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Bizzozero-Peroni B, Martínez-Vizcaíno V, Fernández-Rodríguez R, Jiménez-López E, Núñez de Arenas-Arroyo S, Saz-Lara A, Díaz-Goñi V, Mesas AE. The impact of the Mediterranean diet on alleviating depressive symptoms in adults: a systematic review and meta-analysis of randomized controlled trials. Nutr Rev 2024:nuad176. [PMID: 38219230 DOI: 10.1093/nutrit/nuad176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024] Open
Abstract
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.
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Affiliation(s)
- Bruno Bizzozero-Peroni
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Department of Physical Education and Health, Higher Institute of Physical Education, Universidad de la República, Rivera, Uruguay
| | - Vicente Martínez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Grupo de Investigación en Educación Física, Salud y Calidad de Vida, Facultad de Educación, Universidad Autónoma de Chile, Temuco, Chile
| | | | - Estela Jiménez-López
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Department of Psychiatry, Hospital Virgen de La Luz, Cuenca, Spain
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | | | - Alicia Saz-Lara
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Valentina Díaz-Goñi
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Arthur Eumann Mesas
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
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Nowicki GJ, Polak M, Ślusarska B, Czernecki K. The Relationship between Diet and the Occurrence of Depressive Symptoms in a Community Example with High Rates of Social Deprivation: A Cross-Sectional Study. Nutrients 2023; 15:3778. [PMID: 37686809 PMCID: PMC10489963 DOI: 10.3390/nu15173778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/16/2023] [Accepted: 08/28/2023] [Indexed: 09/10/2023] Open
Abstract
Research suggests that various biological and psychosocial mechanisms are involved in the heterogeneous and complex relationship between dietary patterns and depressive symptoms. The occurrence of depressive symptoms is thought to be related to socioeconomic status (SES), with those with lower SES being more likely to experience persistent depression. The aim of the undertaken study was to investigate whether socioeconomic and health variables are associated with dietary assessment in a population with high rates of social deprivation and whether a relationship exists between dietary assessment and depressive symptoms (DS). The respondents' nutrition was evaluated through a qualitative method, using the Perinumeric Periodic Table questionnaire by Starzyńska. At the same time, the prevalence of DS was assessed employing the Patient Health Questionnaire-9 (PHQ-9). In the DS screening (PHQ-9 ≥ 10), in the entire study population, the risk of DS was 16.1% (n = 605). In our entire study population, up to 61.2% (n = 2297) of the respondents exhibited poor dietary patterns. In the multivariate model, women with almost adequate or poor dietary assessment were 1.62 and 2.18 times more likely to score at least 10 on the PHQ-9 questionnaire, as compared to women whose dietary assessment was good or adequate. In conclusion, it was determined that sociodemographic variables affect nutritional habits. Women who lived in rural areas limited to a vocational education had significantly poorer diets. Moreover, men, younger men, smokers, and those without chronic diseases were characterized by a poorer dietary assessment. Additionally, women who had a better dietary assessment were significantly more likely to have lower scores on the questionnaire assessing the occurrence of DS (PHQ-9 10).
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Affiliation(s)
- Grzegorz Józef Nowicki
- Department of Family and Geriatric Nursing, Faculty of Health Sciences, Medical University of Lublin, Staszica 6 Str., PL-20-081 Lublin, Poland; (B.Ś.); (K.C.)
| | - Maciej Polak
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Skawińska 8 Str., PL-31-066 Krakow, Poland;
| | - Barbara Ślusarska
- Department of Family and Geriatric Nursing, Faculty of Health Sciences, Medical University of Lublin, Staszica 6 Str., PL-20-081 Lublin, Poland; (B.Ś.); (K.C.)
| | - Karol Czernecki
- Department of Family and Geriatric Nursing, Faculty of Health Sciences, Medical University of Lublin, Staszica 6 Str., PL-20-081 Lublin, Poland; (B.Ś.); (K.C.)
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Garcia-Toro M, Aguilar-Latorre A, Garcia A, Navarro-Guzmán C, Gervilla E, Seguí A, Gazquez F, Marino JA, Gomez-Juanes R, Serrano-Ripoll MJ, Oliván-Blázquez B, Garcia-Campayo J, Maloney S, Montero-Marin J. Mindfulness skills and experiential avoidance as therapeutic mechanisms for treatment-resistant depression through mindfulness-based cognitive therapy and lifestyle modification. Front Psychol 2023; 14:1008891. [PMID: 36968708 PMCID: PMC10033944 DOI: 10.3389/fpsyg.2023.1008891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 02/15/2023] [Indexed: 03/11/2023] Open
Abstract
Background/objectiveThe COVID-19 pandemic and consequent physical distancing has made it difficult to provide care for those with Treatment-Resistant Depression (TRD). As a secondary analysis of a clinical trial, the aim of this study was to explore potential mechanisms through which three online-delivered approaches, added to treatment as usual, improve depressive symptoms in TRD patients.MethodsThe three approaches included (a) Minimal Lifestyle Intervention (MLI), (b) Mindfulness-Based Cognitive Therapy (MBCT), and (c) Lifestyle Modification Program (LMP). Sixty-six participants with TRD completed assessments pre-post intervention (mindfulness skills [FFMQ]; self-compassion [SCS]; and experiential avoidance [AAQ-II]) and pre-intervention to follow-up (depressive symptoms [BDI-II]). Data were analyzed using within-subjects regression models to test mediation.ResultsMindfulness skills mediated the effect of MBCT on depressive symptoms (ab = −4.69, 95% CI = −12.93 to−0.32), whereas the lack of experiential avoidance mediated the effect of LMP on depressive symptoms (ab = −3.22, 95% CI = −7.03 to−0.14).ConclusionStrengthening mindfulness skills and decreasing experiential avoidance may promote recovery in patients with TRD, MBCT, and LMP have demonstrated that they may help increase mindfulness skills and decrease experiential avoidance, respectively. Future work will need to unpick the components of these interventions to help isolate active ingredients and increase optimization.
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Affiliation(s)
- Mauro Garcia-Toro
- University Institute of Health Science Research (IUNICS), University of the Balearic Islands, Palma, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Department of Medicine, University of the Balearic Islands, Palma, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Carlos III Health Institute, Madrid, Spain
| | - Alejandra Aguilar-Latorre
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Carlos III Health Institute, Madrid, Spain
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- *Correspondence: Alejandra Aguilar-Latorre,
| | - Aurora Garcia
- University Institute of Health Science Research (IUNICS), University of the Balearic Islands, Palma, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | | | - Elena Gervilla
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Department of Psychology, University of the Balearic Islands, Palma, Spain
| | - Andrea Seguí
- University Institute of Health Science Research (IUNICS), University of the Balearic Islands, Palma, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - Francisco Gazquez
- University Institute of Health Science Research (IUNICS), University of the Balearic Islands, Palma, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - Jose Antonio Marino
- University Institute of Health Science Research (IUNICS), University of the Balearic Islands, Palma, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - Rocío Gomez-Juanes
- University Institute of Health Science Research (IUNICS), University of the Balearic Islands, Palma, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - María J. Serrano-Ripoll
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Carlos III Health Institute, Madrid, Spain
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma, Spain
| | - Bárbara Oliván-Blázquez
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Carlos III Health Institute, Madrid, Spain
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | - Javier Garcia-Campayo
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Carlos III Health Institute, Madrid, Spain
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, Zaragoza, Spain
| | - Shannon Maloney
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom
| | - Jesús Montero-Marin
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom
- Teaching, Research and Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health-CIBERESP), Madrid, Spain
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Shen X, Gu X, Liu YY, Yang L, Zheng M, Jiang L. Association between dietary calcium and depression among American adults: National health and nutrition examination survey. Front Nutr 2023; 10:1042522. [PMID: 36845060 PMCID: PMC9948022 DOI: 10.3389/fnut.2023.1042522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 01/23/2023] [Indexed: 02/11/2023] Open
Abstract
Background There is only limited evidence for an association between calcium (Ca) and depression, and the relationship was inconsistent. Therefore, the aim of this study was to assess the relationship between dietary Ca and the risk of depressive symptoms in individuals over the age of 18 in the US. Methods We extracted 14,971 participants from the US National Health and Nutrition Examination Survey (NHANES) 2007-2016 to probe their associations. Dietary Ca intake was measured through 24 h dietary recall method. Patients with the Patient Health Questionnaire-9 (PHQ-9) ≥ 10 scores were believed to have depressive symptoms. The association between dietary Ca and depressive symptoms was investigated using multivariate logistic regression, sensitivity analysis, and restricted cubic spline regression. Results In this study, 7.6% (1,144/14,971) of them had depressive symptoms. After adjusting for sex, age, race, poverty to income ratio (PIR), marital status, education, body mass index (BMI), caffeine intake, carbohydrates intake, total energy intake, smoking status, alcohol consumption, physical activity, diabetes, hypertension, severe cardiovascular disease (CVD), cancer, serum vitamin D, serum Ca, and Ca supplement, the adjusted ORs value [95% confidence interval (CI)] of depression for the lowest category (Q1 ≤ 534 mg/day) vs. Q2-Q4 of Ca intake were 0.83 (0.69-0.99), 0.97 (0.65-0.95), and 0.80 (0.63-0.98) with the p for trend (p = 0.014). The relationship between dietary Ca intake and depressive symptoms was linear (non-linear p = 0.148). None of the interactions were significant except among races (p for interaction = 0.001). Conclusion Association between dietary Ca and the prevalence of depressive symptoms in US adults. And Ca intake was negatively associated with the risk of depressive symptoms. As Ca intake increased, the prevalence of depressive symptoms decreased.
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Affiliation(s)
- Xia Shen
- Wuxi Medical College, Jiangnan University, Wuxi, China
| | - Xue Gu
- Wuxi Medical College, Jiangnan University, Wuxi, China
| | - Yuan-Yuan Liu
- Wuxi Medical College, Jiangnan University, Wuxi, China
| | - Long Yang
- Department of Pediatric Cardiothoracic Surgery, The First Affiliated Hospital of Xinjiang Medical University, Ürümqi, China
| | - Meng Zheng
- The Fifth Medical Center of People’s Liberation Army (PLA) General Hospital, Beijing, China
| | - Lei Jiang
- Department of Radiology, The Convalescent Hospital of East China, Wuxi, China,*Correspondence: Lei Jiang,
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