Article

Fruit and vegetable consumption is associated with improved mental and cognitive health in older adults from non-Western developing countries

October 2018
Public Health Nutrition 22(4)

DOI:10.1017/S1368980018002525

Authors:

Johannes Beller

Hannover Medical School

Bernhard Friedrich Gustav Lange-Asschenfeldt

Klinikum Klagenfurt Am Wörthersee

Wolfgang Dr. Koecher

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Objectives Consumption of fruits and vegetables has been shown to contribute to mental and cognitive health in older adults from Western industrialized countries. However, it is unclear whether this effect replicates in older adults from non-Western developing countries. Thus, the present study examined the contribution of fruit and vegetable consumption to mental and cognitive health in older persons from China, India, Mexico, Russia, South Africa and Ghana. Design Representative cross-sectional and cross-national study. Setting/Subjects We used data from the WHO Study on Global Ageing and Adult Health (SAGE), sampled in 2007 to 2010. Our final sample size included 28 078 participants. Results Fruit and vegetable consumption predicted an increased cognitive performance in older adults including improved verbal recall, improved delayed verbal recall, improved digit span test performance and improved verbal fluency; the effect of fruit consumption was much stronger than the effect of vegetable consumption. Regarding mental health, fruit consumption was significantly associated with better subjective quality of life and less depressive symptoms; vegetable consumption, however, did not significantly relate to mental health. Conclusions Consumption of fruits is associated with both improved cognitive and mental health in older adults from non-Western developing countries, and consumption of vegetables is associated with improved cognitive health only. Increasing fruit and vegetable consumption might be one easy and cost-effective way to improve the overall health and quality of life of older adults in non-Western developing countries.

Fruit and Vegetable Intake and Mental Health in Adults: A Systematic Review

Article

Full-text available

Jan 2020

The role of a properly balanced diet in the prevention and treatment of mental disorders has been suggested, while vegetables and fruits have a high content of nutrients that may be of importance in the case of depressive disorders. The aim of the study was to conduct a systematic review of the observational studies analyzing association between fruit and vegetable intake and mental health in adults. The search adhered to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and the review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42019138148). A search for peer-reviewed observational studies published until June 2019 was performed in PubMed and Web of Science databases, followed by an additional manual search for publications conducted via analyzing the references of the found studies. With respect to the intake of fruit and/or vegetable, studies that assessed the intake of fruits and/or vegetables, or their processed products (e.g., juices), as a measure expressed in grams or as the number of portions were included. Those studies that assessed the general dietary patterns were not included in the present analysis. With respect to mental health, studies that assessed all the aspects of mental health in both healthy participants and subjects with physical health problems were included, but those conducted in groups of patients with intellectual disabilities, dementia, and eating disorders were excluded. To assess bias, the Newcastle-Ottawa Scale (NOS) was applied. A total of 5911 studies were independently extracted by 2 researchers and verified if they met the inclusion criteria using a 2-stage procedure (based on the title, based on the abstract). After reviewing the full text, a total of 61 studies were selected. A narrative synthesis of the findings from the included studies was performed, which was structured around the type of outcome. The studies included mainly focused on depression and depressive symptoms, but also other characteristics ranging from general and mental well-being, quality of life, sleep quality, life satisfaction, flourishing, mood, self-efficacy, curiosity, creativity, optimism, self-esteem, stress, nervousness, or happiness, to anxiety, minor psychiatric disorders, distress, or attempted suicide, were analyzed. The most prominent results indicated that high total intake of fruits and vegetables, and some of their specific subgroups including berries, citrus, and green leafy vegetables, may promote higher levels of optimism and self-efficacy, as well as reduce the level of psychological distress, ambiguity, and cancer fatalism, and protect against depressive symptoms. However, it must be indicated that the studies included were conducted using various methodologies and in different populations, so their results were not always sufficiently comparable, which is a limitation. Taken together, it can be concluded that fruits and/or vegetables, and some of their specific subgroups, as well as processed fruits and vegetables, seems to have a positive influence on mental health, as stated in the vast majority of the included studies. Therefore, the general recommendation to consume at least 5 portions of fruit and vegetables a day may be beneficial also for mental health.

Decline of depressive symptoms in Europe: Differential trends across the lifespan

Article

Full-text available

Jul 2021
SOC PSYCH PSYCH EPID

Purpose: We examined changes in the burden of depressive symptoms between 2006 and 2014 in 18 European countries across different age groups. Methods: We used population-based data drawn from the European Social Survey (N = 64.683, 54% female, age 14-90 years) covering 18 countries (Austria, Belgium, Denmark, Estonia, Finland, France, Germany, Great Britain, Hungary, Ireland, The Netherlands, Norway, Poland, Portugal, Slovenia, Spain, Sweden, Switzerland) from 2006 to 2014. Depressive symptoms were measured via the CES-D 8. Generalized additive models, multilevel regression, and linear regression analyses were conducted. Results: We found a general decline in CES-D 8 scale scores in 2014 as compared with 2006, with only few exceptions in some countries. This decline was most strongly pronounced in older adults, less strongly in middle-aged adults, and least in young adults. Including education, health and income partially explained the decline in older but not younger or middle-aged adults. Conclusions: Burden of depressive symptoms decreased in most European countries between 2006 and 2014. However, the decline in depressive symptoms differed across age groups and was most strongly pronounced in older adults and least in younger adults. Future studies should investigate the mechanisms that contribute to these overall and differential changes over time in depressive symptoms.

Association of Vegetable and Fruit Consumption Patterns with Cognitive Function in Older People with Different BMI Ranges: Findings from China

Article

Full-text available

May 2025
Clin Interv Aging

Purpose There is a lack of research on how vegetable and fruit consumption patterns affect cognitive function in older adults with varying BMIs. Therefore, this study aims to explore their relationship, with a special focus on gender differences. Patients and Methods A cross-sectional survey was conducted in Anhui Province, China, between July and September 2019, and information was collected from 6211 participants regarding socio-demographics, the frequency of vegetable and fruit consumption per week, and cognitive function. The study utilized descriptive analysis and binary logistic regression to determine the association between cognitive function and consumption patterns of vegetable and fruit. Results There were no statistically significant associations between vegetable and fruit consumption patterns and cognitive function in underweight and obese older adults. Among normal weight men, older adults in the V+/F- (AOR=1.65; 95% CI: 1.16–2.35) and V-/F- (AOR=3.95; 95% CI: 1.86–8.42) groups were more likely to have cognitive impairment compared with the V+/F+ group. However, no associations were observed between the two in women of normal weight. For the overweight women, a higher risk of cognitive impairment was found in the V+/F- group (AOR=1.54; 95% CI: 1.12–2.11), while older men did not. Conclusion The correlation between vegetable and fruit consumption patterns and cognitive function varies among older adults with different BMIs. Findings suggest the need for targeted nutritional interventions for these communities to maintain cognitive function in older adults.

Impact of Physical Activity and Dietary Habits on Mental Well-Being in Patients with Diabetes Mellitus

Article

Full-text available

Mar 2025

Background: The prevalence of diabetes mellitus (DM) is increasing worldwide, and mental health problems such as depression, anxiety, and diabetes distress are common co-morbidities that negatively impact the quality of life, complications, and treatment outcomes of patients with DM. Objectives: In this study, we assessed the impact of dietary patterns and physical activity on the well-being of patients with DM. Methods: A cross-sectional design and data from the European Health Interview Survey (EHIS) data collected in Hungary in 2019, and determination of the relationship between dietary habits and physical activity-related variables contained in the data and the World Health Organization-Five Well-Being Index (WHO-5 index) by suitable statistical methods. Results: Logistic regression showed higher odds of poor mental well-being in females (OR = 1.61, 95% CI: 1.08–2.42) and lower odds with daily fruit intake (OR = 0.52, 95% CI: 0.31–0.89). Infrequent white meat (OR = 3.34, 95% CI: 1.35–8.22) and dairy intake (OR = 1.60, 95% CI: 1.18–2.64) were associated with poorer well-being. Walking 4–7 days/week reduced the odds by 57% (OR = 0.43, 95% CI: 0.23–0.83). Conclusions: The results demonstrate that regular exercise and the consumption of fruits, dairy products, and white meat have beneficial effects on the mental well-being of patients with DM.

Zero vegetable or fruit consumption and its associated factors among children aged 6 to 23 months in Kenya: a multilevel analysis of a large population-based survey

Article

Full-text available

Jan 2025
Eur J Pediatr

Poor consumption of fruits and vegetables is associated with an increased risk of non-communicable diseases, micronutrient deficiency, and undernutrition. Fruit and vegetable consumption is generally low worldwide, particularly in rural regions of many low- and middle-income countries. This study aimed to determine the prevalence and determinants of zero vegetable or fruit consumption among children aged 6 to 23 months in Kenya using the most recent Kenya Demographic and Health Survey. A cross-sectional study was employed using data from the most recent nationally representative KDHS 2022. A weighted sample of 2,965 children aged between 6 to 23 months who were living with their mother was included in the study. Data extracted from the KDHS 2022 data sets were cleaned, recoded, and analyzed using STATA/SE version 14.0 statistical software. Multilevel logistic regression was used to determine the factors associated with the dependent variable. Finally, variables with a p-value less than 0.05 were declared statistically significant. The proportion of zero vegetable or fruit consumption among children aged 6 to 23 months in Kenya was 45.50% (95% CI: 43.71%–47.30%). Factors like maternal education [AOR = 0.59; 95% CI (0.37, 0.93)], maternal occupation [AOR = 0.60; 95% CI (0.47, 0.76)], media exposure [AOR = 0.59; 95% CI (0.43, 0.80)], wealth index [AOR = 0.68; 95% CI (0.49, 0.95)], place of delivery [AOR = 0.69; 95% CI (0.51, 0.94)], number of ANC visits [AOR = 1.30; 95% CI (1.05, 1.62)], child’s age [AOR = 0.30; 95% CI (0.21, 0.41)], community media exposure [AOR = 0.30; 95% CI (0.21, 0.41)], community literacy [AOR = 0.29; 95% CI (0.20, 0.43)], and community poverty [AOR = 1.46; 95% CI (1.04, 2.05)] were significantly associated with zero vegetable or fruit consumption. Conclusion: The proportion of zero vegetable or fruit consumption among children aged 6 to 23 months in Kenya was high. Zero vegetable or fruit consumption was significantly associated with maternal education, maternal occupation, media exposure, wealth index, place of delivery, number of ANC visits, child’s age, community media exposure, community literacy, and community poverty. Giving attention to jobless, media-non-exposed mothers, poor wealth status, who gave birth at home, who had no formal education, attended < 4 ANC visits, and children aged 6 to 8 months is recommended. What is Known: • Dietary recommendations for fruit and vegetable consumption were not met by many children in low and middle-income countries. What is New: • The proportion of zero vegetable or fruit consumption among children aged 6 to 23 months in Kenya was high.

Zero Fruit and Vegetables Consumption and Associated Factors Among Children Aged 6–23 Months Old in Eastern Africa

Article

Full-text available

Jul 2024

Introduction Despite WHO and UNICEF recommending the consumption of fruit and vegetables by children as one of their indicators for evaluating infant and young child feeding practices, there is a dearth of literature about the magnitude of fruit and vegetable consumption among 6–23-month-old children in Eastern Africa. The current study adds to the scholarly discourse by providing insight into the magnitude of fruit and vegetable intake among 6–23-months-old children in East Africa. Methods The secondary source data analysis was conducted for 12 Eastern African countries. Twenty-three thousand seven hundred and fourteen children aged 6–23 months were included in this analysis. A multilevel statistical model with an odds ratio of 95% was fitted to estimate the strength of the association between zero fruits and vegetables and explanatory variables. Results Our study showed that 32.20%, with a 95% CI of 31.70–32.81, of children aged 6–23 months did not consume any fruit or vegetables. Mother’s educational status [AOR═ 0.77, CI: (0.69, 0.85)], [AOR ═ 0.75, CI: (0.68, 0.90)], [AOR ═ 0.49, CI: (0.37, 0.64)], husband’s educational status [AOR═ 0.75, CI: (0.62, 0.78)] and [AOR ═ 0.73, CI: (0.62, 0.82)], wealth index [AOR═0.82, CI: (0.73, 0.91), [AOR═0.78, CI: (0.69, 0.87)], [AOR═ 0.77, CI: (0.68, 0.89)], [AOR═ 0.67, CI: (0.56, 0.79)], Media exposure, [AOR═ 0.74, CI: (0.67, 0.81)], Place of delivery [AOR═0.88, CI: (0.80, 0.97)] and child’s postnatal checkup within the first 2 months [AOR═ 0.83, CI: (0.76, 0.91)] were significantly associated with zero fruit and vegetables. Conclusion The magnitude of zero fruit and vegetables was found to be high. These findings are commendable, yet demand emphasis on interventions that target households with lower wealth indexes and integrating nutritional counseling into routine healthcare visits may help increase awareness and benefits of consuming fruits and vegetables.

The relationship between dietary patterns derived from inflammation and cognitive impairment in patients undergoing hemodialysis

Article

Full-text available

Aug 2023

Introduction Dietary patterns were shown to be closely related to inflammation, which was independently associated with cognitive impairment (CI) in patients undergoing hemodialysis (HD). However, it remains unclear the influence of dietary patterns derived from inflammation on CI in this population. This study aimed to examine the association between dietary patterns derived from C-reactive protein (CRP) and interleukin-6 (IL-6) and CI in patients undergoing HD. Methods Dietary intake was obtained from the simplified quantitative food frequency questionnaire. Reduced rank regression (RRR) was used to extract two dietary patterns, with IL-6 and CRP as response variables. Cognitive function was examined by the Montreal Cognitive Assessment (Beijing version). Venous blood was drawn for measuring IL-6 and CRP levels. Multivariable logistic regression was used to investigate the association between dietary patterns and CI. Results Dietary pattern derived from IL-6 was not significantly associated with CI. The third quartile of dietary pattern, which used CRP as the response variable, significantly contributed to the increased risk of CI (AOR 8.62, 95% CI 1.47–50.67) after controlling age, sex, education level, marital status, and residential pattern (p-for-trend = 0.028). After considering hypertension and diabetes, physical activity level, anxiety and depression, smoking and drinking status, social support, energy intake, and the dietary pattern derived from IL-6 (p-for-trend = 0.026), the relationship between the dietary pattern derived from CRP and CI remained significant (AOR 14.54, 95% CI 1.40–151.13). Conclusion Dietary pattern associated with high CRP level, including high intake of rice, liquor, fruit, tea and coffee and low intake of dark vegetables and juice, contributed to the increased risk of CI. The association between the consumption of seafood, sweet beverages, and alcohol and CI is yet to be established. However, they may be dietary contributing factors to inflammation in patients undergoing HD.

Effectiveness of a Two-Year Multicomponent Intervention for the Treatment of Overweight and Obesity in Older People

Article

Full-text available

Nov 2022

This study aimed to assess the effectiveness of a two-year intervention based on the Mediterranean diet for the treatment of overweight and obesity in a sample of 51 older people from the Mediterranean city of Alicante (Spain). We also examined the effects of the intervention on psychological well-being. The participants were randomly assigned to the experimental and control groups. The experimental group received group nutritional education sessions, an individualized dietary-nutritional treatment based on a Mediterranean diet, and a physical activity program; the control group received Mediterranean nutritional education in a written format. The experimental group showed a greater loss in weight (p = 0.017) and percentage of fat mass (p = 0.049), and a greater reduction in body mass index (BMI) (p = 0.014) and waist circumference (p = 0.010). Both groups improved their depression scores using the PHQ-9; however, no significant improvement was seen in adherence to the Mediterranean diet (PREDIMED) and anxiety level (GAD-7). These results suggest that a two-year intervention based on the Mediterranean diet allows an older population with overweight or obesity to achieve greater weight loss and a greater decrease in BMI, waist circumference, and fat mass percentage. In relation to psychological well-being, depression levels improved at the end of said intervention.

Factors Influencing Purchase Decision of Agriculture Products: A Case Study in Selangor

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Sep 2022

Plants, Plants, and More Plants: Plant-Derived Nutrients and Their Protective Roles in Cognitive Function, Alzheimer’s Disease, and Other Dementias

Article

Full-text available

Jul 2022
MED LITH

Background and Objectives: Alzheimer’s disease (AD) is the most common form of dementia, with the risk of developing it attributed to non-modifiable and modifiable factors. Currently, there is no cure for AD. A plant-based diet may protect against cognitive decline, due to the effects of plant-based nutrients such as vitamins, antioxidants, and fiber. The aim of the review is to summarize current literature on plant-based nutrients and their impact on cognition. Materials and Methods: A search was conducted on PubMed for clinical and murine studies, using combinations of the following words: “Alzheimer’s disease”, “dementia”, “cognition”, “plant-based diet”, “mild cognitive impairment”, “vitamin B”, “vitamin C”, “vitamin E, “beta carotene”, “antioxidants”, “fiber”, “vitamin K”, “Mediterranean diet”, “vitamin D”, and “mushrooms”. Results and Conclusions: A diet rich in vitamin B and antioxidants can benefit the cognitive functions of individuals as shown in randomized clinical trials. Vitamin K is associated with improved cognition, although large randomized controlled trials need to be done. Fiber has been shown to prevent cognitive decline in animal studies. Vitamin D may contribute to cognitive health via anti-inflammatory processes. Several medical organizations have recommended a plant-based diet for optimizing cognitive health and potentially helping to prevent dementia.

Fruit and Vegetable Consumption and Cognitive Disorders in Older Adults: A Meta-Analysis of Observational Studies

Article

Full-text available

Jun 2022

Objectives The aim of this meta-analysis was to assess the quantitative associations between fruit and vegetable intake and cognitive disorders in older adults. Design A meta-analysis. Setting and Participants We used the PubMed, Web of Science and Scopus databases for a literature search to 12 April 2022. We preliminarily retrieved 11,759 studies, 16 of which met the inclusion criteria including six cross-sectional studies, nine cohort studies and one case-control study, incorporating 64,348 participants and 9,879 cases. Methods Using the three databases, we identified observational studies exploring the association. The pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random effects model. Results Sixteen studies were included in the meta-analysis, and the results showed that increased fruit and vegetable consumption in older adults was associated with a decline in the prevalence of cognitive disorders (OR: 0.79, 95% CI: 0.76–0.83). Moreover, intake of fruits (OR: 0.83, 95% CI: 0.77–0.89) and vegetables (OR: 0.75, 95% CI: 0.70–0.80) alone were both associated with a lower prevalence of cognitive disorders. Subgroup analyses indicated that the intake of fruits and vegetables was associated with the prevalence of cognitive impairment (OR: 0.72, 95% CI: 0.76–0.80) and dementia (OR: 0.84, 95% CI: 0.78–0.91) but not Alzheimer’s disease (OR: 0.88, 95% CI: 0.76–1.01). Conclusion and Implications Our meta-analysis provides evidence that the intake of fruits and vegetables is inversely proportional and linearly associated with the prevalence of cognitive disorders in older adults. Future research is required to further investigate the preventive effects of the frequency, quantity, and duration of eating vegetables and fruits on cognitive disorders in older adults.

Associations of specific types of fruit and vegetables with perceived stress in adults: the AusDiab study

Article

Full-text available

Sep 2022
EUR J NUTR

Purpose Higher total fruit and vegetable (FV) intakes have been associated with lower perceived stress. The relationship between specific types of FV and perceived stress remains uncertain. The aims of this cross-sectional study were to explore the relationship between consumption of specific types of FV with perceived stress in a population-based cohort of men and women aged ≥ 25 years from the Australian Diabetes, Obesity and Lifestyle (AusDiab) Study. Methods Dietary intake was assessed using a validated Food Frequency Questionnaire ( n = 8,640). Perceived stress was evaluated using a validated Perceived Stress Questionnaire, with values ranging 0–1 (lowest to highest). High perceived stress cut-offs of ≥0.34 for men and ≥0.39 for women were obtained from the highest quartile of the perceived stress score for each sex. Multivariable-adjusted logistic regression was performed to investigate the associations. Results The mean age of participants (50.1% females) was 47.8 (SD 15) years. Persons in the highest, versus lowest, quartiles of apples and pears, orange and other citrus, and banana intakes had a significantly lower odds (24–31%) of having high perceived stress. Similarly, persons with higher intakes of cruciferous, yellow/orange/red, and legume vegetables had significantly lower odds (25–27%) of having high perceived stress. Conclusion In Australian adults, a higher consumption of apples and pears, oranges and other citrus, and bananas, as well as cruciferous, yellow/orange/red, and legume vegetables were associated with lower odds of having high perceived stress. The recommendations of “eating a rainbow” of colours may assist in preventing and/or reducing perceived stress.

Secular Improvements in Cognitive Aging: Contribution of Education, Health, and Routine Activities

Article

Full-text available

Oct 2022
J AGING HEALTH

Objectives Limited evidence exists regarding the reasons for secular changes in cognitive functioning over historical time. Thus, we examined potential explanatory factors for changes in cognitive speed, a central dimension of cognitive functioning. Methods Population-based data of middle-aged and older adults from Germany (N = 5443) was used with baseline participants from 2002 to 2014, comparing the time periods 2002–2014. Results Cognitive speed improved in middle-aged adults (40–65) and older adults (66+). In both age groups, increases were partly explained by education, employment status, volunteering status, routine activities, and physical functioning. Changes in education were more important in explaining increases in older than in middle-aged adults, whereas changes in health were more important for explaining increases in middle-aged adults. Conclusions Cognitive speed increased in both age groups over historical time. Education, employment, volunteering, routine activities, and health were all important in explaining these changes, but their importance differed between age groups.

Behavioral and Mental Responses towards the COVID-19 Pandemic among Chinese Older Adults: A Cross-Sectional Study

Article

Full-text available

Nov 2021

The novel COVID-19 pandemic spread quickly and continuously influenced global societies. As a vulnerable population that accounted for the highest percentage of deaths from the pandemic, older adults have experienced huge life-altering challenges and increased risks of mental problems during the pandemic. Empirical evidence is needed to develop effective strategies to promote preventive measures and mitigate the adverse psychological impacts of the COVID-19 pandemic. This study aimed to investigate the behavioral responses (i.e., preventive behaviors, physical activity, fruit and vegetable consumption) and mental responses (i.e., depression and loneliness) towards the COVID-19 pandemic among Chinese older adults. A further aim was to identify the associations among demographics, behavioral responses, and mental responses. Using a convenience sampling approach, 516 older adults were randomly recruited from five cities of Hubei province in China. Results of the cross-sectional survey showed that 11.7% of participants did not adhere to the WHO recommended preventive measures, while 37.6% and 8.3% of participants decreased physical activity and fruit–vegetable consumption respectively. For mental responses, 30.8% and 69.2% of participants indicated significantly depressive symptoms and severe loneliness, respectively. Participants’ behavioral and mental responses differed significantly in several demographics, such as age group, living situation, marital status, education levels, household income, medical conditions, and perceived health status. Demographic correlates and behavioral responses could significantly predicate the mental response with small-to-moderate effect sizes. This is the first study to investigate the characteristics of behavioral and mental responses of Chinese older adults during the COVID-19 pandemic. Research findings may give new insights into future developments of effective interventions and policies to promote health among older adults in the fight against the pandemic.

Association of Dietary Patterns With Cognitive Function and Cognitive Decline in Sydney Memory and Ageing Study: A Longitudinal Analysis

Article

Oct 2021

Background The relationship of dietary patterns to cognitive health in older adults has attracted much research attention. However, results from existing studies are inconclusive. Objective The aim of this study was to investigate the association between dietary patterns and overall cognitive performance and cognitive change over time. Design This analysis was conducted as part of the longitudinal Sydney Memory and Ageing study with six years follow up. Mediterranean diet and Dietary Approaches to Stop Hypertension (DASH) diet scores were generated based on dietary intake for each individual, assessed by the Dietary Questionnaire for Epidemiological Studies Version 2. Participants/Setting This longitudinal study comprised 1037 community dwelling non-demented participants aged 70-90 years at baseline (September 2005 to December 2007), recruited from Sydney, Australia. Main outcome measures Neuropsychological tests assessed global cognition and 6 cognitive domains on four occasions, at baseline and 2, 4 and 6 years later. Statistical analyses performed Linear mixed model analyses were conducted to examine the relationship between dietary scores, food components and overall cognitive function and cognitive change over six years. Results No associations of Mediterranean or DASH dietary scores with overall cognition and cognitive decline over six years were found. Higher intake of legumes and nuts was related to better overall performance in global cognition (β=0.091; 95% CI:0.035, 0.146; P=0.001) and to multiple cognitive domains, and to less decline in global cognition (β=-0.016; 95% CI: -0.032, -0.001; P=0.032). Conclusion Study findings suggest that greater consumption of legumes and nuts maybe important to slow cognitive decline with age.

Microbial Therapeutics in Neurocognitive and Psychiatric Disorders

Article

Full-text available

Sep 2021

Microbial therapeutics, which include gut biotics and fecal transplantation, are interventions designed to improve the gut microbiome. Gut biotics can be considered as the administration of direct microbial populations. The delivery of this can be done through live microbial flora, certain food like fiber, microbial products (metabolites and elements) obtained through the fermentation of food products, or as genetically engineered substances, that may have therapeutic benefit on different health disorders. Dietary intervention and pharmacological supplements with gut biotics aim at correcting disruption of the gut microbiota by repopulating with beneficial microorganism leading to decrease in gut permeability, inflammation, and alteration in metabolic activities, through a variety of mechanisms of action. Our understanding of the pharmacokinetics of microbial therapeutics has improved with in vitro models, sampling techniques in the gut, and tools for the reliable identification of gut biotics. Evidence from human studies points out that prebiotics, probiotics and synbiotics have the potential for treating and preventing mental health disorders, whereas with paraprobiotics, proteobiotics and postbiotics, the research is limited at this point. Some animal studies point out that gut biotics can be used with conventional treatments for a synergistic effect on mental health disorders. If future research shows that there is a possibility of synergistic effect of psychotropic medications with gut biotics, then a gut biotic or nutritional prescription can be given along with psychotropics. Even though the overall safety of gut biotics seems to be good, caution is needed to watch for any known and unknown side effects as well as the need for risk benefit analysis with certain vulnerable populations. Future research is needed before wide spread use of natural and genetically engineered gut biotics. Regulatory framework for gut biotics needs to be optimized. Holistic understanding of gut dysbiosis, along with life style factors, by health care providers is necessary for the better management of these conditions. In conclusion, microbial therapeutics are a new psychotherapeutic approach which offer some hope in certain conditions like dementia and depression. Future of microbial therapeutics will be driven by well-done randomized controlled trials and longitudinal research, as well as by replication studies in human subjects.

Lifestyles and Cognition

Article

Full-text available

Aug 2021

Shashi Agarwal

Cognitive decline is a growing medical concern. It includes age-related cognitive decline, mild cognitive impairment, and dementia. Dementia results in considerable dysfunction in life and is associated with an increase in mortality. Since there is no cure at this time, attention is being increasingly directed towards prevention. Lifestyle factors, such as smoking, alcoholism, physical inactivity, poor diet, improper sleep, and loneliness are repeatedly being recognized as modifiable factors that can reduce cognitive decline. This manuscript briefly reviews the lifestyle-cognition relationship.

Geriatric malnutrition and depression: Evidence from elderly home care population in Bangladesh

Article

Full-text available

Jul 2021

Malnutrition is the root of numerous complications ranging from physical disability to mental health problems like depression. Depending on the intensity, depression can lead to emotional fluctuations, even suicidal attempts. Geriatric health in a country like Bangladesh is often ignored, although they are a growing segment of society. This community-based cross-sectional study aimed to determine the prevalence and severity of depression and malnutrition in the elderly to evaluate the relationship between depression and malnutrition. Mini Nutritional Assessment (MNA) was used to determine nutritional status, and Geriatric Depression Scale (GDS) was used to assess depression. About 84% of the participants showed a different array of depression symptoms. The rate of malnutrition and depression is higher among the male participants. Being malnourished (OR: 4.05, 95% CI: 2.79-5.87) and people are at risk of malnutrition (OR:1.67, 95% CI:1.24-2.24) had a significantly higher risk of suffering from depression. Maintaining a good physical state, a healthy lifestyle, and a supportive family environment are among the factors that can reduce depression in the elderly population. Therefore, to fight depression, specific programs and targeted interventions focusing on physical and mental stability for the elderly at the community level can enhance awareness at the individual and family levels.

Dietary, physical exercises and mental stress in a Chinese population: a cross-sectional study

Article

Full-text available

Jun 2021
BMC PUBLIC HEALTH

Background Mental health is affected by both genetic and environmental factors. However, previous studies have showed conflict findings about the role of lifestyle and little is known about the situation of the Chinese population. The purpose of this study was to explore the relationship between the frequency of food consumption, physical exercise condition and mental health, as well as factors related to mental stress in Chinese. Methods We recruited 8160 residents who had health examinations in a public hospital during June 2016 to May 2018. Demographic characteristics, the frequency of food consumption, physical exercise condition and mental health status was collected by a questionnaire. We estimated the association using the odds ratio (OR) and 95% confidence interval (CI) based on Binary or ordinal logistic regression models. A classification and regression tree (CART) demonstrated the prediction of the value of a target variable based on other values. Results The logistic regression model and classification tree model both found that the frequency of fresh vegetables or fruit and fried foods consumption and the current state of drinking alcohol were related to mental stress. The degree of mental stress reduced significantly with increasing consumption of fish (OR = 0.80, 95% CI: 0.71–0.90) and regular exercise (OR = 0.55, 95% CI:0.48–0.64) in females and increased consumption of fish (OR = 0.55, 95% CI: 0.48–0.64) and cereal crop (OR = 0.77, 95% CI: 0.68–0.89), fish (OR = 0.87, 95%CI:0.77–0.96) and regular exercise (OR = 0.61, 95%CI:0.53–0.70) in males. On the contrary, the frequency of consumption of desserts (OR = 1.43, 95% CI: 1.26–1.62) and the current of drinking alcohol (OR = 1.47, 95%CI:1.21–1.79) in females and meat (OR = 1.47, 95%CI: 1.31–1.65), pickled and smoked food (OR = 1.18, 95%CI:1.05–1.32) and the current state of drinking alcohol (OR = 1.25, 95%CI:1.12–1.40) in males were related to an increased risk of mental health. Conclusions Our study showed that both the frequency of some food consumption and physical exercise condition were associated with mental health and affected the degree of stress, which provided novel insights into interventions.

Promoting Fruit and Vegetable Consumption in Rural China: Does Off-Farm Work Play a Role?

Article

Full-text available

May 2021

Although off-farm work plays a significant role in facilitating agricultural production and rural development and improving household welfare, little is known about whether off-farm work can promote fruit and vegetable consumption in rural areas of developing countries. This paper sheds new insights by estimating the impact of off-farm work on fruit and vegetable consumption, measured by purchasing frequencies and consumption expenditures. We employ a two-stage residual inclusion estimator to address the self-selection bias and analyze data collected from 558 rural households in China. The results show that household heads' off-farm work promotes rural households’ fruit and vegetable consumption by significantly increasing purchasing frequencies and expenditures. Further analysis confirms that household heads' off-farm work participation, rather than all household members, plays a prominent role in promoting household fruit and vegetable consumption. We also find that farmers’ behaviours of growing fruits and vegetables appear to substitute their purchasing behaviours.

Food consumption and mild cognitive impairment in Qingdao rural elderly: A cross-sectional study

Article

Jan 2020
ASIA PAC J CLIN NUTR

Background and objectives: Diet plays a crucial role in cognition. Mild cognitive impairment has a high prevalence in rural elderly people. However, few studies have investigated the relationship between diet and mild cognitive impairment among rural elderly people in China. The study evaluated the association between diet and the risk of mild cognitive impairment among them. Methods and study design: In this cross-sectional study, we enrolled 1262 participants (≥65 years) living in rural Qingdao, China. Cognitive function was assessed using the Mini-Mental State Examination, and dietary consumption was measured using a food frequency questionnaire. Logistic regression models were used to assess the associations. Results: In all, 315 (25%) participants had mild cognitive impairment. The weekly frequency of food consumption was lower in the mild cognitive impairment group than in the no mild cognitive impairment group. After adjusting for covariates, compared with participants who consumed never/less than once a week, daily consumption of coarse cereals (OR: 0.64, 95% CI: 0.44-0.91), potatoes (OR: 0.54, 95% CI: 0.34-0.87), fruits (OR: 0.49, 95% CI: 0.35-0.69), livestock and poultry meat (OR: 0.66, 95% CI: 0.44-0.99), eggs (OR: 0.67, 95% CI: 0.47-0.97), and nuts (OR: 0.47, 95% CI: 0.28-0.80) was inversely associated with mild cognitive impairment (all p<0.05). Conclusions: Higher dietary diversity and more frequent consumption of coarse cereals, potatoes, fruits, livestock and poultry meat, eggs, and nuts were associated with a lower risk of mild cognitive impairment. Elderly people should develop healthy dietary habits to prevent or delay cognitive decline.

Associations of Lifestyle Factors With Cognition in Community-Dwelling Adults Aged 50 and Older: A Longitudinal Cohort Study

Article

Full-text available

Nov 2020

In the absence of an effective treatment to alter the progressive course of cognitive decline and dementia, identification of modifiable risk factors that could promote healthy cognitive aging has become a public health research priority. This study seeks to comprehensively determine the contemporaneous associations of a broad spectrum of time-varying modifiable lifestyle factors with age-related cognitive decline in a large population-based cohort of older adults. A total of 5,711 subjects aged 50 and older from the WHO Study on global AGEing and adult health (SAGE) in Shanghai were studied. Repeated measures of lifestyle factors and cognitive performance were conducted in 2009-2010 and 2014-2015. Linear random slope models were used to evaluate the contemporaneous associations between time-varying lifestyle factors and cognitive performance. Person-mean centering method was used to disaggregate the between- and within-person effects in the time-varying lifestyle factors in the random slope models. We found that higher vegetable and fruit consumption, as well as higher level of physical activity were positively associated with all cognitive domains. Body mass index (BMI) was negatively associated with all cognitive domains, whereas waist-to-hip ratio (WHR) was negatively associated with verbal fluency score only. Sedentary time was negatively associated with digit span score but positively associated with verbal fluency score. The between-person effects seem to be more dominant than within-person effects. Overall, our findings suggest better management of multiple lifestyle factors may protect against cognitive decline in later life. Higher vegetable and fruit consumption and physical activity are protective, whereas obesity is detrimental to cognitive decline in older adults. This study underpins the development of multi-domain lifestyle recommendations to promote healthy cognitive aging.

Dietary patterns and risk of mild cognitive impairment among Chinese elderly: A cross-sectional study

Article

Full-text available

Jul 2020
PLOS ONE

Objective To investigate the relationship between food patterns and mild cognitive impairment (MCI) among Chinese elderly to provide evidence for risk prevention and control of MCI among elderly population. Methods Between February 2017 to October 2018, a stratified multistage cluster sampling method was used to select participants from 760 communities of six districts in Xi’an, China, for 49-item food frequency questionnaire survey. A total of 2311 participants aged 60 to 88 years were included in the study with 444 (19.2%) participants of MCI among Chinese community-dwelling elderly adults. Food patterns associated with risk of dementia were assessed by using a reduced rank regression (RRR) analysis, and the multivariate linear regression was used to test trends of risk factors across scores for the food pattern. Results Four dietary patterns were extracted which explained 88.65% of the total variation in food intakes. Furthermore, the food pattern 1 (FP1) accounted for 60.25% of the total variation of all responsible variables and as a target dietary pattern in the study, which was related with high intake of legumes, vegetables, fruits, milk and dairy products, nuts and a low intake of noodles and cereals (p<0.05). Multivariate linear regression analysis showed that participants with a high score for FP1 had higher direction, memory and language function and FP1 can improve the ability of cognitive function (p<0.05). Conclusion The FP1 of Chinese dietary patterns was significantly correlated with higher cognitive function which can reduce the risk of MCI among Chinese elderly.

Disability Trends in Europe by Age-Period-Cohort Analysis: Increasing Disability in Younger Cohorts

Article

Full-text available

Jun 2020

Background Several studies have examined trends in disability, but only few have explicitly considered possible age, time period and birth cohort differences simultaneously. Objective We examined disability trends in Europe according to age, time period, and birth cohort. Methods We used population-based data of Europeans (European Social Survey, N = 228159), aged 15 to 90 years, covering 15 countries (Belgium, Finland, France, Germany, Great Britain, Hungary, Ireland, Netherlands, Norway, Poland, Portugal, Slovenia, Spain, Sweden, Switzerland) and spanning a time period from 2002–2016. Results We found that there were only small overall changes in disability over time periods. However, there were strong U-shaped birth cohort effects, such that younger cohorts born after 1960 experienced higher levels of disability. This U-shaped cohort trend appeared strongest for non-severe disability and was most pronounced in Germany. Conclusions Therefore, disability in Europe seemed to generally increase in more recent cohorts, who might thus be at risk to experience more morbidity in the future than previous generations. Future studies should investigate the mechanisms that contribute to these trends, the generalizability of the observed birth cohort effects, and the cross-national differences in time period trends.

Relationship of actual nutrition with estimates of the cognitive function of the population of Novosibirsk

Article

Full-text available

Jan 2020

Objective. To study in cross-sectional research the association of actual nutrition with estimates of cognitive function (CF) in the population of men and women of middle and older age (45–69 years). Materials and methods . The study was conducted in the framework of the international project HAPIEE on a random subsample (2,159 men, 2,525 women) of residents of Novosibirsk. Evaluation of CF was carried out using standard methods (test for direct reproduction of 10 words, test for speech activity (associative thinking) and test for delayed reproduction). Nutrition data was obtained from population surveys in the HAPIEE project using a questionnaire to assess the frequency of food consumption. Statistical data processing was performed using the SPSS 13.0 application package. The GLM procedure was used, allowing to take into account the influence of related factors. Differences were considered statistically significant at p < 0.05. Results . The presence of a significant correlation between the actual nutrition with standardization by age, body mass index and level of education with CF estimates was found. It has been shown that higher consumption of fruits and vegetables was significantly associated with higher scores in both men and women. Women, unlike men, also showed significantly higher CF estimates for consumption of rice, meat products and dairy products. In addition, there was a negative association of CF with the consumption of a number of products. Men showed a significant decrease in the estimates of CF with the consumption of sugar and fats; in women, in the consumption of white bread, sugar and fat. Conclusion : the results of our study showed the presence of a significant association of CF estimates with the level of consumption of a number of products, both positive and negative, in middle-aged and older people. These data may be useful in the development of nutritional recommendations for the prevention of violations of CF.

Ideal Cardiovascular Health and Cognitive Test Performance: Testing a Modified Index of Life's Simple 7 Among Older Chinese Adults

Article

Full-text available

Nov 2018

Evidence suggests that cognitive decline in older adults is influenced by cardiovascular health (CVH), with metabolic and vascular mechanisms hypothesized to underlie the etiology of cognitive impairment. Research in high-income nations suggests that improved CVH is linked with decreased cognitive impairment risk, but it is unclear if this pattern is evident in low-income countries. Nationally-representative data collected in China were drawn from the World Health Organization's Study on global AGing and adult health Wave 1 (2007–2010; n = 11,295). Seven CVH factors were classified as “ideal” or “not ideal”: smoking and drinking frequency, body mass index, physical activity level, blood pressure, diet, and self-reported anxiety. Additionally, scores from five cognitive performance tests (immediate and delayed verbal recall, forward and backward digit span, verbal fluency) were used to create a composite cognitive function variable. Linear regression analyses tested whether ideal CVH measures were associated with higher composite cognitive performance, controlling for sociodemographic factors. As hypothesized, ideal CVH was generally associated with higher cognitive performance. Low anxiety levels and reliable access to sufficient food (including produce) were particularly associated with higher cognitive function. These results suggest early detection and controlling modifiable CVH risks may protect aging individuals in China from cognitive decline.

A comprehensive protocol to study the effects of multilingualism on cognition and the brain in patients with progressive neurological diseases

Article

Apr 2025

Introduction to Neuropsychological Assessment and Intervention

Chapter

Jan 2025

The cross-sectional and longitudinal associations between fruit intake and cognitive performance: A population-based study

Article

Nov 2024
MATURITAS

Dieta Vegetariana, Vegetais e Frutas, Cognição, Sintomas de Depressão e Ansiedade em indivíduos com idade igual ou superior a 45 anos: Uma Revisão Integrativa

Article

Full-text available

Jul 2024

Dietas saudáveis podem ajudar a saúde física, cognitiva e o humor durante o envelhecimento. Alguns estudos mostraram que houve melhora na depressão, ansiedade e cognição ao adotar-se uma dieta vegetariana. Realizar uma revisão integrativa sobre a relação da dieta vegetariana e o consumo de vegetais e frutas com a cognição e os sintomas de ansiedade e depressão no envelhecimento de indivíduos a partir de 45 anos. Revisão integrativa realizada na base de dados da Pubmed, no período de 01/01/2012 a 28/05/2024, utilizando os termos "Cognição", "Depressão", "Ansiedade", "Dietas Vegetarianas", “Frutas e Vegetais” e "Envelhecimento". Foram incluídos artigos em inglês, português e espanhol, que abordavam a temática com a população-alvo a partir de 45 anos. Todos os estudos estavam relacionados ao consumo de vegetais e frutas com a população adulta madura, a partir dos 45 anos e idosos de ambos os sexos. Os dados sugerem que a maior parte dos estudos apresentou associações positivas entre as dietas à base de frutas e vegetais, bem como de plantas com cognição, depressão e estado psicológico. Consumir mais vegetais e frutas e com maior variabilidade pareceu estar associado a um menor risco de comprometimento cognitivo e psicológico entre indivíduos a partir de meia-idade, assim como gera um efeito protetor contra os sintomas depressivos. As deficiências cognitivas e os sintomas depressivos estavam relacionados à alimentação pouco saudável, de baixa qualidade com mais alimentos de origem animal, ácidos graxos, sal e doces em uma população de baixa renda e escolaridade.

Zero fruits/vegetables consumption and associated factors among Children aged 6–23 months in Ethiopia: Mixed effect logistic regression analysis

Article

Full-text available

Jul 2023
PLOS ONE

Background The first two years of life is a vital period for promoting optimal growth, development and health. The lifelong nutritional habit and overall health of children is influenced by their early age feeding practice. Ethiopia is among the top five countries in Sub-Saharan Africa with the highest burden of zero fruits/vegetables consumption. This study aims to access factors associated with zero fruits/vegetables consumption among children aged 6–23 months in Ethiopia. Methods The study analyzed Ethiopian Mini Demographic and Health Survey 2019 dataset with a total weighted sample of 1459 young children aged between 6–23 months and who were living with their mothers. Data cleaning, coding and labeling were done using STATA version 14 software. Multilevel mixed effect logistic regression model was employed to identify associated factors. Results Exactly 69.3% of children aged 6–23 months in Ethiopia had zero fruits/vegetables consumption. In the multivariable multilevel binary logistic regression analysis a child from household with middle (AOR = 0.55, 95% CI: 0.35, 0.86) and rich (AOR = 0.37, 95% CI: 0.23, 0.60) wealth index, mothers who aged between 25–34 years old (AOR = 0.44; 95%CI = 0.29–0.69), mothers who were married/living with partner (AOR = 3.21; 95%CI: 1.58–6.52), children of mothers who follow Islamic religion (AOR = 0.34, 95% CI: 0.19, 0.61), mothers who had more than four ANC visits during their most recent pregnancy (AOR = 0.57; 95%CI: 0.39–0.83), children in age group of 12–18 month(AOR = 0.41, 95% CI: 0.28, 0.59), and 19–23 months (AOR = 0.26, 95% CI: 0.17, 0.40), health facility delivery (AOR = 1.52, 95% CI; 1.00–2.30), and small peripheral regions (AOR = 4.40, 95% CI; 1.39–13.97) were found to be significant factors associated with children’s zero fruits /vegetables consumption. The Interclass correlation coefficient (ICC) value in the null model was 0.34, which indicates that 34% of the variation in children’s zero fruits /vegetables consumption was attributed to the variation between clusters. Conclusion This study found that zero fruits/vegetables consumption among children aged 6–23 months in Ethiopia is high. Therefore, efforts should be made by stakeholders who are concerned about optimal diet and health of children to improve fruits/vegetables consumption of children particularly those from poor households, young mothers (15–24), and peripheral regions of Ethiopia. This could be done during ANC follow up visits and during nutrition counseling.

Barriers to consumption of fruits and vegetables and strategies to overcome them in low and middle income countries (LMICs): a narrative review

Article

Aug 2022
NUTR RES REV

Sukhdeep Kaur

This review provides an overview of the barriers to the consumption of fruits and vegetables (FVs) as well as strategies to improve the intake of FVs in low- and middle-income countries (LMICs). The importance of the consumption of FVs and its role in disease prevention are discussed briefly. Trends in the consumption of FVs in LMICs are also summarised. The WHO recommends that every individual should consume at least five servings or 400 grams of FVs per day. Epidemiological and clinical investigations have demonstrated that FVs contain numerous bioactive compounds with health-protecting activities. Despite their health benefits, the intake of FVs in LMICs remains low. Major barriers identified were socio-demographic factors, environmental conditions, individual and cultural factors, and macrosystem influences. These barriers may be lowered at the household, school, community, and national level through multi-component interventions including behaviour change communication (BCC) initiatives, nutrition education (NE), gardening initiatives, farm to institution programs (FIPs), food baskets, cash transfers, nutrition–agriculture policy and program linkages, and food-market environment-based strategies. This review has research implications due to the positive outcomes of strategies that lower such barriers and boost consumption of FVs in LMICs.

Fruit and Vegetable Intakes and Sleep in Linkage With Cognition Among Older Adults in China

Preprint

Full-text available

Nov 2021

Background: Identifying factors associated with cognitive impairment among older adults is critical. This study aims to examine associations of fruit and/or vegetable intake (FVI), sleep quality and duration, and their interactions with cognitive performance among older adults in China. Methods: We utilize nationwide datasets in 2008 and 2011 in China to examine associations between sleep quality and duration, FVI, and cognitive impairment. Interactions between sleep and FVI on cognitive performance are also examined. All analyses are further stratified by gender, age group, and urban-rural residence. Results: When all covariates are fully adjusted for in the cross-sectional analyses, frequent FVI is associated with a 29% lower risk of cognitive impairment compared with less frequent FVI, and daily sleeping durations of ≤6h and ≥10h are associated with a 13% and a 51% higher risk of cognitive impairment, respectively, as compared with the duration of 8h. Sleep quality is not significantly associated with cognitive impairment compared with fair/poor sleep quality when all covariates are adjusted, though it is associated with a 31% lower risk when only demographics are controlled for. Interaction analyses reveal that frequent FVI offsets the higher risk of cognitive impairment for poor sleep quality and excessive sleep durations. Subgroup analyses show a generally similar pattern for both sexes but a more pronounced association for young older adults than for oldest-old adults. The patterns of the interactions of FVI, sleep quality, and sleep duration with cognitive impairment differ by urban-rural residence. However, associations of good sleep quality, adequate sleep duration, and frequent FVI with the incidence of cognitive impairment over a 3-year follow-up period are mostly not significant. Conclusions: The positive association of good sleep quality, appropriate sleep duration, frequent FVI, with good cognitive is mainly cumulative or long-term. Frequent FVI could offset a higher risk of cognitive impairment for poor sleep quality and/or excessive sleep durations. The associations are similar for both sexes but are stronger in oldest-old adults and differ by urban-rural residence.

Going with the grain: Fiber, cognition, and the microbiota-gut-brain-axis

Article

Feb 2021

Healthy dietary intake has been acknowledged for decades as one of the main contributors to health. More recently, the field of nutritional psychiatry has progressed our understanding regarding the importance of nutrition in supporting mental health and cognitive function. Thereby, individual nutrients, including omega-3 fatty acids and polyphenols, have been recognized to be key drivers in this relationship. With the progress in appreciating the influence of dietary fiber on health, increasingly research is focusing on deciphering its role in brain processes. However, while the importance of dietary fiber in gastrointestinal and metabolic health is well established, leading to the development of associated health claims, the evidence is not conclusive enough to support similar claims regarding cognitive function. Albeit the increasing knowledge of the impact of dietary fiber on mental health, only a few human studies have begun to shed light onto the underexplored connection between dietary fiber and cognition. Moreover, the microbiota-gut-brain axis has emerged as a key conduit for the effects of nutrition on the brain, especially fibers, that are acted on by specific bacteria to produce a variety of health-promoting metabolites. These metabolites (including short chain fatty acids) as well as the vagus nerve, the immune system, gut hormones, or the kynurenine pathway have been proposed as underlying mechanisms of the microbiota-brain crosstalk. In this minireview, we summarize the evidence available from human studies on the association between dietary fiber intake and cognitive function. We provide an overview of potential underlying mechanisms and discuss remaining questions that need to be answered in future studies. While this field is moving at a fast pace and holds promise for future important discoveries, especially data from human cohorts are required to further our understanding and drive the development of public health recommendations regarding dietary fiber in brain health.

Identification of determinants of healthy ageing in Italy: results from the national survey IDAGIT

Article

Dec 2020
AGEING SOC

Healthy ageing is a public health problem globally. In Europe, the dependency ratio of the elderly is expected to increase by 21.6 per cent to 51.2 per cent in 2070. The World Health Organization (WHO) study on healthy ageing started in 2002 as a concept whereby all people of all ages should be able to live in a healthy, safe and socially inclusive way. The aim of this study is to present preliminary results of the project Identification of Determinants of Healthy Ageing in Italy (IDAGIT) that aimed to collect data on the active and healthy ageing of the Italian population aged over 18 using the conceptual framework of the WHO's ageing model. To link the determinants of the IDAGIT studies to those of the WHO model, we performed a confirmatory factor analysis which reported these variables as significant (in order of factor loading): smoking, cognition score, comorbidity, outdoor built environment, participation, working expertise and income. Considering comorbidity, 83.8 per cent of the sample declared not having any chronic diseases or to have only one, and regarding neurological diseases, only nine people had received a diagnosis of stroke. Regarding gender, the personal determinants and physical and social environments did not result in statistically significant differences, whereas we found statistical differences between the aged groups in all variables analysed. These results provide a first bio-psycho-social perspective on ageing in the Italian population.

Personal Values and Mortality: Power, Benevolence and Self-Direction Predict Mortality Risk

Article

Full-text available

May 2020
PSYCHOL HEALTH

Johannes Beller

Objectives: Although personal values guide one’s life in several important aspects, no study has examined how personal values relate to mortality. The current study strives to fill this gap. I ask: Which personal values prospectively predict mortality? Design: A large population-based sample of middle-aged and older adults in Germany was used (N=6089). Methods: Personal values were measured in 2008 according to Schwartz using the Portraits Value Questionnaire. Mortality was monitored up to 2017, resulting in a maximum follow-up period of about 10years. Results: Using Cox survival regression analyses, I found that Self-direction and, in part, Benevolence predicted a decreased mortality risk. Conversely, Power predicted an increased mortality risk. Conclusions: Thus, valuing independent thought and action (Self-Direction) and valuing the well-being of close others (Benevolence) seem to be associated with improved health, whereas valuing dominance and materialism (Power) is associated with diminished health. Future research should examine the mechanisms by which these personal values relate to mortality.

Does the MIND diet decrease depression risk? A comparison with Mediterranean diet in the SUN cohort

Article

Full-text available

Apr 2019
EUR J NUTR

PurposeTo prospectively evaluate the association of the Mediterranean-DASH diet intervention for neurodegenerative delay (MIND) diet and the Mediterranean diet (and their components), and depression risk. Methods We followed-up (median 10.4 years) 15,980 adults initially free of depression at baseline or in the first 2 years of follow-up. Food consumption was measured at baseline through a validated food-frequency questionnaire, and was used to compute adherence to the MIND and the Mediterranean diets. Relationships between these two diets and incident depression were assessed through Cox regression models. ResultsWe identified 666 cases of incident depression. Comparing the highest versus the lowest quartiles of adherence, we found no association of the MIND diet and incident depression. This relation was statistically significant for the Mediterranean diet {hazard ratio (HR) 0.75, [95% confidence interval (95% CI) 0.61, 0.94]; p < 0.01}, although with departure from linearity. A reduced depression risk was associated with higher consumption of both fruits and nuts [HR 0.82 (95% CI 0.69, 0.96); p = 0.02], moderate nuts consumption [HR 0.77 (95% CI 0.64, 0.93); p = 0.01], and avoidance of fast/fried food [HR 0.63 (95% CI 0.41, 0.96); p = 0.03]. Conclusions The Mediterranean diet was associated with reduced depression risk, but we found no evidence of such an association for the MIND diet.

Consumption of fruit and vegetables in relation with psychological disorders in Iranian adults

Article

Full-text available

Sep 2018
EUR J NUTR

Objective Findings from observational studies on the relationship between fruit and vegetables consumption and risk of mental disorders are contradictory. We aimed to examine the association between fruit and vegetables intake and prevalence of depression, anxiety, and psychological distress in a large group of Iranian adults. Methods This cross-sectional study was conducted on 3362 people of Iranian adults working in 50 health centers. Dietary data were collected using a validated dish-based 106-item semi-quantitative food frequency questionnaire (FFQ). The Iranian-validated version of Hospital Anxiety and Depression Scale (HADS) was used to screen for anxiety and depression. The General Health Questionnaire (GHQ) was used to assess psychological distress. ResultsThe prevalence of depression, anxiety, and high psychological distress among the study population was 30.0, 15.2, and 25.0%, respectively. Women in the top quintile of fruit intake, compared with those in the bottom quintile, had 57, 50, and 60% lower odds of depression, anxiety, and psychological distress. Consumption of vegetables was significantly associated with lower odds of depression (OR 0.65; 95% CI 0.46, 0.93) in women and lower odds of anxiety (OR 0.43; 95% CI 0.22, 0.87) in men. In addition, after adjustment for potential confounders, women in the highest quintile of fruit and vegetables intake, compared with those in the bottom quintile, had significantly lower odds of depression (OR 0.55; 95% CI 0.37, 0.80) and psychological distress (OR 0.60; 95% CI 0.40, 0.90). Furthermore, high intake of total fruit and vegetables was associated with lower odds of psychological distress (OR 0.42; 95% CI 0.21, 0.81) in men. Conclusion We found significant inverse associations between high intake of fruit with depression, anxiety, and psychological distress in Iranian women. High consumption of vegetables was also associated with lower risk of depression and anxiety, respectively, in women and men. In addition, high intake of total fruit and vegetable was associated with lower odds of depression and psychological distress in women and men.

Of Microbes and Minds: A Narrative Review on the Second Brain Aging

Article

Full-text available

Mar 2018

In recent years, an extensive body of literature focused on the gut–brain axis and the possible role played by the gut microbiota in modulating brain morphology and function from birth to old age. Gut microbiota has been proposed as a relevant player during the early phases of neurodevelopment, with possible long-standing effects in later life. The reduction in gut microbiota diversity has also become one of the hallmarks of aging, and disturbances in its composition are associated with several (age-related) neurological conditions, including depression, Alzheimer’s disease, and Parkinson’s disease. Several pathways have been evoked for gut microbiota–brain communication, including neural connections (vagus nerve), circulating mediators derived by host-bacteria cometabolism, as well as the influence exerted by gut microbiota on host gut function, metabolism, and immune system. Although the most provoking data emerged from animal studies and despite the huge debate around the possible epiphenomenal nature of those findings, the gut microbiota–brain axis still remains a fascinating target to be exploited to attenuate some of the most burdensome consequences of aging.

Nutritional psychiatry: the present state of the evidence

Article

Full-text available

Sep 2017

Mental illness, including depression, anxiety and bipolar disorder, accounts for a significant proportion of global disability and poses a substantial social, economic and heath burden. Treatment is presently dominated by pharmacotherapy, such as antidepressants, and psychotherapy, such as cognitive behavioural therapy; however, such treatments avert less than half of the disease burden, suggesting that additional strategies are needed to prevent and treat mental disorders. There are now consistent mechanistic, observational and interventional data to suggest diet quality may be a modifiable risk factor for mental illness. This review provides an overview of the nutritional psychiatry field. It includes a discussion of the neurobiological mechanisms likely modulated by diet, the use of dietary and nutraceutical interventions in mental disorders, and recommendations for further research. Potential biological pathways related to mental disorders include inflammation, oxidative stress, the gut microbiome, epigenetic modifications and neuroplasticity. Consistent epidemiological evidence, particularly for depression, suggests an association between measures of diet quality and mental health, across multiple populations and age groups; these do not appear to be explained by other demographic, lifestyle factors or reverse causality. Our recently published intervention trial provides preliminary clinical evidence that dietary interventions in clinically diagnosed populations are feasible and can provide significant clinical benefit. Furthermore, nutraceuticals including n -3 fatty acids, folate, S -adenosylmethionine, N -acetyl cysteine and probiotics, among others, are promising avenues for future research. Continued research is now required to investigate the efficacy of intervention studies in large cohorts and within clinically relevant populations, particularly in patients with schizophrenia, bipolar and anxiety disorders.

Dietary patterns and depressive symptoms in a UK cohort of men and women: a longitudinal study

Article

Full-text available

Sep 2017

Objective There is evidence to suggest that individual components of dietary intake are associated with depressive symptoms. Studying the whole diet, through dietary patterns, has become popular as a way of overcoming intercorrelations between individual dietary components; however, there are conflicting results regarding associations between dietary patterns and depressive symptoms. We examined the associations between dietary patterns extracted using principal component analysis and depressive symptoms, taking account of potential temporal relationships. Design Depressive symptoms in parents were assessed using the Edinburgh Postnatal Depression Scale (EPDS) when the study child was 3 and 5 years of age. Scores >12 were considered indicative of the presence of clinical depressive symptoms. Diet was assessed via FFQ when the study child was 4 years of age. Setting Longitudinal population-based birth cohort. Subjects Mothers and fathers taking part in the Avon Longitudinal Study of Parents and Children when their study child was 3–5 years old. Results Unadjusted results suggested that increased scores on the ‘processed’ and ‘vegetarian’ patterns in women and the ‘semi-vegetarian’ pattern in men were associated with having EPDS scores ≥13. However, after adjustment for confounders all results were attenuated. This was the case for all those with available data and when considering a sub-sample who were ‘disease free’ at baseline. Conclusions We found no association between dietary patterns and depressive symptoms after taking account of potential confounding factors and the potential temporal relationship between them. This suggests that previous studies reporting positive associations may have suffered from reverse causality and/or residual confounding.

Associations of C-reactive protein and psychological distress are modified by antidepressants, supporting an inflammatory depression subtype: Findings from UKHLS

Article

Full-text available

Jul 2017

Background: Clinical evidence increasingly suggests inflammation may be important specifically for an etiologically distinct depression subtype, characterized by resistance to antidepressant medication. However, epidemiological investigations of the relationship of inflammation with depression and psychological distress have failed to acknowledge these developments, which may have resulted in bias or masking of associations driven by the subtype. This may have contributed to inconsistent results in epidemiological studies, and equivocal support for an inflammation-depression link. Methods: An antidepressant-resistant, inflammatory depression subtype would result in stronger associations of depressive symptomatology with inflammation among antidepressant users than non-users, due to over-representation of subtype individuals among antidepressant users experiencing severe or persistent symptoms. We investigate, in a sample of 10,363 UK adults aged 16-98, modification by antidepressants of cross-sectional and longitudinal associations between C-reactive protein and psychological distress (General Health Questionnaire score, GHQ). We account for confounding by age, gender, income, inflammatory somatic illness, body mass index and, in longitudinal models, baseline psychological distress. Sensitivity analyses consider smoking, ethnicity, and other medications. Results: Robust associations of log-CRP and GHQ were seen for antidepressant users but not for non-users in both cross-sectional (coeff:0.54, p=0.01 vs 0.06, p=0.28) and longitudinal models (coeff: 0.57, p=0.006 vs 0.04, p=0.39 two waves post-baseline). Cross-sectional associations were strongest for tricyclic users, and longitudinal associations strongest for SSRI users. In multilevel, repeated-measures longitudinal models, associations for antidepressant users peaked two waves after baseline before declining. Conclusions: Results suggest evidence for existence of an inflammatory depression subtype. Previous studies' exclusion of antidepressant users and failure to consider interactive effects may have obscured associations driven by the subgroup. Follow-up work is now needed in community samples with clinical depression measures and prescription histories, to further elucidate the mechanisms involved.

Radical-Scavenging Activity of a Sunscreen Enriched by Antioxidants Providing Protection in the Whole Solar Spectral Range

Article

Full-text available

Mar 2017

Background/aim: The main reason for extrinsic skin aging is the negative action of free radicals. The formation of free radicals in the skin has been associated with ultraviolet (UV) exposure and also to visible (VIS) and near-infrared (NIR) irradiations. The aim of the present study was to evaluate the efficacy of a sunscreen in the whole solar range. Methods: The radical-scavenging activity of a sunscreen in the UV, VIS, and NIR ranges was evaluated using electron paramagnetic resonance spectroscopy. Ex vivo penetration profiles were determined using confocal Raman microscopy on porcine ear skin at different time points after application. Results: Compared to the untreated skin, the sunscreen decreased the skin radical formation in the UV and VIS regions. Additional protection in the VIS and NIR ranges was observed for the sunscreen containing antioxidants (AO). The penetration depth of the cream was less than 11.2 ± 3.0 µm for all time points. Conclusion: A sunscreen containing AO improved the photoprotection in the VIS and NIR ranges. The sunscreen was retained in the stratum corneum. Therefore, these results show the possibility of the development of effective and safer sunscreen products.

Youthful Brains in Older Adults: Preserved Neuroanatomy in the Default Mode and Salience Networks Contributes to Youthful Memory in Superaging

Article

Full-text available

Sep 2016

Significance statement: Memory performance typically declines with age, as does cortical structural integrity, yet some older adults maintain youthful memory. We tested the hypothesis that superagers (older individuals with youthful memory performance) would exhibit preserved neuroanatomy in key brain networks subserving memory. We found that superagers not only perform similarly to young adults on memory testing, they also do not show the typical patterns of brain atrophy in certain regions. These regions are contained largely within two major intrinsic brain networks: the default mode network, implicated in memory encoding, storage, and retrieval, and the salience network, associated with attention and executive processes involved in encoding and retrieval. Preserved neuroanatomical integrity in these networks is associated with better memory performance among older adults.

Dietary patterns are associated with depressive symptoms among Chinese adults: a case–control study with propensity score matching

Article

Full-text available

Dec 2017
EUR J NUTR

PurposePrevious studies have indicated that consumption of particular foods or nutrients is associated with depressive symptoms, but little is known about the role of overall dietary patterns in depressive symptoms. We design this case–control study to evaluate the associations between dietary patterns and high depression symptoms in Chinese adults. MethodsA total of 1351 participants with high depressive symptoms were matched with 1351 controls using the 1:1 ratio propensity score matching method. Dietary intake was assessed using a valid self-administered food frequency questionnaire, and high depressive symptoms were assessed with the Zung Self-Rating Depression Scale, wherein cutoff point of 45 was used as a definition of high depressive symptoms. ResultsExploratory factor analysis revealed three dietary patterns (vegetables and fruits pattern; sweets pattern; and animal foods pattern) explaining 25.1 % of the total variance. Compared with the participants in the lowest quartile, the participants in the highest quartile of vegetables and fruits pattern, which was defined as a healthy pattern, were associated with reduced odds of high depressive symptoms (OR 0.65, 95 % CI 0.52–0.83, P for trend <0.001) while the sweets pattern (OR 1.33, 95 % CI 1.06–1.66) and the animal foods pattern (OR 1.79, 95 % CI 1.43–2.24, P for trend <0.0001) were associated with increased prevalence of high depressive symptoms, respectively. Conclusion The present study adds to the evidence that the sweets pattern and animal foods pattern are positively associated with the prevalence of high depressive symptoms. In contrast, the dietary pattern rich in vegetables, fruits, and soya bean products, but low in animal foods, candied fruits, cakes, ice cream, sugared beverages, and alcoholic drinks is negatively associated with the prevalence of high depressive symptoms.

Clinical Significance of the Number of Depressive Symptoms in Major Depressive Disorder: Results from the CRESCEND Study

Article

Full-text available

Apr 2016

Our study aimed to establish the relationship between the number of depressive symptoms and the clinical characteristics of major depressive disorder (MDD). This would enable us to predict the clinical significance of the number of depressive symptoms in MDD patients. Using data from the Clinical Research Center for Depression (CRESCEND) study in Korea, 853 patients with DSM-IV MDD were recruited. The baseline and clinical characteristics of groups with different numbers of depressive symptoms were compared using the χ(2) test for discrete variables and covariance (ANCOVA) for continuous variables. In addition, the scores of these groups on the measurement tools were compared by ANCOVA after adjusting the potential effects of confounding variables. After adjusting the effects of monthly income and history of depression, a larger number of depressive symptoms indicated higher overall severity of depression (F [4, 756] = 21.458, P < 0.001) and higher levels of depressive symptoms (F [4, 767] = 19.145, P < 0.001), anxiety symptoms (F [4, 765] = 12.890, P < 0.001) and suicidal ideation (F [4, 653] = 6.970, P < 0.001). It also indicated lower levels of social function (F [4, 760] = 13.343, P < 0.001), and quality of life (F [4, 656] = 11.975, P < 0.001). However, there were no significant differences in alcohol consumption (F [4, 656] = 11.975, P < 0.001). The number of depressive symptoms can be used as an index of greater illness burden in clinical psychiatry.

Food patterns and the prevention of depression

Article

Full-text available

Feb 2016

An emerging field of research in nutritional epidemiology is the assessment of several links between nutritional quality and mental health. Specifically, some studies have pointed out that several food patterns could be associated with a reduced risk of depression among adults. This association seems to be consistent across countries, cultures and populations according to several systematic reviews and meta-analyses of observational studies. Some previously described food patterns, specifically the Mediterranean Food Pattern, the Alternative Healthy Eating Index, the Prudent diet or the Provegetarian Food Pattern may be effective to reduce the future risk of depression. Among them, only the Mediterranean Food Pattern has been tested for primary prevention in a large randomised trial, but the inverse association found was not statistically significant. The scientific report of the 2015 Dietary Guidelines for Americans Advisory Committee concluded that current evidence is still limited. Notwithstanding, this field is promising and, according to large and well-conducted observational studies, food patterns potentially associated with reduced risk of depression are those emphasising seafood, vegetables, fruits and nuts. There is a need to assess whether differences in the intake of some micro or macronutrients between these dietary patterns can make a difference in their association with a lower risk of depression. Moreover, the shape of the dose–response curve and the potential existence of a nonlinear threshold effect have not yet been established.

Oxidative stress, anti-oxidants and the cross-sectional and longitudinal association with depressive symptoms: Results from the CARDIA study

Article

Full-text available

Feb 2016

Depression may be accompanied by increased oxidative stress and decreased circulating anti-oxidants. This study examines the association between depressive symptoms, F2-isoprostanes and carotenoids in a US community sample. The study includes 3009 participants (mean age 40.3, 54.2% female) from CARDIA (Coronary Artery Risk Development in Young Adults). Cross-sectional analyses were performed on data from the year 15 examination (2000-01) including subjects whose depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale (CES-D) and had measurements of plasma F2-isoprostanes (gas chromatography/mass-spectrometry) or serum carotenoids (high-performance liquid chromatography). Carotenoids zeaxanthin/lutein, β-cryptoxanthin, lycopene, α-carotene, β-carotene were standardized and summed. Longitudinal analyses were conducted using data from other examinations at 5-year intervals. Cross-lagged analyses investigated whether CES-D predicted F2-isoprostanes or carotenoids at the following exam, and vice versa. Regression analyses were controlled for socio-demographics, health and lifestyle factors. F2-isoprostanes were higher in subjects with depressive symptoms (CES-D≥16) after adjustment for socio-demographics (55.7 vs. 52.0 pg/ml; Cohen’s d=0.14, p<0.001). There was no difference in F2-isoprostanes after further adjustment for health and lifestyle factors. Carotenoids were lower in those with CES-D scores ≥16, even after adjustment for health and lifestyle factors (standardized sum 238.7 vs. 244.0, Cohen’s d=-0.16, p<0.001). Longitudinal analyses confirmed depression predicts subsequent F2-isoprostane and carotenoid levels. Neither F2-isoprostanes or carotenoids predicted subsequent depression. In conclusion, depressive symptoms were cross-sectionally and longitudinally associated with increased F2-isoprostanes and decreased carotenoids. The association with F2-isoprostanes can largely be explained by lifestyle factors, but lower carotenoids were independently associated with depressive symptoms.

Depression and Its Associated Factors in Older Indians

Article

Full-text available

Jun 2015
J AGING HEALTH

Objective: To estimate the prevalence of depression and determine the factors associated with it in older Indians aged 50 years and above. Method: This study was based on a nationally representative sample of 7,150 older Indians from WHO’s Study of Global Aging and Adult Health, SAGE-2007. Mild, moderate, and severe depression was assessed through International Classification of Diseases, 10th revision, Diagnostic Criteria for Research (ICD-10-DCR). Logistic regression analysis was used to assess the impact of socio-demographic, health, and diet-related characteristics on depression. Results: Estimated prevalence of mild, moderate, and severe depression in the past 12 months was 13.6%, 12.4%, and 8.2% respectively, in older Indians. Functional disability, cognitive impairment, low quality of life, low wealth status, and chronic conditions such as angina, asthma, or chronic lung disease were the significant ( p < . 05 o r . 1 ) risk factors for depression. Discussion: Protective and risk factors identified can be helpful in formulation of different policies for older Indians.

Fruit and vegetable intake and cause-specific mortality in the EPIC study

Article

Full-text available

Aug 2014
EUR J EPIDEMIOL

Consumption of fruits and vegetables is associated with a lower overall mortality. The aim of this study was to identify causes of death through which this association is established. More than 450,000 participants from the European Prospective Investigation into Cancer and Nutrition study were included, of which 25,682 were reported deceased after 13 years of follow-up. Information on lifestyle, diet and vital status was collected through questionnaires and population registries. Hazard ratios (HR) with 95 % confidence intervals (95 % CI) for death from specific causes were calculated from Cox regression models, adjusted for potential confounders. Participants reporting consumption of more than 569 g/day of fruits and vegetables had lower risks of death from diseases of the circulatory (HR for upper fourth 0.85, 95 % CI 0.77-0.93), respiratory (HR for upper fourth 0.73, 95 % CI 0.59-0.91) and digestive system (HR for upper fourth 0.60, 95 % CI 0.46-0.79) when compared with participants consuming less than 249 g/day. In contrast, a positive association with death from diseases of the nervous system was observed. Inverse associations were generally observed for vegetable, but not for fruit consumption. Associations were more pronounced for raw vegetable consumption, when compared with cooked vegetable consumption. Raw vegetable consumption was additionally inversely associated with death from neoplasms and mental and behavioral disorders. The lower risk of death associated with a higher consumption of fruits and vegetables may be derived from inverse associations with diseases of the circulatory, respiratory and digestive system, and may depend on the preparation of vegetables and lifestyle factors.

A Prospective Cohort Study to Examine the Association between Dietary Patterns and Depressive Symptoms in Older Chinese People in Hong Kong

Article

Full-text available

Aug 2014
PLOS ONE

IntroductionDietary patterns are culturally specific and there is limited data on the association of dietary patterns with late-life depression in Chinese. This study examined the associations between dietary patterns and baseline and subsequent depressive symptoms in community-dwelling Chinese older people in Hong Kong.Methods Participants aged ≥65 year participating in a cohort study examining the risk factors for osteoporosis completed a validated food frequency questionnaire at baseline between 2001 and 2003. Factor analysis was used to identify three dietary patterns: "vegetables-fruits" pattern, "snacks-drinks-milk products" pattern, and "meat-fish" pattern. Depressive symptoms were measured at baseline and 4-year using the validated Geriatric Depression Scale. Multiple logistic regression was used for cross-sectional analysis (n = 2,902) to assess the associations between dietary patterns and the presence of depressive symptoms, and for longitudinal analysis (n = 2,211) on their associations with 4-year depressive symptoms, with adjustment for socio-demographic and lifestyle factors.ResultsThe highest quartile of "vegetables-fruits" pattern score was associated with reduced likelihood of depressive symptoms [Adjusted OR = 0.55 (95% CI: 0.36-0.83), ptrend = 0.017] compared to the lowest quartile at baseline. Similar inverse trend was observed for the highest quartile of "snacks-drinks-milk products" pattern score [Adjusted OR = 0.41 (95% CI: 0.26-0.65), ptrend

Reactive Molecule Species and Antioxidative Mechanisms in Normal Skin and Skin Aging

Article

Full-text available

Jun 2014
SKIN PHARMACOL PHYS

Reactive oxygen and nitrogen species (ROS/RNS) which may exist as radicals or nonradicals, as well as reactive sulfur species and reactive carbon species, play a major role in aging processes and in carcinogenesis. These reactive molecule species (RMS), often referred to as 'free radicals' or oxidants, are partly by-products of the physiological metabolism. When RMS concentrations exceed a certain threshold, cell compartments and cells are injured and destroyed. Endogenous physiological mechanisms are able to neutralize RMS to some extent, thereby limiting damage. In the skin, however, pollutants and particularly UV irradiation are able to produce additional oxidants which overload the endogenous protection system and cause early aging, debilitation of immune functions, and skin cancer. The application of antioxidants from various sources in skin care products and food supplements is therefore widespread, with increasingly effective formulations being introduced. The harmful effects of RMS (aside from impaired structure and function of DNA, proteins, and lipids) are: interference with specific regulatory mechanisms and signaling pathways in cell metabolism, resulting in chronic inflammation, weakening of immune functions, and degradation of tissue. Important control mechanisms are: MAP-kinases, the aryl-hydrocarbon receptor (AhR), the antagonistic transcription factors nuclear factor-κB and Nrf2 (nuclear factor erythroid 2-related factor 2), and, especially important, the induction of matrix metalloproteinases which degrade dermal connective tissue. Recent research, however, has revealed that RMS and in particular ROS/RNS are apparently also produced by specific enzyme reactions in an evolutionarily adapted manner. They may fulfill important physiologic functions such as the activation of specific signaling chains in the cell metabolism, defense against infectious pathogens, and regulation of the immune system. Normal physiological conditions are characterized by equilibrium of oxidative and antioxidative mechanisms. The application of antioxidants in the form of 'cosmeceuticals' or systemic 'nutraceuticals' should aim to support a physiologically balanced oxidation status in the skin. © 2014 S. Karger AG, Basel.

Structural changes and cognitive deficits in depression and their clinical correlates

Article

Full-text available

Jan 2013

Neuroprotective and cognitive enhancing effects of a multi-targeted food intervention in an animal model of neurodegeneration and depression

Article

Full-text available

Nov 2013

Rising neurodegenerative and depressive disease prevalence combined with the lack of effective pharmaceutical treatments and dangerous side effects, has created an urgent need for the development of effective therapies. Considering that these disorders are multifactorial in origin, treatments designed to interfere at different mechanistic levels may be more effective than the traditional single-targeted pharmacological concepts. To that end, an experimental diet composed of zinc, melatonin, curcumin, piperine, eicosapentaenoic acid (EPA, 20:5, n-3), docosahexaenoic acid (DHA, 22:6, n-3), uridine, and choline was formulated. This diet was tested on the olfactory bulbectomized rat (OBX), an established animal model of depression and cognitive decline. The ingredients of the diet have been individually shown to attenuate glutamate excitoxicity, exert potent anti-oxidant/anti-inflammatory properties, and improve synaptogenesis; processes that all have been implicated in neurodegenerative diseases and in the cognitive deficits following OBX in rodents. Dietary treatment started 2 weeks before OBX surgery, continuing for 6 weeks in total. The diet attenuated OBX-induced cognitive and behavioral deficits, except long-term spatial memory. Ameliorating effects of the diet extended to the control animals. Furthermore, the experimental diet reduced hippocampal atrophy and decreased the peripheral immune activation in the OBX rats. The ameliorating effects of the diet on the OBX-induced changes were comparable to those of the NMDA receptor antagonist, memantine, a drug used for the management of Alzheimer's disease. This proof-of-concept study suggests that a diet, which simultaneously targets multiple disease etiologies, can prevent/impede the development of a neurodegenerative and depressive disorders and the concomitant cognitive deficits.

Food, Nutrigenomics, and Neurodegeneration-Neuroprotection by What You Eat!

Article

Full-text available

Jun 2013
MOL NEUROBIOL

Diet in human health is no longer simple nutrition, but in light of recent research, especially nutrigenomics, it is linked via evolution and genetics to cell health status capable of modulating apoptosis, detoxification, and appropriate gene response. Nutritional deficiency and disease especially lack of vitamins and minerals is well known, but more recently, epidemiological studies suggest a role of fruits and vegetables, as well as essential fatty acids and even red wine (French paradox), in protection against disease. In the early 1990s, various research groups started considering the use of antioxidants (e.g., melatonin, resveratrol, green tea, lipoic acid) and metabolic compounds (e.g., nicotinamide, acetyl-L-carnitine, creatine, coenzyme Q10) as possible candidates in neuroprotection. They were of course considered on par with snake oil salesman (women) at the time. The positive actions of nutritional supplements, minerals, and plant extracts in disease prevention are now mainstream and commercial health claims being made are subject to regulation in most countries. Apart from efficacy and finding, the right dosages, the safety, and especially the level of purification and lack of contamination are all issues that are important as their use becomes widespread. From the mechanistic point of view, most of the time these substances replenish the body's deficiency and restore normal function. However, they also exert actions that are not sensu stricto nutritive and could be considered pharmacological especially that, at times, higher intake than recommended (RDA) is needed to see these effects. Free radicals and neuroinflammation processes underlie many neurodegenerative conditions, even Parkinson's disease and Alzheimer's disease. Curcumin, carotenoids, acetyl-L-carnitine, coenzyme Q10, vitamin D, and polyphenols and other nutraceuticals have the potential to target multiple pathways in these conditions. In summary, augmenting neuroprotective pathways using diet and finding new natural substances that can be more efficacious, i.e., induction of health-promoting genes and reduction of the expression of disease-promoting genes, could be incorporated into neuroprotective strategies of the future.

Elderly depression in India: An emerging public health challenge

Article

Full-text available

Mar 2013
AMJ

Most countries allocate less than 1% of their total health expenditures to mental health budgets. Depression, along with other mental health disorders, has long been segregated and neglected. The elderly age group comprise a particularly vulnerable group as they often have multiple co-existing medical and psychological problems.

Data Resource Profile: The World Health Organization Study on global AGEing and adult health (SAGE)

Article

Full-text available

Dec 2012
INT J EPIDEMIOL

Population ageing is rapidly becoming a global issue and will have a major impact on health policies and programmes. The World Health Organization's Study on global AGEing and adult health (SAGE) aims to address the gap in reliable data and scientific knowledge on ageing and health in low- and middle-income countries. SAGE is a longitudinal study with nationally representative samples of persons aged 50+ years in China, Ghana, India, Mexico, Russia and South Africa, with a smaller sample of adults aged 18-49 years in each country for comparisons. Instruments are compatible with other large high-income country longitudinal ageing studies. Wave 1 was conducted during 2007-2010 and included a total of 34 124 respondents aged 50+ and 8340 aged 18-49. In four countries, a subsample consisting of 8160 respondents participated in Wave 1 and the 2002/04 World Health Survey (referred to as SAGE Wave 0). Wave 2 data collection will start in 2012/13, following up all Wave 1 respondents. Wave 3 is planned for 2014/15. SAGE is committed to the public release of study instruments, protocols and meta- and micro-data: access is provided upon completion of a Users Agreement available through WHO's SAGE website (www.who.int/healthinfo/systems/sage) and WHO's archive using the National Data Archive application (http://apps.who.int/healthinfo/systems/surveydata).

Critical Review: Vegetables and Fruit in the Prevention of Chronic Diseases

Article

Full-text available

Jun 2012
EUR J NUTR

Vegetables and fruit provide a significant part of human nutrition, as they are important sources of nutrients, dietary fibre, and phytochemicals. However, it is uncertain whether the risk of certain chronic diseases can be reduced by increased consumption of vegetables or fruit by the general public, and what strength of evidence has to be allocated to such an association. Therefore, a comprehensive analysis of the studies available in the literature and the respective study results has been performed and evaluated regarding obesity, type 2 diabetes mellitus, hypertension, coronary heart disease (CHD), stroke, cancer, chronic inflammatory bowel disease (IBD), rheumatoid arthritis (RA), chronic obstructive pulmonary disease (COPD), asthma, osteoporosis, eye diseases, and dementia. For judgement, the strength of evidence for a risk association, the level of evidence, and the number of studies were considered, the quality of the studies and their estimated relevance based on study design and size. For hypertension, CHD, and stroke, there is convincing evidence that increasing the consumption of vegetables and fruit reduces the risk of disease. There is probable evidence that the risk of cancer in general is inversely associated with the consumption of vegetables and fruit. In addition, there is possible evidence that an increased consumption of vegetables and fruit may prevent body weight gain. As overweight is the most important risk factor for type 2 diabetes mellitus, an increased consumption of vegetables and fruit therefore might indirectly reduces the incidence of type 2 diabetes mellitus. Independent of overweight, there is probable evidence that there is no influence of increased consumption on the risk of type 2 diabetes mellitus. There is possible evidence that increasing the consumption of vegetables and fruit lowers the risk of certain eye diseases, dementia and the risk of osteoporosis. Likewise, current data on asthma, COPD, and RA indicate that an increase in vegetable and fruit consumption may contribute to the prevention of these diseases. For IBD, glaucoma, and diabetic retinopathy, there was insufficient evidence regarding an association with the consumption of vegetables and fruit. This critical review on the associations between the intake of vegetables and fruit and the risk of several chronic diseases shows that a high daily intake of these foods promotes health. Therefore, from a scientific point of view, national campaigns to increase vegetable and fruit consumption are justified. The promotion of vegetable and fruit consumption by nutrition and health policies is a preferable strategy to decrease the burden of several chronic diseases in Western societies.

Study protocol for the World Health Organization project to develop a Quality of Life assessment instrument (WHOQOL)WHOQOL-GroupQual Life Res1993221531598518769

Article

Full-text available

Apr 1993

The World Health Organization (WHO) has undertaken a project to develop an instrument (the WHOQOL) for measuring quality of life. Quality of life is defined as an individual's perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns. It is a broad ranging concept affected in a complex way by the person's physical health, psychological state, level of independence, social relationships, and their relationship tc salient features of their environment. The instrument will be developed in the framework of a collaborative project involving numerous centres in different cultural settings. In addition, it will have proven psychometric properties of validity, responsiveness and reliability and will be sensitive to the cultural setting in which it is applied, whilst maintaining comparability of scores across different cultural settings. This paper outlines the characteristics of the planned instrument and the study protocol governing work on its development. To date steps 1 through 5 have been completed and work is progressing on step 6. It is anticipated that the instrument will be available for piloting in July 1993 and a final version available for use in June 1994.

Fruit and vegetable intake and cognitive decline in middle-aged men and women: The Doetinchem Cohort Study

Article

Full-text available

Apr 2011
BRIT J NUTR

To postpone cognitive decline and dementia in old age, primary prevention is required earlier in life during middle age. Dietary components may be modifiable determinants of mental performance. In the present study, habitual fruit and vegetable intake was studied in association with cognitive function and cognitive decline during middle age. In the Doetinchem Cohort Study, 2613 men and women aged 43-70 years at baseline (1995-2002) were examined for cognitive function twice, with a 5-year time interval. Global cognitive function and the domains memory, information processing speed and cognitive flexibility were assessed. Dietary intake was assessed with a semi-quantitative FFQ. In multivariate linear regression analyses, habitual fruit and vegetable intake was studied in association with baseline and change in cognitive function. Higher reported vegetable intake was associated with lower information processing speed (P = 0·02) and worse cognitive flexibility (P = 0·03) at baseline, but with smaller decline in information processing speed (P < 0·01) and global cognitive function (P = 0·02) at follow-up. Total intakes of fruits, legumes and juices were not associated with baseline or change in cognitive function. High intakes of some subgroups of fruits and vegetables (i.e. nuts, cabbage and root vegetables) were associated with better cognitive function at baseline and/or smaller decline in cognitive domains. In conclusion, total intake of fruits and vegetables was not or inconsistently associated with cognitive function and cognitive decline. A high habitual consumption of some specific fruits and vegetables may diminish age-related cognitive decline in middle-aged individuals. Further research is needed to verify these findings before recommendations can be made.

A Meta-Analysis of Cytokines in Major Depression

Article

Full-text available

Dec 2009

Major depression occurs in 4.4% to 20% of the general population. Studies suggest that major depression is accompanied by immune dysregulation and activation of the inflammatory response system (IRS). Our objective was to quantitatively summarize the data on concentrations of specific cytokines in patients diagnosed with a major depressive episode and controls. We performed a meta-analysis of studies measuring cytokine concentration in patients with major depression, with a database search of the English literature (to August 2009) and a manual search of references. Twenty-four studies involving unstimulated measurements of cytokines in patients meeting DSM criteria for major depression were included in the meta-analysis; 13 for tumor necrosis factor (TNF)-alpha, 9 for interleukin (IL)-1beta, 16 for IL-6, 5 for IL-4, 5 for IL-2, 4 for IL-8, 6 for IL-10, and 4 for interferon (IFN)-gamma. There were significantly higher concentrations of TNF-alpha (p < .00001), weighted mean difference (WMD) (95% confidence interval) 3.97 pg/mL (2.24 to 5.71), in depressed subjects compared with control subjects (438 depressed/350 nondepressed). Also, IL-6 concentrations were significantly higher (p < .00001) in depressed subjects compared with control subjects (492 depressed/400 nondepressed) with an overall WMD of 1.78 pg/mL (1.23 to 2.33). There were no significant differences among depressed and nondepressed subjects for the other cytokines studied. This meta-analysis reports significantly higher concentrations of the proinflammatory cytokines TNF-alpha and IL-6 in depressed subjects compared with control subjects. While both positive and negative results have been reported in individual studies, this meta-analytic result strengthens evidence that depression is accompanied by activation of the IRS.

High Fruit and Vegetable Intake is Positively Correlated with Antioxidant Status and Cognitive Performance in Healthy Subjects

Article

Full-text available

Jul 2009
J ALZHEIMERS DIS

A higher daily intake of fruits and vegetables in healthy elderly is associated with an improved antioxidant status in comparison to subjects consuming diets poor in fruits and vegetables, but the impact on cognitive performance is unclear. Healthy community dwellers (45 to 102 years old, n=193) underwent cognitive testing and blood withdrawal for the measurement of antioxidant micronutrients and biomarkers of oxidative stress as well as administration of a food frequency questionnaire to assess the daily intake of fruits and vegetables (high intake HI, low intake LI). Ninety-four subjects of the HI group had significantly higher cognitive test scores, higher levels of carotenoids, α- and γ-tocopherol as well as lower levels of F2α isoprostanes than the 99 subjects of the LI group. Cognitive scores were directly correlated with blood levels of α-tocopherol and lycopene and negatively correlated with F2α isoprostanes and protein carbonyls. The results were independent of age, gender, body mass index, education, total cholesterol, LDL- and HDL-cholesterol, triglycerides, and albumin. Healthy subjects of any age with a high daily intake of fruits and vegetables have higher antioxidant levels, lower levels of biomarkers of oxidative stress, and better cognitive performance than healthy subjects of any age consuming low amounts of fruits and vegetables. Modification of nutritional habits aimed at increasing intake of fruits and vegetables should be encouraged to lower prevalence of cognitive impairment in later life.

Psychiatric disorders and 15-month mortality in a community sample of older adults

Article

Full-text available

Jul 1989

The relation between psychiatric disorders, defined by the Diagnostic Interview Schedule (DIS), and mortality over 15 months is compared in 3007 adults age 55 and over in the New Haven Epidemiologic Catchment Area (ECA) project. Our results indicate that the odds of dying are more than four times greater for individuals with affective disorders than for others in the sample, controlling for age, sex, and physical health. Cause of death is also examined. There were no suicides or deaths from external causes.

The Association of Depression and Mortality in Elderly Persons: A Case for Multiple, Independent Pathways

Article

Full-text available

Sep 2001

The evidence for an association between depression and mortality among community-dwelling elderly persons remains inconclusive, although it is well established for younger individuals. Extant studies suggest that this association weakens when adjusted for potential confounding factors, especially functional impairment. A cohort of elderly subjects followed for 3 years was analyzed to determine the association of depression and 3-year mortality, controlling for the major known risk factors for mortality in the elderly population. Information on depression (CES-D scores), mortality, demographics, body mass index, chronic disease, smoking history, cognitive impairment, functional impairment, self-rated health, and social support was obtained from a stratified probability-based sample of community-dwelling elderly persons, with equal distribution between African Americans and whites in the Piedmont of North Carolina. Descriptive statistics were calculated, and logistic regression was used for a series of models with progressively more control variables. The unadjusted relative odds of mortality among depressed subjects at baseline was 1.98 over 3 years of follow-up. Inclusion of age, gender, and race into the model did not reduce the relative odds. When chronic disease and health habits, cognitive impairment, functional impairment, and social support were added to the model, the odds ratios for mortality with depression were 1.74, 1.69, 1.29, and 1.21, respectively. This decrease in odds ratios was not observed for other variables in the model when additional variables were added. The estimated odds of dying if depressed moved toward unity as other risk factors for mortality were controlled. Unlike other known risk factors for mortality in the elderly population, depression appears to be associated with mortality through a number of independent mechanisms, perhaps through complex feedback loops.

Fruit and Vegetable Consumption and Risk of Coronary Heart Disease: A Meta-Analysis of Cohort Studies

Article

Full-text available

Oct 2006

The consumption of fruit and vegetables is associated with a reduced rate of coronary heart disease (CHD) in observational cohorts. The purpose of this study was to assess the strength of this association in a meta-analysis. Cohort studies were selected if they reported relative risks (RRs) and 95% CI for coronary heart disease or mortality and if they presented a quantitative assessment of fruit and vegetable intake. The pooled RRs were calculated for each additional portion of fruit and/or vegetables consumed per day, and the linearity of the associations were examined. Nine studies were eligible for inclusion in the meta-analysis that consisted of 91,379 men, 129,701 women, and 5,007 CHD events. The risk of CHD was decreased by 4% [RR (95% CI): 0.96 (0.93-0.99), P = 0.0027] for each additional portion per day of fruit and vegetable intake and by 7% [0.93 (0.89-0.96), P < 0.0001] for fruit intake. The association between vegetable intake and CHD risk was heterogeneous (P = 0.0043), more marked for cardiovascular mortality [0.74 (0.75-0.84), P < 0.0001] than for fatal and nonfatal myocardial infarction [0.95 (0.92-0.99), P = 0.0058]. Visual inspection of the funnel plot suggested a publication bias, although not statistically significant. Therefore, the reported RRs are probably overestimated. This meta-analysis of cohort studies shows that fruit and vegetable consumption is inversely associated with the risk of CHD. The causal mechanism of this association, however, remains to be demonstrated.

Cognitive deficits in depression: possible implications for functional neuropathology

Article

Mar 2001

Background: While depression is known to involve a disturbance of mood, movement and cognition, its associated cognitive deficits are frequently viewed as simple epiphenomena of the disorder. Aims: To review the status of cognitive deficits in depression and their putative neurobiological underpinnings. Method: Selective computerised review of the literature examining cognitive deficits in depression and their brain correlates. Results: Recent studies report both mnemonic deficits and the presence of executive impairment--possibly selective for set-shifting tasks--in depression. Many studies suggest that these occur independent of age, depression severity and subtype, task 'difficulty', motivation and response bias: some persist upon clinical 'recovery'. Conclusions: Mnemonic and executive deficits do no appear to be epiphenomena of depressive disorder. A focus on the interactions between motivation, affect and cognitive function may allow greater understanding of the interplay between key aspects of the dorsal and ventral aspects of the prefrontal cortex in depression.

Role of Fruits, Nuts, and Vegetables in Maintaining Cognitive Health

Article

Dec 2016

Population aging is leading to an increase in the incidence of age-related cognitive dysfunction and, with it, the health care burden of caring for older adults. Epidemiological studies have shown that consumption of fruits, nuts, and vegetables is positively associated with cognitive ability; however, these foods, which contain a variety of neuroprotective phytochemicals, are widely under-consumed. Surprisingly few studies have investigated the effects of individual plant foods on cognitive health but recent clinical trials have shown that dietary supplementation with individual foods, or switching to a diet rich in several of these foods, can improve cognitive ability. While additional research is needed, increasing fruit, nut, and vegetable intake may be an effective strategy to prevent or delay the onset of cognitive dysfunction during aging.

Dietary fiber intake and depressive symptoms in Japanese employees: The Furukawa Nutrition and Health Study

Article

May 2016
NUTRITION

Objective: Dietary fiber may play a favorable role in mood through gut microbiota, but epidemiologic evidence linking mood to dietary fiber intake is scarce in free-living populations. We investigated cross-sectionally the associations of dietary intakes of total, soluble, insoluble, and sources of fiber with depressive symptoms among Japanese workers. Methods: Participants were 1977 employees ages 19-69 y. Dietary intake was assessed via a validated, brief self-administered diet history questionnaire. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. Logistic regression was used to estimate odds ratios of depressive symptoms adjusted for a range of dietary and non-dietary potential confounders. Results: Dietary fiber intake from vegetables and fruits was significantly inversely associated with depressive symptoms. The multivariable-adjusted odds ratios (95% confidence intervals) for the lowest through the highest tertile of vegetable and fruit fiber were 1.00 (reference), 0.80 (0.60-1.05), and 0.65 (0.45-0.95), respectively (P for trend = 0.03). Dietary intake of total, soluble, insoluble, and cereal fiber was not associated with depressive symptoms. Conclusions: Higher dietary fiber intake from vegetables and fruits may be associated with lower likelihood of having depressive symptoms.

Inflammation: Depression Fans the Flames and Feasts on the Heat

Article

Sep 2015
AM J PSYCHIAT

Depression and inflammation fuel one another. Inflammation plays a key role in depression's pathogenesis for a subset of depressed individuals; depression also primes larger cytokine responses to stressors and pathogens that do not appear to habituate. Accordingly, treatment decisions may be informed by attention to questions of how (pathways) and for whom (predispositions) these links exist, which are the focus of this article. When combined with predisposing factors (moderators such as childhood adversity and obesity), stressors and pathogens can lead to exaggerated or prolonged inflammatory responses. The resulting sickness behaviors (e.g., pain, disturbed sleep), depressive symptoms, and negative health behaviors (e.g., poor diet, a sedentary lifestyle) may act as mediating pathways that lead to further, unrestrained inflammation and depression. Depression, childhood adversity, stressors, and diet can all influence the gut microbiome and promote intestinal permeability, another pathway to enhanced inflammatory responses. Larger, more frequent, or more prolonged inflammatory responses could have negative mental and physical health consequences. In clinical practice, inflammation provides a guide to potential targets for symptom management by signaling responsiveness to certain therapeutic strategies. For example, a theme across research with cytokine antagonists, omega-3 fatty acids, celecoxib, and exercise is that anti-inflammatory interventions have a substantially greater impact on mood in individuals with heightened inflammation. Thus, when inflammation and depression co-occur, treating them in tandem may enhance recovery and reduce the risk of recurrence. The bidirectional links between depression, inflammation, and disease suggest that effective depression treatments could have a far-reaching impact on mood, inflammation, and health.

Fruits, vegetables, 100% juices, and cognitive function

Article

Dec 2014
NUTR REV

Although reviews of the association between polyphenol intake and cognition exist, research examining the cognitive effects of fruit, vegetable, and juice consumption across epidemiological and intervention studies has not been previously examined. For the present review, critical inclusion criteria were human participants, a measure of fruit, vegetable, or 100% juice consumption, an objective measure of cognitive function, and a clinical diagnosis of neuropsychological disease. Studies were excluded if consumption of fruits, vegetables, or juice was not assessed in isolation from other food groups, or if there was no statistical control for education or IQ. Seventeen of 19 epidemiological studies and 3 of 6 intervention studies reported significant benefits of fruit, vegetable, or juice consumption for cognitive performance. The data suggest that chronic consumption of fruits, vegetables, and juices is beneficial for cognition in healthy older adults. The limited data from acute interventions indicate that consumption of fruit juices can have immediate benefits for memory function in adults with mild cognitive impairment; however, as of yet, acute benefits have not been observed in healthy adults. Conclusions regarding an optimum dietary intake for fruits, vegetables, and juices are difficult to quantify because of substantial heterogeneity in the categorization of consumption of these foods.

Erratum to “Inflammatory dietary pattern and risk of depression among women” [Brain Behav. Immun. 36 (2014) 46–53]

Article

Mar 2014

Spectroscopic biofeedback on cutaneous carotenoids as part of a prevention program could be effective to raise health awareness in adolescents

Article

Nov 2014
J BIOPHOTONICS

The cutaneous carotenoid concentration correlates with the overall antioxidant status of a person and can be seen as biomarker for nutrition and lifestyle. 50 high school students were spectroscopically measured for their cutaneous carotenoid concentrations initially in a static phase, followed by an intervention phase with biofeedback of their measured values, living a healthy lifestyle and on healthy food this time. The volunteers showed higher carotenoid concentrations than found in previous studies. A significant correlation of healthy lifestyle habits and a high antioxidant status could be determined. Subjects improved their nutritional habits and significantly increased their carotenoid concentration during intervention. Follow-up five months later showed a consolidation of the increase. The investigations show that a healthy diet and a well-balanced lifestyle correlate with a high cutaneous antioxidant concentration and that spectroscopic biofeedback measurement of cutaneous carotenoids as part of an integrated prevention program is a feasible and effective means to raise the health awareness in adolescents. (© 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim)

Inflammatory dietary pattern and risk of depression among women

Article

Oct 2013
BRAIN BEHAV IMMUN

Inflammation is considered as a mechanism leading to depression, but the association between inflammatory dietary pattern and depression risk is unknown. Using reduced-rank regression, we identified a dietary pattern that was related to plasma levels of inflammatory markers (C-reactive protein, interleukin-6, tumor necrosis factor receptor 2), and we conducted a prospective analysis of the relationship of this pattern and depression risk among participants in the Nurses' Health Study. A total of 43,685 women (aged 50-77) without depression at baseline (1996) were included and followed up until 2008. Diet information was obtained from food frequency questionnaires completed between 1984 through 2002 and computed as cumulative average of dietary intakes with a 2-year latency applied. We used a strict definition of depression that required both self-reported physician-diagnosed depression and use of antidepressants, and a broader definition that included women who reported either clinical diagnosis or antidepressant use. During the 12-year follow-up, we documented 2,594 incident cases of depression using the stricter definition and 6,446 using the broader definition. After adjustment for body mass index and other potential confounders, relative risks comparing extreme quintiles of the inflammatory dietary pattern were 1.41 (95% confidence interval [CI], 1.22, 1.63; P-trend <.001) for the strict definition and 1.29 (95% CI, 1.18, 1.41; P-trend <.001) for the broader definition of depression. The inflammatory dietary pattern is associated with a higher depression risk. This finding suggests that chronic inflammation may underlie the association between diet and depression.

P2-283 Fruit and vegetable consumption and cognitive decline in women

Article

Jul 2004
NEUROBIOL AGING

The World Health Organization Quality of Life Assessment (WHOQOL) - Position Paper from the World Health Organization

Article

Nov 1995

This paper describes the World Health Organization's project to develop a quality of life instrument (the WHOQOL). It outlines the reasons that the project was undertaken, the thinking that underlies the project, the method that has been followed in its development and the current status of the project. The WHOQOL assesses individuals' perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns. It has been developed collaboratively in several culturally diverse centres over four years. Piloting of the WHOQOL on some 4500 respondents in 15 cultural settings has been completed. On the basis of this data the revised WHOQOL Field Trial Form has been finalized, and field testing is currently in progress. The WHOQOL produces a multi-dimensional profile of scores across six domains and 24 sub-domains of quality of life

Position paper from the World Health OrganizationThe World Health Organization Quality of Life assessment (WHOQOL)Soc Sci Med199541140314098560308

Article

Nov 1995

Photoprotection by dietary carotenoids: Concept, mechanisms, evidence and future development

Article

Feb 2012
MOL NUTR FOOD RES

Carotenoids are micronutrients present mainly in fruits and vegetables, and they are ingested from these sources with the diet. They exhibit specific antioxidant activity but also influence signaling and gene expression at the cellular level. β-Carotene and lycopene, the colorants of carrots and tomatoes, respectively, are among the most prominent members of this group of lipids, and they are usually the dominating carotenoids in human blood and tissues. Both compounds modulate skin properties when ingested as supplements or as dietary products. There is evidence that they protect the skin against sunburn (solar erythema) by increasing the basal defense against UV light-mediated damage. Their photoprotective efficacy, however, is not comparable to the use of a sunscreen. In vitro data show that also other carotenoids are efficient photoprotectors. Among them are lutein and structurally unusual phenolic polyenes like 3,3'-dihydroxyisorenieratene.

Interleukin (IL)-6, tumour necrosis factor alpha (TNF-alpha) and soluble interleukin-2 receptors (sIL-2R) are elevated in patients with major depressive disorder: A meta-analysis and meta-regression

Article

Aug 2011

Many studies have explored the association between soluble interleukin-2 receptor (sIL-2R), cytokines and major depressive disorder (MDD). However, the results of these studies were not consistent. The aim of our study is to compare the levels of sIL-2R and cytokines in the blood between MDD patients and controls by a meta-analysis and to identify moderators accounting for potential heterogeneity in the levels of sIL-2R and cytokines in MDD patients versus controls by meta-regression analyses. A comprehensive literature search was performed to identify studies comparing the levels of sIL-2R and cytokines between MDD patients and controls. We pooled the effect sizes for standardized mean differences (SMD) of the levels of sIL-2R and cytokines. We also performed meta-regression and sensitivity analyses to investigate the roles of age, gender, sample type, ethnic origin and selected studies' quality in explaining potential heterogeneity and differences in results respectively. Twenty-nine studies were selected for this analysis. The levels of sIL-2R, TNF-α and IL-6 in MDD patients were significantly higher than those of healthy controls (SMD=0.555, p<0.001, SMD=0.567, p=0.010; SMD=0.680, p<0.001). Mean age of all subjects was a significant moderator to explain the high heterogeneity of IL-6. Sensitivity analysis found that European but not non-European subjects have higher levels difference of sIL-2R, TNF-α and IL-1β between MDD patients and controls. The severity of MDD was not considered. The blood levels of sIL-2R, TNF-α and IL-6 were significantly higher in MDD patients than controls. Age, samples source and ethnic origins may play a potential role in heterogeneity.

Interaction between Carotenoids and Free Radicals in Human Skin

Article

Mar 2011
SKIN PHARMACOL PHYS

Environmental factors like air pollutants, radiation of the sun and stress factors such as illness, smoking, or alcohol abuse produce free radicals in the human tissue as well as in the skin. Free radicals serve as the main cause for premature skin aging. Additionally, they also contribute towards immunosuppression and the formation of skin diseases including cancer. The human organism has developed a protection system against the destructive action of free radicals by means of the antioxidant network. In the present study, the interaction of free radicals and carotenoid antioxidants in the human skin under in vivo conditions was investigated and summarized. The measurement of carotenoids in human skin was performed in vivo using resonance Raman spectroscopy.

The Weirdest People in the World?

Article

Jun 2010
BEHAV BRAIN SCI

Behavioral scientists routinely publish broad claims about human psychology and behavior in the world's top journals based on samples drawn entirely from Western, Educated, Industrialized, Rich, and Democratic (WEIRD) societies. Researchers - often implicitly - assume that either there is little variation across human populations, or that these "standard subjects" are as representative of the species as any other population. Are these assumptions justified? Here, our review of the comparative database from across the behavioral sciences suggests both that there is substantial variability in experimental results across populations and that WEIRD subjects are particularly unusual compared with the rest of the species - frequent outliers. The domains reviewed include visual perception, fairness, cooperation, spatial reasoning, categorization and inferential induction, moral reasoning, reasoning styles, self-concepts and related motivations, and the heritability of IQ. The findings suggest that members of WEIRD societies, including young children, are among the least representative populations one could find for generalizing about humans. Many of these findings involve domains that are associated with fundamental aspects of psychology, motivation, and behavior - hence, there are no obvious a priori grounds for claiming that a particular behavioral phenomenon is universal based on sampling from a single subpopulation. Overall, these empirical patterns suggests that we need to be less cavalier in addressing questions of human nature on the basis of data drawn from this particularly thin, and rather unusual, slice of humanity. We close by proposing ways to structurally re-organize the behavioral sciences to best tackle these challenges.

Howren MB, Lamkin DM, Suls J. Associations of depression with C-reactive protein, IL-1, and IL-6: a meta-analysis. Psychosom Med 71: 171-186. Epub 2009 Feb 2

Article

Feb 2009
PSYCHOSOM MED

To assess the magnitude and direction of associations of depression with C-reactive protein (CRP), interleukin (IL)-1, and IL-6 in community and clinical samples. Systematic review of articles published between January 1967 and January 2008 in the PubMed and PsycINFO electronic databases was performed. Effect sizes were calculated as stat d and meta-analyzed, using random-effects models. Each inflammatory marker was positively associated with depression; CRP, d = 0.15 (95% CI = 0.10, 0.21), p < .001; IL-6, d = 0.25 (95% CI = 0.18, 0.31), p < .001; IL-1, d = 0.35 (95% CI = 0.03, 0.67), p = .03; IL-1ra, d = 0.25 (95% CI = 0.04, 0.46), p = .02. Associations were strongest in clinically depressed patient samples--but were also significant in community-based samples--and when clinical interviews were used. Studies adjusting for body mass index (BMI) had smaller associations, albeit significant. Relationships were inconsistent with respect to age, medication, and sex. Depression was related to CRP and IL-6 among patients with cardiac disease or cancer. Depression and CRP, IL-1, and IL-6 are positively associated in clinical and community samples and BMI is implicated as a mediating/moderating factor. Continuity in clinic- and community-based samples suggests there is a dose-response relationship between depression and these inflammatory markers, lending strength to the contention that the cardiac (or cancer) risk conferred by depression is not exclusive to patient populations. Available evidence is consistent with three causal pathways: depression to inflammation, inflammation to depression, and bidirectional relationships.

Austin MP, Mitchell P, Goodwin GM. Cognitive deficits in depression: possible implications for functional neuropathology. Br J Psychiatry 178: 200-206

Article

Apr 2001

While depression is known to involve a disturbance of mood, movement and cognition, its associated cognitive deficits are frequently viewed as simple epiphenomena of the disorder. To review the status of cognitive deficits in depression and their putative neurobiological underpinnings. Selective computerised review of the literature examining cognitive deficits in depression and their brain correlates. Recent studies report both mnemonic deficits and the presence of executive impairment--possibly selective for set-shifting tasks--in depression. Many studies suggest that these occur independent of age, depression severity and subtype, task 'difficulty', motivation and response bias: some persist upon clinical 'recovery'. Mnemonic and executive deficits do no appear to be epiphenomena of depressive disorder. A focus on the interactions between motivation, affect and cognitive function may allow greater understanding of the interplay between key aspects of the dorsal and ventral aspects of the prefrontal cortex in depression.

Participating in Social Activities Helps Preserve Cognitive Function: An Analysis of a Longitudinal, Population-Based Study of the Elderly

Article

Aug 2005

This study examines how changes in cognition over time are related to participation in social activities and the extent of social networks. Data are drawn from a population-based, longitudinal study that began in 1989 among elderly Taiwanese. An over-dispersed Poisson model is used to regress the number of failed cognitive tasks (0-5) in 1996, 1999, and 2000 on prior measures of cognitive impairment, social activities, social networks, health status, and sociodemographic characteristics. The analysis sample comprises 2387 individuals, who contribute a total of 4603 observations across three survey intervals (1993-96, 1996-99, 1999-2000). After adjusting for prior cognitive impairment, baseline health status, and sociodemographic factors, respondents who participated in one or two social activities failed 13% fewer cognitive tasks (P < 0.01) than those with no social activities; those who engaged in three or more activities failed 33% fewer cognitive tasks (P < 0.001). In contrast, none of the social network measures was related to cognitive impairment. Despite a social structure where elderly persons often live with their children and social interaction is likely to be more family-centered than in western countries, data from Taiwan suggest that participation in social activities outside the family may have a bigger impact on cognitive function than social contacts with family or non-relatives.

Fruit and vegetable consumption and cognitive function

Article

May 2005

We prospectively examined fruit and vegetable intake in relation to cognitive function and decline among aging women. Participants were followed from in 1976 with biennial questionnaires, and food frequency questionnaires were administered in 1984, 1986, and every 4 years thereafter. From 1995 to 2001, we administered, by telephone, six cognitive tests measuring general cognition, verbal memory, category fluency, and working memory. We repeated assessments two years later for 13,388 women (>90% follow-up). We averaged dietary intakes from 1984 through the first cognitive assessment, and used linear regression to obtain multivariable-adjusted mean differences in performance and decline in performance across intake levels. Fruits were not associated with cognition or cognitive decline. However, total vegetable intake was significantly associated with less decline. Specifically, on a global score combining all tests, women in the highest quintile of cruciferous vegetables declined slower (by 0.04 unit; 95% confidence interval, 0.003, 0.07; p trend = 0.1) compared with the lowest quintile. Women consuming the most green leafy vegetables also experienced slower decline than women consuming the least amount (by 0.05 unit; 95% confidence interval, 0.02, 0.09; p trend < 0.001). These mean differences were equivalent to those observed for women about 1 to 2 years apart in age.

Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference

Apr 1946
100

World Health Organization (1948) Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June 1946; signed on 22 July 1946 by the representatives of 61 States and entered into force on 7 April 1948. Official Records of the World Health Organization no. 2, p. 100. http://apps. who.int/iris/bitstream/handle/10665/85573/official_record2_eng. pdf?sequence=1 (accessed September 2018).

Associations of depression with C-reactive protein, IL-1, and IL-6: a metaanalysis

Jan 2009
PSYCHOSOM MED
171-186

M B Howren
D M Lamkin
J Suls

Howren MB, Lamkin DM & Suls J (2009) Associations of depression with C-reactive protein, IL-1, and IL-6: a metaanalysis. Psychosom Med 71, 171-186.

Fruit and vegetable consumption is associated with improved mental and cognitive health in older adults from non-Western developing countries

Abstract

No full-text available

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