Sugar intake from sweet food and beverages, common mental disorder and depression: prospective findings from the Whitehall II study

Characterization of Gut Microbiome Composition in Depression and Completed Suicide

Growing evidence supports a bidirectional relationship between the gut microbiome and mental health. This study investigated the association between gut microbiota, depression, and suicidal behavior by analyzing fecal samples from 35 individuals with varying depression levels and 36 completed suicide cases. Standardized psychometric assessments were used for depression evaluation. Analysis revealed significant taxonomic differences between groups, with increased abundance of Firmicutes, Clostridia, Lachnospiraceae, Blautia, and Dorea in suicide cases, which also positively correlated with depression severity. Metabolic pathway analysis demonstrated a notable dichotomy: suicide cases showed elevated pathways related to infection processes, inflammation, and antibiotic resistance, while the control group exhibited higher energy metabolism and vitamin synthesis pathways. The findings establish specific microbiome profiles associated with both depression symptoms and suicidal behavior, suggesting that gut dysbiosis may influence mental health through altered energy metabolism and inflammatory processes, potentially offering new perspectives for diagnostic and therapeutic approaches.

Ketogenic diet, adenosine, and dopamine in addiction and psychiatry

Adhering to the ketogenic diet can reduce or stop seizures, even when other treatments fail, via mechanism(s) distinct from other available therapies. These results have led to interest in the diet for treating conditions such as Alzheimer's disease, depression and schizophrenia. Evidence points to the neuromodulator adenosine as a key mechanism underlying therapeutic benefits of a ketogenic diet. Adenosine represents a unique and direct link among cell energy, neuronal activity, and gene expression, and adenosine receptors form functional heteromers with dopamine receptors. The importance of the dopaminergic system is established in addiction, as are the challenges of modulating the dopamine system directly. A mediator that could antagonize dopamine's effects would be useful, and adenosine is such a mediator due to its function and location. Studies report that the ketogenic diet improves cognition, sociability, and perseverative behaviors, and might improve depression. Many of the translational opportunities based on the ketogenic diet/adenosine link have come to the fore, including addiction, autism spectrum disorder, painful conditions, and a range of hyperdopaminergic disorders.

Association between nighttime snacking during pregnancy and postpartum depression among community-dwelling pregnant women: a prospective cohort study

BACKGROUND/OBJECTIVES

The effect of the frequency of nighttime snacking during pregnancy on postpartum depression (PPD) remains unclear. This prospective cohort study aimed to explore the association between the frequency of nighttime snacking during pregnancy and the incidence of PPD.

METHODS

This study included 609 community-dwelling pregnant women who were recruited between July 2019 and July 2022. Data on the frequency of nighttime snacking and sociodemographic, economic, and lifestyle factors were obtained using self-administered questionnaires. Data on dietary intake were obtained using a validated brief self-administered diet history questionnaire. PPD was assessed using the Japanese version of the Edinburgh Postnatal Depression Scale (EPDS). The incidence of PPD (EPDS score of ≥9) based on the frequency of nighttime snacking was analyzed using multiple logistic regression analysis.

RESULTS

After adjusting for potential confounding factors, the odds ratio (OR) of PPD in participants who had a frequency of nighttime snacking 3 times/week or more compared with those who had a frequency of nighttime snacking less than 1 time/week was 2.59 (95% confidence interval, 1.14-5.86). Sensitivity analysis was repeated for the excluded participants with depressive symptoms during pregnancy, yielding similar results. The OR of PPD in those who indulged in nighttime snacking ≥3 times/week was the highest (2.81; 95% confidence interval, 1.13-6.96).

CONCLUSIONS

The present study clarified the association between the frequency of nighttime snacking and PPD. Further studies with large and diverse samples are needed to overcome any potential selection bias.

"You always have a high sugar if you don't communicate": A qualitative secondary analysis of 'Diabetes Together' process evaluation data from couples in South Africa

Type 2 Diabetes Mellitus (T2D) can negatively impact relationships which may affect health and disease management. This can be moderated by positive communication between partners. Our aims were first, to identify ways in which couples' communication and T2D impact each other. Second, we aimed to explore how improving couples' communication may enhance self-management for people living with T2D (PLWD) and their partners in South Africa. We conducted secondary data analysis of qualitative interview and focus group data from an intervention pilot study designed to improve T2D self-management - 'Diabetes Together'. 14 PLWD and their partners took part in two diabetes self-management workshops, including communication skills training, and were offered two couples counselling sessions. Inductive thematic and dyadic analysis explored how T2D and couples' communication were connected, and how participants perceived the impact of couples' communication skills training. Findings were compared to data collected from qualitative interviews with intervention-naive participants. We generated four themes linking couples' communication and T2D: tone of discussions; listening; openness; and being informed about T2D. Participants described that T2D can create negative moods and stress (both from the disease and its management) and this can make communication challenging. They reported that negative communication styles can create stress worsening T2D and making it harder to manage. Participants felt that positive communication could ease stress, enable problem-solving and support behaviour change, which may improve T2D management. Couples reported that communication skills training helped them to address communication-related issues in their relationships. This included managing negative moods, changing communication styles and developing skills to discuss, listen and collaborate on improving T2D self-management. PLWD and their partners perceived that T2D and couples' communication can affect one another positively and negatively. Equipping couples with effective communication skills may empower them to manage T2D more effectively.

Identifying major depressive disorder among US adults living alone using stacked ensemble machine learning algorithms

Background

It has been increasingly recognized that adults living alone have a higher likelihood of developing Major Depressive Disorder (MDD) than those living with others. However, there is still no prediction model for MDD specifically designed for adults who live alone.

Objective

This study aims to investigate the effectiveness of utilizing personal health data in combination with a stacked ensemble machine learning (SEML) technique to detect MDD among adults living alone, seeking to gain insights into the interaction between personal health data and MDD.

Methods

Our data originated from the US National Health and Nutrition Examination Survey (NHANES) spanning 2007 to 2018. We finally selected a set of 30 easily accessible variables encompassing demographic profiles, lifestyle factors, and baseline health conditions. We constructed a SEML model for MDD detection, incorporating three conventional machine learning algorithms as base models and a Neural Network (NN) as the meta-model. Furthermore, SHapley Additive exPlanations (SHAP) analysis was used to explain the impact of each predictor on MDD.

Results

The study included 2,642 adult participants who lived alone, of whom 10.6% (279 out of 2,642) had a PHQ-9 score of 10 or above, indicating the presence of MDD. The performance of our SEML model was robust, with an area under the curve (AUC) of 0.85. Further analysis using SHAP revealed positive correlations between the occurrence of MDD and factors such as sleep disorders, number of prescription medications, need for specific walking aids, leak urine during nonphysical activities, chronic bronchitis, and Healthy Eating Index (HEI) scores for sodium. Conversely, age, the Family Monthly Poverty Level Index (FMMPI), and HEI scores for added sugar showed negative correlations with MDD occurrence. Additionally, a U-shaped relationship was noted between the occurrence of MDD and both sleep duration and Body Mass Index (BMI), as well as HEI scores for dairy.

Conclusion

The study has successfully developed a predictive model for MDD, specifically tailored for adults living alone using a stacked ensemble technique, enhancing the identification of MDD and its risk factors among adults living alone.

Impact of dietary magnesium intake on depression risk in American adults: a cross-sectional study of the National Health and Nutrition Examination Survey 2005-2020

Introduction

Depression is a major global mental health challenge. Previous research suggests a link between magnesium consumption and depression, but the dose-response relationship remains unclear. This study investigates the relationship between dietary magnesium intake and depression risk among American adults.

Methods

Data from the 2005-2020 National Health and Nutrition Examination Survey (NHANES) were examined. Depression was measured with the Patient Health Questionnaire-9 (PHQ-9), and dietary magnesium consumption was calculated from two 24-h meal recalls. We used restricted cubic spline models, logistic regression, and sensitivity analyses to assess the connection.

Results

Among 35,252 participants (mean age: 49.5 ± 17.6 years; 49.9% women), we observed a nonlinearity in the relationship between dietary magnesium intake and depression. Below the inflection point (366.7 mg/day), the odds ratio (OR) was 0.998 (95% CI: 0.997-0.999, p < 0.001). Above this point, the OR was 1.001 (95% CI: 1.000-1.002, p = 0.007). In participants aged ≥60 years, the association was inverse L-shaped, with magnesium intake ≥270.7 mg/day increasing depression incidence by 0.1% per 1 mg/d increase.

Conclusion

A nonlinear dose-response relationship exists between dietary magnesium intake and depression risk among US adults. Age significantly moderates this association, suggesting dietary recommendations should be tailored to different age groups.

Triangulated evidence provides no support for bidirectional causal pathways between diet/physical activity and depression/anxiety

BACKGROUND

Previous studies (various designs) present contradicting insights on the potential causal effects of diet/physical activity on depression/anxiety (and vice versa). To clarify this, we employed a triangulation framework including three methods with unique strengths/limitations/potential biases to examine possible bidirectional causal effects of diet/physical activity on depression/anxiety.

METHODS

Study 1: 3-wave longitudinal study (n = 9,276 Dutch University students). Using random intercept cross-lagged panel models to study temporal associations. Study 2: cross-sectional study (n = 341 monozygotic and n = 415 dizygotic Australian adult twin pairs). Using a co-twin control design to separate genetic/environmental confounding. Study 3: Mendelian randomization utilizing data (European ancestry) from genome-wide association studies (n varied between 17,310 and 447,401). Using genetic variants as instrumental variables to study causal inference.

RESULTS

Study 1 did not provide support for bidirectional causal effects between diet/physical activity and symptoms of depression/anxiety. Study 2 did provide support for causal effects between fruit/vegetable intake and symptoms of depression/anxiety, mixed support for causal effects between physical activity and symptoms of depression/anxiety, and no support for causal effects between sweet/savoury snack intake and symptoms of depression/anxiety. Study 3 provides support for a causal effect from increased fruit intake to the increased likelihood of anxiety. No support was found for other pathways. Adjusting the analyses including diet for physical activity (and vice versa) did not change the conclusions in any study.

CONCLUSIONS

Triangulating the evidence across the studies did not provide compelling support for causal effects of diet/physical activity on depression/anxiety or vice versa.

Effects of Excessive Sucrose Intake on Aggressive Behavior and Peripheral Stress-Related Hormone and Catecholamines in BALB/c Mice during Adolescent Development

As binge eating and unbalanced diets increase the prevalence of obesity and metabolic disorders, it has been noted that the increase in psychiatric disorders is also a consequence of diet. The present study examined aggressive behavior and peripheral stress-related hormone and catecholamine levels in BALB/c mice fed a high-sucrose diet during adolescent development. BALB/c mice are rarely used in research assessing the effect of diet, but were used for ethnic and personal differences and as a new experimental model. BALB/c mice were fed a diet in which all carbohydrate components were replaced with sucrose for 4 wk and were subjected to the resident-intruder and social dominance tube test. Plasma insulin, corticosterone, and catecholamine levels were also compared to mice fed a control diet. The high-sucrose diet did not alter body weight, glucose tolerance, and plasma insulin levels in BALB/c mice, indicating that the diet was resilient to obesity. Mice fed a high-sucrose diet exhibited increased aggressive behaviors in the resident-intruder test and had a significantly higher win rate in the tube test. Increases in adrenal weight and plasma corticosterone as well as noradrenaline and adrenaline levels were exhibited in mice fed a high-sucrose diet. In particular, this is the first evidence of increased social dominance and hyperplasia of the adrenal glands by a sucrose diet. Sucrose diet intake increased aggression in mice and caused elevated peripheral hormones involving the HPA axis and the sympathetic nervous system, indicating that this may be a central nervous system-mediated effect of excess sucrose.

Association Between Different Dietary Carbohydrate and Risk of Depression, Anxiety, and Stress Among Female Adolescents

Purpose

Mental disorders account for a large part of the burden of disease in young population. The present study aimed to investigate the relationship between carbohydrate intakes and the risk of depression, anxiety, and stress among female adolescents.

Methods

In this cross-sectional study, 263 female adolescents aged 15-18 years participated. Depression, anxiety, and stress scores were determined by DASS-21 (Depression Anxiety Stress Score-21 items) questionnaire, and dietary intakes were assessed using a validated 168-item food frequency questionnaire. Crude and multivariable-adjusted odds ratios (OR) and 95% confidence intervals (CIs) were estimated through logistic regression analysis.

Results

Adolescents with depression consumed more glucose and sucrose and less lactose compared to adolescents without depression. After adjustment for all confounders, higher intakes of glucose and sucrose were significantly associated with increased risk of depression (OR glu = 1.3, P = 0.035 and OR suc = 1.41, P = 0.034), anxiety (OR glu = 1.3, P = 0.019 and OR suc = 1.81, P = 0.027), and stress (OR glu = 1.41, P = 0.046 and OR suc = 1.8, P = 0.044). In addition, increasing lactose intake was significantly associated with reducing the risk of depression (OR = 0.96, P = 0.013) and stress (OR = 0.96, P = 0.015).

Conclusions

This study found significant associations between dietary carbohydrate intake and mental disorders among female adolescent.

Association between different diet quality scores and depression risk: the REGICOR population-based cohort study

BACKGROUND

Our aim was to determine the association between diet quality and depression incidence in the population-based REGICOR cohort study, Catalonia, Spain.

METHODS

Prospective observational study using participants' baseline (2003-2006), follow-up (2007-2013) and clinical records data. Five diet quality scores were derived from a food frequency questionnaire (FFQ) at baseline: the relative Mediterranean Diet Score (rMED), the Modified Mediterranean Diet Score (ModMDS), a Dietary Approaches to Stop Hypertension (DASH) score, a Healthful Plant-based Diet Index (HPDI) and the World Health Organization Healthy Diet Indicator (WHO-HDI). Participants using pharmacological antidepressant treatment were excluded as a proxy for presence of depression at baseline. At follow-up, the Patient Health Questionnaire (PHQ-9) was applied to assess depressive symptoms (≥ 10 defining depressive disorder). A secondary outcome was depression diagnosis assessed through clinical records. Logistic regression and Cox proportional hazards models were used.

RESULTS

Main analysis included 3046 adults (50.3% women) with a mean age of 54.7 (SD = 11.6) years. After 6-years follow-up, 184 (6.04%) cases of depressive disorder were identified. There was 16% lower odds of depressive disorder per 1SD increase of rMED (OR = 0.84; 95%CI = 0.71-0.98). Secondary outcome analysis (n = 4789) identified 261 (5.45%) incident cases of clinical depression diagnosis over 12 years follow-up, and 19% lower risk of clinical depression was observed with the WHO-HDI (HR = 0.81; 95%CI = 0.70-0.93). Adjusting for BMI did not attenuate the findings.

CONCLUSIONS

A significant inverse association between diet quality and depression incidence was found in this population-based cohort study, independent of sociodemographic, health and lifestyle. Adherence to a healthy diet could be a complementary intervention for the prevention of depression.

Prevalence and lifestyle determinants of depressive symptoms among Chinese children and adolescents

Based on Chinese Students' Fitness Health Examination, this study sought to investigate the relationships between depressive symptoms and family environment, physical activity, dietary habits, sleep and sedentary behavior among children and adolescents. A cross-sectional study was carried out to estimate the prevalence of depressive symptoms in 32,389 participants (grades 4-12) using the CES-D. Logistic regression was used to evaluate the relationships between lifestyle determinants and depressive symptoms, and a random forest model was used to rank the importance of those determinants. The overall prevalence of depressive symptoms was 39.93%. Students with depressive symptoms had higher grades, lower parental educational levels and unhealthy lifestyles (P < 0.05). The top ten most important determinants of depressive symptoms were grade, egg intake, milk/soy product intake, frequency of muscle strength training, screen time, sleep duration, parental educational level, sugar beverage intake and total physical activity. Socioeconomic status, physical activity, sleep and screen time, and diet habits are determinants of depressive symptoms, and surveillance of lifestyles may be an effective way to detect students with depressive symptoms early.

Altered reward processing following sucrose bingeing in male and female mice

Objectives: Binge eating disorder (BED) is the most prevalent eating disorder associated with multiple adverse health effects, especially mental health issues, including substance use disorders and mood and anxiety disorders. Given these high comorbidities, the objective of our study was to examine whether bingeing behavior would lead to altered perception of reinforcing properties of EtOH and changes in well-being. Methods: We used a sucrose bingeing model based on an intermittent access paradigm with a two-bottle choice, without fasting, in male and female mice. We examined the effect of 2-week sucrose paradigm on ethanol-reinforcing properties using a conditioned place preference test (CPP). Well-being, anxiety- and depressive-like behavioral tests were performed to assess emotional state following 2 and 8-week sucrose bingeing paradigm. Results: Mice with intermittent access to sucrose developed a binge-like behavior assessed by higher sucrose intake and escalation rate during the 1st hour of access, in comparison with mice with a continuous sucrose access. We show for the first time that sucrose bingeing in mice modifies positive reinforcing effect of EtOH in a CPP paradigm without marked alteration of emotional state. Interestingly, prolonging sucrose access for 8 weeks revealed an exacerbated bingeing behavior in female mice, and some signs of emotional state alterations in female with continuous access. Discussion: In sum, our findings broaden the understanding of behavioral alterations associated with bingeing, highlighting the need to investigate addictive-like properties of palatable food both in male and female mice.

Association of sugar consumption with risk of depression and anxiety: a systematic review and meta-analysis

Background

Sugar consumption has increased dramatically around the world, and at the same time, the prevalence of mental illnesses such as depression and anxiety continues to increase. While previous research has explored the impact of various dietary factors on mental health, the specific impact of dietary sugar consumption on the risk of depression and anxiety disorders remains elusive. This study aimed to comprehensively assess this relationship through a systematic review and meta-analysis.

Methods

PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Network (CNKI), and WangFang were systematically searched for studies of the association between total dietary sugar intake and risk of depression and/or anxiety. The articles that meet the criteria are screened and included in the systematic review, and the data are extracted after assessing their quality. Stata 18.0 software was used for the meta-analysis.

Results

Forty studies with 1,212,107 participants were included in the analysis. Results showed that sugar intake increased the risk of depression by 21% (OR = 1.21, 95% CI: 1.14, 1.27), while the overall association between sugar intake and anxiety risk was not statistically significant (OR = 1.11, 95% CI: 0.93, 1.28). Despite high heterogeneity (I 2 = 99.7%), the results were statistically significant (p < 0.000). Subgroup analyses showed that the association between sugar consumption and depression risk remains consistent across different study designs (cross-sectional, cohort, and case-control studies) and different sample sizes (<5,000, 5,000-10,000, >10,000). Women have a higher risk of depression than men (OR = 1.19, 95% CI: 1.04, 1.35). Among the different exposure measures, the Food Frequency Questionnaire (FFQ) showed the most significant effect (OR = 1.32, 95% CI: 1.08, 1.67, I 2 = 99.7%, p < 0.000). The measuring tool of subgroup analysis showed that there was a significant correlation between sugar intake and risk of depression, PHQ-9 (OR = 1.29, 95% CI: 1.17, 1.42, I2 = 86.5%, p < 0.000), and CES-D (OR = 1.28, 95% CI: 1.14, 1.44, I 2 = 71.3%, p < 0.000). High-quality cross-sectional and cohort studies showed a significant association between sugar intake and depression risk, with most results being robust. While the overall analysis of sugar intake and anxiety risk was not significant, some subgroups approached significance, particularly in studies with a sample size of <5,000 (OR = 1.14, 95% CI: 0.89, 1.46) and studies using the FFQ questionnaire (OR = 1.31, 95% CI: 0.90, 1.89).

Conclusion

Total dietary sugar consumption was significantly associated with increased risk of depression in the general population, whereas the association with risk of anxiety was not significant. Further high-quality studies are needed to verify these associations and ensure their reliability. This study highlights the impact of dietary sugar intake on mental health, identifies potentially high-risk groups through subgroup analysis, and provides new insights into the prevention of depression and anxiety.

Systematic review registration

CRD42024540548.

The association between soft drinks consumption and risk of mental disorders among Iranian adults: The LIPOKAP study

OBJECTIVE

With rising demand for soft drinks (SDs) in low-income countries, studies examining mental disorders in relation to SDs are rather scarce. Therefore, we aimed to explore this association in a sample of Iranian adults.

METHODS

This cross-sectional study was carried out within the framework of the multi-centric LIPOKAP project, with 1970 Iranian healthy adults. Dietary intake and symptoms of depression and anxiety were collected using validated, Persian versions of a food frequency questionnaire and a Hospital Anxiety and Depression Scale (HADS), respectively. Artificial juices were considered fruit-flavored carbonated sugar beverages, sugar-sweetened beverages (SSB) included fruit-flavored carbonated sugar beverages and carbonated colas, and soft drinks included SSB and drinks containing non-nutritive sweeteners.

RESULTS

The mean age of the participants was 39.8 ± 13.9 years. Compared to lower intake, higher intake of SDs (OR = 1.30, 95 % CI: 1.01, 1.69; P = 0.041), SSBs (OR = 1.30, 95 % CI: 1.00, 1.67; P = 0.045) and artificial juice (OR = 1.63, 95 % CI: 1.24, 2.13; P < 0.001) was associated with higher risk of depression in adjusted model. These associations were sex-specific and more evident in males. No significant association was found between any of the drinks and anxiety risk except for artificial juice in men which was directly associated with anxiety risk (OR = 1.66, 95 % CI: 1.06, 2.61; P = 0.028).

CONCLUSION

This study found a positive association between SDs, SSBs and artificial juice and depression, but not anxiety. These associations varied between men and women. Prospective cohort studies are warranted to confirm our results and reveal the causal relationship.

The Interrelationship between Stress, Sugar Consumption and Depression

Depression is a leading cause of disability in the United States. Previous research has shown that added sugar consumption and stress are both risk factors for depression. Despite evidence that stress predicts added sugar consumption, and both affect the HPA axis, no research has explored how stress, added sugar consumption and depression are related. In this study, we investigated the possible effects of total added sugar and sugar-sweetened beverage consumption on depression, as well as their potential interactions with chronic stress. Measures of sugar consumption, chronic stress and depression were taken in an adult community sample at two time points. We hypothesized that high sugar consumption would predict more depression even after stress was statistically adjusted for, but that stress would moderate the relationship between added sugar consumption and depressive symptoms, amplifying the effect. We found that both total sugar consumption and sugar-sweetened beverage consumption at baseline predicted depressive symptoms one month later. However, only sugar-sweetened beverage consumption was a significant predictor of depression after controlling for stress, possibly because stress is related to diet quality. Stress did not moderate the relationship between added sugar consumption and depressive symptoms. These results suggest that stress should be included in future research on sugar and depression.

Obesity, Metabolic Syndrome, and Sugar-Sweetened Beverages (SSBs) in America: A Novel Bioethical Argument for a Radical Public Health Proposal

The prevalence of obesity, metabolic syndrome, and the associated long-term chronic diseases (cardiovascular disease, type II diabetes, cancer, Alzheimer's disease, depression) have reached epidemic levels in the United States and Western nations. In response to this public health calamity, the author of this paper presents and defends a novel bioethical argument: the consistency argument for outlawing SSBs (sugar-sweetened beverages) for child consumption (the "consistency argument"). This argument's radical conclusion states that the government is justified in outlawing SSBs consumption for child consumption. The reasoning is as follows: if one accepts that the physical harm caused by chronic alcohol consumption justifies the government outlawing alcoholic beverages for child consumption, and there is strong evidence that comparable physical harms result from chronic SSBs consumption, then, mutatis mutandis, the government is also justified in outlawing child consumption of SSBs. To support this argument, the author provides extensive evidence based on epidemiological observational studies, interventional studies, controlled trials, large meta-analyses, and the pathophysiology and biological mechanisms of action behind SSBs and chronic disease. Chronic consumption of large doses of SSBs and alcoholic beverages both drive the same diseases: obesity and insulin resistance, cardiovascular disease, hypertension, and cancer. Chronic SSB consumption carries the additional risk of Alzheimer's disease, dementia, and depression. The author concludes this paper by considering prominent objections to the consistency argument, and then demonstrating that each objection is unsound.

Testing the causal relationship of fat and sugar intake with depression and cortisol: a Mendelian Randomisation study

Unhealthy diets high in fat and sugar content may have an impact on psychological health and increase the risk of Major Depressive Disorder (MDD) and stress levels. On the other hand, MDD and stress might be related to food choices and intake. However, it is not clear whether diet, and specifically fat and sugar intake, is causally related to stress and MDD, and whether this relationship may be bi-directional. This study utilised Mendelian Randomisation (MR) to investigate the causal nature of the relationship of fat and sugar intake with MDD and cortisol (as a proxy of stress), and to shed light on the direction of this relationship. Summary-level data for all exposure and outcome variables were obtained from large-scale, non-overlapping GWASs in individuals of European ancestry. Bidirectional analyses were performed: one with macronutrients as exposures and one with MDD/cortisol as exposures. Random-effects inverse-variance weighted regression was used as the primary analytic method for genetic instruments with at least two single nucleotide polymorphisms (SNPs) available (and individual Wald ratio was used when only one SNP was available). Higher levels of genetically predicted relative sugar intake were causally associated with lower MDD risk, for both genome-wide significant p-value threshold of p < 1 × 10-8, (OR = 0.553, 95% CI: 0.395-0.775) and relaxed p-value threshold of p < 1 × 10-6 (OR = 0.786, 95% CI: 0.630-0.981). No reverse causality was detected in the opposite direction as MDD was not associated with sugar consumption. The associations observed for all the other pairs of variables were weak and imprecise. A number of limitations was present in the study, such as low-SNP based heritability for some exposures, inability to prove whether variants were correlated with unmeasured confounders and self-reporting of MDD data. Lifestyle and/or pharmacological interventions targeting sugar-related physiological mechanisms may help to reduce depressive symptoms. However, more research is necessary on short- and long-term effects of sugar on the risk of MDD. Additionally, future studies should investigate whether the amount and type of sugar consumed may underlie the impact of sugar on mood and stress levels.

Factors Associated with the Development of Depression and the Influence of Obesity on Depressive Disorders: A Narrative Review

Depression affects several aspects of life, including socioeconomic status, relationships, behavior, emotions, and overall health. The etiology of depression is complex and influenced by various factors, with obesity emerging as a significant contributor. This narrative review aims to investigate the factors associated with the development of depression, with a particular focus on the role of obesity. The literature search was conducted on PubMed, Embase, and PsycINFO from May to July 2024. The review highlights the impact of environmental and socioeconomic conditions; lifestyle choices, including physical activity and dietary habits; stress; traumatic experiences; neurotransmitter imbalances; medical and psychological conditions; hormone fluctuations; and epigenetic factors on depression. A key emphasis is placed on the inflammatory processes linked to obesity, which may drive the bidirectional relationship between obesity and depression. The findings suggest that obesity is associated with an increased risk of depression, potentially due to chronic inflammation, neurochemical dysregulation, and the emotional and social challenges related to weight stigma and obesity management. Understanding these interconnected factors is important for developing targeted interventions to address both obesity and depression, leading to improved quality of life for those affected.

Consumption of sugary beverages, genetic predisposition and the risk of depression: a prospective cohort study

Background

The associations between sugary beverages and genetic predisposition to depression risk remain unclear.

Aims

This study aimed to investigate the associations of sugar-sweetened beverages (SSBs), artificially sweetened beverages (ASBs) and natural juices (NJs) with depression and to assess whether these associations were modified by genetic predisposition.

Methods

We used data from the UK Biobank of 180 599 individuals aged 39-72 years who were depression-free at baseline. Dietary intake of SSBs, ASBs and NJs was accessed by a 24-hour dietary recall between 2009 and 2012. The Polygenic Risk Score for depression was estimated and categorised as low (lowest tertile), intermediate (tertile 2) and high (highest tertile). Cox proportional hazard and substitution models were conducted to evaluate hazard ratios (HRs) and 95% CIs.

Results

Over the 12-year follow-up, 4915 individuals developed depression. Higher consumption (>2 units/day) of SSBs (HR: 1.26, 95% CI 1.12 to 1.43) and ASBs (HR: 1.40, 95% CI 1.23 to 1.60) were both associated with an increased risk of depression. However, moderate consumption (>0-1 units/day) of NJs was associated with a lower risk of depression (HR: 0.89, 95% CI 0.83 to 0.95). Furthermore, genetic predisposition did not modify these associations (p interaction>0.05). In substitution models, the HRs for depression risk were 0.94 (95% CI 0.89 to 0.99) and 0.89 (95% CI 0.85 to 0.94), respectively, when 1 unit/day of SSBs or ASBs was replaced by an equivalent intake of NJs.

Conclusions

Higher consumption of SSBs and ASBs was associated with an increased risk of depression; in contrast, moderate consumption of NJs was inversely associated with a lower risk of depression. In theory, substituting SSBs and ASBs with NJs would suppose a reduction of depression risk.

The Relationship between Lifestyle Behaviors and Mental Illness in Women in College

Women, particularly those in college, have the highest prevalence of any mental illness (MI), which negatively impacts social connection, academic performance, and health. Research into alternative treatment methods suggests that lifestyle behaviors are safer and more effective than medication at reducing MI symptoms. This study explores the relationship between lifestyle behaviors and MI in college women through an online survey. The survey included a food frequency questionnaire (Diet History Questionnaire II) and questions about lifestyle behaviors, symptoms of MI, and sociodemographic information. Diet quality was calculated using the Healthy Eating Index (HEI), and MI was assessed using the Depression, Anxiety, and Stress Scale-21. Independent sample t-tests, ANOVA, and chi-square analyses were conducted. A total of 222 women completed the survey. Overall, diet quality was poor, with a mean HEI of 62.6 ± 10.4. No significant differences or associations were found between MI groups for total HEI score, sleep, or tobacco use. However, alcohol use was significantly associated with MI (p = 0.049). Individuals with fewer concurrent unhealthy lifestyle behaviors had less severe symptoms of depression (p = 0.009) and anxiety (p < 0.001) compared to those with more unhealthy lifestyle behaviors. In this study, alcohol use was the only independent lifestyle behavior associated with symptoms of MI. We also found an association between the number of concurrent unhealthy lifestyle behaviors and depression and anxiety symptoms. Future research should explore the benefits of a healthy lifestyle on MI in a more diverse sample of women.

Sex-specific effects of sucrose withdrawal on anxiety-like behavior and neuroimmune response

Sugar bingeing induces maladaptive neuroadaptations to decrease dietary control and promote withdrawal symptoms. This study investigated sex differences in sucrose bingeing, sucrose withdrawal-induced negative mood effects and underlying neuroimmune response in the prefrontal cortex (PFC) and nucleus accumbens (NAc) of C57BL/6J male and female mice. Two-bottle sucrose choice paradigm was used to develop sucrose dependence in mice. Female mice consumed more sucrose than male mice when given free access to water and 10% sucrose for four weeks. A significant increase in the mRNA expression of neuroinflammatory markers (Il1β, Tnfα) was found in the PFC of males exposed to sucrose withdrawal. Sucrose bingeing and subsequent sucrose withdrawal showed elevated protein levels of pro-inflammatory cytokines/chemokines/growth factors in the PFC (IL-1β, IL-6, TNFα, IFN-γ, IL-10, CCL5, VEGF) and NAc (IL-1β, IL-6, IL-10, VEGF) of male mice as compared to their water controls. These effects were concurrent with reduced mRNA expression of neuronal activation marker (cFos) in the PFC of sucrose withdrawal males. One week of sucrose withdrawal after prolonged sucrose consumption showed anxiety-like behavior in male mice, not in females. In conclusion, this study demonstrates that repeated access to sucrose induces anxiety-like behavior when the sugar is no longer available in the diet and these effects are male-specific. Elevated neuroinflammation in reward neurocircuitry may underlie these sex-specific effects.

Associations of diet quality and daily free sugar intake with depressive and anxiety symptoms among Chinese adolescents

BACKGROUND

Assessing diet quality has been challenging, and the associations of diet quality and daily free sugar intake with depressive and/or anxiety symptoms have shown inconsistency.

METHODS

A total of 1749 students aged 12-16 years were recruited using stratified random cluster sampling across three cities in China. The overall Global Dietary Recommendations (GDR) score, a novel indicator of diet quality, was constructed using the low-burden Diet Quality Questionnaire. Free sugar intake, including from beverages and foods, was measured using the Food Frequency Questionnaire. Daily free sugar intake was divided into low, medium, and high categories based on the latest version of the dietary guidelines for Chinese residents. Binomial and multinominal logistic regression analyses were used to examine the associations of the overall GDR score and daily free sugar intake categories or different sources of free sugar intake with depressive and/or anxiety symptoms.

RESULTS

The overall GDR score was negatively associated with depressive symptoms (adjusted odds ratio[aOR] = 0.92, 95%CI: 0.87-0.98) and anxiety symptoms (0.95, 0.90-0.99), particularly with comorbid depression and anxiety (0.90, 0.84-0.97). Conversely, daily free sugar intake was positively associated with symptoms of depression and/or anxiety, the multiple aOR for symptoms depression or anxiety were significantly increased with higher daily free sugar intake (all Ptrend < 0.05). Both free sugar from beverages and from foods were positively associated with depressive and/or anxiety symptoms. These associations were consistent between males and females.

LIMITATIONS

Cross-sectional design and self-reported symptoms.

CONCLUSIONS

Diet quality was negatively associated with symptoms of depression or anxiety, especially with comorbid symptoms among adolescents. Daily free sugar intake, regardless of its sources, was positively associated with symptoms of depression and/or anxiety.

The Southern European Atlantic diet and all-cause and cause-specific mortality: a European multicohort study

AIMS

The Southern European Atlantic diet (SEAD) is the traditional dietary pattern of northwestern Spain and northern Portugal, but it may resemble that of central, eastern, and western European countries. The SEAD has been found associated with lower risk of myocardial infarction and mortality in older adults, but it is uncertain whether this association also exists in other European populations and if it is similar as that found in its countries of origin.

METHODS AND RESULTS

We conducted a prospective analysis of four cohorts with 35 917 subjects aged 18-96 years: ENRICA (Spain), HAPIEE (Czechia and Poland), and Whitehall II (United Kingdom). The SEAD comprised fresh fish, cod, red meat and pork products, dairy, legumes and vegetables, vegetable soup, potatoes, whole-grain bread, and moderate wine consumption. Associations were adjusted for sociodemographic variables, energy intake, lifestyle, and morbidity. After a median follow-up of 13.6 years (range = 0-15), we recorded 4 973 all-cause, 1 581 cardiovascular, and 1 814 cancer deaths. Higher adherence to the SEAD was associated with lower mortality in the pooled sample. Fully adjusted hazard ratios and 95% confidence interval per 1-standard deviation increment in the SEAD were 0.92 (0.89, 0.95), 0.91 (0.86, 0.96), and 0.94 (0.89, 0.99) for all-cause, cardiovascular, and cancer mortality, respectively. The association of the SEAD with all-cause mortality was not significantly different between countries [Spain = 0.93 (0.88, 0.99), Czechia = 0.94 (0.89,0.99), Poland = 0.89 (0.85, 0.93), United Kingdom = 0.98 (0.89, 1.07); P for interaction = 0.16].

CONCLUSION

The SEAD was associated with lower all-cause, cardiovascular, and cancer mortality in southern, central, eastern, and western European populations. Associations were of similar magnitude as those found for existing healthy dietary patterns.

Adapting the Dietary Fat and Free Sugar Short Questionnaire: A Comprehensive Polish Modification for Enhanced Precision in Nutritional Assessments

BACKGROUND

This study aimed to investigate whether The Dietary Fat and Free Sugar-Short Questionnaire (DFS) is a reliable and valid measure that can be used in Polish conditions. It involved 291 participants, aged 14 to 70 (M = 25.9, SD = 10.1), the majority of whom were women (75%).

METHODS

The questionnaire consisted of, among others, Polish DFS version, FFQ-6, TFEQ, and SCOFF. Test-retest reliability was established on the group of 26 students with a 2-week interval. Participants' percentage of energy intake from both free sugars and saturated fats based on FFQ was correlated with DFS total and subscales scores. To investigate convergent and divergent validity, DFS scores with TFEQ correlations were performed. Diagnostic validity was established based on difference analysis between groups with the risk of eating disorders and those without the risk of those based on SCOFF.

RESULTS

Test-retest reliability (rtr = 0.856) and internal consistency (α = 0.797) indicated excellent reliability. DFS correlated significantly with FFQ for both total scores (r = 0.82) and each subscale: sugar (0.79), fat (0.75), and fat-sugar (0.59). The correlations of DFS and TFEQ were statistically significant for cognitive restraint (r = 0.32) and uncontrolled eating (r = 0.19). There also have been found significant differences based on SCOFF regarding DFS.

CONCLUSIONS

The results suggest good reliability and validity of the Polish version of DFS.

Association between dietary sugar intake and depression in US adults: a cross-sectional study using data from the National Health and Nutrition Examination Survey 2011-2018

BACKGROUND

Studies examining whether diet sugar intake increases the risk of depression have produced inconsistent results. Therefore, we investigated this relationship, using the US' National Health and Nutrition Examination Survey (NHANES) database.

METHODS

This cross-sectional study included 18,439 adults (aged ≥ 20 years) from NHANES (2011-2018). Depressive symptoms were assessed using the nine-item version of the Patient Health Questionnaire (PHQ-9). Covariates, including age, sex, race/ethnicity, poverty-income ratio, education, marital status, hypertension, diabetes mellitus, cardiovascular disease, alcohol intake, smoking status, physical activity, and dietary energy intake, were adjusted in multivariate logistic regression models. Subgroup and threshold saturation effect analyses were performed.

RESULTS

After adjusting for potential confounders, we found that a 100 g/day increase in dietary sugar intake correlated with a 28% higher prevalence of depression (odds ratio = 1.28, 95% confidence interval = 1.17-1.40, P < 0.001).

CONCLUSION

Dietary sugar intake is positively associated with depression in US adults.

The use of diet for preventing and treating depression in young men: current evidence and existing challenges

Emerging evidence suggests that diet therapy (nutrients, foods and dietary patterns) could be effective as a potential adjunctive treatment option for major depressive disorder. Numerous mechanisms have been proposed, including the role inflammation, oxidative stress, brain-derived neurotrophic factor, the gastrointestinal tract microbiome and tryptophan/serotonin metabolism. Despite known differences in depression characteristics and treatment responses between males and females, there are limited sex-specific studies examining the role of diet in young men specifically. This is important as young men are often reluctant to seek mental health support, so finding treatment strategies which appeal to this demographic is crucial. This brief report provides an overview of the most recent advances in the use of diet for preventing and treating depression in young men, highlighting existing challenges and opportunities for future research. We recommend that clinicians discuss the role of diet with depressed young men, so that diet may be used alongside current treatment options.

Unhealthy behaviors associated with mental health disorders: a systematic comparative review of diet quality, sedentary behavior, and cannabis and tobacco use

Background

There are well-established literatures documenting the associations between mental disorders and unhealthy behaviors such as poor diet quality, sedentary behavior, and cannabis and tobacco use. Few studies have attempted to understand the respective findings in light of each other, however.

Objective

The purpose of this review was to assemble comparable data for each behavior-disorder association and assess the associations in terms of their overall strength. The review aimed to include a representative, but not exhaustive, range of studies that would allow for explorative comparisons.

Methods

Eligible studies were identified via Pubmed searches and citation searching, restricted to publications no older than 2015 written in English. To obtain comparable data, only studies that reported findings as odds ratios were included, and risk of bias related to study samples, behavioral measurement disparities, and control variables was assessed via sensitivity analyses. Findings for each disorder were compared on the basis of different measures of central tendency.

Results

From 3,682 records, 294 studies were included. The review found evidence of associations between each of the four unhealthy behaviors and psychosis, depression, anxiety, bipolar disorder, attention-deficit/hyperactivity disorder (ADHD), and post-traumatic stress disorder (PTSD), while personality disorder was only investigated in relation to cannabis and tobacco use. In overall comparison, the associations were generally of similar strength, and only the association between cannabis use and personality disorder was exceptional in terms of being significantly stronger than its counterparts across disorders and across behaviors. Analyses of bias risk identified some influence from behavioral measurement disparities and lack of adequate statistical control, but findings were generally robust across a range of sensitivity analyses.

Conclusion

This explorative and comparative review found that poor diet quality, sedentary behavior, and cannabis and tobacco use are about equally strongly associated with a range of different mental disorders. Given the general nature of these associations, we should probably understand them to reflect a general and shared etiology. However, the findings in this review should be regarded as tentative until confirmed by more comprehensive investigations.

Association between Western Dietary Patterns, Typical Food Groups, and Behavioral Health Disorders: An Updated Systematic Review and Meta-Analysis of Observational Studies

Western dietary patterns (WDP) and typical food groups may play a major role in the risk of behavioral health disorders. Nevertheless, the relationships between WDP, common food categories, and mental health disorders lack consistency and remain incompletely understood in relation to potential mechanisms. Therefore, the objective of the present study was conducted to synthesize available evidence linking WDP and typical food groups to these outcomes. Web of Science, PubMed, EMBASE, and MEDLINE were searched up to August 2023. Random effect meta-analyses were performed to obtain pooled odds ratio and the relative risk for the prevalence of outcomes and the incidence of outcomes, respectively. A total of 54 articles were included. WDP was associated with increased risk of both depression (1.19; 95% CI: 1.06-1.32) and depressive symptoms (1.20; 95% CI: 1.08-1.34). Except for high-fat dairy products, food groups are associated with an increased risk of anxiety, depression, and depressive symptoms. This review presents evidence to further understand the relationship between WDP, typical food groups, and the incidence of behavioral health disorders, and more randomized controlled trials and cohort studies are urgently required to confirm these findings and elucidate potential mechanisms.

Pathogenesis and treatment of depression: Role of diet in prevention and therapy

In recent years, there has been a significant increase in depression, which is related to, among other things, the COVID-19 pandemic. Depression can be fatal if not treated or if treated inappropriately. Depression is the leading cause of suicide attempts. The disease is multifactorial, and pharmacotherapy often fails to bring satisfactory results. Therefore, increasingly more importance is attached to the natural healing substances and nutrients in food, which can significantly affect the therapy process and prevention of depressive disorders. A proper diet is vital to preventing depression and can be a valuable addition to psychological and pharmacologic treatment. An inadequate diet may reduce the effectiveness of antidepressants or increase their side effects, leading to life-threatening symptoms. This study aimed to review the literature on the pathogenesis of the development and treatment of depression, with particular emphasis on dietary supplements and the role of nutrition in the prevention and treatment of depressive disorders.

Secondary analysis of a randomized trial testing community health educator interventions for diabetes prevention among refugees with depression: effects on nutrition, physical activity and sleep

BACKGROUND

Refugees have high levels of psychological distress that hamper lifestyle change efforts. We previously reported that community health educator (CHE) diabetes prevention interventions decreased HbA1c and depressive symptoms among Cambodian-American refugees with depression; this paper reports health behavior outcomes of those interventions.

METHODS

Participants were aged 35-75, Khmer speaking, at risk for diabetes, and met study criteria for likely depression by either a) antidepressant medication and/or b) prolonged elevated depressive symptoms. Participants were randomized to one of three CHE interventions: 1) lifestyle intervention called Eat, Walk, Sleep (EWS), 2) EWS plus medication therapy management with a pharmacist/CHE team (EWS + MTM), or, 3) social services (SS; control). Physical activity and sleep were measured with 7 days of actigraphy. Nutrition was measured as carbohydrates as reported in a culturally tailored food frequency questionnaire. Assessments were at baseline, end point (12 months), and follow-up (15 months).

RESULTS

The n = 188 participants were 78% female, average age of 55 years, half had a household income < $20,000, and modal education was 7.0 years. Individuals in the two treatment groups that received the EWS intervention significantly increased their brown rice consumption (p < .001, Cohen's d = 0.76) and their moderate-to-vigorous activity (p = .039, d = 0.32). No intervention changed sleep duration, timing, efficiency or wake after sleep onset. Across groups, individuals who increased brown rice consumption, increased vigorous activity and decreased total sleep time variability showed decreased HbA1c, with small effect sizes.

CONCLUSIONS

CHEs may improve nutrition and physical activity in refugees with depression but more intensive interventions may be required to impact sleep. Improvements in all three behaviors appear to be associated with HbA1c lowering TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT02502929.

The associations of dietary patterns with depressive and anxiety symptoms: a prospective study

BACKGROUND

Diet is increasingly recognized as an important risk factor for mental health. However, evidence regarding the association between diet pattern and depressive and anxiety symptoms is limited. We aimed to investigate the associations of dietary patterns characterized by a set of nutrients of interest with depressive and anxiety symptoms.

METHODS

The analyses included a total of 126,819 participants in the UK Biobank who had completed at least two dietary questionnaires. Dietary data were obtained through 24-h dietary assessment at baseline between 2006 and 2010 and four rounds of online follow-ups between 2011 and 2012. Reduced rank regression was applied to derive dietary patterns (DPs) explaining variability in energy density, free sugars, saturated fat, and fiber intakes. Depressive and anxiety symptoms were measured by the Patient Health Questionnaire-9 and General Anxiety Disorder-7 between 2016 and 2017, respectively. Logistic regression models were performed to investigate the associations between dietary patterns and depressive and anxiety symptoms.

RESULTS

During a mean follow-up of 7.6 years, 2746 cases of depressive symptoms and 2202 cases of anxiety symptoms were recorded. Three major DPs were derived, explaining 74% of the variation in nutrients hypothesized to be related to depressive and anxiety symptoms. DP1 was characterized by high intakes of chocolate, confectionery, butter, and low vegetable/fruit intakes. Compared to the lowest quintile of DP1, the odds ratio (95% confidence interval) of depressive symptoms for Q2-Q5 was 0.82 (0.72-0.93), 0.86 (0.76-0.98), 1.02 (0.90-1.15), and 1.17 (1.03-1.32), respectively. Compared to the lowest quintile of DP1, the odds ratio (95% CI) of anxiety symptoms for Q2-Q5 was 0.84 (0.73-0.97), 0.91 (0.79-1.05), 1.01 (0.88-1.15), and 1.18 (1.03-1.35), respectively. DP2 featured high intakes of sugar-sweetened beverages, added sugars, and low intakes of butter/cheese but showed no significant links to depressive or anxiety symptoms. DP3 was characterized by high butter and milk desserts and low alcohol/bread intakes. Compared to the lowest quintile of DP3, the odds ratio (95% CI) of depressive symptoms for Q2-Q5 was 0.90 (0.79-1.01), 1.00 (0.88-1.13), 1.06 (0.94-1.20), and 1.17 (1.03-1.32), respectively. Compared to the lowest quintile of DP3, the odds ratio (95% CI) of anxiety symptoms for Q2-Q5 was 0.90 (0.78-1.04), 1.05 (0.91-1.20), 1.02 (0.89-1.17), and 1.21 (1.05-1.38), respectively.

CONCLUSIONS

A DP characterized by high intakes of chocolate and confectionery, butter, high-fat cheese, added sugars, along with low intakes of fresh fruit and vegetables, is associated with a higher risk of depressive and anxiety symptoms.

The impact of non-caloric artificial sweetener aspartame on female reproductive system in mice model

BACKGROUND

Artificial sweeteners, used as sugar substitutes have found their ways into almost all the food items due to the notion that they are non-caloric. Aspartame is used in numerous food products throughout the world. The primary users of aspartame include diabetics and calorie conscious people who intend to limit their calorie intake.

METHODS

Female Swiss albino mice were divided into three groups (12 mice each) for the duration of 30 and 60 days consecutively. The treatment groups received 40 mg/kg b. w. aspartame orally. Hormone assays using ELISA and tissue histopathology have been performed along with the fertility assay to access the treatment outcomeon the fertility of treated mice in comparison to controls.

RESULTS

Present study reports that female mice treated with aspartame for 30 and 60 days showed significant reduction in body weight, relative organ weight of (liver and kidney) and gonadosomatic index. These changes were more significantly recorded in 60 days treatment group. Aspartame treated animals for 30 and 60 days showed duration-dependent decrease gonandotropins (follicle stimulating hormone and luteinizing hormone), and steroids (estradiol and progesterone). Moreover, severe histopathological changes, reduction in number of growing follicles, degenerative changes in follicular structure, corona radiata and zonagranulosa were also observed. Besides, histomorphological changes were also observed in the uterine structure including atrophic uterine endometrial glands, contracted endometrial lining, disruption of the endometrial structure and the shapes of blood vessels were also altered.

CONCLUSION

Non-nutritive artificial sweeteners including aspartame negatively impact the function of ovaries and feedback mechanism of reproductive hormones by affecting the hypothalamic-pituitary-gonadal axis. In light of present findings the aspartame negatively impacted the reproductive system of female mice. More studies are required to identify the molecular mechanism and the pathways involved.

On the Importance of Mental Health in STEM

From homework to exams to proposal deadlines, STEM academia bears many stressors for students, faculty, and administrators. The increasing prevalence of burnout as an occupational phenomenon, along with anxiety, depression, and other mental illnesses in the STEM community is an alarming sign that help is needed. We describe common mental illnesses, identify risk factors, and outline symptoms. We intend to provide guidance on how some people can cope with stressors while also giving advice for those who wish to help their suffering friends, colleagues, or peers. We hope to spark more conversation about this important topic that may affect us all-while also encouraging those who suffer (or have suffered) to share their stories and serve as role models for those who feel they cannot speak.

Longitudinal analysis for the risk of depression according to the consumption of sugar-sweetened carbonated beverage in non-diabetic and diabetic population

Studies have presented that high intake of sugar-sweetened carbonated beverage (SSCB) was more associated with the prevalence of depression. However, longitudinal evidence is still insufficient to identify whether the effect of SSCB on incident depression is independent of metabolic factors. Therefore, to evaluate the effect of SSCB consumption on the risk of depression, we analyzed the risk of depression according to the consumption of SSCB in 87,115 working aged Koreans who responded to Center for Epidemiologic Studies Depression (CES-D) scale. They were categorized into 5 groups by SSCB consumption based on one serving dose (200 ml) with never/almost never, < 1 serving/week, 1 ≤ serving/week < 3, 3 ≤ serving/week < 5, and 5 ≤ serving/week. During follow-up, CES-D ≥ 16 was determined as incident depressive symptom. Cox proportional hazards model was used to calculate the multivariable-adjusted hazard ratio (HR) and 95% confidence intervals (CI) for depressive symptom. In analysis for all study participants, the risk of depressive symptom significantly increased proportionally to SSCB consumption (never/almost never: reference, < 1 serving/week: 1.12 [1.07-1.17], 1 ≤  ~  < 3 serving/week: 1.26 [1.19-1.33], 3 ≤  ~  < 5 serving/week: 1.32 [1.23-1.42], and ≥ 5 serving/week: 1.45 [1.33-1.59]). This association was identically observed in men, women, normal glycemic subgroup and prediabetes subgroup.

The Southern European Atlantic diet and depression risk: a European multicohort study

The Southern European Atlantic diet (SEAD) is the traditional dietary pattern of north-western Spain and northern Portugal, but it may resemble that of other European countries. The SEAD has been found associated with lower risk for myocardial infarction and mortality. Since dietary patterns may also influence mental health, we examined the association between the SEAD and depression risk in southern, central, eastern, and western European populations. We conducted a prospective analysis of five cohorts (13,297 participants aged 45-92 years, free of depression at baseline): Seniors-ENRICA-1 and Seniors-ENRICA-2 (Spain), HAPIEE (Czechia and Poland), and Whitehall-II (United Kingdom). The SEAD comprised cod, other fresh fish, red meat and pork products, dairy, legumes and vegetables, vegetable soup, potatoes, whole-grain bread, and moderate wine consumption. Depression at follow-up was defined according to presence of depressive symptoms (based on available scales), use of prescribed antidepressants, inpatient admissions, or self-reported diagnosis. Associations were adjusted for sociodemographic, lifestyle, and dietary variables. During a median follow-up of 3.9 years (interquartile range 3.4-4.9), there were 1437 new depression cases. Higher adherence to the SEAD was associated with lower depression risk in the pooled sample. Individual food groups showed a similar tendency, albeit non-significant. The fully adjusted odds ratio (95% confidence interval) per 1-standard deviation increment in the SEAD was 0.91 (0.86, 0.96). This association was rather consistent across countries [Spain = 0.86 (0.75, 0.99), Czechia = 0.86 (0.75, 0.99), Poland = 0.97 (0.89, 1.06), United Kingdom = 0.85 (0.75, 0.97); p for interaction = 0.24], and was of similar magnitude as that found for existing healthy dietary patterns. In conclusion, the SEAD was associated with lower depression risk across European populations. This may support the development of mood disorder guidelines for Southern European Atlantic regions based on their traditional diet, and for central, eastern, and western European populations based on the SEAD food groups that are culturally rooted in these places.

Maternal monosaccharide diets evoke cognitive, locomotor, and emotional disturbances in adolescent and young adult offspring rats

Anxiety and depression are the most common mental disorders affecting people worldwide. Recent studies have highlighted that a maternal high-sugar diet (HSD) could be a risk factor for neurobehavioural dysregulations, including mood disorders. Increased consumption of added sugar in food such as refined fructose/glucose can increase the risk of metabolic disorders and impact susceptibility to mental disorders. Furthermore, a few papers have reported disabilities in learning and memory among offspring after maternal HSD, thus suggesting a relationship between maternal nutrition and offspring neurogenesis. In this study, we evaluated the impact of maternal monosaccharide consumption based on a glucose (GLU) or fructose (FRU) diet during pregnancy and lactation in adolescent and young adult offspring rats of both sexes on cognitive, locomotor, and emotional disturbances. Locomotor activity, short-term memory, anxiety-like and depressive-like behavior were evaluated in the offspring. We report for the first time that the maternal GLU or FRU diet is sufficient to evoke anxiety-like behavior among adolescent and young adult offspring. Moreover, we found that maternal monosaccharide diets lead to hyperactivity and depressive-like behavior in male adolescent rats. We also noticed that a maternal FRU diet significantly enhanced novelty-seeking behavior only in young adult male rats. Our novel findings indicated that the maternal monosaccharide diet, especially a diet enriched in FRU, resulted in strong behavioral alterations in offspring rats at early life stages. This study also revealed that male rats were more susceptible to hyperactivity and anxiety- and depressive-like phenotypes than female rats. These results suggest that maternal monosaccharide consumption during pregnancy and lactation is an important factor affecting the emotional status of offspring.

Efficacy of low carbohydrate and ketogenic diets in treating mood and anxiety disorders: systematic review and implications for clinical practice

BACKGROUND

There is mounting interest in the potential efficacy of low carbohydrate and very low carbohydrate ketogenic diets in various neurological and psychiatric disorders.

AIMS

To conduct a systematic review and narrative synthesis of low carbohydrate and ketogenic diets (LC/KD) in adults with mood and anxiety disorders.

METHOD

MEDLINE, Embase, PsycINFO and Cochrane databases were systematically searched for articles from inception to 6 September 2022. Studies that included adults with any mood or anxiety disorder treated with a low carbohydrate or ketogenic intervention, reporting effects on mood or anxiety symptoms were eligible for inclusion. PROSPERO registration CRD42019116367.

RESULTS

The search yielded 1377 articles, of which 48 were assessed for full-text eligibility. Twelve heterogeneous studies (stated as ketogenic interventions, albeit with incomplete carbohydrate reporting and measurements of ketosis; diet duration: 2 weeks to 3 years; n = 389; age range 19 to 75 years) were included in the final analysis. This included nine case reports, two cohort studies and one observational study. Data quality was variable, with no high-quality evidence identified. Efficacy, adverse effects and discontinuation rates were not systematically reported. There was some evidence for efficacy of ketogenic diets in those with bipolar disorder, schizoaffective disorder and possibly unipolar depression/anxiety. Relapse after discontinuation of the diet was reported in some individuals.

CONCLUSIONS

Although there is no high-quality evidence of LC/KD efficacy in mood or anxiety disorders, several uncontrolled studies suggest possible beneficial effects. Robust studies are now needed to demonstrate efficacy, to identify clinical groups who may benefit and whether a ketogenic diet (beyond low carbohydrate) is required and to characterise adverse effects and the risk of relapse after diet discontinuation.

The relationship between diet/nutrition and the mental health of immigrants in Western societies through a holistic bio-psycho-socio-cultural lens: A scoping review

Epidemiological evidence suggests that diet and nutrition not only impact individuals' physical health but also shape their mental health (MH). The nutrition/diet-MH relationship may be critical among immigrants due to socioeconomic and sociocultural factors. Despite the complex nutrition/diet-MH relationship, most scholarship in this area employs a biomedical perspective. This scoping review of 63 studies deployed a holistic bio-psycho-socio-cultural framework to examine the relationship between diet/nutrition and immigrants' MH. Five automated databases (Embase, PubMed, Medline, PsycINFO and Anthropology Plus) were systematically searched for relevant articles from Western countries. A bio-psycho-socio-cultural conceptual model guided the analysis of the multi-faceted diet/nutrition-MH relationship. Consumption of fruit/vegetables, unsaturated fats, vitamin D-rich foods and whole grains was significantly positively related to MH. Reported pathways included enhanced self-esteem and ability to stay physically active. Energy-dense food consumption emanating from unhealthful dietary acculturation to the Western lifestyle was associated with poor MH through various mechanisms, including exhaustion and worry about developing non-communicable diseases. Food insecurity and related hunger were significantly positively associated with depression and anxiety among immigrants through different pathways, including family conflicts, homesickness, social exclusion, feelings of shame/stigma, and helplessness related to not affording nutritious foods that meet one's cultural dietary requirements. Ethnic food consumption appeared to mitigate MH issues and enhance immigrants' well-being. A bio-psycho-socio-cultural-informed model is needed to gain an in-depth and encompassing understanding of immigrant MH as it relates to diet/nutrition. The first iteration of such a model is presented in this review alongside an illustration of how it may be used to strengthen an analysis and understanding of the multi-faceted diet/nutrition-MH relationship amongst immigrants and inform public health professionals and dieticians/practitioners.

Evaluating the Association Between Artificial Sweetener Intake and Indicators of Stress and Anxiety

The purpose of this study was to evaluate the association between non-nutritive sweetener (NNS) consumption and stress and anxiety, among a sample of college students. Two-hundred and twenty-seven students from a large mid-western university participated in this cross-sectional study. Students completed an online survey that evaluated NNS using a validated food frequency questionnaire. Stress and anxiety were evaluated using previously validated instruments. Most students reported very low/low/average concern for stress (63.9%), and had low/moderate anxiety (82.3%). Participants experiencing high and very high levels of stress had significantly higher NNS consumption compared to those with a very low and low risk, and concern for stress (p < .046; d = 0.28). There was no difference however for NNS intake and anxiety. Reduction of artificial sweetener intake may be associated with stress levels among college students. However, more research is needed to examine any causal relationship between artificial sweetener intake and stress.

Sugar-sweetened beverage consumption retarded weight gain but not induced depression and anxiety-like behaviors in mice

AIMS

To assess the effects of sugar-sweetened beverage (SSB) consumption and exercise on behaviors.

METHODS

Twenty-four male mice were divided into four groups: the water + sedentary (WS), the SSB + sedentary (CS), the water + exercise (WE), and the SSB + exercise (CE). After three-month of interventions, forced swim test (FST), open field test (OFT), and morris water maze (MWM) were conducted. Then, mRNA levels of MAO-A, COMT, and 5-HT1A and protein levels of synapsin, STAT3, A2AR, CRTC1, CREB, and BDNF were measured.

RESULTS

Under a similar baseline body weight condition, SSB consumption reduced the weight gain from the 3rd week (p < 0.05, or p < 0.01). Exercise decreased the escape latency in the CE group when compared to the CS group on day5 (p < 0.01) and increased the time in the target quadrant in the WE group than the WS group on day4 (p < 0.05) and 5 (p < 0.01) during MWM. No significant differences were found during the FST and OFT. COMT mRNA level was increased after SSB consumption (p < 0.05), but no differences were found in the MAO-A and 5-HT1A mRNA levels and the concerned biomarkers, all of which were previously reported to be associated with depression and anxiety-like behaviors.

CONCLUSION

SSB consumption reduced weight gain but not result in depression and anxiety-like behaviors in mice. Therefore, the behavioral effects of exercise were not significant. This is not consistent with the results of previous epidemiological surveys of humans.

Association of sugar intake from different sources with incident depression in the prospective cohort of UK Biobank participants

PURPOSE

To elucidate the association of different sources of free sugars (FS) and intrinsic sugars with depression risk in the prospective population-based UK Biobank cohort.

METHODS

Sugar consumption was assessed in 188,426 participants (age range: 39-72 years, 54.4% female) with at least one web-based dietary questionnaire (Oxford WebQ). The hazard ratios (HR) for incident depression were assessed with Cox proportional hazard regression models including sugar intake from different sources as penalized cubic splines to allow non-linear predictor effects. Over a mean follow-up of 12.3 (standard deviation 1.8) years, 5410 incident depression cases occurred.

RESULTS

FS intake was significantly associated with depression risk in an ascending approximately linear way with the lowest HR observed at 9% total energy (%E). In contrast, consumption of intrinsic sugars was not significantly related with incident depression. FS in beverages were significantly associated with depression risk in an ascending approximately linear way with the lowest HR at 4%E whereas no association was found for FS in solids. Concerning beverage types, FS in soda/fruit drinks, milk-based drinks, and tea/coffee were significantly and positively related to depression risk whereas the association was U-shaped for juice. Major findings were robust in sensitivity analyses.

CONCLUSION

Only some sources of FS are positively associated with incident depression. Public health initiatives targeting FS subtypes might be most effective concerning depression risk if focused on the reduction of sugary beverages and more specifically soda/fruit drinks, milk-based drinks, and tea/coffee.

The Impact of Free Sugar on Human Health-A Narrative Review

The importance of nutrition in human health has been understood for over a century. However, debate is ongoing regarding the role of added and free sugars in physiological and neurological health. In this narrative review, we have addressed several key issues around this debate and the major health conditions previously associated with sugar. We aim to determine the current evidence regarding the role of free sugars in human health, specifically obesity, diabetes, cardiovascular diseases, cognition, and mood. We also present some predominant theories on mechanisms of action. The findings suggest a negative effect of excessive added sugar consumption on human health and wellbeing. Specific class and source of carbohydrate appears to greatly influence the impact of these macronutrients on health. Further research into individual effects of carbohydrate forms in diverse populations is needed to understand the complex relationship between sugar and health.

Dose-response associations between modifiable lifestyle behaviours and anxiety, depression and psychological distress symptoms in early adolescence

OBJECTIVE

To investigate associations between key modifiable lifestyle behaviours (sleep; physical activity; fruit, vegetable and sugar-sweetened beverage consumption; screen time; alcohol use and tobacco use) and mental health among early adolescents in Australia.

METHODS

Cross-sectional self-report data from 6,640 Year 7 students (M_age:12.7[0.5]; 50.6% male, 48.9% female, 0.5% non-binary) from 71 schools in New South Wales, Queensland and Western Australia were analysed using multivariate linear regression adjusting for sociodemographic factors and school-level clustering.

RESULTS

All examined behaviours were associated with anxiety, depression and psychological distress (p≤0.001), with the lowest mental health symptom scores observed in participants who slept 9.5-10.5 hours per night; consumed three serves of fruit daily; consumed two serves of vegetables daily; never or rarely drank sugar-sweetened beverages; engaged in six days of moderate-to-vigorous physical activity per week; kept daily recreational screen time to 31-60 minutes; had not consumed a full standard alcoholic drink (past six months); or smoked a cigarette (past six months).

CONCLUSIONS

Targeting modifiable risk behaviours offers promising prevention potential to improve adolescent mental health; however, further longitudinal research to determine directionality and behavioural interactions is needed.

IMPLICATIONS FOR PUBLIC HEALTH

While Australian Dietary, Movement and Alcohol Guidelines target physical health, findings indicate similar behaviour thresholds may offer mental health benefits.

Dietary factors, risk of developing depression, and severity of its symptoms in older adults-A narrative review of current knowledge

Depression is one of the most common diseases in the older population. Difficulties in recognizing its etiology and recurrence make depression a major challenge for health care professionals. The risk of developing depression is influenced by many factors, including lifestyle and diet. Research studies have shown a relationship between the consumption of specific macro- and microelements and depression. However, so far, no nutritional recommendations on how to reduce the risk of the disease and its relapses in older adults have been developed. This review outlines research results of conducted studies and focuses on both basic and potentially promising elements of diet, such as proteins, carbohydrates, fats, dietary fiber, vitamins (D, E, C, and B), and microelements such as magnesium, zinc, selenium, or iron.

The association between healthy beverage index and quality of life among overweight and obese women: a cross-sectional study

BACKGROUND

Although several studies have evaluated the association between patterns of beverage consumption with different components of quality of life separately, the findings are controversial. In addition, none have examined all components of quality of life together in relation to patterns of beverage consumption. Therefore, this study was conducted to identify the association between healthy beverage index (HBI) and quality of life among overweight and obese women.

METHODS

For this cross-sectional study, 210 obese and overweight women were recruited from health centers in Tehran, Iran. Using reliable and verified standard protocols, data on beverage intake, socio-demographic, physical activity, and anthropometric variables were assessed. Based on past studies, the predetermined HBI was estimated. Serum samples were used to determine biochemical characteristics, and quality of life was assessed using SF-36 questionnaires.

RESULTS

There was a significant association between total QoL score with T2 tertile of HBI in the adjusted model (β: 13.11, 95% CI: 1.52, 24.69, p-value = 0.027). General health had a significant negative association with T2 (β: -5.83; 95% CI: - 11.48, - 0.18; p-value = 0.043) and T3 (β: -6.20; 95% CI: - 12.37, - 0.03; p-value = 0.049). Women with greater adherence to the HBI had a higher physical functioning score, and there was a significant upward trend from the second to the third tertile (7.74 vs 0.62) (-trend = 0.036). There was a significant positive association between mental health with T3 of HBI (β: 4.26; 95% CI: 1.51, 5.98; p-value = 0.015) and a significant increasing trend was observed with increasing tertiles (P-trend = 0.045).

CONCLUSION

In conclusion, there is a significant association between total QoL score, and its components, with HBI among overweight and obese women. However, additional well-designed studies are needed to confirm these findings.

Total sugar intake is associated with higher prevalence of depressive symptoms in obese adults

Background

The existing literature has repeatedly assessed the association between sugar-sweetened beverages and depressive symptoms, but studies of the association of total dietary sugar with depressive symptoms and of this association in obese adults are scarce. Thus, the purpose of this cross-sectional study was to assess the association between total sugar consumption and depressive symptoms in the study population and then in the population stratified by body mass index.

Methods

This study was conducted in a nationally representative sample of 16,009 adults from the 2011-2018 National Health and Nutrition Examination Survey in the US. Total sugar intake was assessed by 24 h dietary recalls, and depressive symptoms were assessed by the nine-item Patient Health Questionnaire. Logistic regression models were used to evaluate the association between total sugar consumption and depressive symptoms.

Results

Total sugar intake was positively associated with higher prevalence of depressive symptoms, and the adjusted odds ratio (95% confidence interval) of depressive symptoms for the highest vs. lowest quintile of total sugar intake was 1.56 (1.18, 2.05). In stratified analysis, we found a positive association between total sugar intake and depressive symptoms in adults with body mass index ≥30 kg/m2 (P for trend = 0.013), whereas no association was found in normal weight or overweight adults.

Conclusions

A higher intake of total sugar was associated with increased odds of clinically relevant depressive symptoms among obese adults. Further studies are necessary to confirm the role of total sugar in depressive symptoms among obese adults.

The Association between Sugar-Sweetened Beverages and Male Pattern Hair Loss in Young Men

We performed this study to investigate the association between sugar-sweetened beverage (SSB) consumption and male pattern hair loss (MPHL) in young men. We conducted this cross-sectional study from January to April 2022 in mainland China. Young people aged 18-45 years (n = 1951) were recruited from 31 provinces in China. We used a self-reported online survey for data collection. We explored the associations between the amount/frequency of SSB consumption and MPHL by using a binary logistic regression model, with adjustments for sociodemographic, hair status, dietary intake, lifestyle, and psychological factors. Among the 1028 participants (27.8 ± 7.2 years) in the final analysis, we found that high SSB consumption is associated with a higher risk of MPHL. We recommend more support to decrease SSB consumption among young people to minimize negative health outcomes.

Effects of chronic bubble tea administration on behavior and cognition in C57BL/6 mice

PURPOSE

There is a lack of rigorous experimental evidence to verify the effects of bubble tea on body weight and mental health, especially whether it is an addictive thing.

MATERIALS AND METHODS

Male adult C57BL/6 mice were randomly assigned to two groups, including the bubble-tea and the control group. The change in their body weight was calculated. Behavior tests include novel object recognition test (NORT), elevated plus maze test (EPMT), forced swim test (FST), tail suspension test (TST), conditioned place preference (CPP).

RESULTS

There was a significant time effect on weight change of the two groups (F = 36.83, P < 0.01). The bubble tea-treated mice spent significantly less time in the open arms, indicating an increase in anxiety (t = 2.39, P = 0.03). In FST, bubble tea treatment produced a significantly increased immobility time (186.58 ± 29.67 s) as compared to pure water treated group (112.50 ± 46.67 s) (t = -3.79, P < 0.01). Similarly, the immobility time in the TST was also significantly increased by bubble tea treatment (437.63 ± 27.72 s) compared to the treatment with pure water (340.24 ± 77.22 s) (t = -3.36, P < 0.01). We investigated the rewarding effects of bubble tea, using the CPP paradigm, which measures the rewarding properties of abused drugs. Independent-samples t-test revealed no significant difference between the two groups (t = -0.47, P = 0.65).

CONCLUSION

In conclusion, we showed that long-term administration of bubble tea could not induce addictive behavior in mice. Meanwhile, the long-term effects of bubble tea on weight were also very limited. However, long-term consumption of bubble tea can lead to anxiety and depression-like behaviors and impair cognitive function in mice.

Cross-sectional examination of ultra-processed food consumption and adverse mental health symptoms

OBJECTIVE

To explore whether individuals who consume higher amounts of ultra-processed food (UPF) have more adverse mental health symptoms.

DESIGN

Using a cross-sectional design, we measured the consumption of UPF as a percentage of total energy intake in kilo-calories using the NOVA food classification system. We explored whether individuals who consume higher amounts of UPF were more likely to report mild depression, more mentally unhealthy days and more anxious days per month using multivariable analyses adjusting for potential confounding variables.

SETTING

Representative sample from the United States National Health and Nutrition Examination Survey between 2007 and 2012.

PARTICIPANTS

10 359 adults aged 18+ without a history of cocaine, methamphetamine or heroin use.

RESULTS

After adjusting for covariates, individuals with the highest level of UPF consumption were significantly more likely to report at least mild depression (OR: 1·81; 95 % CI1·09, 3·02), more mentally unhealthy (risk ratio (RR): 1·22; 95 % CI 1·18, 1·25) and more anxious days per month (RR: 1·19; 95 % CI 1·16, 1·23). They were also significantly less likely to report zero mentally unhealthy (OR: 0·60; 95 % CI 0·41, 0·88) or anxious days (OR: 0·65; 95 % CI 0·47, 0·90).

CONCLUSIONS

Individuals reporting higher intakes of UPF were significantly more likely to report mild depression, more mentally unhealthy and more anxious days and less likely to report zero mentally unhealthy or anxious days. These data add important information to a growing body of evidence concerning the potential adverse effects of UPF consumption on mental health.

Association between food intake and mental health problems among preschoolers in China

Objective

Our knowledge of associations between specific types of food and mental health problems in preschool children, an important developmental period, remains scarce. Using a large sample size and a brief measure, we aimed to examine associations between food groups and mental health problems in preschoolers.

Methods

A descriptive cross-sectional study was conducted among 19,548 preschoolers in nine counties in China using a two-stage cluster sampling method. Information on food frequencies, physical activity, sedentary behavior, and sleep conditions was collected by a parent-reported questionnaire. Mental health status was assessed by a parent-reported Strength and Difficulty Questionnaire (SDQ). Height and weight were measured, and BMI was calculated. Relationships between specific types of food groups and mental health status were examined using multivariable regression modeling.

Results

Of the present study sample, 47.45% of children were girls. Boys had higher scores relating to total difficulties, conduct problems, hyperactivity, and peer problems than girls but lower scores in emotional symptoms and prosocial behavior. Children with more types of food categories tended to get lower SDQ total scores even after adjusting for confounding variables (p < 0.0001). The subscale scores of SDQ varied depending on the types and numbers of food consumed. Notably, boys' mental health problems were more likely to be associated with their consumed food type. Processed meat frequency intake among boys and girls was positively related to prosocial behavior (Girls: pickled food: p = 0.003, fried food: p < 0.0001, barbecued food: p = 0.006, smoked food: p = 0.005; Boys: pickled food: p = 0.3, fried food: p < 0.0001, barbecued food: p = 0.006, smoked food: p = 0.005) and negatively associated with the SDQ total and the other subscale scores (Girls: pickled food: p ≤ 0.02, fried food: p ≤ 0.005 except for emotions (p = 0.1), barbecued food: p ≤ 0.047, smoked food: p ≤ 0.04 (except for emotions (p = 0.06) and conduct behaviors (p = 0.2)); Boys: pickled food: p < 0.01 except for hyperactivity (p = 0.5), fried food: p ≤ 0.005 except for emotions (p = 0.1), barbecued food: p ≤ 0.007 except for hyperactivity (p = 0.8), smoked food: p ≤ 0.001 except for hyperactivity (p = 0.1) and peer problem (p = 0.08)). Adequate intake frequency of confectionery (2-4 times/week) was beneficial to their emotions, conduct, and total difficulties and was also beneficial for peer and prosocial behavior for boys (Girls: emotions: p = 0.02, conduct: p = 0.02, hyperactivity: p = 0.4, peer: p = 0.06, total difficulties: p = 0.01, prosocial behavior: p = 0.1; Boys: emotions: p = 0.009, conduct: p = 0.0009, hyperactivity: p = 0.7, peer: p = 0.02: total difficulties: p = 0.003, prosocial behavior: p = 0.0002).

Conclusion

Diverse food categories and adequate frequency of confectionery were found to be beneficial for children's mental health, with the exception of processed meat. These findings provide novel information and supportive data for children's dietary guidelines and the improvement of mental health.