Independent and combined associations of sugar-sweetened beverage consumption, TV viewing, and physical activity with severe depressive symptoms among 59,402 adults

Association between health-enhancing physical activity and the social factors, lifestyle and dietary characteristics

The World Health Organization (WHO) recommends minimum of 150 minutes of moderate intensity aerobic physical activity or 75 minutes of vigorous intensity aerobic physical activity along with at least two sessions of muscle strengthening exercises per week. Compliance with these recommendations is classified as Health Enhancing Physical Activity (HEPA). The aim of this study was to analyze the association between the HEPA and the social factors, lifestyle and dietary characteristics. We conducted the secondary analyses of the data from the Serbian National Health Survey 2019, on 12067 adult participants classified in two groups: with HEPA and without HEPA based on the compliance with the WHO recommendations. Prevalence of HEPA was 3.3% (394/12067). Multivariate logistic regression analysis showed positive association between HEPA and male sex (OR: 4.25, 95% CI: 2.68-6.73), average (OR: 3,01, 95% CI: 1.13-8.04), good (OR: 3.10, 95% CI: 1.21-7.94) and very good (OR: 4.64, 95% CI: 1.82-11.84) income quintile being single (OR: 1.85, 95% CI: 1.16-2.95), the number of portions of fruits per day (OR: 1.29, 95% CI: 1.09-1.53), the frequency fresh fruit/vegetable juice consumption (OR: 1.20, 95% CI: 1.02-1.40), and being non-smoker (OR: 1.67, 95% CI: 1.03-2.73). There was a negative association between HEPA and age (OR: 0.96, 95% CI: 0.95-0.98), BMI (OR: 0.94, 95% CI: 0.88-1.00), average self-rated health (OR: 0.18, 95% CI: 0.12-0.60), and the frequency of non-alcoholic beverages consumption (OR: 0.75, 95% CI: 0.62-0.89). Since only a small percentage of the adult population in Serbia meets the WHO recommendations for physical activity, action is required. This should involve creating future strategies and policies, as well as initiatives focused on education and raising awareness about the importance of physical activity and health.

Relationship between the number of lost teeth and the occurrence of depressive symptoms in middle-aged adults: a cross-sectional study

BACKGROUND

Many recent studies suggest the existence of a relationship between oral health and the occurrence of depressive symptoms. The aim of this study was to assess the relationship between the number of lost teeth and the occurrence of depressive symptoms in middle-aged adults.

METHODS

An analysis was performed on the data obtained from the PONS project (POlish-Norwegian Study), conducted in the Świętokrzyskie Province in Poland in 2010-2011. The research material included the cross-sectional data of 11,901 individuals aged 40-64 years (7967 women). Depressive symptoms, used as outcome variables, were assessed with a questionnaire. The participants provided the responses to questions concerning the occurrence of eight symptoms over the last 12 months. The answers were scored as 1 point or 0 points. The participants were divided into three tercile groups based on their total scores: no or mild (0-2 points), moderate (3-5 points), and severe depressive symptoms (6-8 points). The self-reported number of lost teeth was analysed according to the following categories: 0-4, 5-8, 9-27, and a complete lack of natural teeth. Multivariable logistic regression analysis for depressive symptoms was used in relation to the number of lost teeth. The following covariates were included in the adjusted model: age, sex, place of residence, education, marital status, BMI, diabetes status, stressful life events in the last year, use of antidepressants, smoking, and sugar and sweet consumption.

RESULTS

The likelihood of both moderate (OR = 1.189; 95%CI: 1.028-1.376; p < .020) and severe (OR = 1.846; 95%CI: 1.488-2.290; p < .001) depressive symptoms showed the strongest relationship with a total lack of natural teeth. A loss of more than 8 natural teeth was also significantly associated (OR = 1.315; 95%CI: 1.075-1.609; p < .008) with the occurrence of severe depressive symptoms.

CONCLUSIONS

The loss of natural teeth was positively related to the occurrence of depressive symptoms in middle-aged adults. Thus, there is an urgent need to intensify stomatological prophylaxis, education and treatment for middle-aged individuals.

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.

Magnitude of sugar-sweetened beverage consumption and associated factors among women aged 15-49 years old in two Sub-Saharan African countries

BACKGROUND

The consumption of Sugar-Sweetened Beverages (SSBs) has been linked to the global epidemic of obesity and chronic disease. Following the economic growth, urbanization, and attractive market for beverage companies, the consumption of SSBs is a rising public health challenge in low and middle-income countries. Hence, this study aimed to assess the magnitude of SSBs consumption and associated factors among women of reproductive age group in two SSA countries.

METHODS

This cross-sectional study used data from Integrated Public Use Micro Data Series-Performance Monitoring for Action (IPUMS-PMA) with a total sample of 3759 women aged 15-49 years old in Burkina Faso and Kenya. The data was collected on June - August 2018 in Burkina Faso, and May -August 2018 in Kenya. SSBs consumption was measured by asking a woman if she drank SSBs yesterday during the day or night, whether at home or anywhere else. A mixed-effect logistic regression model was employed to identify associated factors.

RESULT

Half (50.38%) [95%CI; 46.04, 54.71] of women consumed SSBs. Sociodemographic characteristics like primary education (AOR = 1.35; 95%CI: 1.05-1.74), secondary education (AOR = 1.46; 95%CI: 1.13-1.90), being employed (AOR = 1.28; 95%CI: 1.05-1.56),and dietary characteristics like consumption of savory and fried snack (AOR = 1.61; 95%CI = 1.24-2.09), achieved minimum dietary diversity (AOR = 1.67; 95%CI: 1.38-2.01), moderate household food insecurity (AOR = 0.74, 95% CI: 0.58, 0.95), and sever household food insecurity (AOR = 0.71, 95% CI: 0.56, 0.89) had significant statistical association with SSBs consumption.

CONCLUSION

Consumption of SSBs among women in two Sub-Saharan African countries (Burkina Faso and Kenya) is high. Having higher educational status, being employed, achieved minimum dietary diversity, and having low/no household food in-security were found to be significantly associated with SSBs compared with their counterparts. We recommend for further study in other African countries using objective measurements of SSBs consumption.

The association of ultra-processed food consumption with adult mental health disorders: a systematic review and dose-response meta-analysis of 260,385 participants

OBJECTIVE

We aimed to conduct a systematic review and meta-analysis of observational studies examining the relationship between ultra-processed food (UPF) consumption and the risk of mental health disorders.

METHODS

The ISI Web of Science, PubMed/MEDLINE, and Scopus databases were searched without date restriction until 28 December 2021. Data were extracted from 26 studies, including 260,385 participants from twelve countries. Risk ratios for mental health disorders were pooled by a random-effects model.

RESULTS

Meta-analyses suggested that UPF consumption was associated with an increased risk of depression (RR = 1.28; 95% CI: 1.19, 1.38; I2 = 61.8%; p = 0.022) but not anxiety (RR = 1.35; 95% CI: 0.86, 2.11; I2 =  77.8%; p = 0.198). However, when analyzed for the dietary assessment method, UPF consumption was significantly associated with an enhanced risk of depression among studies utilizing food frequency questionnaires (RR = 1.31; 95% CI: 1.21, 1.41; I2 = 60.0%; p < 0.001) as opposed to other forms of dietary recall approaches. Additionally, for every 10% increase in UPF consumption per daily calorie intake, 11% higher risk of depression (RR = 1.11; 95% CI: 1.01, 1.17; I2 = 88.9%; p < 0.001) was observed among adults. Dose-response analysis further emphasized a positive linear association between UPF consumption with depression risk (p-nonlinearity = 0.819, p-dose-response = p < 0.001).

CONCLUSION

Our findings indicate that UPF consumption is related to an enhanced depressive mental health status risk. There may be different causes for this increased risk, and further studies are needed to investigate if there is a causal relationship between consumption of UPF and mental health.

Soft Drinks and Symptoms of Depression and Anxiety in Overweight Subjects: A Longitudinal Analysis of an European Cohort

BACKGROUND

Studies about the association of carbonated/soft drinks, coffee, and tea with depression and anxiety are scarce and inconclusive and little is known about this association in European adults. Our aim was to examine the association between the consumption of these beverages and depressive and anxiety symptom severity.

METHODS

A total of 941 European overweight adults (mean age, 46.8 years) with subsyndromal depression that participated in the MooDFOOD depression prevention randomized controlled trial (Clinical Trials.gov identifier: NCT2529423; date of the study: from 2014 to 2018) were analyzed. Depressive and anxiety symptom severity and beverage consumption were assessed using multilevel mixed-effects ordinal logistic regression models for each beverage consumption (carbonated/soft drink with sugar, carbonated/soft drink with non-nutritive sweeteners, coffee, and tea) with the three repeated measures of follow-up (baseline and 6 and 12 months). A case report form for participants' sociodemographic and clinical characteristics, the Food Frequency Questionnaire, the Patient Health Questionnaire-9, the Generalized Anxiety Disorder 7-Item Scale, the MINI International Neuropsychiatric Interview 5.0, the Short Questionnaire to Assess Health-Enhancing Psychical Activity, and the Alcohol Use Disorders Identification Test were the research tools used.

RESULTS

Daily consumption of carbonated/soft drinks with sugar was associated with a higher level of anxiety. Trends towards significance were found for associations between both daily consumption of carbonated/soft drinks with sugar and non-nutritive sweeteners and a higher level of depression. No relationship was found between coffee and tea consumption and the level of depression and anxiety.

CONCLUSIONS

The high and regular consumption of carbonated/soft drink with sugar (amount of consumption: ≥1 unit (200 mL)/day) tended to be associated with higher level of anxiety in a multicountry sample of overweight subjects with subsyndromal depressive symptoms. It is important to point out that further research in this area is essential to provide valuable information about the intake patterns of non-alcoholic beverages and their relationship with affective disorders in the European adult population.

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.

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.

Physical Activity Is Associated With Improved Eating Habits During the COVID-19 Pandemic

The aim of this study was to analyze the association between physical activity and eating habits during the COVID-19 pandemic among Brazilian adults. A sample of 1,929 participants answered an online survey, however 1,874 were included in the analysis. The impact of the COVID-19 pandemic on eating habits was assessed inquiring about participants' intake of fruits, vegetables, fried foods, and sweets during the pandemic. Physical activity was assessed by asking participants about their weekly frequency, intensity and number of minutes/hours engaging in structured physical activities per week. Participants were then stratified into categories based on moderate-to-vigorous intensity (0-30; 31-90; 91-150; 151-300; and >300 min/week) and into active (≥150 min) or inactive (<150 min). Increased sweets consumption was the most commonly reported change to eating habits (42.5%), followed by an increase in the consumption of vegetables (26.6%), fruits (25.9%), and fried foods (17.9%). Physical activity practice was related to lower consumption of fried foods (OR = 0.60; p < 0.001) and sweets (OR = 0.53; p < 0.001). A cluster analysis revealed subjects with higher the level of physical activity was more likely to follow a healthy diet (p < 0.001). Thus, physical activity was positively associated with healthier eating habits. Health authorities must recommend regular physical as a strategy to improve overall health during the COVID-19 pandemic. Future studies should address the physical activity interventions to improve health status during a pandemic.