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Abstract

Background: It has been claimed that the quality of a diet is associated with the incidence of depressive disorders. We sought to investigate the evidence for this claim. Methods: Systematic searches were performed up to March 6th, 2017 in order to identify prospective cohort studies that reported on exposure to dietary patterns or food groups and the incidence of depression/depressive symptoms. Data from 24 independent cohorts (totalling 1,959,217 person-years) were pooled in random-effects meta-analyses. Results: Adherence to a high-quality diet, regardless of type (i.e., healthy/prudent or Mediterranean), was associated with a lower risk of depressive symptoms over time (odds ratios ranged 0.64-0.78 in a linear dose-response fashion [P < 0.01]). A relatively low dietary inflammatory index was also associated with a somewhat lower incidence of depressive symptom (odds ratio = 0.81), although not in a dose-response fashion. Similar associations were found for the consumption of fish and vegetables (odds ratios 0.86 and 0.82 respectively) but not for other high quality food groups (e.g., fruit). Studies that controlled for depression severity at baseline or that used a formal diagnosis as outcome did not yield statistically significant findings. Adherence to low quality diets and food groups was not associated with higher depression incidence. Limitations: Our ability to detect confounders was only limited. Conclusion: There is evidence that a higher quality of a diet is associated with a lower risk for the onset of depressive symptoms, but not all available results are consistent with the hypothesis that diet influences depression risk. Prospective studies that control for relevant confounders such as obesity incidence and randomized controlled prevention trials are needed to increase the validity of findings in this field.

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... Public Health 2022, 19, 14437 2 of 10 A complex interplay of genetic, biological, psychological, behavioral, and environmental determinants for depression has been proposed [6][7][8]. In particular, the role of diet in the etiology and course of depression has received more attention in recent years as a modifiable lifestyle factor that could contribute to the treatment of this mental disorder [9,10]. The pathways through which diet influences depression could be related to inflammation, oxidative stress, hypothalamic-pituitary-adrenal axis function, tryptophan-kynurenine metabolism, neurogenesis and brain-derived neurotrophic factor, epigenetics, mitochondrial function, and the gut microbiota [11]. ...
... The prospective cohort associations between MD adherence and depression in adults have been synthesized in several systematic reviews and meta-analyses of prospective observational studies, which showed mixed results [10,[18][19][20][21]. While high MD adherence reduced the incidence of depression over time in some of these evidence syntheses [10,18,19], no significant association was observed in two other reviews [20,21]. ...
... The prospective cohort associations between MD adherence and depression in adults have been synthesized in several systematic reviews and meta-analyses of prospective observational studies, which showed mixed results [10,[18][19][20][21]. While high MD adherence reduced the incidence of depression over time in some of these evidence syntheses [10,18,19], no significant association was observed in two other reviews [20,21]. Although observational studies provide relevant evidence, randomized controlled trials (RTCs) are known to provide a higher level of evidence for validating and judging the effects of an intervention (such as MD) on a health outcome (such as depressive symptomatology) [22]. ...
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The associations between Mediterranean diet (MD) adherence and depression levels have been synthesized from observational studies. However, a systematic review with meta-analysis including randomized controlled trials (RCTs) on this relationship in adults with depressive disorders remains lacking. This protocol was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis for Protocols statement. MEDLINE (PubMed), Cochrane CENTRAL, PsycINFO, Scopus, and Web of Science databases will be systematically searched to identify studies published from database inception up to 30 September 2022. The inclusion criteria will comprise RCTs reporting pre-post changes in depression status (symptoms or remission) after a MD intervention compared to a control condition in adults over 18 years with depressive disorders. Pooled effect sizes and 95% confidence intervals will be calculated using the DerSimonian random-effects model. This study protocol determines the methodological approach for the systematic review and meta-analysis that will summarize the available evidence on the efficacy of MD interventions on depressive symptoms in adults with depressive disorders. The findings from this review may have implications for public mental health programs. The results will be disseminated through peer-reviewed publication, conference presentation, and infographics. No ethical approval will be required since only published data will be used. PROSPERO registration number: CRD42022341895.
... Depression is estimated to affect more than 300 million people worldwide and, according to the World Health Organization (WHO), is one of the leading causes of disability. 1 On average, it more frequently affects women than men, and it first appears during the late teens to mid-20s. 2 Depression is a psychiatric disorder that goes beyond the normal human experiences of sadness, including a broad range of symptoms such as feeling worthless, losing interest in most or all activities, having thoughts of suicide, experiencing a significant reduction or increase in appetite or sleep, and having difficulty concentrating. 3 Depressive symptoms are often distressing to the individual and can lead to an inability to function normally, such as at work or in maintaining relationships. 4 Although scientists agree in considering that depression is the result of a complex interaction of social, psychological, and biological factors, due to the clinical and etiological heterogeneity it is difficult to clarify its pathophysiology. 5 An increasing body of scientific evidence suggests a relationship between dietary patterns and depression, [6][7][8] and many meta-analyses [9][10][11] have found that adherence to healthy diets is associated with lower risk of depression and less severe depressive symptoms. These findings could be important for the prevention and treatment of depression, but the quality, the precision, and the strength of the evidence need improvement. ...
... [27][28][29][30][31][32][33][34][35][36][37] At the end of the screening process, 19 articles met the inclusion criteria and were included in the analysis. [9][10][11][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53] Characteristics and methodological quality of the included meta-analyses Table 2 9-11,38-53 reports the characteristics and methodological quality of the included meta-analyses. Out of the 19 included meta-analyses, 16 were meta-analysis of observational studies, 2 were meta-analysis of RCTs, and 1 meta-analysis included both observational studies and RCTs. ...
... The largest population (>100 000 subjects) was observed in observational studies, particularly in metaanalyses of the vegetarian diet, 38,41 healthy dietary patterns, 11 and DII. 50 In contrast, the smallest population a This meta-analysis included studies assessing adherence to a healthy diet defined a posteriori, and adherence to the MedDiet measured using different scores. ...
Article
Context: Depression is the most common causes of disease burden worldwide (GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392:1789-1858). Objective: An umbrella review has been performed to assess the strength and validity of the available observational and trial evidence for the association between a variety of dietary patterns and depression. Data sources: MEDLINE/PubMed, Scopus, Web of Science, EMBASE, PsycINFO, and Cochrane Database were searched. Data extraction: The Joanna Briggs Institute Umbrella Review Methodology was used. Data analysis: The review included 19 articles, covering a relatively wide range of dietary patterns: healthy dietary patterns (n = 8), Mediterranean diet (MedDiet) (n = 6), Dietary Inflammatory Index (DII) (n = 5), Western diet (n = 4), Dietary Approaches to Stop Hypertension (DASH) (n = 2), vegetarian diets (n = 4), and other dietary interventions (n = 2). The methodological quality of the included meta-analyses was generally low or critically low. The strength of the evidence was generally weak, although convincing or suggestive evidence was found for an inverse relationship between MedDiet/DII and depression. Higher adherence to the MedDiet and lower DII score were significantly associated with lower risk of depression. Conclusion: Considering the generally high heterogeneity and low quality of the available evidence, further studies adopting more coherent and uniform methodologies are needed. Systematic review registration: PROSPERO registration no. CRD42020223376.
... Although the first meta-analyses of observational studies on this subject suggested an inverse relation between a healthy diet and depression symptoms [36,37], the results were inconclusive as most of the analyzed studies were cross-sectional. Since data obtained in a single time-point cannot allow for determination of whether dietary patterns are a risk factor, concomitant, or an effect of MDD, Molendijk et al. (2018) reviewed only longitudinal observational studies [38]. The authors mainly found an association of high-quality or low pro-inflammatory diet with lower levels of depression symptoms, but not with clinical diagnosis of MDD [38]. ...
... Although the first meta-analyses of observational studies on this subject suggested an inverse relation between a healthy diet and depression symptoms [36,37], the results were inconclusive as most of the analyzed studies were cross-sectional. Since data obtained in a single time-point cannot allow for determination of whether dietary patterns are a risk factor, concomitant, or an effect of MDD, Molendijk et al. (2018) reviewed only longitudinal observational studies [38]. The authors mainly found an association of high-quality or low pro-inflammatory diet with lower levels of depression symptoms, but not with clinical diagnosis of MDD [38]. ...
... Since data obtained in a single time-point cannot allow for determination of whether dietary patterns are a risk factor, concomitant, or an effect of MDD, Molendijk et al. (2018) reviewed only longitudinal observational studies [38]. The authors mainly found an association of high-quality or low pro-inflammatory diet with lower levels of depression symptoms, but not with clinical diagnosis of MDD [38]. Moreover, the lack of association between low-quality diet and incidence of MDD suggested that consumption of low-quality foods is concurrent to MDD, and not a risk factor of this condition [38]. ...
Article
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Dietary interventions for people suffering from major depressive disorder (MDD) are an ongoing field of research. In this article, we present a comprehensive background for understanding the possibility of using edible medicinal mushrooms as an adjunctive treatment for MDD. We start with a brief history of MDD, its diagnosis, epidemiology and treatment, and the effects of diet on depression symptoms, followed by a review of neurobiological, behavioral, and clinical studies of medicinal mushrooms. We specifically highlight the results of preclinical and clinical studies on dietary supplementation with three selected mushroom species: Lion’s mane (Hericium erinaceus), Caterpillar mushroom (Cordyceps militaris), and Lingzhi/Reishi (Ganoderma lucidum). Preliminary small-sample clinical studies suggest that Lion’s mane can influence well-being of humans. In the case of Reishi, the results of clinical studies are equivocal, while in the case of Caterpillar Mushroom, such studies are underway. Edible mushrooms contain 5-hydroxy-L-tryptophan (5-HTP), which is a direct precursor of serotonin—a neurotransmitter targeted in pharmacotherapy of MDD. Therefore, in light of the well-recognized role of stress as a pathogenic factor of MDD, we also describe the neurobiological mechanisms of the interaction between stress and serotonergic neurotransmission; and summarize the current state of knowledge on dietary supplementation with 5-HTP in MDD.
... Despite the fact that the mechanisms revealing the link between diet and depression are not totally explained, several biological processes have been postulated in which diet might act on inflammation, oxidative stress and brain plasticity, leading to depression [14]. Accumulated evidence suggested that inflammation might be involved in the association between diet and depression [15]. A western dietary pattern rich in red meat, refined foods and confectionary is considered as a pro-inflammatory diet and related to an elevated risk of DepS, whereas a healthy dietary pattern characterized by more intake of whole grains, fruits, vegetables, and fish, appears protective in inflammation and DepS [16]. ...
... Nutrients 2023, 15, 84 ...
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This study examined the association between the energy-adjusted Dietary Inflammatory Index (E-DII)-based dietary inflammatory potential and depressive symptoms (DepS) among patients with breast cancer and explores whether systemic inflammation mediates this association. We assessed dietary intake and DepS in 220 breast cancer patients by three 24 h dietary recalls and the Center for Epidemiological Studies Depression Scale (CES-D), respectively, and determined plasma levels of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and interleukin (IL)-1β, IL-4, and IL-6 in 123 blood samples. We found that each one-point increase of E-DII was related to a 53% elevated risk of DepS. Patients with the most pro-inflammatory diets had a 5.13 times higher risk of DepS than those with the most anti-inflammatory diets. Among the E-DII components, vitamin B2, zinc, and iron were inversely associated with DepS risk. Furthermore, E-DII scores were positively associated with CRP and TNF-α. Higher levels of TNF-α and IL-6 were associated with higher DepS risk. A significant mediating effect of TNF-α was revealed between E-DII and DepS. Our findings suggest that a pro-inflammatory diet is positively associated with breast cancer-related DepS, which may be mediated by TNF-α.
... Lower odds of depression were linked to greater adherence to healthy/prudent, Mediterranean, pro-vegetarian (i.e., higher in plant foods than animal foods), and Tuscan dietary patterns. Increased nutrition quality was also linked to a lower incidence of depression (Molendijk et al. 2018). High intakes of fruits, vegetables, seafood, and whole grains characterized these healthy dietary patterns. ...
... Therefore, the International Society for Nutritional Psychiatry Research has recommended that nutritional medicine should be considered mainstream in psychiatric practice. "Healthy" dietary patterns are associated with a lower risk of depression (Lassale et al. 2019;Molendijk et al. 2018). However, the observed associations are most likely the result of a number of biological mechanisms. ...
Chapter
Nutrition plays a variety of physiological roles in the maintenance of mental health, with some potential pathological participations as well. Indeed, suboptimal and anormal nutrition may be implicated in the underlying pathology of mental health disorders and may interfere with treatment response and recovery. Nutrient deficiency is widespread throughout the world, affecting in particular, but not only, low- and middle-income countries and individuals disproportionately. Therefore, the socially and economically disadvantaged population is at a higher risk of major mental health disorders, including depression. Robust recent data relates the poor nutrition or nutritional deficiency (e.g., dietary antioxidants, trace elements) to major depressive disorders. On the contrary, nutrients (e.g., essential fatty acids and folic acid) may be used effectively to treat depression or to augment the existing treatments. The purpose of this chapter is to discuss the current evidence regarding the role of nutrition in depression.KeywordsBehavioral health disordersDietDepressionGut-brain axisMajor depressive disorderNutritionSerotoninTreatment managementTryptophanVitamin
... Current research suggests that the pathophysiology of depression is multifactorial in nature, with etiologies related to genetics and epigenetics (Howard et al. 2019), age (Almeida 2014), gender (Salk et al. 2017), and stress (Park et al. 2019), amongst other factors. Some moderators and mediators of depression also include physical activity (Schuch and Stubbs 2019) and diet (Molendijk et al. 2018). ...
... Research suggests that depression is associated with not only the overall quality of one's diet (Molendijk et al. 2018), but also the consumption of certain types of food and drinks such as fish , coffee , fruits, and vegetables . Several prospective studies showed that unhealthy Western diets high in sweetened beverages, processed meat, fried food, and refined grain are associated with a higher incidence of depression (Lang et al. 2015). ...
Chapter
Recent studies have investigated the association between zinc deficiency and depression, as well as the effectiveness of zinc supplementation in patients with depression. There are several mechanisms with which zinc exerts its antidepressant properties; some have been extensively researched in preclinical and clinical studies, while others still lack supporting evidence. This chapter describes the various antidepressant mechanisms of zinc. It also reviews landmark preclinical and clinical studies that helped to better characterize the association between zinc deficiency and depression, and the importance of zinc supplementation in this condition.
... Nutrition plays a vital role in the onset of depression, its severity, and its duration. Studies suggest that nutritiondeficient diets lacking omega-3 fatty acids are associated with higher risks of compromised mental health [16,17]. Omega-3 long-chain polyunsaturated fatty acids (PUFA), including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are dietary fats found in fish oil are known for their health benefits in fetal development and healthy aging [18]. ...
Article
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Depression is a common mood disorder characterized by persistent sadness and loss of interest. Research suggests an association between the inclusion of omega-3 fatty acids in the diet and a reduced risk for depression. The present study evaluated the effectiveness of omega-3 fatty acid supplements in alleviating depressive symptoms in patients with mild to moderate depression. A total of 165 patients suffering from mild to moderated depression were randomized to receive omega-3 fatty acid supplementation, an antidepressant (single agent), or a combination of an antidepressant and omega-3 fatty acid supplementation. The clinical features of depression were assessed using the Hamilton Depression Rating Scale (HDRS) during the follow-up period. A statistically significant improvement in depressive symptoms was observed from baseline to first, second and third follow-ups within each treatment arm as measured by HRDS scores (p = 0.00001). Further, the HDRS scores at the third follow-up were significantly lower in patients on combination therapy of omega-3 fatty acid supplement and antidepressants (arm-3) than the patients on the omega-3 fatty acid supplement alone (arm-1) [Q = 5.89; p = 0.0001] or the patients taking an antidepressant alone (arm 2) [Q = 4.36; p = 0.0068]. The combination of an omega-3 fatty acid supplement and an antidepressant elicited significantly higher improvement in depressive symptoms than the supplement or the antidepressant alone.
... Furthermore, an inverse association between a healthy diet and risk of depression was reported, but the results are of moderate quality [21]. Further evidence suggests that poor diet is a relevant predictor in the onset of depressive illness [22], whereas healthy eating patterns may reduce anxiety symptoms [23]. The consumption of specific food items and beverages, such as high consumption of fruit, whole grain bread and fish and low consumption of sugar-sweetened beverages, was also associated with lower levels of depressive symptoms in adolescents [24] and lower risk of mental distress among adults [25]. ...
Article
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Background There is increasing need for prospective investigations in the preventing role of health-related behaviours on mental health problems. The aim of this study is to identify patterns of health-related behaviours in adolescence, and the association between the behavioural patterns and the subsequent diagnoses and/or drug treatment for anxiety and/or depression in adulthood. Methods This prospective study consisted of 13–19-year-old participants in the Trøndelag Health Study (Young-HUNT3) in 2006–2008 ( n = 2061, 1205 females and 856 males) in Norway, who also participated in HUNT4 (2017–2019). Survey data on health-related behaviours in adolescence, including low level of physical activity, low consumption of wholegrain bread, fish, fruit, vegetables and high consumption of sugar-sweetened beverages and insomnia were linked on an individual level to prospective information on drug use and diagnosis in national health registries. The different patterns of health-related behaviours were identified through latent class analysis. Subsequent anxiety or depression was defined as at least one recording in either of three registries covering recorded diagnosis in primary and specialist healthcare, or dispensed prescription drugs during 2008–2019. Additionally, self-reported psychological distress measured in young adulthood was applied as a supplemental outcome measure. Results Four patterns of health-related behaviours were identified: high risk behaviours (class 1), moderate to high risk behaviours (class 2), low to moderate risk behaviours (class 3) and low risk behaviours (class 4). Adolescents in class 3 showed higher odds of subsequent diagnoses for anxiety and/or depression in primary and specialist healthcare compared to class 4 participants. In addition, both class 1 and class 4 participants had higher odds for self-reported psychological distress than those class 4 (OR = 1.56 and OR = 1.86, respectively). Conclusions Our findings suggest that health-related behaviours are clustered among Norwegian adolescents. The patterns of unhealthy behaviours during adolescence only partly increased the risk of anxiety and depression in adulthood. Promoting healthy behaviours during adolescence may potentially reduce the burden of mental illness in adulthood, but further research is needed to clarify the nature of the relationships.
... All four Australian randomised control trials found a significant improvement in depression scores between the intervention and social control groups. However, evidence arising from meta-analyses and systematic reviews shows inconsistent or inconclusive findings when the research is viewed as a whole (39,40,(45)(46)(47)(48)(49) . These findings could be clarified through further prospective longitudinal studies on dietary intake and depression (50) . ...
Preprint
Depression is a chronic and complex condition experienced by over 300 million people worldwide. While research on the impact of nutrition on chronic physical illness is well documented, there is growing interest in the role of dietary patterns for those experiencing symptoms of depression. This study aims to examine the association of diet quality (Dietary Questionnaire for Epidemiological Studies version 2) and depressive symptoms (Centre for Epidemiological Studies for Depression short form) of young Australian women over 6 years at two time points, 2003 (n 9081, Mean age = 27·6) and 2009 (n 8199, Mean age = 33·7) using secondary data from the Australian Longitudinal Study on Women’s Health. A linear mixed-effects model found a small and significant inverse association of diet quality on depressive symptoms (β =−0·03, 95 % CI (−0·04, −0·02)) after adjusting for covarying factors such as BMI, social functioning, alcohol and smoking status. These findings suggest that the continuation of a healthy dietary pattern may be protective of depressive symptoms. Caution should be applied in interpreting these findings due to the small effect sizes. More longitudinal studies are needed to assess temporal relationships between dietary quality and depression.
... These foods can represent a risk factor for various diseases such as hypertension, cerebrovascular and cardiovascular diseases, cancer, osteoporosis, tooth decay and obesity (Jones et al., 2018). Diet quality has been associated with adolescents mental health and, in particular, unhealthy eating is related to internalising disorders such as depression, low mood and anxiety (Molendijk et al., 2018). Therefore, it is necessary to promote food education in the younger generations. ...
Article
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SMART is the acronym for Sports, Meals, Activities, Relationships and Technologies. The SMART questionnaire (SMART-Q) has been developed following the Civil Educational Approach by a multidisciplinary team of researchers from Italy and United Kingdom Universities. The questionnaire aims to identify the adolescents at a higher risk of unhealthy behaviours (defined as situations in which adolescents can be capped with criminal behaviours, drug or technology addictions, bullying, and school dropout). Previously studies have used SMART-Q however, its validity and reliability have never been completed. Hence, the following study aims to explain the structure of the SMART-Q and its domains and investigates the questionnaire reliability and validity with repeated measures in a young cohort who took part in the Sport Senza Frontiere over the summer of 2021. The construct validation was conducted through Exploratory Factor Analysis, obtaining the values for Kaiser-Meyer-Olkin index (0.941) and Bartlett's test (χ2 = 3813.903, Df = 325, p ≤ 0.001), which indicates its suitability for factor analysis. Exploratory Factor Analysis was completed with the principal component method to estimate the factor loadings and specificity, using the varimax rotation method. The results indicate that all questions presented moderate reliability. In conclusion, the proposed instrument is valid and applicable, meeting all the parameters necessary for its validation. However, it should be additionally implemented to monitor the correlation between items and its reliability. So it is recommended to use the SMART-Q with caution. Finally, the complete questionnaire with scoring values is reported at the end of the document in the Appendix. SMART è l'acronimo di Sport, Movimento, Alimentazione, Relazioni e Tecnologie. Il questionario SMART (SMART-Q) è stato sviluppato seguendo la Civil Educational Approach da un gruppo multidisciplinare di ricercatori provenienti da Università italiane e britanniche. Il questionario mira a identificare gli adolescenti col più alto rischio di comporta-menti pericolosi (definiti come situazioni in cui gli adolescenti possono essere colpiti da comportamenti criminali, di-pendenze da droghe o tecnologie, bullismo e abbandono scolastico). Precedenti studi hanno utilizzato lo SMART-Q, tuttavia, la sua validità ed affidabilità non sono mai state misurate. Il seguente studio spiega la struttura dello SMART-Q ed indaga sull'affidabilità e la validità del questionario attraverso misure ripetute in un gruppo di adolescenti che ha partecipato a Sport Senza Frontiere. La convalida del costrutto è stata condotta tramite analisi esplorativa fattoriale, ottenendo i valori dell'indice Kaiser (0.941) ed il test di Bartlett (χ2 = 3813.903, Df = 325, p ≤ 0.001). La successiva analisi fattoriale esplorativa è stata completata con il metodo delle componenti principali per stimare i carichi dei fattori e la specificità, utilizzando il metodo della rotazione varimax. I risultati indicano che le domande presentano un'affida-bilità moderata. In conclusione, lo SMART-Q è valido ed applicabile, rispettando tutti i parametri necessari alla sua validazione. Tuttavia, dovrebbe essere ulteriormente implementato per monitorare la correlazione tra gli elementi e la sua affidabilità. Quindi si consiglia di utilizzare SMART-Q con cautela. Infine, il questionario completo con i valori di punteggio è riportato alla fine del documento in Appendice.
... Cross-sectional research has identified that several mental illnesses (e.g., major depression, schizophrenia, bipolar disorder, and post-traumatic stress disorder) are associated with increased intake of calories [7] as well as high consumption of processed foods, sugars, and saturated fats [8][9][10]. A growing body of work is acknowledging the benefits of nutritional medicine in psychiatry to potentially reduce the onset and symptoms of various mental disorders [11,12], including depression and anxiety [13,14], with a healthy diet and other lifestyle factors such as regular exercise recommended in clinical guidelines for initial steps towards management of such disorders [15,16]. ...
Article
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There is increasing academic and clinical interest in understanding the nature of the relation between diet and response to stress exposure as a risk factor for mental illness. Cross-species evidence shows that conditions of chronic and acute stress increase the intake of, and preference for, caloric-dense palatable foods, a phenomenon thought to be explained by the mitigating effects of comfort foods on the activity of the stress-response network. It is largely unknown whether and how real-world dietary intake of saturated fat and sugars impacts stress responsivity in humans. Therefore, here we examined whether real-world dietary intake of saturated fat and sugars predicted salivary cortisol reactivity following an acute physiological stressor. Multilevel modelling of four salivary cortisol measures collected up to 65 min after the stressor on 54 participants (18–49 years old) were analyzed using a quadratic growth curve model. Sugar intake significantly predicted a weaker cortisol response following the Cold Pressor Test (CPT) controlling for BMI and gender, revealing an inhibitory effect of caloric-dense diets on cortisol reactivity to stress. As the consumption of sugar rose individuals had lower post-stressor cortisol levels, a smaller rate of increase in cortisol 20 and 35 min after the CPT, a lower cortisol peak, and an overall weaker quadratic effect. These observations add to a growing body of evidence reporting suppressive effects of high-energy foods on stress-associated glucocorticoids reactivity and are consistent with the comfort food hypothesis, where people are seen as motivated to eat palatable foods to alleviate the detrimental repercussions of stressor exposure.
... However, patient adherence was quite poor, with as many as half of patients interrupting their therapy in the first six weeks [5]. Increasing data also shows that dietary factors have an impact on depression symptoms [6,7]. Previous studies have reported a protective effect of chocolate against depression [5]. ...
Article
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Objective The purpose of this study is to investigate the possible link between dietary theobromine intake and symptoms of depression. Materials and methods These results are based on the responses of 3637 people who took part in the National Health and Nutrition Examination Survey in 2017–2018. Participants' daily theobromine intake was determined using a 24-h food questionnaire from the 2017–2018 cycle. Presence of depression was defined as a score of 5 or above on the Patient Health Questionnaire. Association between theobromine intake and depression was examined using a multivariate logistic regression adjusting for several relevant sociodemographic, lifestyle and health-related factors. Results A total of 6903 participants were included in the study. The results of multivariate logistic regression showed a correlation between depressive symptoms and theobromine intake (OR:1.17, 95%CI:1.02–1.34). Conclusions Our cross-sectional population based study suggests that increased theobromine intake is associated with increased risk for depression. Nevertheless, more investigations are needed to confirm our findings.
... Depression is associated with several lifestyle behaviours such as physical inactivity (Gianfredi et al., 2020), poor diet (Molendijk et al., 2018), disturbed sleep (Fang, Tu, Sheng, & Shao, 2019), and increased alcohol consumption (Churchill & Farrell, 2017). Multiple reviews have indicated that physical activity is an effective strategy for treating depression (Cooney et al., 2013;Josefsson et al., 2014;Schuch et al., 2016), and the evidence for interventions based on improving diet and sleep is growing (Firth et al., 2019;Gee et al., 2019). ...
Article
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Unlabelled: The prevalence of Major Depressive Disorder in men is half that of women, yet depression affects approximately 109 million men worldwide. Alarmingly, men account for three quarters of suicides in Western countries but are unlikely to seek help for mental health concerns. It is possible that existing mental health treatments are not engaging or accessible to men. The aim of this review was to quantify the number of men involved in randomised trials of psychotherapy or lifestyle behaviour change targeting depression. Results found men represented 26% of participants in 110 eligible articles compared to 73% women. Men's representation was low across all intervention characteristics (e.g., delivery mode). No studies used a completely male sample, compared to 19 studies targeting women only. Men are substantially underrepresented in research trials targeting depression. Supplementary information: The online version contains supplementary material available at 10.1007/s12144-022-04017-7.
... Meta-analyses have found a significant association between depressive symptom reduction and eating a healthy diet [46,47]. In addition, a randomized clinical trial found that adults with elevated depression symptoms under the diet intervention (i.e., a healthy diet) showed significantly reduced symptoms of depression compared with the habitual diet control group [48]. ...
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This study aimed to identify the interaction of depression and diets on cardiovascular diseases (CVD) incident and death in China and key subpopulations. We included 40,925 participants from the Prospective Urban Rural Epidemiology (PURE)-China cohort which recruited participants aged 35–70 years from 45 urban and 70 rural communities. Depression was measured by the adapted Short-Form (CIDI-SF). The unhealthy diet was considered when the score of Alternative Healthy Eating Index was below the lowest tertile. The primary outcome was a composite outcome of incident CVD and all-cause mortality. Cox frailty models were used to examine the associations. During a median follow-up of 11.9 years (IQR: 9.6–12.6 years), depression significantly increased the risk of the composite outcome (HR = 2.00; 95% CI, 1.16–3.27), major CVD (HR = 1.82; 95% CI, 1.48–2.23), and all-cause mortality (HR = 2.21; 95% CI, 1.51–3.24) for the unhealthy diet group, but not for the healthy diet group. The interaction between depression and diet for the composite outcome was statistically significant (RERI = 1.19; 95% CI, 0.66–1.72; AP = 0.42, 95% CI, 0.27–0.61; SI = 3.30, 95% CI, 1.42–7.66; multiplicative-scale = 1.74 95% CI, 1.27–2.39), even in the subgroup and sensitivity analyses. In addition, the intake of vegetable and polyunsaturated fatty acids contributed most to the interaction of diets and depression. Depressive participants should focus on healthy diets, especially vegetables and polyunsaturated fatty acids, to avoid premature death and CVD.
... Obesity before pregnancy and excess gestational weight gain during pregnancy have also been associated with poor child neurodevelopmental outcomes (23), child obesity (24), and maternal and child chronic disease later in life (25)(26)(27). A healthful diet and greater diet quality have been linked to better mental health and mood (28,29) and lower risk of obesity or excessive gestational weight gain (30). Further, other studies using NEST (Newborn Epigenetics STudy) data have shown that maternal dietary patterns are associated with offspring behavior in 12-to 24-mo-old offspring, and suggest a possible link through epigenetic mechanisms (31,32). ...
Article
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Background Psychosocial and physiologic stressors, such as depression and obesity, during pregnancy can have negative consequences, such as increased systemic inflammation, contributing to chronic disease for both mothers and their unborn children. These conditions disproportionately affect racial/ethnic minorities. The effects of recommended dietary patterns in mitigating the effects of these stressors remain understudied. Objectives We aimed to evaluate the relations between maternal Mediterranean diet adherence (MDA) and maternal and offspring outcomes during the first decade of life in African Americans, Hispanics, and Whites. Methods This study included 929 mother–child dyads from the NEST (Newborn Epigenetics STudy), a prospective cohort study. FFQs were used to estimate MDA in pregnant women. Weight and height were measured in children between birth and age 8 y. Multivariable linear regression models were used to examine associations between maternal MDA, inflammatory cytokines, and pregnancy and postnatal outcomes. Results More than 55% of White women reported high MDA during the periconceptional period compared with 22% of Hispanic and 18% of African American women (P < 0.05). Higher MDA was associated with lower likelihood of depressive mood (β = −0.45; 95% CI: −0.90, −0.18; P = 0.02) and prepregnancy obesity (β = −0.29; 95% CI: −0.57, −0.0002; P = 0.05). Higher MDA was also associated with lower body size at birth, which was maintained to ages 3–5 and 6–8 y—this association was most apparent in White children (3–5 y: β = −2.9, P = 0.02; 6–8 y: β = −3.99, P = 0.01). Conclusions If replicated in larger studies, our data suggest that MDA provides a potent avenue by which effects of prenatal stressors on maternal and fetal outcomes can be mitigated to reduce ethnic disparities in childhood obesity.
... There are some studies showing that depression and its severity increase in the post-op first year in patients who have undergone bariatric surgery 15,16 . Depression can negatively affect diet quality by causing symptoms such as loss of appetite or overeating 17 . ...
Article
ABSTRACT Introduction: This study aims to determine the relationship of diet quality in women with weight change, body mass index (BMI), and depression one year after undergoing sleeve gastrectomy. Material and Methods: This is a cross-sectional descriptive study with 62 women aged 18-65 years who underwent sleeve gastrectomy in a private hospital and completed their first postoperative year. The participants were asked to fill a questionnaire on 3-day food consumption record, sociodemographic characteristics, and nutritional status; beck depression inventory (BDI) was applied. Mean adequacy ratio (MAR) was used to evaluate diet quality. Results: The mean age was 33.6±9.5 years. The mean MAR score was 76.0±31.8, and the mean BDI score was 8.2±6.4. The excess weight loss rate was high in patients with good diet quality, and the BMI and depression scores were low (PEWL, BMI > 0.05, PBeck < 0.001). Diet quality was found to be negatively correlated with body weight, BMI and depression scores and positively correlated with excess weight loss. Conclusions: Enhancing the diet quality can help patients in overcoming postoperative depression and increasing the success of weight loss. Regular follow-up and guidance provided to the patients by specialized dietitians can further augment the success rates.
... Engaging in health risk behaviours, which are behaviours that undermine health, such as alcohol and drug use, are found to be predictive of poor psychological functioning in adolescents (Robinson et al., 2011). Other health risk behaviours associated with greater mental health difficulties in adolescents include poor diet quality (Molendijk et al., 2018), low levels of physical activity (Biddle & Asare, 2011), low sleep quantity (Scott et al., Similar U-shape curves have been observed in relation to sleep, social media use and mental health outcomes (Dooley et al., 2019;Fitzgerald et al., 2011). ...
Article
Research has documented relationships between individual health behaviours and mental health, but few studies have examined patterns of health behaviours (i.e., health lifestyles) and mental health outcomes. This study investigated the relationship between health lifestyles and mental health and psychological wellbeing in adolescents. Data from the My World Survey 2 - Second Level (MWS2-SL), a random national sample of 9493 adolescents (44.2% male) aged 12–18 years (M = 14.8, SD = 1.66) in second level education in Ireland were used. TwoStep cluster analysis identified clustering of health behaviours (sleep, alcohol use, cannabis use, social media use, sport and hobby participation). ANOVA and Chi Square tests identified potential differences in demographic characteristics (age, gender, socioeconomic status, ethnicity) and psychological outcomes (anxiety, depression, life satisfaction, daily functioning) across clusters. Three clusters were identified; 1. Low (22.0%), 2. Moderate-high (41.5%) and 3. High (36.5%), health promoting. The ‘Low’ health-promoting cluster, characterised by high alcohol, cannabis and social media use, moderate sport and hobby participation, and low sleep duration, demonstrated the highest levels of anxiety and depression and the lowest levels of life satisfaction, self-esteem and daily functioning. The ‘High’ health-promoting cluster reported the most favourable psychological outcomes. Cluster 1 were more likely to be older and male, Cluster 3 were more likely to be younger and female. Findings demonstrate the potential for health promotive lifestyles to mitigate mental health difficulties and promote life satisfaction and daily functioning in adolescents. Health lifestyles represent important indicators of mental health and targets for prevention/promotion efforts.
... This suggested that both individuals and policymakers should take the initiatives to address the mental health crisis during the COVID-19 pandemic [56]. From the perspective of individuals, individuals can take actions, such as exercising regularly and maintaining a healthy diet pattern, as well as keeping in touch with friends and family by phone calls, to effectively ease and prevent symptoms of depression [57][58][59][60]. From the perspective of policymakers, with very limited mental health professionals in LMICs [61], we urgently require strong intervention policies, such as building capacities among nonspecialists to deliver psychological services, strengthening remote mental health services, and implementing digital mental health interventions [62,63] in order to address the need for mental health services in resource-poor areas to avoid exacerbating health inequities and to move towards achieving SDG 3: Good Health and Well-Being [64]. ...
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To date, there is a lack of comprehensive understanding regarding the effect of coronavirus disease 2019 (COVID-19) on the healthcare-seeking behavior and utilization of health services in rural areas where healthcare resources are scarce. We aimed to quantify the long-term impact of COVID-19 on hospital visits of rural residents in China. We collected data on the hospitalization of all residents covered by national health insurance schemes in a county in southern China from April 2017 to March 2021. We analyzed changes in residents’ hospitalization visits in different areas, i.e., within-county, out-of-county but within-city, and out-of-city, via a controlled interrupted time series approach. Subgroup analyses based on gender, age, hospital levels, and ICD-10 classifications for hospital visits were examined. After experiencing a significant decline in hospitalization cases after the COVID-19 outbreak in early 2020, the pattern of rural residents’ hospitalization utilization differed markedly by disease classification. Notably, we found that the overall demand for hospitalization utilization of mental and neurological illness among rural residents in China has been suppressed during the pandemic, while the utilization of inpatient services for other common chronic diseases was redistributed across regions. Our findings suggest that in resource-poor areas, focused strategies are urgently needed to ensure that people have access to adequate healthcare services, particularly mental and neurological healthcare, during the COVID-19 pandemic.
... Healthcare 2022, 10, 1848 ...
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This study examines the association of depressive and anxiety symptoms with diet quality among university students while controlling for different demographic and other health and lifestyle factors. This cross-sectional study was carried out between April 2021 and June 2021 among a total of 440 (unweighted) university students. Diet quality was assessed using a 10-item mini-dietary assessment index tool. The depressive and anxiety symptoms of participants were measured using the validated Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder (GAD-7) scale, respectively. Multivariable logistic regression and mediation analyses were performed. In this study, 61.1% (95% CI: 56.6% to 65.7%) of university students’ diet quality was good during the COVID-19 pandemic. Being a post-graduate student, an urban resident, having no depressive (AOR = 2.15, 95% CI: 1.20 to 3.84) and anxiety symptoms (AOR = 1.96, 95% CI: 1.07 to 3.59), no changes or improvement in appetite, and no changes in sleep duration were significantly associated with good diet quality among our study participants. Depressive and anxiety symptoms during COVID-19 had a significant effect on the diet quality of university students. Future public health policies need to be focused on improving the mental health and well-being of students particularly during pandemic situations to enhance their diet quality.
... Consistent with other literature on the diet-mental health relationship [15,18,44], cross-sectional study design was the one most commonly used. While the cross-sectional study design can help generate hypotheses, in respect to the diet-mental health relationship this task has already been fulfilled. ...
Article
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Objective: Recent evidence suggests that adequate fruit and vegetables intake (FVI) might be associated with lower risk of common mental disorders (CMDs) in adults, but studies in youth are also beginning to emerge and are synthesized in this systematic review. Methods: Online databases were searched from inception to 30 October 2020 to locate cross-sectional, cohort, and case-control studies focusing on the FVI and CMDs in youth (i.e., 10–18 years old). The risk of bias of studies was assessed using Joanna Briggs Institute Critical Appraisal Tool and the Newcastle-Ottawa quality assessment scale. Results: Among 3,944 records identified, 12 studies (8 cross-sectional, 1 case-control, and 3 prospective cohort studies) were included in the final synthesis. None of the prospective cohort studies identified a statistically significant association between FVI and CMDs in youth, although inconsistent associations were reported in cross-sectional and case-control studies. Conclusion: The lack of associations between FVI and CMDs in youth, along with consistent associations in adults, might be explained by the accumulation of risk theoretical model and methodological challenges.
... In our study, depression was associated with a decrease in the PNNS-GS2. A systemic review performed before the COVID-19 pandemic already showed an association between a high-quality diet and a lower risk of depression [28], and this was confirmed during the COVID-19 crisis [29,30]. During that crisis, the changes in teaching modalities created much stress for students (45-48). ...
Article
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Introduction: The COVID-19 pandemic and the lockdowns have affected many aspects of university students' daily lives, including their dietary habits. This study aimed to evaluate the change of diet quality of university students before and during the COVID-19 period, and the factors associated with unfavorable changes in diet quality. Methods: An online cross-sectional study was performed in May 2021 among Rouen (France) university students. Socio-demographic characteristics, body mass index, depression, academic stress, risk of eating disorders and food security were collected. The French "Programme National Nutrition Santé-Guidelines Score 2" (PNNS-GS2) was used to access diet quality. Results: A total of 3508 students were included, 74.4% were female, the mean age was 20.7 (SD = 2.3), and 7.0% were in a situation of food insecurity. The PNNS-GS2 score decreased between the pre- and the COVID-19 pandemic period for 33.1% of university students. The associated factors with the decrease in the PNNS-GS2 score were food insecurity, financial insecurity, not living with parents, depression, academic stress, eating disorders, being in the two first years of study and having been infected by COVID-19. Conclusions: Diets with healthy components decreased for one-third of university students since the COVID-19 pandemic, and this was shown to be associated with food insecurity, poor mental health and eating disorder. This study provides important information to help public health authorities and universities give better support to student health feeding programs during pandemics and lockdowns.
... Among these factors, diet have attracted lot of attention by researchers off late. [16][17][18][19][20][21][22][23] Growing body of researches indicates significant role of diet not only in promoting positive mental well-being, but also in treatment of mental illness. Few of the concluding theories that have churned out of researchers in this direction are as follows: ...
Article
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The use of psychotropic medication in psychiatric disorders has brought significant reduction in mental health morbidity and related mortality. However, over the years, we have realized that the benefit of these medication on mental health are overshadowed by many important side effects, necessity of medication for an uncomfortably long period, and inadequate compliance requiring significant adherence-oriented efforts. Additionally, medication may be effective in a third of the population and end up in relapse, regardless, in significant half of the population. Of late, there has been growing interest toward lifestyle-related factors, which appears to be of both prophylactic and therapeutic value in mental well-being. Research evidence for the role of physical exercise, sleep, mindfulness, social connectedness, environmental mastery, and so on, have been adequate and growing. Among these factors, diet have attracted lot of attention by researchers.
... As the consumption of ultra-processed foods has continued to increase, investigations have started to hypothesize whether or not an association between diet quality and depression risk exists. A recent meta-analysis illustrated that adherence to high-quality diets utilizing whole foods or focusing on the Mediterranean diet were associated with a lower risk of depression onset [74]. Such results were later confirmed in population subsets such as pregnant women and showed that higher adherence to healthy dietary patterns led to lower feelings of sadness or depression and vice versa when ultra-processed food consumption was tracked (32). ...
Article
Objective We aimed to conduct a systematic review and meta-analysis of observational studies examining the relationship between ultra-processed food (UPF) consumption and the risk of mental health disorders. Methods The ISI Web of Science, PubMed/MEDLINE, and Scopus databases were searched without date restriction until 28 December 2021. Data were extracted from 26 studies, including 260,385 participants from twelve countries. Risk ratios for mental health disorders were pooled by a random-effects model. Results Meta-analyses suggested that UPF consumption was associated with an increased risk of depression (RR = 1.28; 95% CI: 1.19, 1.38; I2 = 61.8%; p = 0.022) but not anxiety (RR = 1.35; 95% CI: 0.86, 2.11; I2 = 77.8%; p = 0.198). However, when analyzed for the dietary assessment method, UPF consumption was significantly associated with an enhanced risk of depression among studies utilizing food frequency questionnaires (RR = 1.31; 95% CI: 1.21, 1.41; I2 = 60.0%; p < 0.001) as opposed to other forms of dietary recall approaches. Additionally, for every 10% increase in UPF consumption per daily calorie intake, 11% higher risk of depression (RR = 1.11; 95% CI: 1.01, 1.17; I2 = 88.9%; p < 0.001) was observed among adults. Dose-response analysis further emphasized a positive linear association between UPF consumption with depression risk (p-nonlinearity = 0.819, p-dose-response = p < 0.001). Conclusion Our findings indicate that UPF consumption is related to an enhanced depressive mental health status risk. There may be different causes for this increased risk, and further studies are needed to investigate if there is a causal relationship between consumption of UPF and mental health.
... Dessa forma, a avaliação nutricional no paciente adulto, pode ser realizada a partir da utilização de diferentes indicadores antropométricos, tendo como propósito identificar alterações, compreender de que maneira o comportamento pode influenciar na saúde humana e gerar intervenções de saúde (Brasil, 2020;World Health Organization, 2018;Schuh, et al., 2019). Os hábitos saudáveis, como alimentação de qualidade e a prática de atividade física trazem benefícios à saúde, em contrapartida os hábitos inadequados de vida, como o sedentarismo e alimentação inadequada trazem resultados negativos Mozaffarian, et al., 2018;Molendijk, et al., 2018). ...
Article
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Avaliar se há associação entre o estado nutricional e o consumo alimentar de pacientes com depressão. O estudo foi desenvolvido no Centro de Atenção Psicossocial (CAPS), localizado na cidade de Sobral - CE, com 100 pacientes com transtorno depressivo, na faixa etária entre 20 e 59 anos, ambos os sexos. Foram coletados dados socioeconômicos, antropométricos, e o consumo alimentar através de um Questionário de Frequência Alimentar (QFA). O projeto foi aprovado pelo Comitê de Ética em Pesquisa, sob parecer nº 2.596.743. Dos 100 participantes da amostra, 67% (n= 67) foram mulheres, na faixa etária “menor que 39 anos”, 55% (n= 55), a cor negra 51% (n = 51), a união consensual∕casado 56% (n= 56) e a renda de até um salário mínimo 55% (n=55). Ao analisarmos o estado nutricional, ambos os sexos, apresentaram um número maior de participantes com sobrepeso e obesidade. A prevalência de excesso de peso foi de 89%, sendo 58% do sexo feminino e 31% do sexo masculino. Quanto ao consumo alimentar não houve diferença entre os participantes, segundo o Índice de Massa Corpórea (IMC) (p > 0,05). Há alta proporção de excesso de peso entre os pacientes avaliados e este não foi associado ao consumo alimentar.
... Several investigations, including two large prospective cohort studies in Europe, suggest that individuals whose diets lack essential nutrients, have a high glycaemic index, and are high in added sugars also have significantly increased risks of depression and anxiety. They also found that those who consume diets, high in fish, vegetables, olive oil, beans, nuts, PUFA and low in saturated fats, such as the Mediterranean diet, have significantly lower risks of depression (4)(5)(6)9,21,22,(36)(37)(38)(39)(40)(41)(42)(43) . ...
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Objective To explore whether individuals who consume higher amounts of ultra-processed food have more adverse mental health symptoms. Design Using a cross-sectional design, we measured the consumption of ultra-processed foods as a percentage of total energy intake in kilo-calories using the NOVA food classification system. We explored whether individuals who consume higher amounts of ultra-processed food were more likely to report mild depression, more mentally unhealthy days and more anxious days per month using multivariable analyses adjusting for potential confounding variables. Setting Representative sample from the United States National Health and Nutrition Examination Survey between 2007 and 2012. Participants 10,359 adults aged 18+ without a history of cocaine, methamphetamine, or heroin use. Results After adjusting for covariates, individuals with the highest level of ultra-processed food consumption were significantly more likely to report at least mild depression (OR 1.81; 95% CI: 1.09-3.02), more mentally unhealthy (RR 1.22; 95% CI: 1.18-1.25), and more anxious days per month. (RR 1.19; 95% CI: 1.16-1.23). They were also significantly less likely to report zero mentally unhealthy (OR 0.60; 95% CI: 0.41-0.88) or anxious days (OR 0.65; 95% CI 0.47-0.90). Conclusions Individuals reporting higher intakes of ultra-processed food were significantly more likely to report mild depression, more mentally unhealthy and more anxious days, and less likely to report zero mentally unhealthy or anxious days. These data add important information to a growing body of evidence concerning the potential adverse effects of ultra-processed food consumption on mental health.
... Therefore, long-term high sodium intake may affect neurological function over time [27][28][29]. Dash et al. have reviewed animal experiments and shown that high sodium, saturated fat, and added sugar have negative effects on brain function through damage to frontal, limbic, and hippocampal areas of the brain [30,31], while the increased intake of fruits and vegetables was associated with a lower risk of depression in adults [32][33][34]. The reasons for the link between fruit and vegetable intake and depression may be as follows. ...
Article
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This study aimed to investigate the association between the alternative healthy eating index-2010 (AHEI-2010) with cognitive function and the mediating role of depressive symptoms in older adults using the data from the 2011–2014 National Health and Nutrition Examination Survey (NHANES). The AHEI-2010 was calculated from NHANES individual food data and Food Patterns Equivalents Database (FPED) diet data. Cognitive function was assessed by the Consortium to Establish a Registry for Alzheimer’s disease (CERAD, memory function indicator), Word Learning sub-test, digital symbol substitution test (DSST, processing speed indicator), animal fluency test (AFT, executive function indicator), and the comprehensive z-score (global cognition indicator). A weighted multiple linear regression model was used to explore the relationship between AHEI-2010 and cognitive function, and Karlson–Holm–Breen (KHB) method was used to explore the mediating effect of depressive symptoms. A total of 2644 participants were included in this study. Participants with higher AHEI-2010 scores were more likely to have higher scores in DSST, AFT, and comprehensive z-score compared with the lowest quartile. Depressive symptoms play a significant mediating role between AHEI-2010 and cognitive function. The proportion of mediating in CERAD, DSST, AFT, and comprehensive z-score was 14.14%, 9.10%, 9.15%, and 10.47%, respectively. This study found that higher dietary quality was associated with better cognitive function. In addition, depressive symptoms may be an important pathway linking diet and cognitive function.
... Diet pattern has been associated with mood disorders. Dietary quality is associated with a lower risk for the onset of mood disorder symptoms (Molendijk et al., 2018). Yet, the improvement of banana starch on diabetic-induced mood disorders has not been tested in humans. ...
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Bananas (Musa spp.) enriched in resistant starch displayed multiple health benefits for diabetes. Here, we showed that banana starch administered to diabetic rats improved animal depressive-like behaviours of mood disorders. Four weeks of banana starch diet to high-sugar, high-fat, and STZ-induced diabetic rats lowered their blood insulin resistance, but increased their plasma HDL cholesterol and 5-HT levels, compared to the control groups of rats. The banana starch diet reconstructed the gut microbiota and increased their metabolite of butyrate, as well as increased the activity of superoxidase in diabetic rats. Furthermore, Banana starch intervention significantly increased the exhaustion time of the diabetic rats, and almost restored it to the normal state of control groups in their swimming and tail suspension tests. Together, our results indicated the modulation of the gut-microbiota-brain axis as a possible mechanism that enables the banana starch diet as a potential therapeutic way for diabetes-associated mood disorders. © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
... Among these factors, diet have attracted lot of attention by researchers off late. [16][17][18][19][20][21][22][23] Growing body of researches indicates significant role of diet not only in promoting positive mental well-being, but also in treatment of mental illness. Few of the concluding theories that have churned out of researchers in this direction are as follows: ...
Chapter
Everybody eats, and what we eat – or do not – affects the brain and mind. There is significant general, applied, academic, and industry interest about nutrition and the brain, yet there is much misinformation and no single reliable guide. Diet Impacts on Brain and Mind provides a comprehensive account of this emerging multi-disciplinary science, exploring the acute and chronic impacts of human diet on the brain and mind. It has a primarily human focus and is broad in scope, covering wide-ranging topics like brain development, whole diets, specific nutrients, research methodology, and food as a drug. It is written in an accessible format and is of interest to undergraduate and graduate students studying nutritional neuroscience and related disciplines, healthcare professionals with an applied interest, industry researchers seeking topic overviews, and interested general readers.
Article
Background: Frailty increases the risk of negative health-related events, such as falls, disability, hospitalizations, and death. Although the association between oral health and physical frailty is well established, the relationship between oral health and psychological frailty has not yet been investigated. Therefore, we conducted a cross-sectional study to examine the association between maximal occlusal force and psychological frailty in Japanese community-dwelling older adults. Methods: Psychological frailty was defined as a World Health Organization-5 scale (WHO-5) score of <13, cognitive and functional status was defined as a Japanese version of the Montreal Cognitive Assessment (MoCA-J) score of <23, and psychological robustness was defined as a WHO-5 score of ≥13 and a MoCA-J score of ≥23. We used a cross-sectional study design to measure maximal occlusal force in 1810 participants, and examined the following factors relevant to psychological frailty: educational level, financial status, living situation, history of chronic diseases, handgrip strength, and instrumental activities of daily living. We used propensity score matching to match the psychological frailty and psychological robustness groups according to demographic and confounding factors. This process, resulted in 344 participants, of whom 172 were in the psychological frailty group and 172 were in the psychological robustness group. In the matched cohort, differences between groups with and without psychological frailty were compared using generalized estimating equations for maximal occlusal force after adjusting for the number of teeth. Results: After controlling for potential confounding factors of frailty, the psychological frailty group showed lower maximal occlusal force compared with the psychological robustness group (unstandardized regression coefficients = -72.7, 95% confidence interval: -126.3 to -19.1). Conclusions: Maximal occlusal force was associated with a reduced prevalence of psychological frailty among Japanese community-dwelling older adults participating in our study.
Article
Importance: Depression and anxiety may significantly affect women during the menopausal transition. In addition to traditional treatment strategies such as hormone therapy, antidepressants, and psychotherapy, nutritional interventions have been increasingly studied, but there is no consensus about their role in this patient population. Objective: This systematic review and meta-analysis aimed to evaluate the effect of nutritional interventions on the severity of depressive (DS) and anxiety (AS) symptoms in women during the menopausal transition or menopausal years. Evidence review: Electronic search using databases PubMed, Cochrane, and Embase to identify articles indexed until January 31, 2021, focusing on randomized placebo-controlled trials documenting the effect of diet, food supplements, and nutraceuticals on DS and AS. Findings: Thirty-two studies were included (DS, n = 15; AS, n = 1; DS and AS combined, n = 16). We found two studies that demonstrated data combined with other interventions: one with lifestyle interventions (vitamin D plus lifestyle-based weight-loss program) and another with exercise (omega 3 plus exercise). The pooled effect size favored the intervention group over placebo for both DS and AS (DS: standardized mean difference, -0.35 [95% confidence interval, -0.68 to -0.03; P = 0.0351]; AS: standardized mean difference, -0.74 [95% CI, -1.37 to -0.11; P = 0.0229]). There was significant heterogeneity in the pooled results, which can be attributed to differences in assessment tools for depression and anxiety as well as the variety of nutritional interventions studied. The subgroup analysis showed a statistically significant effect of menopausal status (perimenopausal or menopausal) but not the type or duration of nutritional intervention. Older age was the only significant predictor of the effect size of nutritional interventions in the meta-regression. Conclusions and relevance: Nutritional interventions are promising tools for the management of mood/anxiety symptoms in women during the menopausal transition and in postmenopausal years. Because of significant heterogeneity and risk of bias among studies, the actual effect of different approaches is still unclear.
Article
Internalizing mental disorders are highly comorbid with one another, and evidence suggests that etiological processes contributing to these disorders often overlap. This systematic umbrella review aimed to synthesize meta-analytic evidence from observational longitudinal studies to provide a comprehensive overview of potentially modifiable risk and protective factors across the depressive, anxiety, and eating disorder psychopathology domains. Six databases were searched from inception to August 2022. Only meta-analyses of longitudinal studies that accounted for baseline psychopathology (either via exclusion of baseline cases or statistical adjustment for baseline symptoms) were included. Methodological quality of meta-analyses was evaluated using the AMSTAR 2, and quality of evidence for each analysis was rated using GRADE. Study selection, quality assessment, and data extraction were conducted in duplicate by independent reviewers. The protocol for this review was registered with PROSPERO (CRD42020185575). Sixty-one meta-analyses were included, corresponding to 137 meta-analytic estimates for unique risk/protective factor-psychopathology relationships. Most potential risk/protective factors, however, were examined only in relation to depressive psychopathology. Concern over mistakes and self-esteem were the only risk and protective factors, respectively, identified as statistically significant across depressive, anxiety, and eating disorder psychopathology domains. Eight risk factors and four protective factors also emerged as having transdiagnostic relevance across depressive and anxiety domains. Results suggest intervention targets that may be valuable for preventing/treating the spectrum of internalizing psychopathology and reducing comorbidity. However, few factors were identified as transdiagnostically relevant across all three internalizing domains, highlighting the need for more research investigating similar sets of potential risk/protective factors across internalizing domains.
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Objectives: Food price is a determining factor in food choices. However, its relationship with diet quality is unclear in Chinese adults. This study aimed to examine daily energy-adjusted dietary cost (CNY/2000kcal) concerning diet quality in northeast central Chinese adults. Design: Cross-sectional study. The food consumed by 680 Chinese adults from Henan province during the year 2020 was recorded by 24-h dietary recalls. Three dietary quality indices, namely the nutrient-rich foods (NRF) index, the mean adequacy ratio (MAR), and the energy density (ED), were adopted. Daily energy-adjusted diet cost was calculated by dividing the estimated daily diet costs (CNY/day) by the energy intake per day (kcal/day) and multiplying 2000. Setting: Three communities in Zhengzhou city, Henan province, China. Participants:A total of 680 adults were recruited from Henan as the subjects. Results: Subjects who closely adhered to the NRF9.2, MAR, and ED paid daily ¥8.92, ¥13.17, and ¥14.34 more for food consumption, respectively, than those who weakly adhered to these dietary patterns. Furthermore, adjusted linear regression analysis revealed that an increase in ¥1 of the energy-adjusted diet cost per day was associated with a change of 0.494 units (P< 0.001), 0.003 units (P<0.001), and -0.018 units (P<0.001) in the NRF9.2, MAR, and ED, respectively. Conclusion:Higher energy-adjusted diet costs were associated with higher-quality diets. This might be of importance for public health policies in an effort to develop strategies to promote healthy diets by regulating food and diet costs.
Article
Background Cardiovascular health (CVH) declines in young adulthood, and mood disorders commonly emerge during this life stage. This study examined the association between depression, anxiety, and CVH metrics among young adults. Methods and Results We conducted a cross‐sectional analysis of participants aged 18 to 34 years who completed the Emory Healthy Aging Study Health History Questionnaire (n=875). We classified participants as having poor, intermediate, or ideal levels of the 8 CVH metrics using definitions set forth by the American Heart Association with adaptions when necessary. We defined depression and anxiety as absent, mild, or moderate to severe using standard cutoffs for Patient Health Questionnaire and General Anxiety Disorder scales. We used multivariable regression to examine the association between depression and anxiety and CVH, adjusting for age, sex, race and ethnicity, income, and education. The mean participant age was 28.3 years, and the majority identified as women (724; 82.7%); 129 (14.7%) participants had moderate to severe anxiety, and 128 (14.6%) participants had moderate to severe depression. Compared with those without anxiety, participants with moderate to severe anxiety were less likely to meet ideal levels of physical activity (adjusted prevalence ratio [aPR], 0.60 [95% CI, 0.44–0.82]), smoking (aPR, 0.90 [95% CI, 0.82–0.99]), and body mass index (aPR, 0.79 [95% CI, 0.66–0.95]). Participants with moderate to severe depression were less likely than those without depression to meet ideal levels of physical activity (aPR, 0.48 [95% CI, 0.34–0.69]), body mass index (aPR, 0.75 [95% CI, 0.61–0.91]), sleep (aPR, 0.79 [95% CI, 0.66–0.94]), and blood pressure (aPR, 0.92 [95% CI, 0.86–0.99]). Conclusions Anxiety and depression are associated with less ideal CVH in young adults. Interventions targeting CVH behaviors such as physical activity, diet, and sleep may improve both mood and CVH.
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BACKGROUND: The literature suggests that nutritional status is associated with the onset and maintenance of depressive symptoms, but the association is still unclear. OBJECTIVES: Describe the association between malnutrition and depressive disorder. METHODS: Cross-sectional study, in 221 non-randomly selected, community dwelling, individuals. Data were collected through individual, face-to-face interviews, which included questions on health, nutritional status, sociodemographic characteristics, and the interviewer versions of the Mini Nutritional Assessment and the Geriatric Depression Scale. Statistical analyses were conducted using IBM SPSS Statistics 27.0, and statistical significance for all procedures was set at 0.05. RESULTS: The most prevalent clinical feature was pain during the last month (73.3%). 58 participants (26.2%) were at risk for malnutrition and 2 participants (0.9%) presented malnutrition. Depression was more prevalent in women (55.3%) than in men (37.5%). Odds to exhibit depression are 1.83 times higher (95% CI 1.16–3.68, p = 0.036) with malnutrition and 2.45 times higher (95% CI 1.25–4.78, p = 0.009) if reporting pain. CONCLUSIONS: Clinicians should consider the assessment and intervention for both depression and malnutrition when encountering one of these conditions. Acute pain seems to have a strong association with depression and must also be addressed and considered in this regard.
Article
Background: During the COVID-19 pandemic, all health workforces, including nursing students, were mobilized to prevent the spread of the disease. The physical and mental health of frontline healthcare workers has been shown to have several adverse effects during the COVID-19 outbreak. However, few studies analyzed the mental health of nursing students participating in COVID-19 prevention, especially in Vietnam. Objective: The study was to identify and analyze the mental health of students and its related factors during the fourth wave of COVID-19 in Vietnam. Methods: A cross-sectional survey was conducted among 672 nursing students participating in COVID-19 in Ho Chi Minh City, Vietnam, from September to October 2021. Self-administered and online-based surveys were used to collect data using Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-9),and the Insomnia Severity Index. Descriptive statistics and logistic regression were done for data analysis using R 3.6.0 software. Results: Among our participants, the proportion of depression symptoms, anxiety symptoms, and insomnia were 2.88%, 5.1%, and 4.33%, respectively. Students who had physical activity habits before involvement in COVID-19 and maintained physical activity while participating in the epidemic had lower symptoms of anxiety, depression, and the risk of sleep disturbances. Furthermore, students with healthy diet status had fewer negative consequences on their mental health. Conclusions: Our findings provided evidence for organizations strategizing to preserve the emotional health of nursing students while engaging in the COVID-19 campaign.
Article
Background: The relationship between diet, inflammation and mental health has been receiving increasing interest. However, limited data are available on the inflammatory role of diet in university students, among whom depression is commonly observed. Aim: The aim of our study is to investigate the relationship between dietary inflammatory index (DII) and depression among female students of nutrition and dietetics department, whom we assume to be conscious about health. Methods: DII scores were determined by averaging the 3-day dietary records. Depression status of the students was determined by using Beck Depression Inventory (BDI). Results: Our study was conducted with 122 female university students. The mean total BDI score of the students in the first tertile (more anti-inflammatory effect) was found significantly lower than those of the students in the second and third tertiles ( p = 0.001). In addition, there were no significant difference between the depression scores of the students and their grade level ( p = 0.114) and place of residence ( p = 0.866). We found a positive association between DII and depressive symptoms (Model 1, B = 0.512, %95 CI: 0.236–0.789, p = 0.000). This relationship was also found when adjusting for age, weight, body mass index, smoking status, and presence of chronic disease (Model 2, B = 0.496, %95 CI: 0.217–0.776, p = 0.006; Model 3, B = 0.493, %95 CI: 0.210–0.777, p = 0.024. Conclusion: Supporting that the inflammatory burden of diet is associated with mental health, our findings are of significance for the development of anti-inflammatory nutritional approaches among students who are prone to depression.
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Depression is one of the most common diseases in the older population. Difficulties in recognizing the etiology and its recurrence make depression a major challenge for healthcare professionals. The risk of developing depression is influenced by many factors, including lifestyle and diet. Research studies have shown a relationship between the consumption of specific macro and micro elements and depression. However, so far no nutritional recommendations on how to reduce the risk of the disease and its relapses in older adults have been developed. In this review, we will outline research results of conducted studies and focus on both basic and potentially promising elements of diet such as proteins, carbohydrates, fats, dietary fiber, vitamins D, E, C and B as well as microelements such as magnesium, zinc, selenium or iron.
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Researchers are currently debating whether theories of addiction explain compulsive overeating of highly processed (HP) foods (i.e., industrially created foods high in refined carbohydrates and/or fat), which contributes to obesity and diet‐related disease. A subset of individuals consumes HP foods with behavioral phenotypes that mirror substance use disorders. Withdrawal, the emergence of aversive physical and psychological symptoms upon reduction or cessation of substance use, is a core component of addiction that was central to historical debates about other substances' addictive potential (e.g., nicotine and cocaine). However, no one has systematically considered evidence for whether HP foods cause withdrawal, which represents a key knowledge gap regarding the utility of addiction models for understanding compulsive overeating. Thus, we reviewed evidence for whether animals and humans exhibit withdrawal when reducing or eliminating HP food intake. Controlled experimental evidence indicates animals experience HP food withdrawal marked by neural reward changes and behaviors consistent with withdrawal from other addictive substances. In humans, preliminary evidence supports subjective withdrawal‐like experiences. However, most current human research is limited to retrospective recall. Further experimental research is needed to evaluate this construct. We outline future research directions to investigate HP food withdrawal in humans and consider potential clinical implications.
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Background: The effect of dietary patterns on sleep disorders and mental illness has previously been investigated. However, these studies have reported contradictory findings, and thus, the present study aimed to assess the association of the MIND diet on the sleep pattern and mental health in obese women. Methods: This is a cross-sectional study in which 282 women, aged 18-56 years with BMI ≥ 25 kg/m2.with no underlying diseases and malignancies, and participated. We used a semi-quantitative food frequency questionnaire (FFQ) to collect participant's dietary intake. The Pittsburgh Sleep Quality Index (PSQI) and Depression Anxiety Stress Scales (DASS) were used to measure the status of sleep disturbance and psychological disorders, including depression, anxiety, and stress respectively. Results: A decreasing trend for psychological stress was observed in the highest quartiles of MIND diet score vs. the lowest quartiles (OR = 0.6 CI: 0.23-1.5 vs. 1.16 CI: 0.55-2.47). No significant difference was observed between severity of depression (OR = 0.87 95%, CI: 0.7-1.09, P = 0.23), anxiety (OR = 1.02, 95% CI: 0.81-1.27, P = 0.86), stress (OR = 0.99 95%, CI: 0.79-1.23, P = 0.92), and MIND diet adherence in the crude and adjusted models. Conclusion: The main finding from this study was that there is no significant association between adherence to the MIND diet and studied psychological disorders.
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Background: Medical students' health and wellbeing are highly concerned during the COVID-19 pandemic. This study examined the impacts of fear of COVID-19 (FCoV-19S), healthy eating behavior, and health-related behavior changes on anxiety and depression. Methods: We conducted an online survey at 8 medical universities in Vietnam from 7th April to 31st May 2020. Data of 5,765 medical students were collected regarding demographic characteristics, FCoV-19S, health-related behaviors, healthy eating score (HES), anxiety, and depression. Logistic regression analyses were used to explore associations. Results: A lower likelihood of anxiety and depression were found in students with a higher HES score (OR = 0.98; 95%CI = 0.96, 0.99; p = 0.042; OR = 0.98; 95%CI = 0.96, 0.99; p = 0.021), and in those unchanged or more physical activities during the pandemic (OR = 0.54; 95%CI = 0.44, 0.66; p < 0.001; OR = 0.44; 95%CI = 0.37, 0.52; p < 0.001) as compared to those with none/less physical activity, respectively. A higher likelihood of anxiety and depression were reported in students with a higher FCoV-19S score (OR = 1.09; 95%CI = 1.07, 1.12; p < 0.001; OR = 1.06; 95%CI = 1.04, 1.08; p < 0.001), and those smoked unchanged/more during the pandemic (OR = 6.67; 95%CI = 4.71, 9.43; p < 0.001; OR = 6.77; 95%CI = 4.89, 9.38; p < 0.001) as compared to those stopped/less smoke, respectively. In addition, male students had a lower likelihood of anxiety (OR = 0.79; 95%CI = 0.65, 0.98; p = 0.029) compared to female ones. Conclusions: During the pandemic, FCoV-19S and cigarette smoking had adverse impacts on medical students' psychological health. Conversely, staying physically active and having healthy eating behaviors could potentially prevent medical students from anxiety and depressive symptoms.
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Depressive symptoms are major public health problems. Leisure-time Physical activity (LPA) and dietary inflammatory preference are emerging factors that tends to affect the mental health status. There is limited evidence regarding the joint influence of LPA and dietary status on the prevalence of depression. This study was a cross-sectional study, which used a nationwide represented sample from the National Health and Nutrition Examination Survey (NHANES) to assess the relationship among LPA, diet status and depression. Depression and LPA status was reported by the 9-item Patient Health Questionnaire (PHQ-9) and Physical Activity Questionnaire (PAQ), respectively. To assess dietary inflammatory preferences, dietary inflammatory index (DII) was applied based on a 24-h dietary recall interview. A total of 11,078 subjects was included in this study and weighted participants were 89,682,020. Weighted multivariable linear regression showed that DII was negatively associated with LPA after full adjustment, with β (95% CI): −0.487 (−0.647, −0.327). Weighted multivariable logistic regression showed that LPA was significantly associated with depressive symptoms after full adjustment, with odds ratios OR (95% CIs): 0.986 (0.977, 0.995). By DII stratification analysis, this phenomenon was also existed in groups with anti-inflammatory diet. Mediation effect analysis was further performed, which showed that DII significantly mediating the association between LPA and depression with proportion mediated as 3.94%. Our findings indicated the mediating role of DII in the association between LPA condition and incident depression. More well-designed studies are still needed to validate the causal relationship.
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Objectives: Food price is a determining factor in food choices. However, its relationship with diet quality is unclear in Chinese adults. This study aimed to examine daily energy-adjusted dietary cost (Chinese Yuan, CNY/2000kcal) concerning diet quality in northeast central Chinese adults. Methods: The food consumed by 680 Chinese adults from Henan province during the year 2020 was recorded by 24-h dietary recalls. Three dietary quality indices, namely the nutrient-rich foods (NRF) index, the mean adequacy ratio (MAR), and the energy density (ED), were adopted. Daily energy-adjusted diet cost was calculated by dividing the estimated daily diet costs (CNY/day) by the energy intake per day (kcal/day) and multiplying 2000. Results: Subjects who closely adhered to the NRF9.2, MAR, and ED paid daily ¥8.92, ¥13.17, and ¥14.34 more for food consumption, respectively, than those who weakly adhered to these dietary patterns. Furthermore, adjusted linear regression analysis revealed that an increase in ¥1 of the energy-adjusted diet cost per day was associated with a change of 0.494 units (P< 0.001), 0.003 units (P<0.001), and -0.018 units (P<0.001) in the NRF9.2, MAR, and ED, respectively. Conclusion: Higher energy-adjusted diet costs were associated with higher-quality diets. This might be of importance for public health policies in an effort to develop strategies to promote healthy diets by regulating food and diet costs.
Chapter
Depression does not always equal major depressive disorder. Depression is a nonspecific symptom that can result from a number of different causes, and not all of them are psychiatric illnesses—or even pathologic at all. Clinically significant depression in the real world is also usually multifactorial. This can have important implications for both prognosis and treatment. When making a diagnosis of a depressive disorder, it is therefore important to be able to appreciate the differences in how these disorders most commonly present. This chapter will describe the most important and common depressive disorders and explain how to recognize them in your patients.KeywordsDiagnosisMajor depressive disorderAdjustment disorderDysthymiaBipolar disorderCyclothymiaSeasonal affective disorderPremenstrual dysphoric disorder
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Depression affects 264 million persons in the world, accounting for some 4.3% of the global burden of disease. Current studies indicate that the decrease in the consumption of omega-3 food sources is associated with the increasing incidence of depression. The study aims to assess the association between the consumption of omega-3 and the maintenance and incidence of depressive episodes in adults (39-64 years) and elderly adults (>65 years). This was a longitudinal study using data from the baseline and first follow-up wave of the Longitudinal Study of Adult Health (ELSA-Brasil). Depressive episodes were obtained with the Clinical Interview Schedule Revised (CIS-R), and food consumption was measured with the Food Frequency Questionnaire (FFQ). Logistic regression was used to analyze associations between the consumption of omega-3 and depressive episodes. Fatty acids from the omega-3 family showed a protective effect against the maintenance of depressive episodes. In relation to incidence, the estimates suggest that the higher the consumption of omega-3 acids, the lower the risk of developing depressive episodes, and significant associations were found between the consumption of omega-3 and alpha-linolenic acid. Dietary consumption of omega-3, DHA, EPA, DPA, and alpha linolenic fatty acids may have a protective effect against the maintenance and incidence of depressive episodes.
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Depression is a chronic and complex condition experienced by over 300 million people worldwide. While research on the impact of nutrition on chronic physical illness is well-documented, there is growing interest in the role of dietary patterns for those experiencing symptoms of depression. This study aims to examine the association of diet quality (Dietary Questionnaire for Epidemiological Studies version 2) and depressive symptoms (Centre for Epidemiological Studies for Depression short form) of young Australian women over six years at two time points, 2003 (n = 9,081, Mean age = 27.6) and 2009 (n = 8,199, Mean age = 33.7) using secondary data from the Australian Longitudinal Study on Women’s Health. A linear mixed-effects model found a small and significant inverse association of diet quality on depressive symptoms ( b = -0.03, 95% CI; -0.04, -0.02) after adjusting for covarying factors such as BMI, social functioning, alcohol and smoking status. These findings suggest that the continuation of a healthy dietary pattern may be protective of depressive symptoms. Caution should be applied in interpreting these findings due to the small effect sizes. More longitudinal studies are needed to assess temporal relationships between dietary quality and depression.
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Objective To examine the cross-sectional and longitudinal (2-year follow-up) associations between Dietary Diversity (DD) and depressive symptoms. Design An energy-adjusted Dietary Diversity Score (DDS) was assessed using a validated food-frequency questionnaire and was categorized into quartiles (Q). The variety in each food group was classified into 4 categories of diversity (C). Depressive symptoms were assessed with Beck Depression Inventory-II (Beck II) questionnaire and depression cases defined as physician-diagnosed or Beck II>=18. Linear and logistic regression models were used. Setting Spanish older adults with Metabolic Syndrome. Participants A total of 6625 adults aged (55-75 years) from the PREDIMED-Plus study with overweight or obesity and MetS. Results Total DDS was inversely and statistically significantly associated with depression in the cross-sectional analysis conducted; Odds Ratio (OR) Q4 vs Q1= 0.76 (95% confidence interval (CI): 0.64, 0.90). This was driven by high diversity compared to low diversity (C3 vs. C1) of vegetables [OR (95%CI) = 0.75 (0.57, 0.93)], cereals [OR (95%CI) = 0.72 (0.56-0.94)] and proteins [OR (95%CI) = 0.27 (0.11, 0.62)]. In the longitudinal analysis, there was no significant association between the baseline DDS and changes in depressive symptoms after 2 y- of follow-up, except for DD in vegetables C4 vs C1= [β (95%CI) = 0.70 (0.05, 1.35)]. Conclusions According to our results, DD is associated with the presence of depressive symptoms but eating more diverse does not seem to reduce the risk of future depression. Additional longitudinal studies (with longer follow-up period) are needed to confirm these findings.
Article
Depresyon, dünya çapında 300 milyondan fazla insanın etkilendiği, yaygın olarak görülen bir duygu durum bozukluğudur. Depresyonu tedavi etmek için uygulanan yöntemlerin olumlu etkilerinin düşük ve yan etki oranlarının yüksek olması farklı tedavi arayışlarına yol açmaktadır. Nörotransmitter ve endokrin salgılar, inflamasyon ve bağışıklık mekanizmaları, beyinden türetilen nörotrofik faktör (BDNF) ve hipotalamus hipofiz adrenal aksı (HPA) gibi faktörler aracılığıyla bağırsak mikrobiyotası ile beyin arasındaki iletişimin depresyon oluşumu ve tedavisinde etkili olabileceği yapılan çalışmalarla ortaya konmuştur. Beslenme ise hem mikrobiyota hem de depresyon üzerindeki etkilerinden dolayı önemsenmesi gereken bir konudur. Bu nedenle beslenmenin ve mikrobiyotanın depresyon üzerine etkileri kanıta dayalı veriler ışığında tartışılmıştır.
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Purpose: This study examines whether adherence to the Mediterranean Diet (MD) measured by several dietary indexes was associated with incident depressive symptoms in a large French cohort. Methods: The study sample consisted of 3523 participants from the Supplémentation en Vitamines et Minéraux Antioxydants (SU.VI.MAX) cohort who had at least three dietary records at baseline during the first 2 years of follow-up (1994-1996), free of depression at the beginning of the study (1996-1997) and available Center for Epidemiologic Studies Depression Scale (CES-D) data at the end of follow-up (2007-2009). The rMED was computed. Incident depressive symptoms were defined by a CES-D score ≥17 for men and ≥23 for women in 2007-2009. Odds ratios (OR) and 95% confidence intervals (95% CI) were estimated using multivariable logistic regression models. Several sensitivity analyses were performed. Results: In the present study, 172 incident cases of depressive symptoms were identified during the follow-up (mean = 12.6 years). After adjustment for a wide range of potential confounders, adherence to the rMED score (continuous variable) was significantly associated with incident depressive symptoms in men (OR 0.91; 95% CI 0.83-0.99; p = 0.03), but not in women. Use of the Literature-Based Adherence Score to the Mediterranean Diet (LAMD) and the classic MD score (MDS) provide similar findings. Conclusions: In the current study, higher adherence to the Mediterranean Diet at midlife was associated with a lower risk of incident depressive symptoms, particularly in men, increasing scientific evidence for a beneficial role of Mediterranean Diet on health. Further investigations in particular among women are needed.
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This review critically evaluates previous studies investigating the association between dietary intake of children and young people and depression and related mental health problems. A systematic literature search was conducted using electronic databases such as PsycINFO, MEDLINE, PubMed and Cochrane. A total of twenty studies were identified that met inclusion criteria and were subsequently rated for quality. The studies used a range of methods to measure dietary intake and mental health. Important potential confounding variables (e.g. socio-economic status) were often not included or controlled. There were also inconsistencies in the use of key constructs, which made comparisons between studies difficult. Despite some contradictory results, overall there was support for an association between healthy dietary patterns or consumption of a high-quality diet and lower levels of depression or better mental health. Similarly, there was a relationship between unhealthy diet and consumption of low-quality diet and depression or poor mental health. However, where significant relationships were reported, effect sizes were small. Future research on the relationship between diet and mental health in young people should use more clearly defined constructs to define diet and include or control for important confounders.
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Background The possible therapeutic impact of dietary changes on existing mental illness is largely unknown. Using a randomised controlled trial design, we aimed to investigate the efficacy of a dietary improvement program for the treatment of major depressive episodes. Methods ‘SMILES’ was a 12-week, parallel-group, single blind, randomised controlled trial of an adjunctive dietary intervention in the treatment of moderate to severe depression. The intervention consisted of seven individual nutritional consulting sessions delivered by a clinical dietician. The control condition comprised a social support protocol to the same visit schedule and length. Depression symptomatology was the primary endpoint, assessed using the Montgomery–Åsberg Depression Rating Scale (MADRS) at 12 weeks. Secondary outcomes included remission and change of symptoms, mood and anxiety. Analyses utilised a likelihood-based mixed-effects model repeated measures (MMRM) approach. The robustness of estimates was investigated through sensitivity analyses. Results We assessed 166 individuals for eligibility, of whom 67 were enrolled (diet intervention, n = 33; control, n = 34). Of these, 55 were utilising some form of therapy: 21 were using psychotherapy and pharmacotherapy combined; 9 were using exclusively psychotherapy; and 25 were using only pharmacotherapy. There were 31 in the diet support group and 25 in the social support control group who had complete data at 12 weeks. The dietary support group demonstrated significantly greater improvement between baseline and 12 weeks on the MADRS than the social support control group, t(60.7) = 4.38, p < 0.001, Cohen’s d = –1.16. Remission, defined as a MADRS score <10, was achieved for 32.3% (n = 10) and 8.0% (n = 2) of the intervention and control groups, respectively (χ² (1) = 4.84, p = 0.028); number needed to treat (NNT) based on remission scores was 4.1 (95% CI of NNT 2.3–27.8). A sensitivity analysis, testing departures from the missing at random (MAR) assumption for dropouts, indicated that the impact of the intervention was robust to violations of MAR assumptions. Conclusions These results indicate that dietary improvement may provide an efficacious and accessible treatment strategy for the management of this highly prevalent mental disorder, the benefits of which could extend to the management of common co-morbidities. Trial registration Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12612000251820. Registered on 29 February 2012.
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This research assessed the association between the adherence to a Mediterranean lifestyle beyond the Mediterranean diet and the risk of depression in a prospective cohort of Spanish university graduates. Through a dynamic cohort study method, diet was assessed with a validated semiquantitative food-frequency questionnaire. The baseline assessment included a validated questionnaire on physical activity and average time spent with friends (socializing). Mediterranean lifestyle was defined as the joint exposure to Mediterranean diet, level of physical activity, and level of socializing. After a median follow-up of 8.5 years, 806 cases of depression among 11,800 participants were observed. Participants with the highest adherence to the Mediterranean lifestyle showed a 50% relative risk reduction in depression risk as compared to those participants with the lowest adherence (multivariable hazard ratio = 0.50; 95% confidence interval = [0.32, 0.81]). The Mediterranean lifestyle might reduce depression risk in the Seguimiento Universidad de Navarra cohort study beyond the known effects of the Mediterranean diet.
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Crosstalk between inflammatory pathways and neurocircuits in the brain can lead to behavioural responses, such as avoidance and alarm, that are likely to have provided early humans with an evolutionary advantage in their interactions with pathogens and predators. However, in modern times, such interactions between inflammation and the brain appear to drive the development of depression and may contribute to non-responsiveness to current antidepressant therapies. Recent data have elucidated the mechanisms by which the innate and adaptive immune systems interact with neurotransmitters and neurocircuits to influence the risk for depression. Here, we detail our current understanding of these pathways and discuss the therapeutic potential of targeting the immune system to treat depression.
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Received: January 23, 2015 Accepted: March 21, 2015 Published online: September 25, 2015 Issue release date: October 2015
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Background: Some studies have pointed out that several dietary patterns could be associated with a reduced risk of depression among adults. This association seems to be consistent across countries, cultures and populations. The objective of the study was to compare and to establish the type of relationship between three diet quality scores and depression in the SUN (Seguimiento Universidad de Navarra) Cohort study. Methods: We performed a dynamic cohort study based on Spanish university graduates free of depression at baseline. Dietary intake was repeatedly assessed at baseline and after 10 years of follow-up with a validated semi-quantitative food-frequency questionnaire. Three previously described diet quality scores: Mediterranean Diet Score (MDS), Pro-vegetarian Dietary Pattern (PDP) and Alternative Healthy Eating Index-2010 (AHEI-2010) were built. Participants were classified as having depression if they reported a new clinical diagnosis of depression by a physician or initiated the use of an antidepressant drug during follow-up. Time-dependent Cox regression models with cumulative averages of diet and restricted cubic splines were used to estimate hazard ratios of depression according to quintiles of adherence to the MDS, PDP and AHEI-2010. Results: One thousand and fifty one incident cases of depression were observed among 15,093 participants from the SUN Cohort after a median follow-up of 8.5 years. Inverse and significant associations were observed between the three diet quality scores and depression risk. The hazard ratios and 95 % confidence intervals for extreme quintiles (fifth versus first) of updated adherence to MDS, PDP and AHEI-2010 were 0.84 (0.69-1.02), 0.74 (0.61-0.89) and 0.60 (0.49-0.72), respectively. The dose-response analyses showed non-linear associations, suggesting that suboptimal adherence to these dietary patterns may partially be responsible for increased depression risk. Conclusions: Better adherence to the MDS, PDP and AHEI-2010 was associated with a reduced risk of depression among Spanish adults. However, our data suggested a threshold effect so that although the risk of depression was reduced when comparing moderate versus lower adherence, there was not much extra benefit for the comparison between moderate and high or very high adherence.
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It is well established in the literature that healthier diets cost more than unhealthy diets. The aim of this review was to examine the contribution of food prices and diet cost to socioeconomic inequalities in diet quality. A systematic literature search of the PubMed, Google Scholar, and Web of Science databases was performed. Publications linking food prices, dietary quality, and socioeconomic status were selected. Where possible, review conclusions were illustrated using a French national database of commonly consumed foods and their mean retail prices. Foods of lower nutritional value and lower-quality diets generally cost less per calorie and tended to be selected by groups of lower socioeconomic status. A number of nutrient-dense foods were available at low cost but were not always palatable or culturally acceptable to the low-income consumer. Acceptable healthier diets were uniformly associated with higher costs. Food budgets in poverty were insufficient to ensure optimum diets. Socioeconomic disparities in diet quality may be explained by the higher cost of healthy diets. Identifying food patterns that are nutrient rich, affordable, and appealing should be a priority to fight social inequalities in nutrition and health. © The Author(s) 2015. Published by Oxford University Press on behalf of the International Life Sciences Institute.
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To investigate the association of dietary patterns with a 3-year incidence of depression among healthy older adults. Multiple logistic regression models adjusted for age, sex, marital status, smoking, education, total energy intake, physical activity, body mass index, hypertension, functional autonomy, cognitive functioning, social activities, and stressful life events. Energy and macronutrient intakes were also analyzed as potential predictors of depression. Cities of Montréal, Laval, and Sherbrooke in Quebec, CA. Community-dwelling older adults, free of depression at baseline (N=1,358, 67-84 y), followed for 3y in the Québec Longitudinal Study on Nutrition and Aging (NuAge). Dietary patterns derived from principal components analysis of three 24 h-recalls at baseline, and depression incidence as measured by the 30-item Geriatric Depression Scale (≥11) and/or use of antidepressants at follow-up years. 170 people (63% women) became depressed over the 3 years. People in the highest tertile of adherence to the "varied diet" had lower risk of depression before adjustment (OR 0.58, 98% C.I. 0.38-0.86) but not significant once age and sex were controlled. No other dietary pattern was associated with the incidence of depression. The highest tertile of energy intake was associated with lower depression incidence after controlling for all confounders (OR 0.55, 95%CI 0.34-0.87). Among healthy older adults, dietary patterns do not appear to be related to depression. Those who eat less, however, possibly reflecting declining health, are at higher risk of becoming depressed.
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Psychiatry is at an important juncture, with the current pharmacologically focused model having achieved modest benefi ts in addressing the burden of poor mental health worldwide. Although the determinants of mental health are complex, the emerging and compelling evidence for nutrition as a crucial factor in the high prevalence and incidence of mental disorders suggests that diet is as important to psychiatry as it is to cardiology, endocrinology, and gastroenterology. Evidence is steadily growing for the relation between dietary quality (and potential nutritional defi ciencies) and mental health, and for the select use of nutrient-based supplements to address defi ciencies, or as monotherapies or augmentation therapies. We present a viewpoint from an international collaboration of academics (members of the International Society for Nutritional Psychiatry Research), in which we provide a context and overview of the current evidence in this emerging fi eld of research, and discuss the future direction. We advocate recognition of diet and nutrition as central determinants of both physical and mental health.
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Objective Non-pharmacological approaches to the treatment of depression and anxiety are of increasing importance, with emerging evidence supporting a role for lifestyle factors in the development of these disorders. Observational evidence supports a relationship between habitual diet quality and depression. Less is known about the causative effects of diet on mental health outcomes. Therefore a systematic review was undertaken of randomised controlled trials of dietary interventions that used depression and/or anxiety outcomes and sought to identify characteristics of programme success. Design A systematic search of the Cochrane, MEDLINE, EMBASE, CINAHL, PubMed and PyscInfo databases was conducted for articles published between April 1971 and May 2014. Results Of the 1274 articles identified, seventeen met eligibility criteria and were included. All reported depression outcomes and ten reported anxiety or total mood disturbance. Compared with a control condition, almost half (47 %) of the studies observed significant effects on depression scores in favour of the treatment group. The remaining studies reported a null effect. Effective dietary interventions were based on a single delivery mode, employed a dietitian and were less likely to recommend reducing red meat intake, select leaner meat products or follow a low-cholesterol diet. Conclusions Although there was a high level of heterogeneity, we found some evidence for dietary interventions improving depression outcomes. However, as only one trial specifically investigated the impact of a dietary intervention in individuals with clinical depression, appropriately powered trials that examine the effects of dietary improvement on mental health outcomes in those with clinical disorders are required.
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Background/objectives: There is continued interest in the associations between diet and depression and several studies have focused on individual dietary factors or diet patterns to investigate the relationship. We investigated the association between fruit and vegetables and symptoms of depression in the mid-age cohort of the Australian Longitudinal Study on Women's Health. Subjects/methods: A total of 6271 women with a mean age of 55.45 (1.45 s.d.) years were followed up at three surveys over 6 years. A score of ⩾ 10 on the Center for Epidemiological Studies Depression-10 scale indicated depressive symptoms. Fruit and vegetable intake was assessed using short questions. Results: A total of 381 women (6.1%) were depressed at all three surveys over the 6-year survey period. Cross-sectional logistic regression analysis using general estimating equations showed a reduced odds of depressive symptoms (odds ratio (OR) 0.86 (95% confidence interval (CI) 0.79-0.95, P=0.001)) among women who ate ⩾ 2 of fruit/day even after adjustment for several factors including smoking, alcohol, body mass index, physical activity, marital status, education, energy, fish intake and comorbidities. The predictive model also showed a reduced odds of depressive symptoms (OR 0.82 (95% CI 0.70-0.96, P=0.012)) among women who ate ⩾ 2 pieces of fruit/day. There was also an association between vegetable intake and prevalence of depressive symptoms at higher levels of intake. Conclusions: Increasing fruit consumption may be one important factor for reducing both the prevalence and incidence of depressive symptoms in mid-age women.
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We systematically reviewed 12 epidemiological studies to determine whether an association exists between diet quality and patterns and mental health in children and adolescents; 9 explored the relationship using diet as the exposure, and 3 used mental health as the exposure. We found evidence of a significant, cross-sectional relationship between unhealthy dietary patterns and poorer mental health in children and adolescents. We observed a consistent trend for the relationship between good-quality diet and better mental health and some evidence for the reverse. When including only the 7 studies deemed to be of high methodological quality, all but 1 of these trends remained. Findings highlight the potential importance of the relationship between dietary patterns or quality and mental health early in the life span.
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Data on the association between dietary patterns and depression are scarce. The objective of this study was to examine the longitudinal association between dietary patterns and depressive symptoms assessed repeatedly over 10 years in the French occupational GAZEL cohort. A total of 9,272 men and 3,132 women, aged 45-60 years in 1998, completed a 35-item Food Frequency Questionnaire (FFQ) at baseline. Dietary patterns were derived by Principal Component Analysis. Depressive symptoms were assessed by the Center for Epidemiologic Studies Depression scale (CES-D) in 1999, 2002, 2005 and 2008. The main outcome measure was the repeated measures of CES-D. Longitudinal analyses were performed with logistic regression based on generalized estimating equations. The highest quartile of low-fat, western, high snack and high fat-sweet diets in men and low-fat and high snack diets in women were associated with higher likelihood of depressive symptoms at the start of the follow-up compared to the lowest quartile (OR between 1.16 and 1.50). Conversely, the highest quartile of traditional diet (characterized by fish and fruit consumption) was associated with a lower likelihood of depressive symptoms in women compared to the lowest quartile, with OR = 0.63 [95%CI, 0.50 to 0.80], as the healthy pattern (characterized by vegetables consumption) with OR = 0.72 [95%CI, 0.63 to 0.83] and OR = 0.75 [95%CI, 0.61 to 0.93] in men and women, respectively. However, there was probably a reverse causality effect for the healthy pattern. This longitudinal study shows that several dietary patterns are associated with depressive symptoms and these associations track over time.
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Background: Anxiety and depression contribute to morbidity in elderly adults and may be associated with diet. We investigated the association between diet and psychological distress as a marker for depression. Methods: Dietary patterns were defined by factor analysis or the Mediterranean Diet Score (MDS); depression and anxiety were assessed 12 years later. A total of 8,660 generally healthy men and women born in Australia and aged 50-69 years from the Melbourne Collaborative Cohort Study were included. At baseline (1990-1994), diet (food frequency questionnaire), education, Socio-Economic Indexes for Areas (SEIFA) - Index of Relative Socio-economic Disadvantage, medication use, social engagement, physical activity, smoking status, alcohol use, and health conditions were assessed; at follow-up (2003-2007), psychological distress was assessed using the Kessler Psychological Distress Scale (K10). Logistic regression was used to identify associations between diet and a K10 score ≥20, indicative of psychological distress. Results: The MDS was inversely associated with psychological distress, with the odds ratio in the top-scoring group relative to the lowest scoring group being 0.72 (95% confidence interval = 0.54-0.95). Stronger adherence to a traditional Australian-style eating pattern was also associated with a lower K10 score at follow-up, with the odds ratio for having a K10 score indicative of psychological distress for the top 20% of adherence to this pattern relative to the lowest being 0.61 (95% confidence interval = 0.40-0.91). Conclusions: A Mediterranean-style diet was associated with less psychological distress, possibly through provision of a healthy nutrient profile. The Australian dietary pattern, which included some foods high in fat and sugar content along with whole foods, also showed a weak inverse association. Adherence to this pattern may reflect a feeling of belonging to the community associated with less psychological distress.
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Background: Nutrition may be a risk factor for unipolar depression. We aimed to review the association between dietary variables and the risk of depression. Methods: Fifteen databases were searched up to May 2010. Only longitudinal studies for which outcomes were unipolar depression and/or depressive symptoms in adults were eligible for inclusion. Eleven studies were included and critically evaluated. Participants were in the age range 18-97 years and the study sample size was in the range 526-27 111. Follow-up ranged from 2 to 13 years. The diversity of dietary variables and nonlinear associations precluded formal meta-analysis and so a narrative analysis was undertaken. Results: Variables inversely associated with depression risk were the consumption of nutrients such as folate, omega-3 fatty acids and monounsaturated fatty acids; foods such as olive oil and fish; and a diet rich in fruits, vegetables, nuts and legumes. Some of these associations varied by sex and some showed a nonlinear association. Conclusions: At the study level, weaknesses in the assessment of exposure and outcome may have introduced bias. Most studies investigated a cohort subgroup that may have resulted in selection bias. At the review level, there is a risk of publication bias and, in addition, narrative analyses are more prone to subjectivities than meta-analyses. Diet may potentially influence the risk of depression, although the evidence is not yet conclusive. Strengthening healthy-eating patterns at the public health level may have a potential benefit. Robust prospective cohort studies specially designed to study the association between diet and depression risk are needed.