Tag: anxiety

The EAT-Lancet Diet Helps Lower Depression and Anxiety Risk?

Posted on by CNP Staff

 

  • An analysis of UK Biobank data published in Nature Communications showed that individuals adhering to the EAT-Lancet diet have a lower risk of depression and anxiety.
  • The group with the highest adherence to this diet had around 20% lower risk of depression and anxiety compared to the lowest adherence group.
  • The EAT-Lancet diet emphasizes plant-based foods, moderate animal product consumption, and limited processed and red meat intake.

We can often read that eating certain foods might be good for our health. Studies frequently report that heightened or decreased intake of a certain type of food is associated with increased or reduced risk of certain diseases. For example,  regular consumption of refined sugars, particularly sugary drinks, has been linked to a host of adverse health outcomes (Hedrih, 2023; Huang et al., 2023). On the other hand, snacking on whole almonds has been found to reduce LDL cholesterol and improve endothelial function (Dikariyanto et al., 2020) and was, therefore, beneficial for overall health.

These findings refer to individual foods or food components. However, scientists also study the effects of broad dietary patterns on health and overall well-being.

Regular consumption of refined sugars has been linked to a host of adverse health outcomes.

Dietary patterns

A dietary pattern is the overall composition and combination of foods and beverages one consumes over time. It’s not just about individual nutrients but the synergistic effects of various foods in a person’s diet. Examples of dietary patterns include the Mediterranean diet, which emphasizes whole grains, vegetables, and healthy fats, and the MIND diet, which focuses on brain health.  These patterns define an individual’s long-term eating habits. Scientists have defined certain broad dietary patterns that individuals’ diets can be compared to for research purposes. These diets reflect the general dietary habits of certain groups and cultures or are created by scientists to improve health or research a certain topic.

For example, many studies explore the associations between the Western diet and health, finding that adherence to this diet is linked to various adverse health outcomes. The Western diet is characterized by a high intake of processed foods, red and processed meats, refined grains, sugars, and unhealthy fats (Hayes et al., 2024). On the other hand, studies link adherence to the Mediterranean diet and the Nordic diet with beneficial health outcomes (Adamsson et al., 2012; Araste et al., 2024; Camprodon-Boadas et al., 2024; Poulsen et al., 2014; The InterAct Consortium, 2011).

A dietary pattern is the overall combination and frequency of foods and beverages a person consumes regularly.

The EAT-Lancet diet

In January 2019, the EAT-Lancet Commission, a group of scientists and experts, developed recommendations for a sustainable and healthy diet that can support human health and environmental stability. The Commission based its diet on the best available evidence for what constitutes a healthy diet and considered food production sustainability. Their recommendations were published in the Lancet, one of the leading scientific journals in the world (Willett et al., 2019).

The EAT-Lancet diet is largely plant-based. It consists of whole grains, fruits, vegetables, nuts, legumes, unsaturated oils, low to moderate amounts of seafood and poultry, and no or low red meat, processed meat, added sugar, refined grains, and starchy vegetables. Adherence to this diet would represent a substantial dietary shift for most people. Adopting worldwide would require the global consumption of healthy foods to double, halving the consumption of less nutritious foods (Dalile et al., 2022).

The current study

Study author Xujia Lu and her colleagues wanted to explore how adherence to the EAT-Lancet diet might be associated with anxiety and depression among UK adults (Lu et al., 2024). They analyzed data from the UK Biobank, a large-scale biomedical database and research resource containing health and genetic information from half a million U.K. participants. This database is available for scientific purposes to researchers worldwide.

This study used data from 180,466 participants. At the start of the study, their average age was 56 years, and 46% were male.

These participants completed a dietary questionnaire called Oxford WebQ. This questionnaire asks participants to recall their food and drink intake in the previous 24 hours. Some participants completed it when they were included in the UK Biobank group, and all participants received invitations to complete it on multiple occasions.

Study authors used these data to calculate how much participants’ diets resembled the EAT-Lancet diet (i.e., how much participants adhered to it). There is currently no consensus about the right way to calculate adherence to the EAT-Lancet diet, so the study authors created several different scores to express this adherence. Data about depression and anxiety came from participants’ reports, hospital data, and the death registry records.

Individuals adhering to the EAT-Lancet diet were less likely to suffer from depression and anxiety

During the follow-up of around 11-12 years on average, 4548 cases of depression, 6026 cases of anxiety, and 1262 individuals with both depression and anxiety were identified.

Depending on the way adherence to the EAT-Lancet diet was calculated, participants with the strongest adherence to the EAT-Lancet diet had between 16% and 26% lower risk of developing depression or anxiety disorders compared to those with the lowest adherence to the EAT-Lancet diet. The risk reduction was the strongest for the co-occurrence of depression and anxiety, i.e., for suffering from both depression and anxiety at the same time (see Figure 1).

 

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Figure 1. Study procedure and findings (Lu et al., 2024)

 

Participants with the strongest adherence to the EAT-Lancet diet had between 16% and 26% lower risk of developing depression or anxiety disorders.

 

Participants with higher adherence to the EAT-Lancet diet were more likely to be women, slightly older, nonsmokers, more physically active, and have lower body mass index and total energy intake.

Conclusion

Overall, the study suggests that higher adherence to the EAT-Lancet diet is associated with lower risks of depression, anxiety, and co-occurrence. Individuals adhering to this diet also tended to have healthier lifestyle habits.

The design of this study does not allow any cause-and-effect conclusions to be derived from the results. Because of this, we do not know whether this dietary pattern itself reduces the risk of anxiety and depression. It is also possible that factors producing the lowered risk of depression and anxiety make individuals more likely to adhere to a healthy diet. Still, it is possible that promoting the dietary pattern described by the EAT-Lancet diet might help prevent depression and anxiety.

The paper “Adherence to the EAT-Lancet diet and incident depression and anxiety” was authored by Xujia Lu, Luying Wu, Liping Shao, Yulong Fan, Yalong Pei, Xinmei Lu, Yan Borné, and Chaofu Ke.

 

References

Adamsson, V., Reumark, A., Cederholm, T., Vessby, B., Risérus, U., & Johansson, G. (2012). What is a healthy Nordic diet? Foods and nutrients in the NORDIET study. Food & Nutrition Research, 56(1), 18189. https://doi.org/10.3402/fnr.v56i0.18189 

Araste, A., Moghadam, M. R. S. F., Mohammadhasani, K., Fard, M. V., Khorasanchi, Z., Latifi, M., Hasanzadeh, E., Talkhi, N., Sharifan, P., Asadiyan-Sohan, P., Bidokhti, M. K., Ghassemi, A., Darban, R. A., Ferns, G., & Ghayour-Mobarhan, M. (2024). Adherence to the Nordic diet is associated with anxiety, stress, and depression in recovered COVID-19 patients, a case-control study. BMC Nutrition, 10(1), 38. https://doi.org/10.1186/s40795-024-00845-x 

Camprodon-Boadas, P., Gil-Dominguez, A., De La Serna, E., Sugranyes, G., Lázaro, I., & Baeza, I. (2024). Mediterranean Diet and Mental Health in Children and Adolescents: A Systematic Review. Nutrition Reviews, nuae053. https://doi.org/10.1093/nutrit/nuae053 

Dalile, B., Kim, C., Challinor, A., Geurts, L., Gibney, E. R., Galdos, M. V., Fata, G. L., Layé, S., Mathers, J. C., Vauzour, D., Verkuyl, J. M., & Thuret, S. (2022). The EAT–Lancet references diet and cognitive function across the life course. The Lancet Planetary Health, 6(9), e749–e759. https://doi.org/10.1016/S2542-5196(22)00123-1 

Dikariyanto, V., Smith, L., Francis, L., Robertson, M., Kusaslan, E., O’Callaghan-Latham, M., Palanche, C., D’Annibale, M., Christodoulou, D., Basty, N., Whitcher, B., Shuaib, H., Charles-Edwards, G., Chowienczyk, P. J., Ellis, P. R., Berry, S. E. E., & Hall, W. L. (2020). Snacking on whole almonds for 6 weeks improves endothelial function and lowers LDL cholesterol but does not affect liver fat and other cardiometabolic risk factors in healthy adults: The ATTIS study, a randomized controlled trial. The American Journal of Clinical Nutrition, 111(6), 1178–1189. https://doi.org/10.1093/AJCN/NQAA100 

Hayes, A. M. R., Lauer, L. T., Kao, A. E., Sun, S., Klug, M. E., Tsan, L., Rea, J. J., Subramanian, K. S., Gu, C., Tanios, N., Ahuja, A., Donohue, K. N., Décarie-Spain, L., Fodor, A. A., & Kanoski, S. E. (2024). Western diet consumption impairs memory function via dysregulated hippocampus acetylcholine signaling. Brain, Behavior, and Immunity, 118, 408–422. https://doi.org/10.1016/j.bbi.2024.03.015 

Hedrih, V. (2023, June 6). Health Consequences of High Sugar Consumption. CNP Articles in Nutritional Psychology. https://www.nutritional-psychology.org/health-consequences-of-high-sugar-consumption/ 

Huang, Y., Chen, Z., Chen, B., Li, J., Yuan, X., Li, J., Wang, W., Dai, T., Chen, H., Wang, Y., Wang, R., Wang, P., Guo, J., Dong, Q., Liu, C., Wei, Q., Cao, D., & Liu, L. (2023). Dietary sugar consumption and health: Umbrella review. BMJ (Clinical Research Ed.), 381, e071609. https://doi.org/10.1136/bmj-2022-071609

Lu, X., Wu, L., Shao, L., Fan, Y., Pei, Y., Lu, X., Borné, Y., & Ke, C. (2024). Adherence to the EAT-Lancet diet and incident depression and anxiety. Nature Communications, 15(1), 5599. https://doi.org/10.1038/s41467-024-49653-8 

Poulsen, S. K., Due, A., Jordy, A. B., Kiens, B., Stark, K. D., Stender, S., Holst, C., Astrup, A., & Larsen, T. M. (2014). Health effect of the New Nordic Diet in adults with increased waist circumference: A 6-mo randomized controlled trial1234. The American Journal of Clinical Nutrition, 99(1), 35–45. https://doi.org/10.3945/ajcn.113.069393

The InterAct Consortium. (2011). Mediterranean Diet and Type 2 Diabetes Risk in the European Prospective Investigation Into Cancer and Nutrition (EPIC) Study. Diabetes Care, 34(9), 1913–1918. https://doi.org/10.2337/dc11-0891 

Willett, W., Rockström, J., Loken, B., Springmann, M., Lang, T., Vermeulen, S., Garnett, T., Tilman, D., DeClerck, F., Wood, A., Jonell, M., Clark, M., Gordon, L. J., Fanzo, J., Hawkes, C., Zurayk, R., Rivera, J. A., Vries, W. D., Sibanda, L. M., … Murray, C. J. L. (2019). Food in the Anthropocene: The EAT–Lancet Commission on healthy diets from sustainable food systems. The Lancet, 393(10170), 447–492. https://doi.org/10.1016/S0140-6736(18)31788-4

 

 

A High-Fat Diet Increases Anxiety-Related Behaviors in Rats by Altering Gut Microbiota-Brain Communication

Posted on by CNP Staff
  • A study on rats published in Biological Research found that a high-fat diet alters gut microbiota composition and makes them obese
  • This alteration changes specific aspects of communication between gut microbiota and the brain, increasing the expression of genes related to the neurotransmitter serotonin in a part of the brain that is involved in anxiety-related behaviors
  • These changes make rats show more anxiety-related behaviors

Most people understand that eating lots of high-calorie food will make us gain weight. That is rather straightforward. However, human bodies have an intricate food intake regulation mechanism that tells us when to eat and when we have had enough. That mechanism is crucial for our survival. Without it, we could starve to death without ever feeling a desire to eat. Or we could eat so much that we die from overeating without ever noticing that we have eaten too much. Luckily, this never happens as our food intake mechanism works and works well. So, if we have this mechanism that regulates our food intake, how does obesity develop?

The development of obesity


Many argue that the world has been undergoing an obesity epidemic in the past several decades. The share of overweight and obese people has been increasing worldwide (Wong et al., 2022). This coincided with the wider availability of highly processed, energy-dense industrial foods, many of which contain additives and combinations of high-calorie ingredients not found in nature (Gearhardt et al., 2023; Hedrih, 2023; Monteiro et al., 2019; Wilding, 2001).

 

The share of overweight and obese people has been increasing worldwide, coinciding with the wider availability of highly processed, energy-dense industrial foods

 

While obesity in humans is thought to be caused by an interplay of many different factors (Wilding, 2001), studies on rodents consistently indicate that feeding them high-fat diets will dysregulate their food intake mechanisms, making them obese (Ikemoto et al., 1996, Lippert et al., 2020). Unlike normal chow for laboratory rodents, which is rich in carbohydrates but contains little fat, this obesity-inducing high-fat diet for laboratory rodents is rich both in fats and carbohydrates. This is similar to highly processed, industrial energy-dense foods considered a key generator of obesity in humans by many (Wilding, 2001).

Obesity and anxiety


Various changes in brain activity accompany the development of obesity. Studies have reported low-grade inflammation of the hypothalamus in obese individuals, the part of the brain that plays a key role in food intake regulation (Thaler et al., 2013), and specific alterations of activity in various other parts of the brain (Bhatt et al., 2023).

 

Various changes in brain activity accompany the development of obesity

 

Studies have also linked obesity with anxiety disorders. Researchers believe that inflammation of specific areas of the brain, thought to play a role in the development of obesity, might also lead to increased anxiety (De Noronha et al., 2024) (see Figure 1).

 

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Figure 1. Impact of Obesity on brain activity and anxiety disorders

 

The current study


Study author Sylvana I. S. Rendeiro de Noronha and her colleagues note that previous studies indicate that feeding rats a high-fat diet leads to obesity and anxiety-like behaviors. However, the mechanism that produces this effect remains unknown, and these researchers wanted to explore it.

They hypothesized that eating a high-fat diet would alter the diversity and composition of the gut microbiome. This will, in turn, change the communication between the brain and gut microbiota (through the microbiota-gut-brain axis), leading to increased expression of serotonergic genes (genes involved in the synthesis, transport, reception, and breakdown of the neurotransmitter serotonin) in the caudal part of the dorsomedial dorsal raphe nucleus subregion of the brain (De Noronha et al., 2024). This subregion of the brain is associated with stress- and anxiety-related behavior. Therefore, these changes could lead to an increase in anxiety-like behaviors, explaining their association with the consumption of a high-fat diet (see Figure 2).

 

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Figure 2. Hypothesis (Rendeiro de Noronha et al., 2024)

 

The study was conducted on 5-6-week-old male Wistar rats (a strain often used in research). The rats weighed around 100 grams each, and researchers housed them in groups of 4 in acrylic cages. They had free access to food and water.

Rats were divided into two groups. One group of 12 rats ate normal rat food (11% fat), while researchers fed the other group a high-fat diet (45% fat) for nine weeks. When the experimental diet started, rats were in a period of life corresponding to middle adolescence (5 weeks). They reached what can be considered adulthood by the time treatment ended and testing began.

The study authors used a series of behavioral tests to evaluate the presence of anxiety-like behaviors in these rats. They also collected rats’ feces to evaluate the composition of their gut microbiota. In the end, the rats were killed, and the study authors analyzed their brain tissue.

 

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Figure 3. Study Procedure (Rendeiro de Noronha et al., 2024)

 

High-fat diet-induced obesity, some anxiety-related behaviors, and altered rats’ gut microbiota composition


Rats fed the high-fat diet developed obesity. They also showed increased anxiety-related behaviors on one behavioral test (elevated plus-maze). Still, in two other tests (light/dark box test and open field test), there were no differences between the two groups of rats.

Feces analysis showed that high-fat diet rats had different gut microbiota composition compared to rats that ate normal food. High-fat diet rats tended to have more bacteria belonging to the Firmicutes phylum in their guts. They also had higher abundances of bacteria belonging to Allobaculum, Blautia, and Dorea genera. On the other hand, rats that ate a normal diet tended to have more bacteria belonging to the genera Lactobacillus and Prevotella.

A high-fat diet increases the expression of serotonergic genes


A high-fat diet increases the expression of specific genes involved in the brain’s serotonin system. Notably, the expression of tph2, htr1a, and slc6a4 mRNA was increased in subregions of the dorsal raphe nucleus region of the brain, just as the study authors hypothesized.

Study authors believe that this increased gene expression was what produced the increase in anxiety-like behaviors. (see Figure 4).

 

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Figure 4. Research findings (Rendeiro de Noronha et al., 2024)

 

Conclusions


The study demonstrated how a high-fat diet altered the gut microbiome in rats and led to obesity. This altered gut microbiome altered signaling to the brain through the microbiome-gut-brain axis, increasing the expression of specific genes involved in the serotonergic system in the part of the brain involved in anxiety-like behaviors. This increase, in turn, increased anxiety-like behaviors. 

This study was done on rats. Humans are a different species, but they share many physiological similarities. Because of this, it is likely that these mechanisms work in a similar way in humans as well and that the effects of a high-fat diet would not be too dissimilar.

The paper “High-fat diet, microbiome-gut-brain axis signaling, and anxiety-like behavior in male rats” was authored by Sylvana I. S. Rendeiro de Noronha, Lauro Angelo Gonçalves de Moraes, James E. Hassell Jr., Christopher E. Stamper, Mathew R. Arnold, Jared D. Heinze, Christine L. Foxx, Margaret M. Lieb, Kristin E. Cler, Bree L. Karns, Sophia Jaekel, Kelsey M. Loupy, Fernanda C. S. Silva, Deoclécio Alves Chianca-Jr. , Christopher A. Lowry, and Rodrigo Cunha de Menezes.

 

 

References

Bhatt, R. R., Todorov, S., Sood, R., Ravichandran, S., Kilpatrick, L. A., Peng, N., Liu, C., Vora, P. P., Jahanshad, N., Gupta, A., & Bhatt, R. R. (2023). Integrated multi-modal brain signatures predict sex-specific obesity status. Brain Communications, 5(2), 1–14. https://doi.org/10.1093/BRAINCOMMS/FCAD098

De Noronha, S. I. S. R., De Moraes, L. A. G., Hassell, J. E., Stamper, C. E., Arnold, M. R., Heinze, J. D., Foxx, C. L., Lieb, M. M., Cler, K. E., Karns, B. L., Jaekel, S., Loupy, K. M., Silva, F. C. S., Chianca-, D. A., Lowry, C. A., & De Menezes, R. C. (2024). High-fat diet, microbiome-gut-brain axis signaling, and anxiety-like behavior in male rats. Biological Research, 57(1), 23. https://doi.org/10.1186/s40659-024-00505-1

Gearhardt, A. N., Bueno, N. B., DiFeliceantonio, A. G., Roberto, C. A., Jiménez-Murcia, S., & Fernandez-Aranda, F. (2023). Social, clinical, and policy implications of ultra-processed food addiction. BMJ, e075354. https://doi.org/10.1136/bmj-2023-075354

Hedrih, V. (2023). Scientists Propose that Ultra-Processed Foods be Classified as Addictive Substances. CNP Articles in Nutritional Psychology. https://www.nutritional-psychology.org/scientists-propose-that-ultra-processed-foods-be-classified-as-addictive-substances/

Ikemoto, S., Takahashi, M., Tsunoda, N., Maruyama, K., Itakura, H., & Ezaki, O. (1996). High-fat diet-induced hyperglycemia and obesity in mice: Differential effects of dietary oils. Metabolism, 45(12), 1539–1546. https://doi.org/10.1016/S0026-0495(96)90185-7

Lippert, R. N., Hess, S., Klemm, P., Burgeno, L. M., Jahans-Price T, Walton, M. E., Kloppenburg, P., & Brüning, J. C. (2020). Maternal high-fat diet during lactation reprograms the dopaminergic circuitry in mice. Journal of Clinical Investigation, 130(7), 3761–3776.

Monteiro, C. A., Cannon, G., Levy, R. B., Moubarac, J. C., Louzada, M. L. C., Rauber, F., Khandpur, N., Cediel, G., Neri, D., Martinez-Steele, E., Baraldi, L. G., & Jaime, P. C. (2019). Ultra-processed foods: What they are and how to identify them. Public Health Nutrition, 22(5), 936–941. https://doi.org/10.1017/S1368980018003762

Thaler, J. P., Guyenet, S. J., Dorfman, M. D., Wisse, B. E., & Schwartz, M. W. (2013). Hypothalamic Inflammation: Marker or Mechanism of Obesity Pathogenesis? Diabetes, 62(8), 2629–2634. https://doi.org/10.2337/DB12-1605

Wilding, J. P. H. (2001). Causes of obesity. Practical Diabetes International, 18(8), 288–292. https://doi.org/10.1002/PDI.277

Wong, M. C., Mccarthy, C., Fearnbach, N., Yang, S., Shepherd, J., & Heymsfield, S. B. (2022). Emergence of the obesity epidemic: 6-decade visualization with humanoid avatars. The American Journal of Clinical Nutrition, 115(4), 1189–1193. https://doi.org/10.1093/AJCN/NQAC005

 

 

Mediterranean Diet Might Be a Protective Factor for Mental Health in Children

Posted on by CNP Staff
  • A systematic review published in Nutrition Reviews found that adherence to a Mediterranean diet could be a protective factor for mental health in children
  • The review included 13 studies, 2 of which were randomized controlled trials, and seven were found to be of high quality
  • Analyzed studies included 3058 children between 8 and 16 years of age

“You are what you eat,” the old saying goes. It means one must eat good food to stay healthy and fit. This link between eating well and staying healthy is obvious – our body needs specific nutrients to function. If we do not obtain them through food, serious health consequences will follow.

Diet and health


Science has known for centuries that a lack of specific nutrients can lead to serious health conditions. Nutrient deficiency diseases such as anemia (caused by a lack of iron, leading to fatigue, weakness, and pale skin), scurvy (caused by a deficiency of vitamin C, leading to bleeding gums, joint pain, and anemia), pellagra (caused by a deficiency of niacin (vitamin B3), leading to dermatitis, diarrhea, and dementia) or hypothyroidism (caused by a deficiency of iodine, leading to fatigue, weight gain, and depression) have been described and well understood for over 100 years.

However, studies in the past several decades revealed much more nuanced links between diet and health. Unlike nutrient deficiency diseases, these new studies link adverse health outcomes to more complex dietary patterns (i.e., patterns involving different foods containing many different nutrients and micronutrients in specific ratios or entire food consumption patterns referred to as diets).

For example, studies report that excessive intake of refined sugars is associated with increased risks of cardiovascular diseases, depression, type 2 diabetes, and even cancer (Hedrih, 2023; Huang et al., 2023; Zhang et al., 2024). Consumption of ultra-processed foods, i.e., food items created through extensive industrial processing, has also been linked to a wide range of adverse health outcomes ranging from cardiovascular and gastrointestinal diseases, depression, and anxiety to cancer (Lane et al., 2024) (see Figure 1).

 

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Figure 1. Link of ultra-processed food to disease

 

These studies effectively tell us which foods or dietary patterns to avoid. But all living organisms need to eat if they want to live. So, are there dietary patterns that may protect our health? One such pattern might be the Mediterranean diet.

The Mediterranean diet


The Mediterranean diet is a pattern inspired by the traditional eating habits of people in countries bordering the Mediterranean Sea. It emphasizes the consumption of fruits, vegetables, whole grains, legumes, nuts, and olive oil, with a moderate intake of fish and poultry and limited consumption of red meat and sweets. This diet also includes moderate wine consumption, usually with meals.

Studies have shown that this diet is associated with numerous health benefits, including reduced risks of heart disease and diabetes (Salas-Salvadó et al., 2018; The InterAct Consortium, 2011). Adherence to the Mediterranean diet is even associated with a slightly lower risk of several types of cancer and a lower overall risk of dying from cancer (Schwingshackl & Hoffmann, 2016).

The current study


Study author Patricia Camprodon-Boadas and her colleagues wanted to investigate the association between adherence to the Mediterranean diet and mental health outcomes in children and adolescents (Camprodon-Boadas et al., 2024).

These authors note that childhood and adolescence are critical periods in the development of mental illness. Anxiety disorders are the most common mental health issue among children, followed by behavior disorders, mood disorders, and substance use disorders. Girls generally tend to have higher rates of mood and anxiety disorders, while boys are more susceptible to behavior disorders. Drug use disorders are equally common among girls and boys (Camprodon-Boadas et al., 2024). But could this diet be a protective factor against these disorders?

 

Childhood and adolescence are critical periods in the development of mental illness

 

These authors conducted a systematic review and meta-analysis of research articles in English and Spanish that investigated the links between adherence to the Mediterranean diet and mental health symptoms in children and adolescents.

Their search of several scientific article databases initially yielded 450 articles. However, after the authors removed duplicates and read these articles in detail to examine whether they contained the data they needed, the number of articles fell to 13.

Eight of the studies described in these articles were conducted in Spain, while the remaining five articles came from Iran, Turkey, and the United Kingdom. One study included participants from five different countries. Two of the studies were randomized controlled trials (researchers had participants eat different diets to test their effects), and one study was longitudinal.

The 13 studies included 3058 children between 8 and 16 years of age. The studies used different ways to assess adherence to the Mediterranean diet, but most of them used the Mediterranean Diet Quality Index, a 16-item questionnaire. Study authors found 7 of these studies to be of high quality (see Figure 2).

 

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Figure 2. Study Procedure (Camprodon-Boadas et al., 2024)

 

High adherence to Mediterranean diet was linked to lower odds of ADHD
4 of the 13 studies examined the links between adherence to the Mediterranean diet and attention-deficit/hyperactivity disorder (ADHD). Their results indicated that children and adolescents with high adherence to the Mediterranean diet had 30% lower odds of suffering from ADHD.

Two studies examined the links between adherence to the Mediterranean diet and impulsivity. 1 of them reported that participants with higher impulsivity tended to have low adherence to a Mediterranean diet, while the other did not find this link. 1 study found no relationship between adherence to the Mediterranean diet and attention capacity

 

Children and adolescents with high adherence to the Mediterranean diet were less likely to suffer from depression or anxiety

 

Five studies examined the links between the Mediterranean diet and depressive symptoms. Of these, four found that participants with depressive symptoms showed much lower adherence to the Mediterranean diet. Conversely, participants with high adherence to the Mediterranean diet were less likely to suffer from depression and had fewer depressive symptoms.

Four studies examined the association between the Mediterranean diet and anxiety. 2 of these studies found participants highly adhering to the Mediterranean diet to have fewer anxiety symptoms. In contrast, the other 2 found no such association (see Figure X).

 

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Figure 3. Findings (Camprodon-Boadas et al., 2024)

 

Conclusion


Overall, the results reported by examined studies were not uniform, but the majority found higher adherence to the Mediterranean diet associated with fewer mental health issues.

 

The majority found higher adherence to the Mediterranean diet associated with fewer mental health issues

 

At the moment, it remains insufficiently clear whether it is the Mediterranean diet that reduces the risks of developing mental health issues or the absence of mental health issues that leads to higher adherence to the Mediterranean diet. A possibility exists that adherence to the Mediterranean diet might indeed be a protective factor for the mental health of children and adolescents.

The paper “Mediterranean Diet and Mental Health in Children and Adolescents: A Systematic Review” was authored by Patricia Camprodon-Boadas, Aitana Gil-Dominguez, Elena De la Serna, Gisela Sugranyes, Iolanda Lazaro, and Immaculada Baeza.


Camprodon-Boadas, P., Gil-Dominguez, A., De La Serna, E., Sugranyes, G., Lázaro, I., & Baeza, I. (2024). Mediterranean Diet and Mental Health in Children and Adolescents: A Systematic Review. Nutrition Reviews, nuae053. https://doi.org/10.1093/nutrit/nuae053

Hedrih, V. (2023, June 6). Health Consequences of High Sugar Consumption. CNP Articles in Nutritional Psychology. https://www.nutritional-psychology.org/health-consequences-of-high-sugar-consumption/

Huang, Y., Chen, Z., Chen, B., Li, J., Yuan, X., Li, J., Wang, W., Dai, T., Chen, H., Wang, Y., Wang, R., Wang, P., Guo, J., Dong, Q., Liu, C., Wei, Q., Cao, D., & Liu, L. (2023). Dietary sugar consumption and health: Umbrella review. BMJ (Clinical Research Ed.), 381, e071609. https://doi.org/10.1136/bmj-2022-071609

Lane, M. M., Gamage, E., Du, S., Ashtree, D. N., McGuinness, A. J., Gauci, S., Baker, P., Lawrence, M., Rebholz, C. M., Srour, B., Touvier, M., Jacka, F. N., O’Neil, A., Segasby, T., & Marx, W. (2024). Ultra-processed food exposure and adverse health outcomes: Umbrella review of epidemiological meta-analyses. BMJ, e077310. https://doi.org/10.1136/bmj-2023-077310

Salas-Salvadó, J., Becerra-Tomás, N., García-Gavilán, J. F., Bulló, M., & Barrubés, L. (2018). Mediterranean Diet and Cardiovascular Disease Prevention: What Do We Know? Progress in Cardiovascular Diseases, 61(1), 62–67. https://doi.org/10.1016/j.pcad.2018.04.006

Schwingshackl, L., & Hoffmann, G. (2016). Does a Mediterranean-Type Diet Reduce Cancer Risk? Current Nutrition Reports, 5(1), 9–17. https://doi.org/10.1007/s13668-015-0141-7

The InterAct Consortium. (2011). Mediterranean Diet and Type 2 Diabetes Risk in the European Prospective Investigation Into Cancer and Nutrition (EPIC) Study. Diabetes Care, 34(9), 1913–1918. https://doi.org/10.2337/dc11-0891

Zhang, L., Sun, H., Liu, Z., Yang, J., & Liu, Y. (2024). Association between dietary sugar intake and depression in US adults: A cross-sectional study using data from the National Health and Nutrition Examination Survey 2011–2018. BMC Psychiatry, 24(110), 1–10. https://doi.org/10.1186/s12888-024-05531-7

 

 

 

 

 

How Nutritional and Social Pathways Influence The Relationship Between Food Insecurity and Mental Well-Being

Posted on by CNP Staff

Food insecurity is a widespread and growing issue in which individuals do not have access to adequate food and food sources that will help them achieve and experience a healthy lifestyle. Many studies are beginning to show that food insecurity impacts individuals’ physical and mental well-being. Researchers strive to better understand the relationship between food insecurity and mental health.

Researchers are striving better to understand the relationship between food insecurity and mental health

A study written by Weaver et al. (2021) investigated two possible explanations to explore the seemingly “black box” that links food insecurity and mental health. Researchers in this study aimed to investigate how food insecurity impacts depression and anxiety through two pathways: nutritional and social. The effect of nutritional pathways on the relationship between food insecurity and mental health was explored by measuring participants’ health markers (such as arm fat area, BMI, and hemoglobin levels). Researchers analyzed the effect of social pathways on food insecurity and mental health by testing social stressors such as not having desirable foods (e.g., meat) or not participating in socially ideal food practices (e.g., sharing foods with neighbors). 

This study took place in two distinct locations: a small rural area in Brazil and a medium-sized urban city in Ethiopia, which both reported high levels of food insecurity and depression. Researchers performed community surveys for households in Brazil and Ethiopia from 2015 to 2019, when the economy and food availability fluctuated.

The research was broken down into three phases. The first two phases involved preliminary procedures that established a mutual understanding of the social variables contributing to food insecurity. In the first research phase, researchers interviewed community members to create lists of socially food-related behaviors. The first variable that demonstrates socially food-related behaviors is defined as “CoC,” which represents normal food-related behaviors and food-related behaviors that reveal food insecurity. A second variable that demonstrated social food-related behaviors was food prestige, which measured how regularly individuals could purchase desired foods (e.g., meat, spices, butter, lasagna). 

A second variable that demonstrated social food-related behaviors was “food prestige,” which measured how regularly individuals could purchase desired foods (e.g., meats, spices, butter, lasagna)

The second phase of this research consisted of a confirmatory rating exercise. Participants rated food items written on cards on a scale of 1–4, indicating the strength of food insecurity and poverty. This phase confirmed a firm agreement with participants regarding which “CoC” food items demonstrated food insecurity and what foods were prestigious. 

The third phase of the research study involved examining the relationship between food insecurity and mental well-being within nutritional and social pathways. Researchers explored the relationship between the social variables (CoC and food prestige scores) and mental well-being variables through Common Mental Disorder Symptoms Scores (CMD). The nutritional variables were explored by testing the relationship between an individual’s arm fat area, body mass index, and hemoglobin level with their CMD scores. Other measured variables were participants’ wealth, household food insecurity, and household demographic data. 

As expected, this study reported that food insecurity scores were positively correlated with CMD symptoms. However, when analyzing the effect of the nutritional and social pathways on CMD symptoms, results varied depending on the location. Researchers found that socially food-related behaviors in this study were significant in Ethiopia. In Ethiopia, both “CoC” and “food prestige” scores were correlated with CMD symptoms. However, in Brazil, “CoC” and “Food Prestige” scores were not correlated with CMD symptoms. 

This study found nutritional deficiencies within both populations; however, the nutritional measures were not correlated with food insecurity in Brazil and Ethiopia. Although no correlations between food insecurity and mental health were explored in the nutritional pathway, researchers state their nutritional assessment was limited to arm fat area, BMI, and hemoglobin. This information allows future researchers to test for other possible nutritional measures that could reveal a relationship between food insecurity and CMD symptoms through other health markers, such as essential nutrients that promote healthy brain function.

Micronutrients that might substantially impact an individual’s mental well-being are B vitamins, folate, and vitamin D

 

Measuring arm fat area, BMI, and hemoglobin levels may play a significant role in revealing how ‘healthy’ we are. However, these three health markers may not be as directly evident of mental well-being as other nutritional factors. Many vitamins and minerals have been researched to reveal a significant relationship with mental health (see Micronutrients and Mental Health in the CNP Research Libraries). Examples of micronutrients that might substantially impact an individual’s mental well-being are B vitamins (Sánchez-Villegas et al., 2009), folate (Bender et al., 2017), and vitamin D ( Högberg et al., 2012). Folate is found in many vegetables and has been previously discovered to be associated with depression significantly. The micronutrients vitamin B-12 and vitamin D are highly available in animal-based foods, and animal-based foods such as meat were labeled as “prestigious” in this study. Those who are “food insecure” were less likely to consume “prestigious” foods. Therefore, exploring vital micronutrients that are more prevalent in “prestigious foods” is an alternative way to assess how food insecurity impacts mental health through nutritional pathways. Analyzing alternative nutritional variables may help reveal significant evidence of how nutrition plays a role in food insecurity and well-being in future studies.

References

Bender, A., Hagan, K. E., & Kingston, N. (2017). The association of folate and depression: A meta-analysis. Journal of Psychiatric Research, 95, 9–18. https://doi.org/10.1016/j.jpsychires.2017.07.019

Högberg, G., Gustafsson, S. A., Hällström, T., Gustafsson, T., Klawitter, B., & Petersson, M. (2012). Depressed adolescents in a case-series were low in vitamin D and depression was ameliorated by vitamin D supplementation. Acta Paediatrica, 101(7), 779–783. https://doi.org/10.1111/j.1651-2227.2012.02655.x

Sánchez-Villegas, A., Doreste, J., Schlatter, J., Pla, J., Bes-Rastrollo, M., & Martínez-González, M. A. (2009). Association between folate, vitamin B6 and vitamin B12 intake and depression in the SUN cohort study. Journal of Human Nutrition and Dietetics, 22(2), 122–133. https://doi.org/10.1111/j.1365-277X.2008.00931.x

Weaver, L. J., Owens, C., Tessema, F., Kebede, A., & Hadley, C. (2021). Unpacking the “black box” of global food insecurity and mental health. Social Science & Medicine (1982), 282, 114042–114042. https://doi.org/10.1016/j.socscimed.2021.114042

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