The relationship between a plant-based diet and mental health: Evidence from a cross-sectional multicentric community trial (LIPOKAP study)

Association between plant-based diets and depression in older adults with heart disease: the mediating role of sleep disturbances

Background

Depression is not uncommon among older adults with heart diseases and is related to poor prognosis at clinical setting. We aim to explore the association between plant-based diets and depression in older adults with heart disease and further investigate the mediating role of sleep disturbances in this relationship.

Methods

A cross-sectional sample of 2039 older adults with heart diseases were recruited from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). Each individual completed assessments on dietary frequency, depression, sleep quality and duration. Plant-based diet index (PDI), healthy plant-based diet index (hPDI) and unhealthy plant-based diet index (uPDI) were calculated. Logistic regression models and restricted cubic spline curves (RCS) were employed to explore the relationship between plant-based diets and depression in older adults with heart disease. Meanwhile, mediation analysis was used to investigate the mediating roles of sleep quality and sleep duration.

Results

The higher the PDI (OR: 0.56, 95% CI: 0.36-0.88) and the hPDI (OR: 0.39, 95% CI: 0.24-0.62), the lower the risk of depression in older adults with heart disease. Conversely, the higher the uPDI, the higher the risk of depression (OR: 1.76, 95% CI: 1.07-2.92). RCS further confirmed a negative linear dose-response relationship between PDI, hPDI and depression in older adults with heart disease, and a positive trend was found between uPDI and depression. Notably, sleep quality (Indirect effect: -0.031, mediated proportion: 61%) partially mediated the relationship between PDI and depression. In the sex-based subgroup analysis, uPDI was only associated with a higher risk of depression in females.

Conclusion

This is the first study to suggest a significant negative relationship between plant-based diets and depression in older adults with heart disease. Sleep quality plays a mediating role in the association between plant-based diets and depression. Optimizing the dietary structure and improve sleep quality may help reduce the risk of depression in older adults with heart disease.

Healthy Moms, Healthy Babies: Culinary and Lifestyle Medicine for PCOS and Preconception Health

Purpose of the Research: Women's reproductive health issues represent a major source of burden to quality of life, productivity, and health care cost, with uneven access to care. Foundational interventions based on lifestyle and food as medicine hold promise as one equitable way to improve individual and family health. In this paper, we summarize the lifestyle and culinary medicine approaches to two of the most common reproductive health diagnoses, polycystic ovary syndrome (PCOS) and infertility. Major findings: For women with PCOS and/or infertility, an overall healthy eating pattern, including a whole-food plant-based or Mediterranean diet, carries clear health benefits. Exercise is of benefit in the PCOS population, and likely so for infertility patients as well. Both diagnoses are risk factors for anxiety and/or depression, and so more attention to mental health and behavioral strategies is needed. Given these findings, the notion of lifestyle interventions holds promise, but studies are overall mixed. Conclusions: PCOS and infertility can respond well to lifestyle and culinary interventions. These approaches, currently underutilized, can be implemented widely with minimal cost, and can also improve obstetric, neonatal, and child health outcomes via epigenetic phenomena. More research is needed to elucidate the best target populations and delivery methods for such interventions.

Exploring Plant-Based Nutrition for Patients with Substance Use Disorders: A Scoping Review of Dietary Intake and Potential Applications

BACKGROUND

Substance use disorders (SUDs) represent a significant global public health challenge, with affected individuals often exhibiting poor dietary habits, nutritional deficiencies, and compromised mental and physical health. This scoping review evaluates existing literature on dietary intake in individuals with SUDs, focusing on the potential benefits of plant-based dietary interventions for improving nutritional status and supporting recovery.

METHODS

A scoping review was conducted following PRISMA guidelines. Four databases were searched using PICO-based terms, targeting studies assessing dietary intake in patients with SUD, particularly plant-based interventions. Inclusion criteria were studies reporting macro- and micronutrient intake among patients with SUD, while studies lacking direct dietary intake data were excluded. Study quality was appraised using the STROBE checklist.

RESULTS

The search yielded 1142 potential articles, with 6 meeting inclusion criteria (4 from the United States and 2 from Iran). Patients with SUD exhibited significant deficiencies in iron (-16.8%, P = .04), folate (-15.0%, P = .04), and vitamins E and A, alongside diets high in simple carbohydrates and unhealthy processed foods. Plant-based dietary interventions were associated with improved Healthy Eating Index scores (P < .001), increased resilience (+31%, P = .031), and enhanced self-esteem (P = .043). High energy intake and low multivitamin use were reported among methadone-treated patients, emphasizing the need for dietary interventions to address nutrient gaps and support recovery.

CONCLUSION

Plant-based dietary interventions may offer a promising strategy to address nutrient deficiencies and improve mental health outcomes in patients with SUD. However, studies are limited, with small sample sizes and variability in dietary assessments. Future research, including randomized controlled trials, is needed to establish the efficacy and feasibility of integrating plant-based nutrition into SUD treatment programs. Addressing barriers such as socioeconomic challenges and food access is also crucial for implementing effective dietary interventions.

Nutritional Psychology: Review the Interplay Between Nutrition and Mental Health

Nutritional psychology is a burgeoning field that examines the intricate relationship between nutrition and mental health. This concept, its historical development, and its current significance in understanding the complex interplay between diet and psychological well-being are explored in this article. The influence of various nutrients on mental health, the role of dietary patterns, and the impact of nutrition on specific mental disorders are examined. Highlighted are the potential mechanisms underlying the nutrition-mental health connection, and the implications for clinical practice and public health interventions are discussed. The discussion in this article underscores the importance of considering nutrition as essential in mental health promotion and treatment.

The association of the Prime Diet Quality Score (PDQS) with depression and anxiety symptoms: the Isfahan functional disorders (ISFUN) cohort study

BACKGROUND

Due to scarce epidemiologic data regarding the Prime Diet Quality Score (PDQS) and mental health disorders, this study aimed to investigate the association of PDQS with depression and anxiety symptoms in Iranian adults.

METHODS

This cross-sectional analysis was performed using the baseline data collected for the Isfahan functional disorders (ISFUN) cohort study. ISFUN was established in 2017 and enrolled apparently healthy adults, aged 18-65 years in Isfahan, Iran. Information on usual dietary intakes was collected using a validated Dish-based, 106-item food frequency questionnaire. The severity of depression and anxiety was assessed using a validated Iranian version of the Hospital Anxiety and Depression Scale.

RESULTS

A total number of1892 participants were enrolled in the present study. In total, 54.50% of subjects were female. In the fully adjusted model, participants with PDQS lower than median compared with those with PDQS higher than median had higher risk of depression (OR =   1.62; 95% CI: 1.11, 2.37) and anxiety (OR: 1.57; 95% CI: 1.08, 2.27). In stratified analysis by sex, males with PDQS lower than median compared with those with PDQS higher than median had greater risk for depressive (OR: 1.57) and anxiety symptoms (OR =   1.52). However, in females, no significant association was found between PDQS and odds of depression, and anxiety in the fully adjusted model.

CONCLUSION

We found evidence indicating a significant inverse association between PDQS and depression and anxiety symptoms among Iranian adults. Further studies, in particular with prospective design, are required to confirm these findings.

Impact of Vegan and Vegetarian Diets on Neurological Health: A Critical Review

BACKGROUND/OBJECTIVES

The global shift towards vegan and vegetarian diets has garnered attention for their ethical, environmental, and potential health benefits. These diets are often rich in phytonutrients and antioxidants, which have been associated with lower levels of inflammatory markers, such as C-reactive protein (CRP) and interleukin-6 (IL-6), suggesting a potential protective effect against systemic inflammation and oxidative stress. However, despite these benefits, concerns remain regarding their impact on neurological health due to the possible deficiencies of critical nutrients such as vitamin B12, DHA, EPA, and iron. This review critically evaluates the influence of these dietary patterns on neurological outcomes, emphasizing their nutritional composition, potential deficiencies, and their interplay with inflammation and oxidative stress.

METHODS

A systematic review of the literature published between 2010 and 2023 was conducted, focusing on studies that explore the relationship between vegan and vegetarian diets and neurological health. Key nutrients such as vitamin B12, omega-3 fatty acids, iron, and zinc were analyzed alongside antinutritional factors and their effects on the nervous system.

RESULTS

Evidence suggests that vegan and vegetarian diets, when well planned, can be rich in phytonutrients and antioxidants, which have been associated with lower levels of inflammatory markers, such as C-reactive protein (CRP) and interleukin-6 (IL-6). These findings indicate a potential role in reducing systemic inflammation and oxidative stress, both of which are linked to neurodegenerative diseases. However, deficiencies in critical nutrients such as vitamin B12, DHA, EPA, and iron have been consistently associated with an increased risk of cognitive decline, mood disturbances, and neurodegenerative disorders. Additionally, the presence of antinutritional factors like phytates and oxalates may further impair nutrient absorption, necessitating careful dietary planning and supplementation.

CONCLUSIONS

While plant-based diets provide anti-inflammatory and antioxidant benefits, their neurological implications depend on nutrient adequacy. Proper planning, supplementation, and food preparation techniques are essential to mitigate risks and enhance cognitive health. Further research is needed to explore long-term neurological outcomes and optimize dietary strategies.

Plant-based eating pattern and psychological symptoms: a cross-sectional survey among patients with migraine

OBJECTIVES

The present study evaluated the association between plant-based diet index (PDI) and psychological symptoms, including depressive symptoms, stress, and anxiety among Iranian women diagnosed with migraine headaches.

METHODS

A cross-sectional study was conducted on 262 patients with migraine (aged 20-50 years; body mass index, 18.5-30 kg/m²). Three versions of the PDI were calculated: overall PDI, healthy PDI (hPDI), and unhealthy PDI (uPDI) based on dietary data collected via a 168-item food frequency questionnaire (FFQ). Psychological symptoms, including depressive symptoms, anxiety, and stress, were assessed using the Depression, Anxiety, Stress Scale-21 (DASS-21) questionnaire.

RESULTS

After adjustment for potential confounders, patients in the highest tertile of the PDI showed a lower risk of depressive symptoms [odds ratio (OR) = 0.41, 95% confidence interval (CI): 0.22, 0.77]. Furthermore, inverse associations were evident between the PDI score and the risk of stress (OR = 0.46, 95% CI: 0.24, 0.85).

DISCUSSION

Higher adherence to a plant-based eating pattern is associated with a reduced risk of psychological symptoms. However, future longitudinal studies and clinical trials should replicate our observations and delineate the underlying mechanisms driving these associations.

Depression, Anxiety, Emotional Eating, and Body Mass Index among Self-Reported Vegetarians and Non-Vegetarians: A Cross-Sectional Study in Peruvian Adults

Background: Vegetarianism is commonly associated with various health benefits. However, the association between this dietary regimen and aspects of mental health remains ambiguous. This study compared the symptoms of depression and anxiety, emotional eating (EmE), and body mass index (BMI) in Peruvian vegetarian and non-vegetarian adults. Methods: A cross-sectional study was conducted on 768 Peruvian adults, of whom 284 (37%) were vegetarians and 484 (63%) were non-vegetarians. The Depression Patient Health Questionnaire-2 (PHQ-2), Generalized Anxiety Disorder Scale-2 (GAD-2), and an EmE questionnaire were applied; additionally, the BMI was calculated. Simple and multiple linear regression and Poisson regression models with robust variance were used to evaluate the association between depression, anxiety, EmE, and BMI with dietary patterns. Results: The vegetarians (Adjusted Prevalence Ratio [PR] = 0.24, 95% CI 0.16-0.31; p < 0.001) reported more depressive symptoms than the non-vegetarians. This trend persisted for anxiety, with an adjusted PR of 0.17 (95% CI: 0.01-0.29; p = 0.012). However, the vegetarians (adjusted PR = -0.38, 95% CI: -0.61--0.14; p < 0.001) reported lower EmE scores compared to the non-vegetarians. Likewise, the vegetarians had a lower mean BMI than the non-vegetarians (B = -0.16, 95% CI: -0.21--0.08; p < 0.001). Conclusions: Vegetarian diets are associated with increased symptoms of depression and anxiety, as well as lower EmE and BMI scores. Further longitudinal studies are needed to elucidate these associations and determine causality and the underlying mechanisms involved.

The associations between plant-based dietary indices with depression and quality of life and insomnia among Iranian adolescent girls in 2015

Although previous research has explored the link between plant-based diets and mental health outcomes, there has been limited study on the quality levels of plant foods in this context. This study was conducted on 733 adolescent girls from cities in northeastern Iran. The validated Iranian version of the Insomnia Severity Index, SF-12v2 questionnaire and Persian version of the Beck Depression Inventory used to assess insomnia and poor quality of life (QoL) and depression, respectively. Dietary intakes assessed using a valid and reliable food frequency questionnaire. The association of scores of plant based dietary index (PDI) and poor QoL, depression and insomnia explored by binary logistic regression. The unadjusted model showed subjects in the highest quartile of healthy PDI had lower chances of insomnia than those in the lowest quartile (OR: 0.50; 95% CI 0.27-0.91, P = 0.024). The association persisted across various adjusted models. Subjects in the highest quartile of unhealthy PDI (uPDI) had higher chances of depression than those in the lowest quartile (OR: 1.83; 95% CI 1.09-3.08, P = 0.022). The significance of the association was maintained after adjusting for other confounders. A healthy plant-based dietary index is associated with a lower odds of insomnia. An unhealthy plant-based dietary index was associated to an increased chance of depression. Findings need to be confirmed by future studies.

Association of plant-based dietary patterns with depression and anxiety symptoms in Chinese older adults: A nationwide study

BACKGROUND

The associations of plant-based dietary patterns with depression and anxiety symptoms among older adults have not been extensively studied. Therefore, the purpose of this study was to examine these associations in Chinese older adults.

METHODS

Data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) was employed in the present study. The simplified food frequency questionnaire was used to assess the overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI). The Center for Epidemiologic Studies Depression Scale-10 (CES-D-10) was used to evaluate depression symptoms, and the Generalized Anxiety Disorder Scale-7 (GAD-7) was used to assess anxiety symptoms. This study employed logistic regression and linear regression to examine the associations between plant-based dietary patterns and symptoms of depression and anxiety.

RESULTS

This study included 11,971 older adults, with a mean age of 83.23 ± 11.10 years. The results indicated that PDI and hPDI were negative associated with depression symptoms (adjusted β -0.09, 95 % CI -0.11, -0.07) (adjusted β -0.09, 95 % CI -0.11, -0.07) and anxiety symptoms (adjusted β -0.03, 95 % CI -0.04, -0.02) (adjusted β -0.04, 95 % CI -0.05, -0.02), while uPDI was positive associated with depression symptoms (adjusted β 0.09, 95 % CI 0.07, 0.11) and anxiety symptoms (adjusted β 0.04, 95 % CI 0.03, 0.05).

CONCLUSIONS

The findings from this study have the potential to promote healthy dietary patterns in older adults, and may have implications for the prevention and management of depression and anxiety in this population.

Plant-Based Diet Indices and Their Association with Frailty in Older Adults: A CLHLS-Based Cohort Study

Within the realm of aging, the nexus between diet and health has garnered considerable attention. However, only select studies have amalgamated insights into the correlation between plant and animal food consumption and frailty. Our aim was to appraise the connections between the overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI) and frailty in the elderly, utilizing data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). This cohort study drew upon CLHLS data spanning from 2008 to 2018. The PDI, hPDI, and uPDI were gauged using a simplified food frequency questionnaire (FFQ). A frailty index, encompassing 35 variables across major health domains, was formulated. Cox proportional hazard models were employed to scrutinize the associations between the three plant-based dietary indices and frailty in older adults, including an exploration of gender disparities in these associations. A cohort of 2883 study participants was encompassed, with 1987 (68.9%) observed to be either frail or in the pre-frail stage. The Cox model with penalized spline exhibited linear associations of PDI, hPDI, and uPDI with the frailty index. Following covariate adjustments, it was discerned that older adults situated in the highest quartiles of PDI (HR = 0.86, 95% CI: 0.77-0.95) and hPDI (HR = 0.83, 95% CI: 0.74-0.93) experienced a 14% and 17% diminished risk of frailty compared to those in the lowest quartiles of PDI and hPDI, respectively. Conversely, when contrasted with those in the lowest quartile of uPDI, older adults adhering to the highest tertile of uPDI exhibited a 21% elevated risk of frailty (HR = 1.21, 95% CI: 1.08-1.36), with both associations achieving statistical significance (p < 0.01). Moreover, additional subgroup analyses revealed that the protective effects of PDI and hPDI against frailty and the deleterious effects of uPDI were more conspicuous in men compared to women. To forestall or decelerate the progression of frailty in the elderly, tailored dietary interventions are imperative, particularly targeting male seniors.