Nutrition, mood and behaviour: a review

Enterogenic metabolomics signatures of depression: what are the possibilities for the future

INTRODUCTION

An increasing number of studies indicate that the microbiota-gut-brain axis is an important pathway involved in the onset and progression of depression. The responses of the organism (or its microorganisms) to external cues cannot be separated from a key intermediate element: their metabolites.

AREAS COVERED

In recent years, with the rapid development of metabolomics, an increasing amount of metabolites has been detected and studied, especially the gut metabolites. Nevertheless, the increasing amount of metabolites described has not been reflected in a better understanding of their functions and metabolic pathways. Moreover, our knowledge of the biological interactions among metabolites is also incomplete, which limits further studies on the connections between the microbial-entero-brain axis and depression.

EXPERT OPINION

This paper summarizes the current knowledge on depression-related metabolites and their involvement in the onset and progression of this disease. More importantly, this paper summarized metabolites from the intestine, and defined them as enterogenic metabolites, to further clarify the function of intestinal metabolites and their biochemical cross-talk, providing theoretical support and new research directions for the prevention and treatment of depression.

The Burden of Carbohydrates in Health and Disease

Foods high in carbohydrates are an important part of a healthy diet, since they provide the body with glucose to support bodily functions and physical activity. However, the abusive consumption of refined, simple, and low-quality carbohydrates has a direct implication on the physical and mental pathophysiology. Then, carbohydrate consumption is postulated as a crucial factor in the development of the main Western diseases of the 21st century. We conducted this narrative critical review using MedLine (Pubmed), Cochrane (Wiley), Embase, and CinAhl databases with the MeSH-compliant keywords: carbohydrates and evolution, development, phylogenetic, GUT, microbiota, stress, metabolic health, consumption behaviors, metabolic disease, cardiovascular disease, mental disease, anxiety, depression, cancer, chronic kidney failure, allergies, and asthma in order to analyze the impact of carbohydrates on health. Evidence suggests that carbohydrates, especially fiber, are beneficial for the well-being and growth of gut microorganisms and consequently for the host in this symbiotic relationship, producing microbial alterations a negative effect on mental health and different organic systems. In addition, evidence suggests a negative impact of simple carbohydrates and refined carbohydrates on mood categories, including alertness and tiredness, reinforcing a vicious circle. Regarding physical health, sugar intake can affect the development and prognosis of metabolic disease, as an uncontrolled intake of refined carbohydrates puts individuals at risk of developing metabolic syndrome and subsequently developing metabolic disease.

Gender Differences in Nutritional, Odontological and Psychological Patterns of Adolescent Students during COVID-19 Pandemic

This research aimed to explore gender differences in nutritional, odontological and psychological patterns of adolescent students during the COVID-19 pandemic. In order to achieve the study’s aim, 127 adolescent students (17.61 ± 7.43 years) completed an online questionnaire which analysed variables regarding their psychological, nutritional, oral health, and physical activity profiles and habits during the COVID-19 crisis. Students showed a higher weekly alcohol consumption and higher levels of loneliness perception when alcohol consumption was lower. In addition, experimental avoidance and psychological inflexibility values were lower when the perception of having dry mouth or lack of saliva is higher. The results also show that males presented a more varied intake of food than females and a stronger adherence to physical activity routines. Female students presented a lower number of meals per day when beer and alcohol consumption was higher, and a higher tendency for fat- and sugar-rich foods such as fast food or bakery products than males. Regarding the oral health profile, females showed higher values in daily tooth brushing and no significant differences were found in dry mouth and gastritis variables. The results from the present study could be used by various educational institutions to implement multidisciplinary interventions to develop healthier habits.

Gender Differences in the COVID-19 Pandemic Risk Perception, Psychology, and Behaviors of Spanish University Students

The actual COVID-19 pandemic scenario has generated a context of uncertainty, helplessness, and inequality. Yet, the perception of COVID-19 risk has influenced nutritional, psychological, and physical activity patterns depending on gender. We conducted the present research with the aim of studying gender differences of university students in the perceived risk of the COVID-19 pandemic, and in psychological, nutritional, oral health, and physical activity habits. To reach the study’s aim, 300 volunteer university students completed an online questionnaire which analyzed variables of perceived risk of the COVID-19 pandemic, psychological profiles, and nutritional, oral health, and physical activity habits. Results showed that females presented a higher perception of danger to the COVID-19 virus than males but showed no differences in how the pandemic has affected personal lives. Females showed higher values of anxiety, conscientiousness, neuroticism, and openness to experience, while males presented higher values of extraversion. Nutritionally, males presented greater consumption of soft drinks, meat, and pasta or rice, and lower buccal hygiene. Yet, no differences were found regarding physical activity patterns. Results from the present study could be used by various educational institutions to implement multidisciplinary interventions to reduce the stress and risk perception.

Sugar rush or sugar crash? A meta-analysis of carbohydrate effects on mood

The effect of carbohydrate (CHO) consumption on mood is much debated, with researchers reporting both mood improvements and decrements following CHO ingestion. As global consumption of sugar-sweetened products has sharply increased in recent years, examining the validity of claims of an association between CHOs and mood is of high importance. We conducted a systematic review and meta-analysis to evaluate the relationship between acute CHO ingestion and mood. We examined the time-course of CHO-mood interactions and considered the role of moderator variables potentially affecting the CHO-mood relationship. Analysis of 176 effect sizes (31 studies, 1259 participants) revealed no positive effect of CHOs on any aspect of mood at any time-point following their consumption. However, CHO administration was associated with higher levels of fatigue and less alertness compared with placebo within the first hour post-ingestion. These findings challenge the idea that CHOs can improve mood, and might be used to increase the public's awareness that the 'sugar rush' is a myth, inform health policies to decrease sugar consumption, and promote healthier alternatives.

Omega-3 Fatty Acids and Cholesterol Have a Main Role in Antidepression Diet of Iranian Traditional Medicine

Depression is one of the major health problems of our world. Recent studies have revealed the relationship between diet and depression. In Iranian traditional medicine, there is a therapeutic diet that is recommended in melancholic diseases like depression. One of the main components of this diet is meat. Meats are divided into 2 groups: recommended and abstinent. The aim of this study was to clarify the logic of this diet through comparing nutritional elements of the 2 groups with each other. For this purpose, prominent books on Iranian traditional medicine were searched for abstinent and recommended meats traditionally prescribed for depressed patients. The results of each group were compared with the other by using Mann-Whitney Test (SPSS version 16). The results showed that recommended meats contain higher amounts of polyunsaturated fatty acids ( P = .01) especially omega-3 ( P = .03). Both groups contain high amounts of cholesterol. Iranian traditional medicine recommends consumption of meats that contains cholesterol with omega-3 fatty acids in depression.

The role of vitamin D in the prevention of late-life depression

BACKGROUND

In this article, we review current evidence regarding potential benefits of vitamin D for improving mood and reducing depression risk in older adults. We summarize gaps in knowledge and describe future efforts that may clarify the role of vitamin D in late-life depression prevention.

METHODS

MEDLINE and PsychINFO databases were searched for all articles on vitamin D and mood that had been published up to and including May 2015. Observational studies and randomized trials with 50 or more participants were included. We excluded studies that involved only younger adults and/or exclusively involved persons with current depression.

RESULTS

Twenty observational (cross-sectional and prospective) studies and 10 randomized trials (nine were randomized placebo-controlled trials [RCTs]; one was a randomized blinded comparison trial) were reviewed. Inverse associations of vitamin D blood level or vitamin D intake with depression were found in 13 observational studies; three identified prospective relations. Results from all but one of the RCTs showed no statistically significant differences in depression outcomes between vitamin D and placebo groups.

LIMITATIONS

Observational studies were mostly cross-sectional and frequently lacked adequate control of confounding. RCTs often featured low treatment doses, suboptimal post-intervention changes in biochemical levels of vitamin D, and/or short trial durations.

CONCLUSION

Vitamin D level-mood associations were observed in most, but not all, observational studies; results indicated that vitamin D deficiency may be a risk factor for late-life depression. However, additional data from well-designed RCTs are required to determine the impact of vitamin D in late-life depression prevention.

Relationships of maternal folate and vitamin B12 status during pregnancy with perinatal depression: The GUSTO study

Studies in the general population have proposed links between nutrition and depression, but less is known about the perinatal period. Depletion of nutrient reserves throughout pregnancy and delayed postpartum repletion could increase the risk of perinatal depression. We examined the relationships of plasma folate and vitamin B12 concentrations during pregnancy with perinatal depression. At 26th-28th weeks of gestation, plasma folate and vitamin B12 were measured in women from the GUSTO mother-offspring cohort study in Singapore. Depressive symptoms were measured with the Edinburgh Postnatal Depression Scale (EPDS) during the same period and at 3-month postpartum. EPDS scores of ≥15 during pregnancy or ≥13 at postpartum were indicative of probable depression. Of 709 women, 7.2% (n = 51) were identified with probable antenatal depression and 10.4% (n = 74) with probable postnatal depression. Plasma folate concentrations were significantly lower in those with probable antenatal depression than those without (mean ± SD; 27.3 ± 13.8 vs 40.4 ± 36.5 nmol/L; p = 0.011). No difference in folate concentrations was observed in those with and without probable postnatal depression. In adjusted regression models, the likelihood of probable antenatal depression decreases by 0.69 for every unit variation (increase) in folate (OR = 0.69 per SD increase in folate; 95% CI: 0.52, 0.94). Plasma vitamin B12 concentrations were not associated with perinatal depression. Lower plasma folate status during pregnancy was associated with antenatal depression, but not with postnatal depression. Replication in other studies is needed to determine the direction of causality between low folate and antenatal depression.

CLINICAL TRIAL REGISTRY

NCT01174875.

Mental health and food consumption among California children 5-11 years of age

OBJECTIVE

The purpose of this research was to determine if poor mental health is associated with the intake of specific foods among California children.

DESIGN

Secondary data analysis of the 2007 and 2009 California Health Interview Survey (CHIS) was conducted. Mental health was measured using a shortened version of the Strengths and Difficulties Questionnaire (SDQ). Dietary measures were self-reported servings of fruit, vegetables, 100% fruit juice, high sugar foods, soda/sweetened drinks, and French fries/fried potatoes consumed the previous day, as well as frequency of fast food consumed during the past week.

SETTING

Phone interviews were conducted via the CHIS on households in California.

SUBJECTS

Data belonging to children (n = 11,190) ages 5-11 years whose parents completed the CHIS 2007 and 2009 random-dial telephone surveys was investigated.

RESULTS

Of an estimated annual population of 3.7 million children, 180,000 (4.9%) had poor mental health. Children with poor mental health consumed more soda/sweetened drinks (0.60 vs 0.45 servings per day, p = 0.024), French fries/fried potatoes (0.27 vs 0.14 servings per day, p = 0.003), and fast food (2.02 vs 1.38 servings per week, p = 0.009) compared to children with good mental health. Mental health was not associated with other dietary measures. Adjusting for relevant socio-demographic characteristics, logistic regression found poor mental health to be significantly associated with any consumption of French fries/fried potatoes (odds ratio (OR) = 2.0, p = 0.001) or vegetables (OR 0.6, p = 0.005) on the previous day, and fast food two or more times in the past week (OR 1.7, p < 0.001). Interaction analysis revealed that an estimated 33% of girls with poor mental health consumed French fries, compared to 12% of girls with good mental health (OR 2.91, p = 0.006).

CONCLUSIONS

Children with poor mental health are more likely to consume calorie-dense but nutrient-poor foods compared to their counterparts. Intake of such foods may contribute to worse physical health as these children mature.

Effects of vitamin and mineral supplementation on stress, mild psychiatric symptoms, and mood in nonclinical samples: a meta-analysis

OBJECTIVE

Biochemical processes in the brain affect mood. Minor dietary inadequacies, which are responsible for a small decline in an enzyme's efficiency, could cumulatively influence mood states. When diet does not provide an optimal intake of micronutrients, supplementation is expected to benefit mood. This meta-analysis evaluated the influence of diet supplementation on mood in nonclinical samples.

METHODS

Databases were evaluated and studies were included if they considered aspects of stress, mild psychiatric symptoms, or mood in the general population; were randomized and placebo-controlled; evaluated the influence of multivitamin/mineral supplements for at least 28 days. Eight studies that met the inclusion criteria were integrated using meta-analysis.

RESULTS

Supplementation reduced the levels of perceived stress (standard mean difference [SMD]=0.35; 95% confidence interval [CI]=0.47-0.22; p=.001), mild psychiatric symptoms (SMD=0.30; 95% CI=0.43-0.18; p=.001), and anxiety (SMD=0.32; 95% CI=0.48-0.16; p<.001), but not depression (SMD=0.20; 95% CI=0.42-0.030; p<.089). Fatigue (SMD=0.27; 95% CI=0.40-0.146; p<.001) and confusion (SMD=0.225; 95% CI=0.38-0.07; p<.003) were also reduced.

CONCLUSIONS

Micronutrient supplementation has a beneficial effect on perceived stress, mild psychiatric symptoms, and aspects of everyday mood in apparently healthy individuals. Supplements containing high doses of B vitamins may be more effective in improving mood states. Questions about optimal levels of micronutrient intake, optimal doses, and active ingredients arise.

The efficacy of acupressure at the Sanyinjiao point in the improvement of women's general health

OBJECTIVES

This study's objective was to examine the effectiveness of Sanyinjiao point (SP6) acupressure on women's general health.

DESIGN

This was a randomized, single-blind clinical trial.

SETTING

The setting for this trial was at Medical University, Bojnoord University of Medical Science, Bojnoord, Iran.

MATERIALS AND METHODS

Eighty-six (86) university students were recruited for this study. Their demographic characteristics were gathered before the intervention commenced. Participants completed General Health Questionnaires (GHQ) prior to participation. Next, they were randomly assigned to either the acupressure-receiving group or the sham-pressure-receiving group. The study group received acupressure at the Sanyinjiao point, while the control group received sham pressure.

OUTCOME MEASURES

Both groups completed GHQ after both the first and second months of intervention. Data analysis was carried out using SPSS version 13.5 for Windows.

RESULTS

The mean age of those who completed the study was 20.84±1.64 years. Mean scores of GHQs were similar between groups before intervention (p>0.05). The general health of participants in both groups improved after intervention, and the amelioration in four domains was significant in the groups (p<0.05 within group). It was found that acupressure was more effective than sham pressure. In addition, there was a statistically significant difference between the two groups in the four domains of their general heath after the first month of the intervention (p<0.0001). Furthermore, the general health status of the participants changed much more after the second month in both the acupressure intervention and the sham pressure groups; nevertheless, acupressure was more effective than sham pressure (p<0.05).

CONCLUSIONS

Both acupressure and sham pressure were effective in promoting women's general health; nevertheless, the efficacy of acupressure was more than that of sham pressure. SP6 acupressure could be regarded as a self-manageable approach to improve women's general health.

Dietary fat intake and the risk of depression: the SUN Project

Emerging evidence relates some nutritional factors to depression risk. However, there is a scarcity of longitudinal assessments on this relationship.

OBJECTIVE

To evaluate the association between fatty acid intake or the use of culinary fats and depression incidence in a Mediterranean population.

MATERIAL AND METHODS

Prospective cohort study (1999-2010) of 12,059 Spanish university graduates (mean age: 37.5 years) initially free of depression with permanently open enrolment. At baseline, a 136-item validated food frequency questionnaire was used to estimate the intake of fatty acids (saturated fatty acids (SFA), polyunsaturated fatty acids (PUFA), trans unsaturated fatty acids (TFA) and monounsaturated fatty acids (MUFA) and culinary fats (olive oil, seed oils, butter and margarine) During follow-up participants were classified as incident cases of depression if they reported a new clinical diagnosis of depression by a physician and/or initiated the use of antidepressant drugs. Cox regression models were used to calculate Hazard Ratios (HR) of incident depression and their 95% confidence intervals (CI) for successive quintiles of fats.

RESULTS

During follow-up (median: 6.1 years), 657 new cases of depression were identified. Multivariable-adjusted HR (95% CI) for depression incidence across successive quintiles of TFA intake were: 1 (ref), 1.08 (0.82-1.43), 1.17 (0.88-1.53), 1.28 (0.97-1.68), 1.42 (1.09-1.84) with a significant dose-response relationship (p for trend = 0.003). Results did not substantially change after adjusting for potential lifestyle or dietary confounders, including adherence to a Mediterranean Dietary Pattern. On the other hand, an inverse and significant dose-response relationship was obtained for MUFA (p for trend = 0.05) and PUFA (p for trend = 0.03) intake.

CONCLUSIONS

A detrimental relationship was found between TFA intake and depression risk, whereas weak inverse associations were found for MUFA, PUFA and olive oil. These findings suggest that cardiovascular disease and depression may share some common nutritional determinants related to subtypes of fat intake.