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Saghafian F, Hajishafiee M, Rouhani P, Saneei P. Dietary fiber intake, depression, and anxiety: a systematic review and meta-analysis of epidemiologic studies. Nutr Neurosci 2023; 26:108-126. [PMID: 36692989 DOI: 10.1080/1028415x.2021.2020403] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Findings of previous studies on relationship between dietary fiber intake and depression were inconsistent. We performed a meta-analysis on the association of dietary fiber intake with depression and anxiety in epidemiologic studies. METHODS We conducted a systematic search of electronic databases, up to May 2021. Data from 18 publications (12 cross-sectional, five cohort and one case-control studies) on dietary fiber consumption in relation to depression or anxiety were included. For depression, fifteen studies were conducted on adults and three others on adolescents. Anxiety was not included in the analysis, due to insufficient eligible studies. RESULTS Total dietary fiber intake was associated with a 10% lower odds of depression (OR = 0.90; 95% confidence interval [CI]: 0.86, 0.95) in adults and a 57% lower odds (OR = 0.43, 95% CI: 0.32, 0.59) in adolescents. Dose-response meta-analysis revealed an inverse linear association between total dietary fiber intake and odd of depression in adults; such that each 5-g increase in total dietary fiber intake was associated with a 5% reduction in risk of depression (OR = 0.95; 95% CI: 0.94, 0.97). An inverse significant association was observed between intake of fiber from vegetables (OR = 0.73; 95% CI: 0.66, 0.82) and soluble fiber (OR = 0.80, 95% CI: 0.71, 0.91) and odds of depression. However, cereal fiber, fiber from fruits and insoluble fiber were marginally associated with a reduction in having depression. CONCLUSIONS High intake of dietary fiber was protectively associated with depression in adults, in a dose-response fashion.
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Affiliation(s)
- Faezeh Saghafian
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, University of Medical Sciences, Tehran, Iran
| | - Maryam Hajishafiee
- Faculty of Health and Medical Sciences, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Parisa Rouhani
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parvane Saneei
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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2
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Warriach ZI, Patel S, Khan F, Ferrer GF. Association of Depression With Cardiovascular Diseases. Cureus 2022; 14:e26296. [PMID: 35911274 PMCID: PMC9313050 DOI: 10.7759/cureus.26296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2022] [Indexed: 11/23/2022] Open
Abstract
Depression has long been associated with cardiovascular morbidity and mortality. We have reviewed the various factors (hormonal, inflammatory, neuroimmune, and behavioral) involved in depression and associated cardiovascular risk factors. Elevation of glucocorticoids due to activation of the hypothalamic-pituitary-adrenal (HPA) axis in chronic stress of depression results in hyperglycemia, causing insulin resistance, which is a risk factor for heart diseases. This increase in glucocorticoids also stimulates the production of pro-inflammatory cytokines interleukin (IL)-1, IL-6, and tumor necrosis factor-alpha. Literature also showed that chronic stress in depression activates platelet receptors resulting in endothelial dysfunction and cardiovascular morbidity. It has been shown by various studies that depressed patients are more prone to unhealthy lifestyles like eating more processed food, physical inactivity, smoking, and alcohol consumption resulting in weight gain and insulin resistance. Further in the literature, we reviewed some genetic factors associated with depression and cardiovascular outcomes. Elevated glucocorticoids reduce brain-derived neurotrophic factor-dependent upregulation of glutamate receptors involved in various neural circuits associated with depression and neural diseases by suppressing microRNA-132 expression. In depressed obese patients, proprotein convertase subtilisin/kexin type 9 (PCSK-9), a regulator of low-density lipoprotein cholesterol, has been shown to be associated with insulin resistance. This review sheds light on the importance of diagnostic, preventive, and treatment strategies in depressed patients to reduce overall cardiovascular morbidity and mortality.
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Food habits and associated risk factors of depressed patients with cardiovascular disease. PLoS One 2022; 17:e0263519. [PMID: 35113956 PMCID: PMC8812911 DOI: 10.1371/journal.pone.0263519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 01/20/2022] [Indexed: 11/23/2022] Open
Abstract
The present study was carried out to investigate food habits and associated risk factors of depressed patients with cardiovascular disease in Riyadh city, Saudi Arabia. Depressed and healthy females (n = 30 each) and males (n = 30 each) aged 18–65 years were involved in this study. Sociodemographic, anthropometric proxies, and nutritional status were evaluated. Cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein cholesterol (LDL-c) levels of respondents’ blood were determined. The respondents were varied according to demographic factors and anthropometric proxies. The majority of depressed males had higher values than healthy ones. The student t-test analysis showed that the average daily intake of fat especially saturated fat, by depressed respondents was higher than that of the healthy ones as well as the dietary requirement intake (DRI). The analysis of respondents’ blood showed that the number of depressed females had higher abnormal HDL-c than males, who were observed to have an abnormal level of cholesterol and triglycerides. The correlation of daily nutrient intake and depression duration, depression severity, and age showed that the nutrients responsible for the extension and severity of depression were intake of food rich in dietary fat. Factors including demographics daily nutrient intake appeared to be associated with depression.
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Rouhani P, Saghafian F, Hajishafiee M, Saneei P. Meta-analysis of dietary fiber intake and depression symptoms: Further analysis is required. Complement Ther Med 2021; 58:102686. [PMID: 33607216 DOI: 10.1016/j.ctim.2021.102686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 02/11/2021] [Indexed: 10/22/2022] Open
Affiliation(s)
- Parisa Rouhani
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Faezeh Saghafian
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Hajishafiee
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Parvane Saneei
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
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5
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Mosarla RC, Wood M. The Impact of Depression and Anxiety on Cardiovascular Disease Risk and Outcomes in Women. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2021. [DOI: 10.1007/s11936-020-00889-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Eisenberg KN, Leiter E, May RT, Reinfeld T, Zwas DR. Psychosocial Functioning, BMI, and Nutritional Behaviors in Women at Cardiovascular Risk. Front Psychol 2020; 11:2135. [PMID: 32982873 PMCID: PMC7485341 DOI: 10.3389/fpsyg.2020.02135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 07/30/2020] [Indexed: 12/12/2022] Open
Abstract
Psychosocial factors such as depression, anxiety, and stress are associated with increased cardiovascular risk. Health behaviors may play a role in this relationship, as individuals experiencing elevated levels of anxiety, stress, and/or depression may be less likely to engage in risk-reducing behaviors such as diet and exercise. Some evidence suggests that this relationship is particularly relevant for women. This study explored the relationship between levels of anxiety, depression, stress, and specific nutritional behaviors in a sample of 187 women at cardiovascular risk. BMI was explored as a possible moderator of these relationships. Higher levels of depression in patients with high BMI was associated with increased fruit consumption, whereas this was not seen in highly depressed patients with normal BMI. The reverse pattern was seen for consumption of sweet drinks. Anxiety was found to have a complex relationship with consumption of sweetened drinks and white bread, with higher consumption at moderately elevated levels of anxiety and reduced consumption at the highest levels. Possible interpretations of these findings, as well as their implications for lifestyle interventions with this population are discussed. These findings suggest a number of questions for further research.
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Affiliation(s)
- Khaya N Eisenberg
- Linda Joy Pollin Cardiovascular Wellness Center for Women, Division of Cardiology, Hadassah University Medical Center, Jerusalem, Israel
| | - Elisheva Leiter
- Linda Joy Pollin Cardiovascular Wellness Center for Women, Division of Cardiology, Hadassah University Medical Center, Jerusalem, Israel
| | - Rivka T May
- Linda Joy Pollin Cardiovascular Wellness Center for Women, Division of Cardiology, Hadassah University Medical Center, Jerusalem, Israel
| | - Tanya Reinfeld
- Linda Joy Pollin Cardiovascular Wellness Center for Women, Division of Cardiology, Hadassah University Medical Center, Jerusalem, Israel
| | - Donna R Zwas
- Linda Joy Pollin Cardiovascular Wellness Center for Women, Division of Cardiology, Hadassah University Medical Center, Jerusalem, Israel
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7
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O'Neil A, Russell JD, Murphy B. How Does Mental Health Impact Women's Heart Health? Heart Lung Circ 2020; 30:59-68. [PMID: 32665170 DOI: 10.1016/j.hlc.2020.05.111] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 05/13/2020] [Accepted: 05/24/2020] [Indexed: 02/07/2023]
Abstract
From adolescence until old age, women are more vulnerable to common mental disorders (CMDs; depression and anxiety) than men at all stages of the life course. By middle age, women who have clinical depression are at twice the risk of having an incident cardiovascular disease (CVD) than those without. This has important implications for the way we prevent, identify and treat both CMDs and coronary heart disease in women. In this paper, we discuss the various genetic, biological, ethnic/racial, and psychological pathways by which women's vulnerability to CMDs elevate their CVD risk and recovery from a cardiac event. We review the evidence from trials that have, to date, failed to show that treating depression can reduce or delay the onset or recurrence of CVD events, especially for female patients. We discuss the value of lifestyle-based therapies for treating depression, to which women may be more responsive, and finish by discussing how population-based approaches including risk factor assessment could be tailored to consider these factors.
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Affiliation(s)
- Adrienne O'Neil
- Heart & Mind Research, iMPACT Institute, Deakin University, Melbourne, Vic, Australia; Faculty of Health, Deakin University, Melbourne, Vic, Australia.
| | - Josephine D Russell
- Heart & Mind Research, iMPACT Institute, Deakin University, Melbourne, Vic, Australia
| | - Barbara Murphy
- Heart & Mind Research, iMPACT Institute, Deakin University, Melbourne, Vic, Australia; Australian Centre for Heart Health, Melbourne, Vic, Australia; Department of Psychology, University of Melbourne, Melbourne, Vic, Australia
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8
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Głąbska D, Guzek D, Groele B, Gutkowska K. Fruit and Vegetable Intake and Mental Health in Adults: A Systematic Review. Nutrients 2020; 12:E115. [PMID: 31906271 PMCID: PMC7019743 DOI: 10.3390/nu12010115] [Citation(s) in RCA: 166] [Impact Index Per Article: 41.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 12/19/2019] [Accepted: 12/28/2019] [Indexed: 12/26/2022] Open
Abstract
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.
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Affiliation(s)
- Dominika Głąbska
- Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 159C Nowoursynowska Street, 02-787 Warsaw, Poland;
| | - Dominika Guzek
- Department of Food Market and Consumer Research, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 159C Nowoursynowska Street, 02-787 Warsaw, Poland; (D.G.); (K.G.)
| | - Barbara Groele
- Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 159C Nowoursynowska Street, 02-787 Warsaw, Poland;
| | - Krystyna Gutkowska
- Department of Food Market and Consumer Research, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 159C Nowoursynowska Street, 02-787 Warsaw, Poland; (D.G.); (K.G.)
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9
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Chen Z, Zhou JL, Liu W, Yu HD. The Negative Emotions Due to Chronic Illness Screening Test (NECIS): Construct Validity in Patients with Coronary Artery Disease in Mainland China. Patient Prefer Adherence 2019; 13:2217-2224. [PMID: 31920291 PMCID: PMC6939403 DOI: 10.2147/ppa.s232935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 11/26/2019] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE Patients with coronary artery disease (CAD) are susceptible to the negative emotion and its adverse influence on the disease prognosis. It is of great necessity to have a simple measurement to timely assess negative emotions in patients with CAD. The Negative Emotions due to Chronic Illness Screening Test (NECIS) is a newly developed tool to measure negative emotions. However, the construct validity has not been established yet. Therefore, the purpose of this study was to test the construct validity of the NECIS in individuals with CAD in mainland China. METHODS The tool was administered in a convenience sample of 376 patients with CAD hospitalized in three general hospitals in Wuhan City, China. Construct validity was evaluated through factorial validity, convergent validity and discriminant validity. Additionally, the assumed relationship between negative emotions with other associated variables (perceived control and perceived social support) was tested to provide additional evidence of the construct validity of the NECIS. RESULTS Exploratory factor analysis and confirmatory factor analysis established and confirmed a two-factorial structure of the NECIS. Convergent validity and discriminant validity of the NECIS were proven to be adequate. Two hypotheses regarding the relationship between negative emotions and associated variables (perceived control and perceived social support) were confirmed, which supported the satisfactory construct validity of the NECIS. CONCLUSION The NECIS had sound construct validity when applied to patients with CAD in mainland China. This study added new knowledge regarding the construct validity of the NECIS, which supported its psychometric properties for future use.
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Affiliation(s)
- Zi Chen
- School of Health Sciences, Wuhan University, Wuhan, Hubei430071, People’s Republic of China
| | - Jia-Li Zhou
- Department of Cardiovascular Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei430060, People’s Republic of China
| | - Wei Liu
- Department of Cardiovascular Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei430060, People’s Republic of China
| | - Hui-Dan Yu
- School of Health Sciences, Wuhan University, Wuhan, Hubei430071, People’s Republic of China
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10
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Dietary patterns and components to prevent and treat heart failure: a comprehensive review of human studies. Nutr Res Rev 2018; 32:1-27. [DOI: 10.1017/s0954422418000148] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
AbstractGrowing evidence has emerged about the role of dietary patterns and components in heart failure (HF) incidence and severity. The objective here is to provide a comprehensive summary of the current evidence regarding dietary patterns/components and HF. A comprehensive search of online databases was conducted using multiple relevant keywords to identify relevant human studies. The Dietary Approaches to Stop Hypertension (DASH) and Mediterranean diets have consistently been associated with decreased HF incidence and severity. Regarding specific dietary components, fruit, vegetables, legumes and whole grains appear beneficial. Current evidence suggests that red/processed meats, eggs and refined carbohydrates are harmful, while fish, dairy products and poultry remain controversial. However, there is a notable lack of human intervention trials. The existing but limited observational and interventional evidence from human studies suggests that a plant-based dietary pattern high in antioxidants, micronutrients, nitrate and fibre but low in saturated/trans-fat and Na may decrease HF incidence/severity. Potential mechanisms include decreased oxidative stress, homocysteine and inflammation but higher antioxidant defence and NO bioavailability and gut microbiome modulation. Randomised, controlled trials are urgently required.
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Abstract
Evidence supporting the role of nutrition in heart failure (HF) incidence and severity is growing. A comprehensive search of online databases was conducted using relevant keywords to identify human studies including diet and HF. Several plant-based diets have consistently been associated with decreased HF incidence and severity, notably the Dietary Approaches to Stop Hypertension (DASH) and Mediterranean diets. Several other plant-based dietary patterns, including low-fat diets and the rice diet, also show promise. Higher dietary quality, as assessed using different scores, seems to provide protective qualities. Fruit, vegetables, legumes and wholegrains appear to be beneficial, whereas red/processed meats, eggs and refined carbohydrates appear harmful. Some evidence suggests detrimental effects of dairy products and poultry, but more research is needed. There is observational and interventional evidence that a plant-based diet high in antioxidants, micronutrients, nitrate and fibre but low in saturated/trans fats may decrease the incidence and severity of HF. Potential mechanisms for this include decreased oxidative stress, homocysteine and inflammation levels, as well as higher antioxidant defence and nitric oxide bioavailability with gut microbiome modulation. Well-designed randomised, controlled nutrition intervention trials specific to HF are urgently required.
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Affiliation(s)
- Conor P Kerley
- Chronic Cardiovascular Disease Management Unit and Heart Failure Unit, St Vincent's Healthcare Group/St Michael's Hospital Dublin, Ireland
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12
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Rahe C, Khil L, Wellmann J, Baune BT, Arolt V, Berger K. Impact of major depressive disorder, distinct subtypes, and symptom severity on lifestyle in the BiDirect Study. Psychiatry Res 2016; 245:164-171. [PMID: 27543830 DOI: 10.1016/j.psychres.2016.08.035] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 07/28/2016] [Accepted: 08/10/2016] [Indexed: 11/26/2022]
Abstract
The aim of this study was to examine associations of major depressive disorder (MDD), its distinct subtypes, and symptom severity with the individual lifestyle factors smoking, diet quality, physical activity, and body mass index as well as with a combined lifestyle index measuring the co-occurrence of these lifestyle factors. A sample of 823 patients with MDD and 597 non-depressed controls was examined. The psychiatric assessment was based on a clinical interview including the Mini International Neuropsychiatric Interview and the Hamilton Depression Rating Scale. Each lifestyle factor was scored as either healthy or unhealthy, and the number of unhealthy lifestyle factors was added up in a combined lifestyle index. Cross-sectional analyses were performed using alternating logistic regression and ordinal logistic regression, adjusted for socio-demographic characteristics. After adjustment, MDD was significantly associated with smoking, low physical activity, and overweight. Likewise, MDD was significantly related to the overall lifestyle index. When stratifying for subtypes, all subtypes showed higher odds for an overall unhealthier lifestyle than controls, but the associations with the individual lifestyle factors were partly different. Symptom severity was associated with the lifestyle index in a dose-response manner. In conclusion, patients with MDD represent an important target group for lifestyle interventions.
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Affiliation(s)
- Corinna Rahe
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany; German Center for Diabetes Research (DZD), München-Neuherberg, Germany.
| | - Laura Khil
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Jürgen Wellmann
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Bernhard T Baune
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Volker Arolt
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany
| | - Klaus Berger
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany; German Center for Diabetes Research (DZD), München-Neuherberg, Germany
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Szpakowski N, Bennell MC, Qiu F, Ko DT, Tu JV, Kurdyak P, Wijeysundera HC. Clinical Impact of Subsequent Depression in Patients With a New Diagnosis of Stable Angina: A Population-Based Study. Circ Cardiovasc Qual Outcomes 2016; 9:731-739. [PMID: 27703034 DOI: 10.1161/circoutcomes.116.002904] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Accepted: 08/23/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Depression is prevalent among patients with myocardial infarction and is associated with a worse prognosis. However, little is known about its importance in patients with chronic stable angina. We conducted a retrospective population-based cohort study to determine the occurrence and predictors of developing depression in patients with a new diagnosis of chronic stable angina. In addition, we sought to understand its impact on subsequent clinical outcomes. METHODS AND RESULTS Our cohort included patients in Ontario, Canada, with stable angina based on obstructive coronary artery disease found on angiogram. Depression was ascertained by physician billing codes and hospital admissions diagnostic codes. We first developed multivariable Cox proportional hazards models to determine predictors of developing depression. Clinical outcomes of interest included all-cause mortality, admission for myocardial infarction, and subsequent revascularization. Using hierarchical multivariable Cox proportional hazards models with occurrence of depression as a time-varying variable to control for potential immortal time bias, we evaluated the impact of depression on clinical outcomes. Our cohort consisted of 22 917 patients. The occurrence of depression after diagnosis of stable chronic angina was 18.8% over a mean follow-up of 1084 days. Predictors of depression included remote history of depression, female sex, and more symptomatic angina based on Canadian Cardiovascular Society class. Patients who developed depression had a higher risk of death (hazard ratio 1.83, 95% confidence interval 1.62-2.07) and admission for myocardial infarction (hazard ratio 1.36, 95% confidence interval 1.10-1.67) compared with nondepressed patients. CONCLUSIONS Depression is common in patients with chronic stable angina and is associated with increased morbidity and mortality.
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Affiliation(s)
- Natalie Szpakowski
- From the Schulich Heart Centre, Division of Cardiology, Department of Medicine, Sunnybrook Health Sciences Center (N.S., M.C.B., D.T.K., J.V.T., H.C.W.), Sunnybrook Research Institute (M.C.B., D.T.K., J.V.T., H.C.W.), Institute for Health Policy Management and Evaluation (D.T.K., J.V.T., P.K., H.C.W.), and Department of Psychiatry and Institute of Medical Science (P.K.), University of Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada (F.Q., D.T.K., J.V.T., P.K., H.C.W.); and Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Ontario, Canada (P.K.)
| | - Maria C Bennell
- From the Schulich Heart Centre, Division of Cardiology, Department of Medicine, Sunnybrook Health Sciences Center (N.S., M.C.B., D.T.K., J.V.T., H.C.W.), Sunnybrook Research Institute (M.C.B., D.T.K., J.V.T., H.C.W.), Institute for Health Policy Management and Evaluation (D.T.K., J.V.T., P.K., H.C.W.), and Department of Psychiatry and Institute of Medical Science (P.K.), University of Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada (F.Q., D.T.K., J.V.T., P.K., H.C.W.); and Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Ontario, Canada (P.K.)
| | - Feng Qiu
- From the Schulich Heart Centre, Division of Cardiology, Department of Medicine, Sunnybrook Health Sciences Center (N.S., M.C.B., D.T.K., J.V.T., H.C.W.), Sunnybrook Research Institute (M.C.B., D.T.K., J.V.T., H.C.W.), Institute for Health Policy Management and Evaluation (D.T.K., J.V.T., P.K., H.C.W.), and Department of Psychiatry and Institute of Medical Science (P.K.), University of Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada (F.Q., D.T.K., J.V.T., P.K., H.C.W.); and Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Ontario, Canada (P.K.)
| | - Dennis T Ko
- From the Schulich Heart Centre, Division of Cardiology, Department of Medicine, Sunnybrook Health Sciences Center (N.S., M.C.B., D.T.K., J.V.T., H.C.W.), Sunnybrook Research Institute (M.C.B., D.T.K., J.V.T., H.C.W.), Institute for Health Policy Management and Evaluation (D.T.K., J.V.T., P.K., H.C.W.), and Department of Psychiatry and Institute of Medical Science (P.K.), University of Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada (F.Q., D.T.K., J.V.T., P.K., H.C.W.); and Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Ontario, Canada (P.K.)
| | - Jack V Tu
- From the Schulich Heart Centre, Division of Cardiology, Department of Medicine, Sunnybrook Health Sciences Center (N.S., M.C.B., D.T.K., J.V.T., H.C.W.), Sunnybrook Research Institute (M.C.B., D.T.K., J.V.T., H.C.W.), Institute for Health Policy Management and Evaluation (D.T.K., J.V.T., P.K., H.C.W.), and Department of Psychiatry and Institute of Medical Science (P.K.), University of Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada (F.Q., D.T.K., J.V.T., P.K., H.C.W.); and Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Ontario, Canada (P.K.)
| | - Paul Kurdyak
- From the Schulich Heart Centre, Division of Cardiology, Department of Medicine, Sunnybrook Health Sciences Center (N.S., M.C.B., D.T.K., J.V.T., H.C.W.), Sunnybrook Research Institute (M.C.B., D.T.K., J.V.T., H.C.W.), Institute for Health Policy Management and Evaluation (D.T.K., J.V.T., P.K., H.C.W.), and Department of Psychiatry and Institute of Medical Science (P.K.), University of Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada (F.Q., D.T.K., J.V.T., P.K., H.C.W.); and Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Ontario, Canada (P.K.)
| | - Harindra C Wijeysundera
- From the Schulich Heart Centre, Division of Cardiology, Department of Medicine, Sunnybrook Health Sciences Center (N.S., M.C.B., D.T.K., J.V.T., H.C.W.), Sunnybrook Research Institute (M.C.B., D.T.K., J.V.T., H.C.W.), Institute for Health Policy Management and Evaluation (D.T.K., J.V.T., P.K., H.C.W.), and Department of Psychiatry and Institute of Medical Science (P.K.), University of Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada (F.Q., D.T.K., J.V.T., P.K., H.C.W.); and Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Ontario, Canada (P.K.).
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14
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Cavallo DN, Horino M, McCarthy WJ. Adult Intake of Minimally Processed Fruits and Vegetables: Associations with Cardiometabolic Disease Risk Factors. J Acad Nutr Diet 2016; 116:1387-1394. [PMID: 27174619 PMCID: PMC5034720 DOI: 10.1016/j.jand.2016.03.019] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 03/21/2016] [Indexed: 01/05/2023]
Abstract
BACKGROUND The US Department of Agriculture launched ChooseMyPlate.gov nutrition recommendations designed to encourage increased fruit and vegetable intake, in part, as a strategy for improving weight control through the consumption of high-satiation foods. OBJECTIVE The purpose of this cross-sectional study was to assess the relationship between adults' reported daily intake of fruits and nonstarchy vegetables (ie, those thought to have the lowest energy density) expressed as a proportion of their total daily food intake and objectively measured cardiovascular and metabolic disease risk factors using data from the 2009-2010 National Health and Nutrition Examination Survey (NHANES). Physical activity was included as a moderator variable. DESIGN This study employed a cross-sectional examination of 2009-2010 NHANES data to assess how daily fruit and nonstarchy vegetable intake was associated with anthropometric measures and cardiometabolic blood chemistry markers. PARTICIPANTS/SETTING Adults free of cardiac or metabolic disease (n=1,197) participated in 24-hour dietary recalls; a variety of cardiometabolic biomarkers and anthropometric measures were also collected from participants. MAIN OUTCOME MEASURES Among participants with complete data on all variables, the ratio of the combined cup-equivalents of fruit and nonstarchy vegetable intake to the total gram weight of all foods consumed daily (F/V ratio) served as the primary independent variable. Main dependent measures included fasting glucose, insulin, glycosylated hemoglobin, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, total cholesterol, waist circumference, and body mass index. STATISTICAL ANALYSES PERFORMED Demographic and behavioral predictors of the F/V ratio and the association between the F/V ratio and cardiometabolic disease risk factors were examined using multivariate regression. RESULTS Body mass index (β=-2.58; 95% CI -3.88 to -1.28), waist circumference (β=-6.33; 95% CI -9.81 to -2.84), and insulin (β=-0.21; 95% CI -0.37 to -0.05) were inversely associated with the F/V ratio. These associations were weakened for the subset that adhered to federal physical activity recommendations. No other statistically significant associations were found between F/V ratio and main dependent measures. CONCLUSIONS In this nationally representative sample, predicted inverse associations between the proportion of daily fruit and nonstarchy vegetable intake relative to total intake and measures reflective of body fat composition and fasting insulin were confirmed. Future research should examine whether a similar association is observed for other sources of resistant starch, such as whole grains, which are arguably more strongly linked with satiety and host insulin levels.
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Affiliation(s)
- David N. Cavallo
- Case Western Reserve University Department of Nutrition, School of Medicine – WG48, 10900 Euclid Avenue, Cleveland, OH 44106,, P: 216-368-6627, F: 216-368-6644
| | - Masako Horino
- University of California Los Angeles, Center for Cancer Prevention and Control Research, Los Angeles, CA, 650 Charles Young Dr. S, A2-125 CHS, Los Angeles, CA 90095,, P: 310-825-2594, F: 310-825-3317
| | - William J. McCarthy
- Fielding School of Public Health & Department of Psychology, University of California Los Angeles, 650 Charles Young Dr. S, A2-125 CHS, Box 690015, Los Angeles, CA 90095-6900,, P: 310-794-7587, F: 310-206-3566
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15
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Rutledge T, Kenkre TS, Thompson DV, Bittner VA, Whittaker K, Eastwood JA, Eteiba W, Cornell CE, Krantz DS, Pepine CJ, Johnson BD, Handberg EM, Bairey Merz CN. Psychosocial predictors of long-term mortality among women with suspected myocardial ischemia: the NHLBI-sponsored Women's Ischemia Syndrome Evaluation. J Behav Med 2016; 39:687-93. [PMID: 27017335 DOI: 10.1007/s10865-016-9737-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 03/21/2016] [Indexed: 11/26/2022]
Abstract
This paper evaluated long-term associations between psychosocial factors and premature mortality among women with suspected coronary artery disease (CAD). We tracked total mortality events over a median 9.3 years in a cohort of 517 women [baseline mean age = 58.3 (11.4) years]. Baseline evaluations included coronary angiography, psychosocial testing, and CAD risk factors. Measures included the Spielberger Trait Anxiety Scale, Beck Depression Inventory, self-rated health, and Social Network Index. Cox regression analysis was used to assess relationships. Covariates included age, CAD risk factors, and CAD severity. BDI scores (HR 1.09, 95 % CI 1.02-1.15), STAI scores (HR .86, 95 % CI .78-.93), and very good self-rated health (relative to the poor self-rated health group; HR .33, 95 % CI .12-.96) each independently predicted time to mortality outcomes in the combined model. SNI scores (HR .91, 95 % CI .81-1.06) and other self-rated health categories (i.e., fair, good, and excellent categories) were not significant mortality predictors after adjusting for other psychosocial factors. These results reinforce and extend prior psychosocial research in CAD populations.
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Affiliation(s)
- Thomas Rutledge
- VA San Diego Healthcare System, Psychology Service 116B, 3350 La Jolla Village Drive, San Diego, CA, 92161, USA.
- University of California, San Diego, CA, USA.
| | | | | | - Vera A Bittner
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kerry Whittaker
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | | | | | - Carol E Cornell
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - David S Krantz
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | | | | | | | - C Noel Bairey Merz
- Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, Los Angeles, CA, USA
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16
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Dickens C. Depression in People with Coronary Heart Disease: Prognostic Significance and Mechanisms. Curr Cardiol Rep 2015; 17:83. [DOI: 10.1007/s11886-015-0640-6] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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17
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Daulatzai MA. “Boomerang Neuropathology” of Late-Onset Alzheimer’s Disease is Shrouded in Harmful “BDDS”: Breathing, Diet, Drinking, and Sleep During Aging. Neurotox Res 2015; 28:55-93. [DOI: 10.1007/s12640-015-9528-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2014] [Revised: 04/03/2015] [Accepted: 04/03/2015] [Indexed: 12/12/2022]
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