Association between dietary patterns and depression: an umbrella review of meta-analyses of observational studies and intervention trials

Dietary Patterns and Major Depression: Results from 15,262 Participants (International ALIMENTAL Study)

BACKGROUND

Different patterns of food consumption may be associated with a differential risk of depression. Differences in dietary patterns between men and women and across different age groups have been reported, but their influence on the risk of depression has not been fully explored.

OBJECTIVES

To investigate the associations between dietary patterns and risk of depression across sex and age groups to identify vulnerable subpopulations, which may inform targeted prevention and intervention strategies.

METHODS

The ALIMENTAL study was a cross-sectional, online international survey conducted between 2021 and 2023. Dietary data were collected using a validated food frequency questionnaire; depression data were collected using a self-reported validated questionnaire. Principal component analysis (PCA) was applied to identify distinct food consumption patterns. Multivariate analyses were then conducted to assess the associations between these patterns and depression, adjusting for multiple potential confounders.

RESULTS

Among 15,262 participants without chronic diseases or current psychotropic treatments, 4923 (32.2%) were classified in the depression group. Among those aged 18-34, the PCA-derived factor of ultra-processed foods consumption was significantly associated with increased risk of depression in both sexes with similar odds ratios (women 1.21, 95% confidence interval (CI): (1.15; 1.27), men 1.21, 95% CI: (1.07-1.18)). In women aged 18-34, the PCA factors for sodas (aOR 1.10, 95% CI: (1.06; 1.95) and canned and frozen foods (aOR 1.10, 95% CI: (1.04; 1.15) were associated with an increased risk of depression. In participants aged 35-54 years, the association between ultra-processed foods and depression was only observed in women (35-54 years: aOR 1.30, 95% CI: (1.20; 1.42), ≥55 years: 1.41, 95% CI: (1.11; 1.79)), with a significant association between a higher adherence to the PCA-derived "healthy diet" factor (e.g., fruits, nuts, green vegetables) and a lower risk of depression (35-54 years: aOR 0.82, 95% CI: (0.75; 0.89), ≥55 years: aOR 0.79, 95% CI: (0.64; 0.97)).

CONCLUSIONS

These results show significant differences between men and women and between age groups regarding associations between dietary patterns and the risk of depression. These findings can help better target public health interventions.

Effectiveness of improving nutrition on depressive symptoms and work ability: Study protocol for the mind nutrition randomized controlled trial

Background: Depression is a growing public health concern that negatively impacts work ability and performance. Psychiatric nurses have an elevated risk for depressive symptoms, and it is essential to ensure their good mental health and work ability. The association between nutrition and depression is recognized, but there is a need for randomized, controlled intervention studies investigating the effectiveness of diet on depressive symptoms and related work impairment. Aim: Mind Nutrition is a randomized, controlled intervention study examining whether improving nutrition can reduce depressive symptoms and depressive symptoms-related sick leaves and enhance work ability and quality of life among mental health and substance abuse professionals. Methods: We will recruit 125 nurses and social welfare professionals from the mental health and substance abuse field of the Satakunta Wellbeing Services County. Half of the participants will be randomized to the intervention and half to the control group. Subjects in the intervention group will participate in two individual and three group counselling sessions during a 6-month intervention. Nutrition counselling follows the Finnish Nutrition Recommendations. The control group will maintain their habitual diet. The Center for Epidemiological Studies - Depression, depressive symptoms-related sick leave days, two work ability indicators, a Food Frequency Questionnaire, three-day food records, Three-Factor Eating Questionnaire - 18 and WHO-8 Eurohis Quality of Life will be assessed at baseline and 6 months. Summary: This study will provide evidence of the effectiveness of nutrition counselling on depressive symptoms and related sick leave days, work ability and quality of life.

Aging, longevity, and healthy aging: the public health approach

BACKGROUND

Population aging is one of the most significant global demographic changes of the 21st century, driven by increased life expectancy and declining fertility rates. This phenomenon presents both achievements and challenges for public health systems worldwide.

AIMS

On the one hand, advances in healthcare and socio-economic conditions have contributed to longer lives and improved quality of life for older adults. On the other hand, aging populations are increasingly affected by chronic diseases, greriatric syndromes, and multimorbidity, leading to greater healthcare demands and higher associated costs.

METHODS

This manuscript explores evidence on regards of the impact of aging on healthcare and economic systems, emphasizing the need for a paradigm shift toward healthy aging.

RESULTS

Healthy aging, as defined by the World Health Organization, focuses on the maintenance of intrinsic capacity, physical, mental, and social well-being throughout life. It highlights the importance of preventive healthcare, proper nutrition, and regular physical activity in delaying the onset of chronic conditions and maintaining functional independence. Furthermore, the manuscript addresses the challenges faced by healthcare infrastructures and pension systems as they adapt to aging populations, with particular attention to the strain caused by workforce shortages and the rising need for long-term care.

DISCUSSION

A coordinated public health approach is essential to promote healthy aging and mitigate the economic and societal impacts of population aging.

CONCLUSIONS

This paper underscores the need for integrated health policies and multidisciplinary care models to ensure that longer life expectancy is accompanied by better quality of life for older individuals.

Dietary Pattern and Depressive Outcomes in Children and Adolescents: Systematic Review and Meta-analysis of Observational Studies

CONTEXT

Research suggests that dietary pattern plays an important role in mental health and constitutes a modifiable risk factor for depression.

OBJECTIVE

The aim of this systematic review and meta-analysis was to evaluate the association between dietary patterns and depressive outcomes in adolescents.

DATA SOURCES

Medline/PubMed, Lilacs, EMBASE, PsycINFO, and PsycARTICLES, gray literature up to March 2024 were searched; the reference lists were also verified. Observational studies in participants with a mean age ⩽19 years reporting associations between dietary patterns and clinical depression or depressive symptoms were searched. Overall, 21 studies were included in this systematic review.

DATA EXTRACTION

Data from eligible articles were extracted by 2 reviewers.

DATA ANALYSIS

Odds ratios (ORs) and confidence intervals (CIs) were determined under a random-effects model. The risk of bias assessment was conducted by 2 independent researchers using the Joanna Briggs Institute Critical Appraisal Checklist tool.

RESULTS

The qualitative results revealed that a higher unhealthy diet score was positively associated with depressive symptoms, while a healthy diet was negatively associated with depressive symptoms. In the study that included adolescents with a clinical diagnosis of depression, the relationship between inflammatory dietary pattern tertiles and depression was attenuated after all covariates were adjusted for. The meta-analysis to evaluate the association between depressive symptoms and a posteriori dietary patterns found that the "healthy" dietary pattern decreased depressive symptoms in adolescents (OR: 0.69; 95% CI: 0.44, 0.95). There was no statistically significant association between depressive symptoms and "unhealthy" and "snacks" patterns (OR: 1.20 [95% CI: 0.95, 1.46]; OR: 1.20 [95% CI: 0.70, 1.48]) dietary patterns.

CONCLUSION

The results identified that a healthy dietary pattern decreased depressive symptoms in adolescents. However, considering the high heterogeneity and the low level of certainty of the evidence, these results should be interpreted with caution.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42020159921.

Relationship Between Fermented Food Consumption Patterns, hs-CRP, and Chronic Diseases Among Middle-Aged Koreans: Data from the 2015-2018 Korea National Health and Nutrition Examination

Background/Objectives: Fermented foods promote digestion and may help prevent chronic diseases. However, studies on their relationship with health indicators in Korea remain limited. This study aimed to identify fermented food consumption patterns among middle-aged Korean adults and to analyze their association with high-sensitivity C-reactive protein (hs-CRP) and chronic disease. Methods: This study analyzed 7111 adults aged 40-64 years from the 6th-7th Korea National Health and Nutrition Examination Survey (KNHANES, 2015-2018). hs-CRP values were categorized as <1 mg/L, 1-3 mg/L, and ≥3 mg/L. Latent profile analysis (LPA) classified fermented foods into 10 categories using Mplus 8.11, with LMR-LRT significance and entropy ≥ 0.7 determining the number of classes. Logistic regression analysis using SPSS 29.0 was conducted to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for hs-CRP and chronic disease (p < 0.05). Results: LPA identified four consumption patterns: (LFP), (FABP), (FDP), and (FGP). hs-CRP was highest in LFP (1.0 ± 1.2 mg/L), followed by FABP (0.8 ± 1.1 mg/L) and FDP and FGP (0.9 ± 1.2 mg/L) (p < 0.001). Compared to LFP, FGP had ORs of 0.810 (95% CI: 0.690-0.950, p < 0.005) for hypertension and 0.586 (95% CI: 0.459-0.747, p < 0.001) for diabetes. For dyslipidemia, ORs were 0.832 (95% CI: 0.720-0.962, p < 0.005) for FABP and 0.832 (95% CI: 0.719-0.962, p < 0.005) for FDP. Conclusions: This study classified fermented food consumption patterns and analyzed their association with hs-CRP and chronic disease. FGP and FDP showed lower inflammation and reduced odds of hypertension, diabetes, and dyslipidemia compared to LFP. These findings highlight the potential of healthy fermented food consumption patterns to support inflammation control and chronic disease prevention.

Combating Prenatal Depression with Diet: A Literature Review on the Association Between Mediterranean or Mediterranean-like Diet Adherence and the Incidence of Depression in Pregnant Women

Background/Objectives: The purpose of this review is to determine if high adherence to the Mediterranean Diet or Mediterranean-like Diet is associated with a decreased incidence of depression or depressive symptoms during pregnancy compared to low or no adherence. Methods: PubMed was used to search for articles. Inclusion criteria consisted of primary research articles from the past 5 years, participants that were pregnant and ages 18-50 years old, the intervention a Mediterranean or Mediterranean-like Diet, and the outcome prenatal depression or prenatal depressive symptoms. Results: Nine primary research studies including five cross-sectional, two longitudinal, one cohort study, and one randomized controlled trial were included in this review. Six of the nine studies reported significant associations between higher Mediterranean or Mediterranean-like Diet adherence and lower incidence of depression or depressive symptoms. Studies with larger sample sizes were more likely to have significant results. Conclusions: Other recent evidence suggests that high adherence to the Mediterranean or Mediterranean-like Diet may decrease the incidence of depression or depressive symptoms in pregnant women. However, there were mixed results reported in the studies included in this review. Thus, conducting further studies of adequate sample sizes, with a unified definition of the Mediterranean Diet in more diverse populations is imperative to further investigate this association.

Adherence to a Mediterranean diet and leisure-time physical activity are associated with reduced initiation of antidepressant, anxiolytic, antipsychotic and antiseizure drug use in older adults: a cohort study

BACKGROUND

We explored how adherence to the Mediterranean diet (MedDiet) and leisure-time physical activity (LTPA) impact psychoactive medication use in older adults.

METHODS

We assessed the cumulative MedDiet adherence and LTPA's impact on mental health medication initiation in older individuals at high risk of chronic disease. Associations between the cumulative average of MedDiet adherence (per one-point increase in the adherence score) and LTPA (per increase in 20 metabolic equivalents of task-minute/day [METs-min/day]) with drug initiation were assessed by multivariable Cox regressions. We explored non-linear exposure-outcome associations using smoothed cubic splines and the multiplicative interaction between MedDiet and LTPA.

RESULTS

A total of 5940-6896 participants (mean age 67, 58% women) over 4.2-4.7 years, each point increase in MedDiet adherence decreased the initiation of antidepressants by 23-28% (HR 0.72, 95% CI 0.67-0.77), anxiolytics (HR 0.75, 0.70-0.81), antipsychotics (HR 0.77, 0.65-0.91), and antiseizures (HR 0.77, 0.69-0.85). Associations for anxiolytics and antiseizures were strong at low MedDiet adherence levels. Relationships between LTPA and initiation of antidepressants and anxiolytics were linear in the lowest LTPA values (0-150 METs-min/day); every 20 METs-min/day increases were associated with 20% lower risk of initiating antidepressants (HR 0.80, 0.75-0.86) and 15% less risk in anxiolytics (HR 0.85, 0.79-0.90). Association with antiseizures was linear (+20 METs-min/day: HR 0.96, 0.94-0.99), and no associations were found for antipsychotics. High MedDiet adherence (≥10) and LTPA (≥150 METs-min/day) reduced psychoactive drug initiation by 42%-59%. Combination was additive for antidepressants, antipsychotics and antiseizures and synergistic for anxiolytics.

CONCLUSIONS

MedDiet and LTPA adherence reduced psychoactive drugs initiation in older adults.

Curvilinear association between cardiometabolic index and depressive symptoms in individuals aged 45 and older: a cross-sectional study of CHARLS

Objective

This research is aimed at investigating the association between the cardiometabolic index (CMI) and depressive symptoms in Chinese population of middle and older age, using data derived from the CHARLS study.

Methods

Using data from 7,800 participants in the 2011-2012 wave of the CHARLS cohort, this cross-sectional analysis concentrated on examining the association between CMI and depressive symptoms, assessed through CESD-10 scores. The study utilized multivariate logistic regression, multiple linear regression, and restricted cubic spline (RCS) models to investigate the link between CMI and depression, with subgroup analyses offering further insights. Sensitivity analyses included propensity score matching and data from 8,457 participants in the 2015-2016 CHARLS wave.

Results

In fully adjusted models, higher CMI was significantly associated with an elevated risk of depression, with participants having a CMI ≥ 0.594 showing a 162% higher risk compared to those with lower CMI. The RCS analysis identified a threshold at CMI = 0.594, where participants with CMI ≥ 0.594 had a 162% elevated possibility of depression in comparison to those with CMI < 0.594 [OR = 2.62, 95% CI: 2.36-2.91]. Sensitivity analyses, including propensity score matching and data from the 2015-2016 CHARLS wave, confirmed the robustness of the findings.

Conclusion

Our analysis demonstrates that elevated CMI levels are independently correlated with a heightened likelihood of experiencing depressive symptoms, highlighting the significance of metabolic interventions in mitigating depressive tendencies in middle-aged and older individuals.

Multiomics analysis reveals aberrant tryptophan-kynurenine metabolism and immunity linked gut microbiota with cognitive impairment in major depressive disorder

OBJECTIVE

Cognitive impairment occurs throughout the entire course of and affects the work and life of patients with major depressive disorder (MDD). The gut microbiota, kynurenine pathway (KP) and inflammatory response may have important roles in the mechanism of cognitive impairment in MDD patients. Consequently, our goal was to investigate the association among the gut microbiota, inflammation, KP, and cognition in MDD.

METHOD

We enrolled patients with MDD (N = 86) and healthy controls (HCs, N = 120) in this research. The study involved participant data regarding the levels of serum inflammatory factors (interleukin [IL]-1β, IL-4, IL-6, brain-derived neurotropic factor [BNDF], migration inhibitory factor [MIF], tumor necrosis factor [TNF]-α, vascular endothelial growth factor [VEGF]), gut microbiota and cognitive function (MCCB) were collected.

RESULTS

Patients demonstrated poorer cognitive function. Gut microbiota, such as Bacteroide, Prevotella, Faecalibacterium and Parabacteroides between MDDs and HCs were significantly different. Moreover, in patients with MDD, we found that different microbiomes were related to cognition and that Acidaminococcus was positively correlated with multiple domains of cognition. Allisonella and Acidaminococcus were significantly positively correlated with BDNF and negatively correlated with MIF. Alloprevotella, Blautia, and Megamonas were positively correlated with kynurenine/tryptophan (KYN/TRP). Acidaminococcus was negatively correlated with 3-hydroxykynurenine (3-HK). BDNF levels was significantly positive correlated with kynurenic acid (KA) and quinolinic acid (QA).

CONCLUSION

The results of the present study suggest that the gut microbiota is associated with cognitive function, cytokine levels and KP metabolism in patients with MDD; however, the mechanism of the interaction between cognition and gut microbiota in MDD patients require further investigation.

Impact of DASH and mediterranean diets on mood and happiness in young adult males: a cross-sectional study

OBJECTIVE

The association between the Mediterranean diet (MED) and the dietary approach to stop hypertension (DASH) with some mental disorders is well-documented. However, a consistent relationship with young adults as a vulnerable population has yet to be known. Therefore, we aimed to investigate the relation between Iranian young male adults' mood and happiness state with DASH/MED patterns.

RESULTS

Participants' mean age was 23.65 ± 1.74 years, within the age range of 18-28 years, and their BMI was 24.23 ± 3.82 kg/m². After adjusting for all covariates, those in the highest DASH tertile had 54% lower odds of poor mood compared to the lowest tertile (OR = 0.46; 95%CI: 0.24, 0.88). An inverse relationship was also found between DASH and low happiness scores (OR T3 vs. T1 = 0.51, 95%CI: 0.27, 0.96). No significant association was found between MED and mood or happiness. Therefore, results showed that participants who adhered more closely to the DASH diet were less likely to report being unhappy or having a poor mood. Further prospective studies are required to confirm these findings.

Association between healthy dietary pattern and common mental disorders in women: a cross-sectional population-based study

OBJECTIVES

Scientific evidence suggests an association between diet quality and the prevalence of common mental disorders (CMD) in women. Thus, this study aimed to investigate the association between a healthy dietary pattern and CMD among women.

METHODS

A cross-sectional population-based study was conducted on a representative sample of 1128 women, aged 20-69 years, residing in the urban area of São Leopoldo, RS, Brazil. A validated food frequency questionnaire was used to assess dietary intake. A healthy dietary pattern, primarily consisting of fruits and vegetables, was identified using principal component analysis. CMD were evaluated using the Self-Reporting Questionnaire (SRQ-20: score ≥ 8). Prevalence ratios (PR) with 95% confidence intervals (CI) were estimated using multivariate Poisson regression with robust variance.

RESULTS

The overall prevalence of CMD was 33.2% (95% CI: 30.6-36.1). After adjusting for potential confounding factors, a statistically significant inverse relationship between a healthy dietary pattern and CMD was observed. High adherence to a healthy dietary pattern was associated with a lower prevalence of CMD (PR = 0.74; 95% CI: 0.59-0.95; p = 0.017). Women with a higher score on the healthy dietary pattern were 26% less likely to have CMD.

CONCLUSIONS

This study highlights a significant inverse association between a healthy dietary pattern and CMD in women. A high prevalence of CMD was also observed in this population group. These findings underscore the importance of promoting healthy dietary intake to prevent psychiatric disorders.

The impact of the Mediterranean diet on alleviating depressive symptoms in adults: a systematic review and meta-analysis of randomized controlled trials

CONTEXT

High adherence to the Mediterranean diet (MD) has been associated with a reduced risk of depression in prospective cohort studies, but whether MD interventions are effective among adults with depression is uncertain.

OBJECTIVE

This study aimed to synthesize findings on the effects of MD interventions on the severity of depressive symptoms in adults with depression.

DATA SOURCES

PubMed, Cochrane CENTRAL, PsycINFO, Scopus, and Web of Science were systematically searched from database inception to March 2023. The Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines and the Cochrane recommendations were followed. We included randomized controlled trials (RCTs) comparing outcomes after MD interventions with outcomes for control conditions in adults with depressive disorders or depressive symptoms.

DATA EXTRACTION

Two authors extracted the data independently. The Sidik-Jonkman estimator, the I2 metric, and the prediction interval were used to estimate between-study heterogeneity. To determine the risk of bias and the certainty of evidence from RCTs, we used the Cochrane Collaboration's Risk of Bias 2 and Grades of Recommendation, Assessment, Development, and Evaluation tools, respectively.

DATA ANALYSIS

In total, 1507 participants (mean age range: 22.0 years-53.3 years) with depression were initially included in the 5 RCTs of this review. Compared with control conditions, MD interventions significantly reduced depressive symptoms among young and middle-aged adults with major depression or mild to moderate depressive symptoms (standardized mean difference: -0.53; 95% confidence interval: -0.90 to -0.16; I2 = 87.1%). The prediction interval ranged from -1.86 to 0.81. The overall risk of bias was within the range of "some concerns" to "high," while the certainty of evidence was low.

CONCLUSION

MD interventions appear to have substantial potential for alleviating depressive symptoms in people experiencing major or mild depression. However, to establish robust recommendations, there remains a need for high-quality, large-scale, and long-term RCTs.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42022341895.

Depression and Accelerated Aging: The Eveningness Chronotype and Low Adherence to the Mediterranean Diet Are Associated with Depressive Symptoms in Older Subjects

BACKGROUND AND OBJECTIVES

Depression often results in premature aging, which increases the risk of other chronic diseases, but very few studies have analyzed the association between epigenetic biomarkers of aging and depressive symptoms. Similarly, limited research has examined the joint effects of adherence to the Mediterranean diet (MedDiet) and chronotype on depressive symptoms, accounting for sex differences. Therefore, these are the objectives of our investigation in a Mediterranean population at high cardiovascular risk.

METHODS

We analyzed 465 older subjects (aged 55-75) with metabolic syndrome and assessed depressive symptoms by the Beck Depression Inventory (BDI-II). MedDiet adherence was measured with the 17-item MedDiet score, and chronotype with the Morningness-Eveningness Questionnaire (MEQ). Blood DNA methylation was analyzed, and epigenomic biomarkers of age acceleration were determined. We focused on the Dunedin Pace of Aging Computed from the Epigenome (DunedinPACE). We fitted multivariable models with interaction terms.

RESULTS

Prevalence of depression was statistically higher in women (p < 0.001). MedDiet adherence was strongly and inversely associated with depressive symptoms in the whole population (p < 0.01), while the MEQ score was inversely associated (p < 0.05). In the joint analysis, both MedDiet adherence and chronotype remained statistically associated with the BDI-II score (p < 0.05), showing additive effects. No interaction effects were observed. In women, a higher score in depressive symptoms was significantly associated with faster age acceleration (measured with the DunedinPACE biomarker). This association remained significant even after adjustment for MedDiet adherence and chronotype.

CONCLUSIONS

In older subjects with metabolic syndrome, the eveningness chronotype was associated with greater depressive symptoms, but a higher adherence to the MedDiet could potentially counteract the chronotype risk with additive effects. Women showed stronger associations, and importantly, we reported for the first time in this population that depressive symptoms were associated with accelerated aging.

Dietary fiber intake moderates the impact of blood cadmium on depression: a nationally representative cross-sectional study

BACKGROUND

Cadmium (Cd) is a very poisonous pollutant in the environment that has harmful implications on the neurological system. While high fiber intake is beneficial for mental health, it remains unknown whether the recommended basis for dietary fiber intake (DFI) (14 g/1000 kcal per day) can alleviate Cd-induced depression.

METHODS

The investigation employed data from the National Health and Nutrition Examination Survey (NHANES) conducted between the years 2005 and 2020. The research encompassed individuals who had information on blood Cd concentrations, two 24-hour dietary recalls, and depression diagnosis. We deployed weighted logistic regression analyses to estimate the association of exposure to Cd and DFI with depression risk.

RESULTS

The adjusted ORs (95% CI) for depression were 1.33 (95% CI: 1.08, 1.65) and 1.64 (95% CI: 1.38, 1.94) for the third and fourth quartiles of blood Cd concentrations, respectively (Ptrend < 0.001). Doubling DFI was connected with a 0.78-fold (95% CI: 0.71, 0.85) decrease in the risk of depression. Participants below recommended DFI levels had a greater depression risk with higher blood Cd concentrations: OR of 1.39 (95% CI: 1.11, 1.73) for the third and 1.67 (95% CI: 1.40, 1.98) for the fourth quartile. No significant association between Cd exposure and depression was perceived for participants meeting recommended DFI levels.

CONCLUSIONS

Higher blood Cd burden was associated with elevated depression risk, while recommended DFI could alleviate this effect. High-fiber dietary pattern may counteract the deleterious effect of environmental pollutants such as Cd on depression.

CLINICAL TRIAL NUMBER

Not applicable.

A personalised nutrition intervention for adolescent depression: a mixed-methods feasibility pilot study

Randomised controlled trials have demonstrated the benefit of diet modification to improve diet quality in the treatment of adult major depressive disorder (MDD). However, research examining nutritional interventions for adolescents with MDD is sparse. This pilot study examined the feasibility of a personalised nutrition intervention for adolescents with MDD. Ten adolescents with MDD and their parents recruited from a tertiary care setting participated in an 8-week, single-arm mixed-methods study. Feasibility was assessed using five criteria (demand, acceptability, implementation, adaptation and limited efficacy testing) alongside qualitative interviews. The intervention involved four bi-weekly virtual nutrition counselling sessions with a stepped approach to dietary change, menu planning, grocery delivery and educational eHealth messages. Study participants sought positive changes in diet, health and lifestyle for adolescents and family-wide benefits. Recruitment challenges included concerns about managing mood fluctuations, anticipated dietary restrictions and the potential time and effort required for diet adherence. Feedback based on interviews emphasised moderate to high acceptability, satisfaction with menu planning and counselling and recognition of the benefits of trying new foods and sustaining positive dietary changes beyond the study. Improvements in depression symptoms (Cohen's d = 0·36, 95 % CI (-0·24, 3·36)), parent food modeling (Cohen's d = 0·24, 95 % CI (-0·43, 1·16) and the family food environment (Cohen's d = 0·61, 95 % CI (-0·04, 2·61)) were observed. This nutrition intervention was feasible for adolescents with MDD and was acceptable to both parents and depressed adolescents. These preliminary data suggest that further examination of the intervention and its potential benefits on depression symptoms and family food dynamics are warranted.

The effects of MIND diet on depression, anxiety, quality of life and metabolic and hormonal status in obese or overweight women with polycystic ovary syndrome: a randomised clinical trial

Polycystic ovary syndrome (PCOS) is a common hormonal disorder in women of reproductive age, associated with increased risks of metabolic disorders, depression and reduced quality of life. This study examined the impact of the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet on mental health, PCOS-related quality of life (PCOSQ), anthropometric indices, hirsutism, and metabolic/hormonal parameters in women with PCOS. Total of 52 women with PCOS, aged between 18 and 45 years, were randomly assigned to either the low calorie MIND diet group or the control group. Anthropometric data, depression and anxiety scores, serum levels of gonadotropins (luteinizing hormone [LH], follicle-stimulating hormone [FSH]), PCOSQ, and Ferriman-Gallwey score were evaluated before and after the intervention. Outcomes were assessed at baseline and at the end of the 8-week follow-up period. After 8 weeks, the MIND diet significantly reduced depression (β -3·03; 95 % CI: [-5·36, -0·70]; P = 0·011) and anxiety (β -3·54; 95 % CI: [-6·60, -0·49]; P = 0·024) scores compared with the control group. The MIND diet group exhibited significant increases in the emotion (β 0·63; 95 % CI: [0·18, 1·08]; P = 0·007) and body hair (β 0·65; 95 % CI: [0·03, 1·28]; P = 0·04) domains of the PCOSQ compared to the control group. The changes in other parameters did not show significant differences between the two groups. Both the MIND diet and control groups showed improvements in weight and BMI, with a slight advantage for the MIND diet group. These findings suggest that the MIND diet may be beneficial for improving mental health and some aspects of PCOSQ in women with PCOS.

Dietary inflammatory index (DII) and sleep quality, duration, and timing: A systematic review

Sleep has strong inflammatory underpinnings and diet is one of the primary determinants of systemic inflammation. A systematic literature review was conducted to synthesize current research associating dietary inflammatory potential, as measured by the dietary inflammatory index (DII®) or the energy-adjusted DII (E-DII™) and sleep quality and duration. The National Library of Medicine (Medline), Web of Science, and PsycInfo databases were searched through March 2023. Studies must have used the DII/E-DII as the independent variable and sleep outcomes as dependent variables. Study characteristics, based on STROBE guidelines, were scored based on the presence of the recommendation. Out of the initial 14 studies identified, a total of 12 studies were included for data synthesis. In all 12 studies, more anti-inflammatory diets (i.e., low DII/E-DII scores) were associated with better sleep in at least one sleep domain (most often sleep efficiency and wake-after-sleep-onset). Among those studies with more rigorous diet and sleep measurements, such as dietary recalls and actigraphy, associations between DII/E-DII and sleep outcomes were stronger and more consistent compared to studies using primarily subjective assessments. More rigorous measurement of diet and sleep, especially those relating to sleep stage structure, should be considered in future studies with prospective designs.

Mediterranean diet-based intervention to improve depressive symptoms: analysis of the PREDIDEP randomized trial

BACKGROUND

The effect of an intervention based on Mediterranean diet on reducing recurrence risk or subsyndromal depressive symptoms in recovered depressed patients has not been explored.

METHODS

The PREDIDEP study was a two-year randomized trial designed to assess the effect of the Mediterranean Diet enriched with extra virgin olive oil on depression recurrence. At baseline and at four, eight, 16, 20, and 24 months of follow-up, depressive symptoms were evaluated through the Beck Depression inventory. Cox regression analysis was fitted to assess the role of dietary intervention on the risk of depression recurrence. Mixed effects linear models were used to assess changes in depressive subsyndromal symptoms according to the intervention.

RESULTS

After two years of intervention, the dietary intervention group (n = 103) compared to the control group (n = 93) showed no differences regarding depression recurrence risk as main outcome. As secondary outcomes, an improvement of depressive symptoms was yielded at four (-2.15; 95% CI = -4.00 to -0.29) and eight months (-2.42; 95% CI = -4.17 to -0.67) in the intervention group, with no changes in control group. Moreover, at 20 months, significant differences were found between groups (-3.35; 95% CI = -6.08 to -0.61).

CONCLUSIONS

An intervention with Mediterranean diet in patients with previous depressive episodes might contribute to the reduction of depressive subsyndromal symptoms.

Is there an "optimal" diet for prevention of inflammatory bowel disease?

Nutritional epidemiological studies have evolved from a focus of single nutrients to diet patterns to capture the protective role of healthy diets on chronic disease development. Similarly, in inflammatory bowel disease (IBD), a healthy diet may be protective against its development in individuals with genetic susceptibility, but the definitions of the optimal diet pattern deserve further exploration. Hence, this review article presents evidence, mainly from prospective cohort studies, for the role of diet quality based on adherence to dietary guidelines, traditional and modern diet patterns in the prevention of IBD. Findings from a limited number of studies on diet quality suggest that high diet quality scores are associated with lower risk of developing Crohn's disease, but the data are inconsistent for ulcerative colitis (UC). There are signals that a Mediterranean diet pattern reduces the risk of Crohn's disease but, again, the data are inconsistent and further studies are much needed. Finally, the evidence is conflicting regarding the role of food additives, with difficulties in the assessment of their intake, namely non-nutritive sweeteners and emulsifiers, precluding accurate assessment of a relationship with IBD risk. In contrast, emerging evidence for a role of ultra-processed food in the development of Crohn's disease but not UC is identified. Given the potential influence of diet quality, a Mediterranean diet and ultra-processed food intake on the risk of Crohn's disease, assessment and implementation of dietary advice for these patients need to be tailored. The search for an optimal diet for UC remains elusive and further research for increasing the evidence in the area is greatly needed.

Association between 29 food groups of diet quality questionnaire and perceived stress in Chinese adults: a prospective study from China health and nutrition survey

PURPOSE

Diet plays a fundamental role in promoting resilience against stress-related disorders. We aimed to examine the overall and sex-specific association between food groups and perceived stress in adults.

METHODS

We analyzed the prospective data of 7,434 adults who completed both the 2011 and 2015 surveys of the China Health and Nutrition Survey (CHNS). The Diet Quality Questionnaire (DQQ) was used to code all the food items of 2011 dietary intake into 29 food groups, and perceived stress in 2015 was measured using a 14-item perceived stress scale (PSS-14). Univariate analysis and logistic regression models were used to examine the relationship between food groups and perceived stress.

RESULTS

People who perceived a higher level of stress (PSS-14 total score > 25) made up 41.5% and 45.1% of the male and female groups, respectively (χ2 = 9.605, p = 0.002). Individuals with increased intake of food groups such as legumes, other vegetables, other fruits, yogurt, poultry, fish & seafood, fluid milk, and fruit juice were less likely to experience a higher level of psychological stress (OR range: 0.544-0.892, p < 0.05). Additionally, we found sex-specific associations between food groups and perceived stress. The difference in the proportion of food groups, such as fluid milk and fish & seafood, between the two stress groups in men was statistically significant (p < 0.025). In the female group, the distribution of eight food groups, like legumes and nuts & seeds, between the two stress groups was statistically significant (p < 0.025).

CONCLUSION

This study indicated that food groups were differentially associated with perceived stress.

Association of dietary saturated fatty acid intake with depression: mediating effects of the dietary inflammation index

Background

Diet and dietary inflammation play an important role in depression. The aim of this study was to assess the association of SFAs with depression risk and the mediating role of DII.

Method

Among 22, 478 U.S. adults (≥ 20, years old) according to the National Health and Nutrition Examination Survey (NHANES), univariate logistic regression, and multivariate logistic regression were used to evaluate the association between dietary intake of SFAs and the risk of depression. Dietary inflammation levels were evaluated using the DII. Mediation analysis was used to investigate the risk of DII and depression. The nonlinear relationship between SFAs and depression was assessed using restricted cubic spline (RCS).

Results

There was a significant difference in SFA 6.0 dietary intake between depression and non-depression individuals. After adjusting for potential confounders, multifactorial logistic regression results showed that SFA 8.0 (Q3 1.58 (1.09, 2.30), p-value = 0.017; Q4 1.55 (1.00, 2.42), p-value = 0.050) may increase the prevalence factor for depression, SFA 14.0 (Q3 0.67 (0.47, 0.94), p-value = 0.020) may decrease the risk of depression. There were sex and age differences in the effects of different subtypes of SFAs on depression. Dietary intake of SFA 12.0 content showed a nonlinear relationship with the risk of depression (p-value = 0.005). Furthermore, DII was recognized as a mediator of the association between SFAs and the risk of depression.

Conclusion

The findings suggest that dietary intake of SFAs is associated with the risk of depression in relation to the chain length of SFAs, and this may be due to the mediating effect of DII.

Exercise and Nutrition in the Mental Health of the Older Adult Population: A Randomized Controlled Clinical Trial

(1) Background: Global population aging is changing demographic structures and presents significant challenges for health systems, which must adapt to an increasingly elderly population. (2) Methods: The study employed a randomized controlled trial design with a total of 116 older adults aged 65 or older, randomly assigned to an experimental group (n = 57) undergoing a combined resistance program and Mediterranean diet program and a control group (n = 59) who did not receive any intervention. Anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale (HADS), sleep quality through the Pittsburgh Sleep Quality Index (PSQI), and perceived stress using the Perceived Stress Scale (PSS). (3) Results: Statistically significant improvements (p < 0.05) were observed both within and between groups in anxiety (Cohen's d = 0.38 and 0.78, respectively), depression (Cohen's d = 0.56 and 0.18, respectively), perceived stress (Cohen's d = 0.15 and 0.39, respectively), and in the PSQI domains: subjective sleep quality (Cohen's d = 1.01 and 0.53, respectively), sleep duration (Cohen's d = 0.112 and 0.53, respectively), sleep disturbances (Cohen's d = 1.92 and 0.95, respectively), use of medications (Cohen's d = 0.34 and 0.40, respectively), and the PSQI total score (Cohen's d = 0.68 and 0.49, respectively). No significant differences were observed in sleep latency or daytime dysfunction. (4) Conclusions: The results of the present study suggest that resistance intervention may be an effective therapeutic option to improve mental health and sleep quality in older adults aged 65 or older, offering a non-pharmacological approach to improving overall well-being in this demographic.

Folate supplementation as a beneficial add-on treatment in relieving depressive symptoms: A meta-analysis of meta-analyses

The results of meta-analyses investigating the role of folate on depression are conflicting. The aim of this umbrella meta-analysis was to obtain an overall effect and give a concise and resolving conclusion. International scientific databases including PubMed, Scopus, and Web of Science were searched up to Oct 2023. All observational and interventional meta-analyses investigating the role of folate in depression were included in the study. Random-effects model was employed to obtain pooled results. I 2 statistics and Cochrane Q test were used to assess the between-study heterogeneity. The quality of included meta-analyses was evaluated using the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR2) questionnaire. Overall 11 studies were included, of which 8 studies went under quantitative evaluation. The results indicated that folate supplementation significantly relieved depression symptoms [(SMD: -0.42; 95% CI: -0.57, -0.27, p < .001; I 2 = 0.0%, p-heterogeneity = 0.554) (WMD: -3.20; 95% CI: -4.00, -2.41, p < .001, I 2 = 14.8%, p-heterogeneity = 0.318)] with low levels of heterogeneity. Also, based on observational studies, folate insufficiency significantly increased the odds ratio of depression by 35% (OR:1.35; 95% CI: 1.27, 1.42, p < .001, I 2 = 8.7%, p-heterogeneity = 0.350). The findings support the fact that folate supplementation could be suggested as an efficacious and adjuvant agent in the alleviation of depression symptoms along with routine medications.

Relationship between serum apolipoprotein B and risk of all-cause and cardiovascular disease mortality in individuals with hypertension: a prospective cohort study

BACKGROUND

Dyslipidemia frequently coexists with hypertension in the population. Apolipoprotein B (ApoB) is increasingly considered a more potent predictor of cardiovascular disease (CVD). Abnormal levels of serum ApoB can potentially impact the mortality risk.

METHODS

The prospective cohort study employed data from the National Health and Nutrition Examination Survey (NHANES), which was performed between 2005 and 2016, with follow-ups extended until December 2019. Serum ApoB concentrations were quantified using nephelometry. In line with the NHANES descriptions and recommendations, the reference ranges for ApoB concentrations are 55-140 and 55-125 mg/dL for men and women, respectively. Participants were categorized into low, normal, and high ApoB levels. The low and high groups were combined into the abnormal group. In this study, all-cause mortality (ACM) and CVD mortality (CVM) were the endpoints. Survey-weighted cox hazards models were used for evaluating the correlation between serum ApoB levels and ACM and CVM. A generalized additive model (GAM) was employed to examine the dose-dependent relationship between ApoB levels and mortality risk.

RESULTS

After a median of 95 (interquartile range: 62-135) months of follow-up, 986 all-cause and 286 CVD deaths were recorded. The abnormal ApoB group exhibited a trend toward an elevated risk of ACM in relative to the normal group (HR 1.22, 95% CI: 0.96-1.53). The risk of CVM was elevated by 76% in the ApoB abnormal group (HR 1.76, 95% CI: 1.28-2.42). According to the GAM, there existed a nonlinear association between serum ApoB levels and ACM (P = 0.005) and CVM (P = 0.009).

CONCLUSIONS

In the US hypertensive population, serum Apo B levels were U-shaped and correlated with ACM and CVM risk, with the lowest risk at 100 mg/dL. Importantly, abnormal Apo B levels were related to an elevated risk of ACM and CVM. These risks were especially high at lower Apo B levels. The obtained findings emphasize the importance of maintaining appropriate Apo B levels to prevent adverse outcomes in hypertensive individuals.

A Narrative Review of the Association Between Healthy Dietary Patterns and Depression

The purpose of the present review is the investigation of healthy dietary patterns and diet quality in relation to depression risk. Nutritional psychiatry is to develop scientifically based research that defines the role of nutrition and nutrients in various aspects of mental health. Growing evidence from the field suggests that diet may play an important role in the prevention and/or treatment of depression. In contrast, there is evidence that unhealthy diets may increase the risk of depression. This emerging research suggests that dietary interventions could help prevent depression or be an alternative or adjunctive therapy for depression. The Mediterranean diet (MedDiet), the Dietary Approaches to Stop Hypertension (DASH) diet, and the vegetarian diet are examined in this review. The electronic databases PubMed, Scopus, and Google Scholar were searched for relevant studies published during the last five years. We found many results that support that healthy eating patterns (high in vegetables, fruits, whole grains, nuts, seeds, and fish, low in processed foods) are related to a reduction in the risk of depression. The most robust findings are related to MedDiet, where we also found several positive results for the DASH diet. Regarding the vegetarian diet, there are inconsistent reports. Furthermore, a consistent finding refers to a lower Dietary Inflammatory Index (DII) as associated with a lower depression risk. It has been observed that people suffering from depression have poorer nutritional quality, with lower fruit and vegetable intake. This observation may strengthen the argument that nutritional interventions should be incorporated as an important "pillar" in the multifactorial treatment of patients. However, more well-designed studies are needed to establish the relationship between dietary patterns and mental health. In particular, interventional, longitudinal studies could be more enlightening.

Dietary Habits and Depression in Community-Dwelling Chinese Older Adults: Cross-Sectional Analysis of the Moderating Role of Physical Exercise

BACKGROUND

Healthy diets and physical exercise, two modifiable lifestyle factors, are protective against depression in older adults. This study aimed to investigate whether physical exercise may influence the associations of dietary habits with depression in Chinese community-dwelling older adults.

METHODS

In the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey, 12,708 community-dwelling older adults aged ≥65 years were included for analyses. Older adults' dietary habits (including daily intake of food components such as fruits, vegetables, animal oil, and so on) and physical exercise were assessed. Depression was evaluated via the 10 item Center for Epidemiologic Studies Depression (CES-D-10) scale. The influences of physical exercise on the associations of dietary habits with depression were estimated using logistic regression models adjusted for confounders.

RESULTS

Older adults who took physical exercise had a significantly decreased probability of depression (adjusted OR = 0.73, p < 0.001). As for dietary habits, the intake of fruits, vegetables, eggs, nut products, mushrooms or algae, and vitamins were inversely associated with the prevalence of depression (adjusted ORs = 0.61-0.81; p-values: from <0.001 to 0.025), while animal oil was positively associated with it (adjusted OR = 1.52, p < 0.001). When stratified by physical exercise, older adults who ate fruits or vegetables had consistent decreased risk of depression, no matter whether they took physical exercise or not (adjusted ORs = 0.52-0.70), while the intake of eggs, nut products, and vitamins were inversely associated, and animal oil was consistently positively associated with depression only in older adults who did not take physical exercise (adjusted ORs = 0.79, 0.68, 0.63, and 1.67, respectively).

CONCLUSIONS

Physical exercise may conceal the potential protective effects of some healthy dietary habits in terms of depression and counteract the detrimental effects of the unhealthy habits. Some dietary habits may be considered as alternative protective measures for depression in community-dwelling older adults when physical exercise cannot be performed.

Association between healthy eating and depression symptoms among Chinese older adults: A cross-sectional study based on the Chinese Longitudinal Healthy Longevity survey

Introduction

This study aimed to assess the relationship between the healthy eating index (HEI) and depression symptoms in an older adult population using the Chinese Longevity Health Survey.

Methods

The HEI was constructed based on the frequency of intake of 13 dietary variables, with higher scores indicating better diet quality. Depression symptoms was assessed by the Center for Epidemiologic Studies Depression-10 scale. We used multivariate binary logistic regression to explore the association between the HEI and depression symptoms and reported as odds ratio (OR) and 95 % confidence interval (95 % CI).

Results

A total of 12,078 older adults were included. The average HEI for this group of older adults was 26.4 ± 7.1. After adjusting for covariates, compared with participants in the lowest quartile of a healthy eating index, those in the second to the fourth quartile group had a 0.93- (95 % CI: 0.83 to 1.03), 0.84- (95 % CI: 0.75 to 0.95) and 0.69- (95 % CI: 0.62 to 0.77) fold risk of depression symptoms, respectively. Restricted cubic spline curves showed that the risk of depression symptoms decreased with increasing HEI, especially above 26, and for each unit increase in the HEI, the risk of depression symptoms in older adults decreased by 3 % (OR = 0.97; 95 % CI: 0.96 to 0.99).

Conclusions

This study found an association between higher levels of the HEI and reduced risk of depression symptoms in older Chinese adults. This result emphasizes the need to focus on dietary diversity in older adults to promote healthy aging.

Adherence to a Mediterranean Diet Is Inversely Associated with Anxiety and Stress but Not Depression: A Cross-Sectional Analysis of Community-Dwelling Older Australians

Diet quality may be an important modifiable risk factor for mental health disorders. However, these findings have been inconsistent, particularly in older adults. We explored the independent associations between adherence to a Mediterranean diet (MedDiet) and severity of symptoms related to depression, anxiety and stress in older adults from Australia. This was a cross-sectional analysis of older Australians ≥ 60 years. MedDiet adherence was assessed using the Mediterranean Diet Adherence Screener (MEDAS), and the Depression, Anxiety and Stress Scale (DASS-21) was used to assess the severity of negative emotional symptoms. A total of n = 294 participants were included in the final analyses (70.4 ± 6.2 years). Adherence to a MedDiet was inversely associated with the severity of anxiety symptoms (β = -0.118; CI: -0.761, -0.012; p = 0.043) independent of age, gender, BMI, physical activity, sleep, cognitive risk and ability to perform activities of daily living. Furthermore, MedDiet adherence was inversely associated with symptoms of stress (β = -0.151; CI: -0.680, -0.073; p = 0.015) independent of age, gender, BMI, physical activity and sleep. However, no relationship between MedDiet adherence and depressive symptoms was observed. We showed that adherence to a MedDiet is inversely associated with the severity of symptoms related to anxiety and stress but not depression. Exploring these findings with the use of longitudinal analyses and robust clinical trials are needed to better elucidate these findings in older adults.

Psychological aspects of rehabilitation nutrition: A position paper by the Japanese Association of Rehabilitation Nutrition (secondary publication)

Psychological aspects of rehabilitation nutrition affect physical, cognitive, and social rehabilitation nutrition. When depression is recognized, not only pharmacotherapy and psychotherapy, but also non-pharmacological therapies such as exercise, nutrition, psychosocial, and other interventions can be expected to improve depression. Therefore, accurate diagnosis and intervention without overlooking depression is important. Psychological aspects of preventive rehabilitation nutrition is also important because depression can be partially prevented by appropriate exercise and nutritional management. Even in the absence of psychological negatives, increasing more psychological positives from a positive psychology perspective can be useful for both patients and healthcare professionals. Positive rehabilitation nutrition interventions can increase more psychological positives, such as well-being, through cognitive-behavioral therapy and mindfulness on their own, as well as through interventions on environmental factors. Consequently, physical, cognitive, and social positives are also expected to be enhanced.

Dietary Inflammatory Potential, Inflammation-Related Lifestyle Factors, and Incident Anxiety Disorders: A Prospective Cohort Study

It is unclear whether diet-associated inflammation is related to the development of anxiety disorders. We aimed to investigate the association between energy-adjusted dietary inflammatory index (E-DII) scores and the incidence of anxiety disorders, and explore the joint effects of E-DII scores with other inflammatory lifestyles in enhancing anxiety risk. In the UK Biobank Study of 96,679 participants, baseline E-DII scores were calculated from the average intake of at least two 24 h dietary recalls. Multivariable-adjusted Cox models were used to evaluate the associations between E-DII scores and the incidence of total anxiety disorders, and primary types and subtypes; additive and multiplicative interactions of a pro-inflammatory diet and seven inflammatory lifestyles were examined. After a median follow-up of 9.4 years, 2785 incident cases of anxiety disorders occurred. Consuming a pro-inflammatory diet was significantly associated with a higher risk of total anxiety disorders (HRQ4vsQ1 = 1.12, 95% CI = 1.00-1.25), and positive associations were consistently identified for primary types and subtypes of anxiety disorders, with HRs ranging from 1.08 to 1.52, and were present in women only. Both additive and multiplicative interactions of current smoking and a proinflammatory diet on total anxiety risk were identified. A proinflammatory diet was associated with a higher incidence of anxiety disorders, and current smoking may synergize with a proinflammatory diet to promote anxiety risk, particularly among women.

Healthy dietary patterns and the risk of individual chronic diseases in community-dwelling adults

It is unclear regarding associations of dietary patterns with a wide range of chronic diseases and which dietary score is more predictive of major chronic diseases. Using the UK Biobank, we examine associations of four individual healthy dietary scores with the risk of 48 individual chronic diseases. Higher Alternate Mediterranean Diet score is associated with a lower risk of 32 (all 8 cardiometabolic disorders, 3 out of 10 types of cancers, 7 out of 10 psychological/neurological disorders, 5 out of 6 digestive disorders, and 9 out of 14 other chronic diseases). Alternate Healthy Eating Index-2010 and Healthful Plant-based Diet Index are inversely associated with the risk of 29 and 23 individual chronic diseases, respectively. A higher Anti-Empirical Dietary Inflammatory Index is associated with a lower risk of 14 individual chronic diseases and a higher incidence of two diseases. Our findings support dietary guidelines for the prevention of most chronic diseases.

The Association between Vegan, Vegetarian, and Omnivore Diet Quality and Depressive Symptoms in Adults: A Cross-Sectional Study

Dietary patterns and depressive symptoms are associated in cross-sectional and prospective-designed research. However, limited research has considered depression risk related to meat-based and plant-based dietary patterns. This study explores the association between diet quality and depressive symptoms across omnivore, vegan, and vegetarian dietary patterns. A cross-sectional online survey utilised the Dietary Screening Tool (DST) and the Centre for Epidemiological Studies of Depression Scale (CESD-20) to measure diet quality and depressive symptoms, respectively. A total of 496 participants identified as either omnivores (n = 129), vegetarians (n = 151), or vegans (n = 216). ANOVA with Bonferroni post hoc corrections indicates that dietary quality was significantly different between groups F(2, 493) = 23.61, p < 0.001 for omnivores and vegetarians and omnivores and vegans. Diet quality was highest in the vegan sample, followed by vegetarian and omnivore patterns. The results show a significant, moderately negative relationship between higher diet quality and lower depressive symptoms (r = -0.385, p < 0.001) across groups. Hierarchical regression showed that diet quality accounted for 13% of the variability in depressive symptoms for the omnivore sample, 6% for vegetarians, and 8% for vegans. This study suggests that diet quality in a meat-based or plant-based diet could be a modifiable lifestyle factor with the potential to reduce the risk of depressive symptoms. The study indicates a greater protective role of a high-quality plant-based diet and lower depressive symptoms. Further intervention research is needed to understand the bi-directional relationship between diet quality and depressive symptoms across dietary patterns.

Association between Psychological Disorders, Mediterranean Diet, and Chronotype in a Group of Italian Adults

Mental health conditions are a significant contributor to the global burden of disease. The aim of this study was to explore the association between psychological disorders, Mediterranean diet (MD), and chronotype. A total of 344 participants (74% women) with a mean age of 33.5 ± 13 years were recruited. According to the Depression Anxiety Stress Scale (DASS-21) score, 22% of participants had symptoms of depression, 23% anxiety, and 10% stress. The assessment of MD adherence through the Medi-Lite score revealed that participants with psychological disorders had significantly (p < 0.05) lower MD adherence than those without these conditions. Furthermore, less than 10% of the subjects with at least one symptom reported consuming the optimal amount of fruit and vegetables, while 72% showed excessive consumption of meat and meat products. Regarding chronotype, evening subjects reported the lowest MD adherence and the highest prevalence of all three psychological disorders analyzed. A multivariate analysis showed that female gender, age, being unmarried/single, sedentary lifestyle, and low MD adherence were associated with a significantly higher risk of depression, anxiety, and stress. Future studies are needed to explore the relationship between mental health and risk factors to improve personal and global population health.