among major dietary patterns, general obesity, and central adiposity in a Middle-Eastern country. Further prospective investigations are required to confirm such associations.
It has been suggested that access to high caloric food attenuates stress response. The present paper investigates whether access to commercial chow enriched with glucose and fat, here referred to as comfort food alters behavioral, metabolic, and hormonal parameters of rats submitted to three daily sessions of foot-shock stress. Food intake, anxiety-like behaviors, and serum levels of insulin, leptin, corticosterone, glucose and triglycerides were determined. The rats submitted to stress decreased the intake of commercial chow, but kept unaltered the intake of comfort food. During the elevated plus maze (EPM) test, stressed rats increased the number of head dipping, entries into the open arms, as well as the time spent there, and decreased the number of stretched-attend posture and risk assessment. These effects of stress were independent of the type of food consumed. Non-stressed rats ingesting comfort food decreased risk assessment as well. Stress and comfort food increased time spent in the center of the open field and delayed the first crossing to a new quadrant. Stress increased the plasma level of glucose and insulin, and reduced triglycerides, although consumption of comfort food increases glucose, triglyceride and leptin levels; no effect on leptin level was associated to stress. The stress induced increase in serum corticosterone was attenuated when rats had access to comfort food. It was concluded that foot-shock stress has an anorexigenic effect that is independent of leptin and prevented upon access to comfort food. Foot-shock stress also has an anxiolytic effect that is potentiated by the ingestion of comfort food and that is evidenced by both EPM and open field tests.
Key biological factors that influence the development of depression are modified by diet. This study examined the extent to which the high-prevalence mental disorders are related to habitual diet in 1,046 women ages 20-93 years randomly selected from the population.
A diet quality score was derived from answers to a food frequency questionnaire, and a factor analysis identified habitual dietary patterns. The 12-item General Health Questionnaire (GHQ-12) was used to measure psychological symptoms, and a structured clinical interview was used to assess current depressive and anxiety disorders.
After adjustments for age, socioeconomic status, education, and health behaviors, a "traditional" dietary pattern characterized by vegetables, fruit, meat, fish, and whole grains was associated with lower odds for major depression or dysthymia and for anxiety disorders. A "western" diet of processed or fried foods, refined grains, sugary products, and beer was associated with a higher GHQ-12 score. There was also an inverse association between diet quality score and GHQ-12 score that was not confounded by age, socioeconomic status, education, or other health behaviors.
These results demonstrate an association between habitual diet quality and the high-prevalence mental disorders, although reverse causality and confounding cannot be ruled out as explanations. Further prospective studies are warranted.
Self-reported effects of stress on eating behaviour and food were assessed in a brief questionnaire in 212 students. Snacking behaviour was reportedly increased by stress in the majority of respondents (73%) regardless of gender or dieting status. The overall increase in snacking during stress was reflected by reports of increased intake of "snack-type" foods in all respondents, regardless of dieting status. In contrast, intake of "meal-type" foods (fruit and vegetables, meat and fish) was reported to decrease during stressful periods. The majority of the respondents reported an effect of stress on overall amount eaten, but while snacking, roughly equal numbers reporting decreased intake (42%) and increased intake (38%). The direction of change in intake could be predicted in part by dieting status, with dieters being more likely to report stress hyperphagia and nondieters being more likely to report stress hypophagia.
The objectives of the National Survey of American Life (NSAL) are to investigate the nature, severity, and impairment of mental disorders among national samples of the black and non-Hispanic white (n = 1,006) populations in the US. Special emphasis in the study is given to the nature of race and ethnicity within the black population by selecting and interviewing national samples of African-American (N = 3,570), and Afro-Caribbean (N = 1,623) immigrant and second and older generation populations. National multi-stage probability methods were used in generating the samples and race/ethnic matching of interviewers and respondents were used in the largely face-to-face interview, which lasted on average 2 hours and 20 minutes. The Diagnostic and Statistical Manual (DSM) IV World Mental Health Composite Interview (WHO-CIDI) was used to assess a wide range of serious mental disorders, potential risk and resilience factors, and help seeking and service use patterns. This paper provides an overview of the design of the NSAL, sample selection procedures, recruitment and training of the national interviewing team, and some of the special problems faced in interviewing ethnically and racially diverse national samples. Unique features of sample design, including special screening and listing procedures, interviewer training and supervision, and response rate outcomes are described.
Prior research on the association between affective disorders and physical conditions has been carried out in developed countries, usually in clinical populations, on a limited range of mental disorders and physical conditions, and has seldom taken into account the comorbidity between depressive and anxiety disorders.
Eighteen general population surveys were carried out among adults in 17 countries as part of the World Mental Health Surveys initiative (N=42, 249). DSM-IV depressive and anxiety disorders were assessed using face-to-face interviews with the Composite International Diagnostic Interview (CIDI 3.0). Chronic physical conditions were ascertained via a standard checklist. The relationship between mental disorders and physical conditions was assessed by considering depressive and anxiety disorders independently (depression without anxiety; anxiety without depression) and conjointly (depression plus anxiety).
All physical conditions were significantly associated with depressive and/or anxiety disorders but there was variation in the strength of association (ORs 1.2-4.5). Non-comorbid depressive and anxiety disorders were associated in equal degree with physical conditions. Comorbid depressive-anxiety disorder was more strongly associated with several physical conditions than were single mental disorders.
Physical conditions were ascertained via self report, though for a number of conditions this was self-report of diagnosis by a physician.
Given the prevalence and clinical consequences of the co-occurrence of mental and physical disorders, attention to their comorbidity should remain a clinical and research priority.
The aim of the study was to explore the association between perceived stress, depression and food consumption frequency. A self-administered questionnaire that included the perceived stress scale, the depression scale and dietary intake was used in the baseline survey of a cohort study of 2579 local college students over 7 cities in China. Gender and city differences were found in perceived stress scores and depression scores. There were also significant differences among diverse smoking levels and among perceived weight categories in perceived stress and depression scores. Stepwise logistic regression models found that frequency of consumption of fresh fruit, ready-to-eat food and snack food had apparently independent effects on perceived stress, whereas the intake level of fresh fruit, ready-to-eat food and fast food was significantly associated with depression. The link between food consumption frequency, perceived stress and depression suggests that diet intervention may be considered a mediate strategy integrated in psychology prevention program among normal population of the college.
Analysis of dietary patterns in epidemiological research
SLATTERY, M.L. (2010): Analysis of dietary patterns in epidemiological research. Appl. Physiol. Nutr. Me., 35, 207–
210.
Manual for the depression anxiety stress scales. Psychology Foundation of Australia
- S H Lovibond
LOVIBOND, S.H. & LOVIBOND, P.F. (1996): Manual for the depression anxiety stress scales. Psychology Foundation of
Australia.Sydney. 42 pages.
Polyphenols: A potential new strategy for the prevention and treatment of anxiety and depression
BOUAYED, J. (2010): Polyphenols: A potential new strategy for the prevention and treatment of anxiety and depression.
Curr. Nutr. Food Sci., 6, 13–18.
Protection and damage from acute and chronic stress: Allostasis and allostatic overload and relevance to the pathophysiology of psychiatric disorders
MCEWEN, B.S. (2004): Protection and damage from acute and chronic stress: Allostasis and allostatic overload and
relevance to the pathophysiology of psychiatric disorders. Ann. NY Acad. Sci., 1032, 1–7.
Lifetime prevalence and age-of-onset distributions of mental disorders in the World Health Organization's world mental health survey initiative
- R C Angermeyer
- M Anthony
- J C De Graaf
- R Demyttenaere
- K Gasquet
- I Degirolamo
- G Gluzman
- S Gureje
- O Haro
KESSLER, R.C., ANGERMEYER, M., ANTHONY, J.C., DE GRAAF, R., DEMYTTENAERE, K., GASQUET, I., DEGIROLAMO, G.,
GLUZMAN, S., GUREJE, O. & HARO, J.M. (2007): Lifetime prevalence and age-of-onset distributions of mental
disorders in the World Health Organization's world mental health survey initiative. World Psychiatry, 6, 168–
176.