Association between dietary insulin index and load and psychological disorders

Neurological and metabolic related pathophysiologies and treatment of comorbid diabetes with depression

BACKGROUND

The comorbidity between diabetes mellitus and depression was revealed, and diabetes mellitus increased the prevalence of depressive disorder, which ranked 13th in the leading causes of disability-adjusted life-years. Insulin resistance, which is common in diabetes mellitus, has increased the risk of depressive symptoms in both humans and animals. However, the mechanisms behind the comorbidity are multi-factorial and complicated. There is still no causal chain to explain the comorbidity exactly. Moreover, Selective serotonin reuptake inhibitors, insulin and metformin, which are recommended for treating diabetes mellitus-induced depression, were found to be a risk factor in some complications of diabetes.

AIMS

Given these problems, many researchers made remarkable efforts to analyze diabetes complicating depression from different aspects, including insulin resistance, stress and Hypothalamic-Pituitary-Adrenal axis, neurological system, oxidative stress, and inflammation. Drug therapy, such as Hydrogen Sulfide, Cannabidiol, Ascorbic Acid and Hesperidin, are conducive to alleviating diabetes mellitus and depression. Here, we reviewed the exact pathophysiology underlying the comorbidity between depressive disorder and diabetes mellitus and drug therapy.

METHODS

The review refers to the available literature in PubMed and Web of Science, searching critical terms related to diabetes mellitus, depression and drug therapy.

RESULTS

In this review, we found that brain structure and function, neurogenesis, brain-derived neurotrophic factor and glucose and lipid metabolism were involved in the pathophysiology of the comorbidity. Obesity might lead to diabetes mellitus and depression through reduced adiponectin and increased leptin and resistin. In addition, drug therapy displayed in this review could expand the region of potential therapy.

CONCLUSIONS

The review summarizes the mechanisms underlying the comorbidity. It also overviews drug therapy with anti-diabetic and anti-depressant effects.

Dietary inflammatory index and neuropsychiatric disorders

Neuropsychiatric disorders (NPDs) are considered a potential threat to mental health. Inflammation predominantly plays a role in the pathophysiology of NPDs. Dietary patterns are widely postulated to be involved in the physiological response to inflammation. This review aims to discuss the literature on how dietary inflammatory index (DII) is related to inflammation and, consequently, NPDs. After comprehensive scrutiny in different databases, the articles that investigated the relation of DII score and various NPDs and psychological circumstances were included. The association between dietary patterns and mental disorders comprising depression, anxiety, and stress proved the role of a proinflammatory diet in these conditions' exacerbation. Aging is another condition closely associated with DII. The impact of proinflammatory and anti-inflammatory diet on sleep quality indicated related disorders like sleep latency and day dysfunctions among the different populations are in relation with the high DII score. The potential effects of genetic backgrounds, dietary patterns, and the gut microbiome on DII are discussed as well. To plan preventive or therapeutic interventions considering the DII, these factors, especially genetic variations, should be considered as there is a growing body of literature indicating the role of personalized medicine in different NPDs. To the best of our knowledge, there is a limited number of RCTs on this subject, so future research should evaluate the causality via RCTs and look for therapeutic interventions with an eye on personalized medicine using information about DII in NPDs.

Insulinemic potential of diet and psychological disorders: A cross-sectional, population-based study

BACKGROUND

Serum insulin levels and insulin sensitivity can impact mental disorders. This study investigates the association of the insulinemic potential of diet calculated using the empirical dietary indices for insulin resistance (EDIR) and hyperinsulinemia (EDIH) with psychological disorders, including depression, anxiety, and stress.

METHODS

This cross-sectional study was undertaken on 5405 individuals, aged 20-70, from the Yazd Health Study (YaHS). The food frequency questionnaire (FFQ) was used to collect dietary intakes. EDIR and EDIH were calculated from the FFQ data. Psychological disorders were assessed by an Iranian-validated version of the depression, anxiety, and stress scale questionnaire 21 (DASS 21). Multivariable logistic regression analysis was performed and odds ratio (OR) and 95 % confidence interval (CI) were reported.

RESULTS

The mean ± SD of EDIR and EDIH were 0.32 ± 0.17 and 0.11 ± 0.08 in the total population, respectively. In the final adjusted model, participants in the highest versus the lowest quartile of EDIR had statistically higher odds of depression (OR: 1.28; 95 % CI: 1.01-1.62, P-trend = 0.032). However, no statistically significant association was observed between the EDIH score and depression. Also, EDIR and EDIH scores were not significantly associated with the odds of anxiety and stress.

LIMITATIONS

The cross-sectional design of the study prevented the inference of causality.

CONCLUSIONS

Higher adherence to EDIR was positively associated with depression, but there was no significant association between EDIH and depression. EDIR and EDIH were also not significantly related to anxiety or stress.

Dietary insulin index and load in relation to cardiometabolic risk factors in patients with type 2 diabetes mellitus: A cross-sectional study on the RaNCD cohort study

OBJECTIVES

The aim of the present study was to evaluate the link between the dietary insulin index (DII) and dietary insulin load (DIL) and cardiometabolic risk factors in patients with type 2 diabetes mellitus (T2DM).

METHOD

In this cross-sectional population-based study, 827 participants with diabetes were included based on the RaNCD (Ravansar Non-Communicable Disease) cohort study baseline data. DII and DIL were calculated based on standard formulas using food insulin index values published earlier. Logistic regression analysis was used to determine the association of DII and DIL with cardiovascular risk factors.

RESULTS

A significantly direct association was shown between DII and metabolic syndrome (MetS; odds ratio [OR], 1.32; 95% confidence interval [CI], 1.05-2.50). The odds of developing abdominal obesity in patients with the highest DII were almost twice as high as those with the lowest DII (OR, 2.06; 95% CI, 1.02-4.99). Patients in the top quintile of DIL had twice the odds of being obese than those in the bottom quintile. Furthermore, positive associations were found between DIL and both MetS (OR, 1.98; 95% CI, 1.10-4.21) and waist circumference (OR, 2.90; 95% CI, 1.10-7.20).

CONCLUSION

Higher DII and DIL were positively related to greater risks for both MetS and abdominal obesity among patients with T2DM. Additionally, higher DIL was associated with a higher risk for obesity in the Ravansar population. However, further prospective investigations are needed to clarify the cause-and-effect link between DII, DIL, and cardiovascular risk factors in patients with T2DM.

Associations of overall and specific carbohydrate intake with anxiety status evolution in the prospective NutriNet-Santé population-based cohort

We investigated the association between carbohydrate intake and anxiety evolution within the general-population NutriNet-Santé cohort (N = 15,602; 73.8% female; mean age = 53.8y; mean follow-up = 5.4y). Carbohydrate intake was estimated at baseline from ≥ 2 24-h dietary records. Trait anxiety (STAI-T) was measured once at baseline (2013-2016) and once at follow-up (2020), resulting in 4 groups: "None" = absence of high anxiety (STAI-T > 40 points) at any time point; "Transient" = high anxiety only at baseline; "Onset at follow-up" = high anxiety only at follow-up; "Persistent" = high anxiety at baseline and follow-up. Polytomous logistic regression models revealed that sweetened beverage intake was associated with higher odds of "Transient" anxiety (OR_Q4vsQ1 = 1.11; 95% CI 1.02-1.21). Intake of complex carbohydrates (OR_Q4vsQ1 = 1.12; 1.01-1.25) was associated with higher odds of anxiety "Onset at follow-up." The % energy from carbohydrates (OR_Q4vsQ1 = 1.11; 1.03-1.19), intakes of total carbohydrates (OR_Q4vsQ1 = 1.10; 1.03-1.18) and complex carbohydrates (OR_Q4vsQ1 = 1.09; 1.02-1.17) were associated with higher odds of "Persistent" anxiety, whereas 100% fruit juice intake showed lower odds of "Persistent" anxiety (OR_Q4vsQ1 = 0.87; 0.81-0.94). This prospective study found significant associations between dietary carbohydrate intake and anxiety status evolution among French adults. The findings could help inform dietary interventions aimed at anxiety prevention and management.

The association between dietary insulin index and load with mental health

Background

Depression, anxiety, and stress are common mental problems. The aim of this cross-sectional study was to investigate the association between two indexes that measure postprandial insulin response to different food, dietary insulin index (DII) and insulin load (DIL), with psychological disorders.

Method

Participants (n = 10,000) aged 20–69 were randomly selected from 200 clusters in Yazd from the recruitment phase of the Yazd Health Study. The dietary intake of participants was collected by a reliable and validated food frequency questionnaire (FFQ) consisting of 178 food items. DII and DIL were calculated from the FFQ data using previously published reference values. To assess psychological disorders an Iranian validated short version of a self-reported questionnaire (Depression Anxiety Stress Scales 21 [DASS21]) was used.

Results

No significant association was observed between DIL and DII with odds of depression or anxiety using crude or adjusted models. However, individuals in the highest quartiles of DIL had the lowest odds of stress (OR: 0.69; 95% CI 0.48–1.01, P-trend = 0.047). This association remained significant after adjustment for potential confounders in model II including marital status, smoking, education, job status, salt intake, and multi-vitamin supplement use (OR: 0.38; 95% CI 0.16–0.91, P-trend = 0.039) and the third and final model which is further adjusted for BMI (OR: 0.39; 95% CI 0.16–0.91, P-trend = 0.041).

Conclusion

Overall, consumption of foods with higher DII as well as DIL were associated with lower stress scores; however, no significant relationship was observed between DII or DIL with respective depression or anxiety scores.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40359-022-00925-2.

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

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

The Association between Dietary Insulin Index and Load with Gastric Cancer in Afghanistan

BACKGROUND

Insulin has a critical role in the pathogenesis of several cancers. We are aware of no study that examined the association between dietary insulin index (DII) and dietary insulin load (DIL) and gastric cancer.

OBJECTIVE

This study aimed to investigate the relationship between dietary insulin index and DIL and odds of gastric cancer in Afghanistan.

METHODS

In this hospital-based case-control study, we recruited 90 patients with newly-diagnosed gastric cancer and 180 healthy controls in Kabul, Afghanistan. Cases were chosen based on convenience-sampling method from the patients with pathologically confirmed gastric cancer aged between 20 and 75 years that had been referred to Jamhuriat Hospital, Kabul, Afghanistan. We applied a pre-tested food frequency questionnaire for dietary assessment of study participants. DIL and DII were calculated based on earlier publications. Multivariable logistic regression models were applied to examine the association between DII and DIL and gastric cancer.

RESULTS

Mean BMI of study participants was 23.55 ± 3.06 kg/m², of them 73% were males. After adjustment for potential confounders, participants in the top tertile of DII had 3.96 times greater odds for gastric cancer compared with those in the first tertile (95% CI: 1.23, 12.69; P-trend = 0.03). After adjustment for potential confounders, people in the highest tertile of DIL were 3.41 times more likely to have gastric cancer compared with those in the lowest tertile (95% CI: 1.28, 9.09; P-trend = 0.01). These associations remained significant even after further controlling for BMI, family history of cancer, H. pylori infection and salt intake.

CONCLUSION

A significant positive association was seen between dietary insulin index and insulin load and odds of gastric cancer in Afghan adults. Prospective cohort studies are required to confirm our findings.

Breakfast consumption is inversely associated with primary headaches in university students: The MEPHASOUS study

OBJECTIVE

This study was conducted to examine the association between breakfast consumption pattern and primary headaches in a large population of university students.

METHODS

This cross-sectional study was done on the MEPHASOUS dataset that contained the information of 83,677 university students, aged ≥18 years, from 28 provinces of Iran. Dietary intakes and breakfast consumption pattern were assessed using a validated self-administered dietary habits questionnaire. Primary headaches were determined according to the International Classification of Headache Disorders-3 (ICHD-3) criteria. Binary logistic regression in different adjusted models was used to assess the association between breakfast consumption and primary headaches.

RESULTS

The mean age of participants was 21.50 ± 4.01. Primary headaches were prevalent among 9% of university students. A significant inverse association was seen between breakfast consumption and odds of primary headaches [odds ratio (OR): 0.57, 95 % confidence interval (CI): 0.51-0.62]. This association remained significant even after taking potential confounders into account; such that students who consumed breakfast frequently had 26 % lower odds of primary headaches compared with those who consumed it <1 day/week (OR: 0.74, 95 % CI: 0.65-0.85). Moreover, such a significant inverse association was observed in female students (OR: 0.54, 95 % CI: 0.49-0.61) as well as those with BMI < 25 kg/m² (OR: 0.68, 95 % CI: 0.58-0.79). However, it became non-significant in male students and those with overweight or obesity.

CONCLUSION

We found that frequent breakfast consumption is associated with a decreased odds of primary headaches in female students and those with BMI < 25 kg/m². Further prospective studies are needed to confirm our findings.