Tag: depression

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).

 

%learn about nutrition mental health %The Center for Nutritional Psychology

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

 

 

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).

 

%learn about nutrition mental health %The Center for Nutritional Psychology

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).

 

%learn about nutrition mental health %The Center for Nutritional Psychology

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).

 

%learn about nutrition mental health %The Center for Nutritional Psychology

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

 

 

 

 

 

Depressive Individuals Tend To Eat More Sugar

Posted on by CNP Staff
  • An analysis of the National Health and Nutrition Examination Survey data published in BMC Psychiatry found an association between sugar intake and depression in U.S. adults.
  • With every 100 grams of additional sugar intake, the prevalence of depression increased by 28%.
  • Results were similar across subgroups by age, sex, education, and other personal characteristics.

Most people know that there is a link between appetite and mood. When stressed, some of us tend to eat more (Dakanalis et al., 2023). A similar thing happens when we do not have enough sleep (Greer et al., 2013). On the other hand, when we are hungry, we tend to become angry and irritable. That is how the term “hangry” came to be (Hedrih, 2023a; Swami et al., 2022). But is there a link between moods or mental health in general and specific foods? For example, do the dietary choices of individuals suffering from depression differ from the dietary choices of individuals who aren’t suffering from depression?

 

Do the dietary choices of individuals with depression differ from the dietary choices of individuals without depression?

 

What is depression?


Depression is a common and serious mental health condition characterized by persistent feelings of sadness, hopelessness, and a lack of interest or pleasure in activities. It can affect a person’s thoughts, behavior, feelings, and sense of well-being, leading to various emotional and physical problems. Symptoms can include changes in appetite, sleep disturbances, fatigue, difficulty concentrating, and even thoughts of death or suicide (see Figure 1).

 

%learn about nutrition mental health %The Center for Nutritional Psychology

Figure 1. Symptoms of depression

 

Depression is one of the most prevalent mental health disorders worldwide. The share of depressed individuals has been on the rise in recent decades in many world countries (Steffen et al., 2020; Weinberger et al., 2018). In 2018, the World Health Organization estimated that 4.4% of the global population is affected by it (Zhang et al., 2024). They expect the numbers to rise further in the coming years.

Unfortunately, existing treatments for depression are not very effective. It is estimated that around 30% of individuals suffering from depression do not respond to standard treatments, i.e., these treatments do not result in the withdrawal of depression symptoms (McIntyre et al., 2023). That is why a large number of scientists are working on finding novel ways to diagnose and treat depression. One of the topics that draw interest in this regard is the dietary specificities of people suffering from depression.

 

Around 30% of individuals suffering from depression do not respond to standard treatments

 

Dietary choices and depression


In recent decades, many studies have reported links between symptoms of depression and anxiety and various food choices. A large-scale study found that depressed women tend to drink artificially sweetened beverages and eat ultraprocessed food more than the average person (Hedrih, 2023b; Samuthpongtorn et al., 2023). Another study linked the consumption of fried food with symptoms of anxiety and depression. These researchers conducted an experiment showing that acrylamide, a product of frying foods such as potatoes, can induce anxiety-like symptoms in zebrafish (Wang et al., 2023). 

Similarly, many studies link increased sugar consumption with adverse health outcomes (Huang et al., 2023). But does this include depression?

 

Many studies report links between symptoms of depression and anxiety and various food choices (artificially sweetened beverages and fried foods)

 

The current study


Study author Lu Zhang and her colleagues wanted to explore whether sugar consumption is associated with the severity of depressive symptoms (Zhang et al., 2024). They analyzed data from the National Health and Nutrition Examination Survey database. The National Health and Nutrition Examination Survey is a program of studies conducted by the National Center for Health Statistics (NCHS), part of the Centers for Disease Control and Prevention (CDC), designed to assess the health and nutritional status of adults and children in the United States through interviews and physical examinations.

The study data


Data used in this study came from participants aged 20 or above who provided their survey responses between 2011 and 2018. The study authors used data on the frequency of depressive symptoms (the Patient Health Questionnaire) and dietary sugar intake. Dietary information was collected from participants through two interviews held 3-10 days apart. In these interviews, researchers asked participants to recall all types and amounts of food and beverages they consumed during the 24 hours before the interviews. Dietary sugar intake was calculated from data collected in these interviews.

The study authors also analyzed data on several other participants’ characteristics. These included body mass index, age, total energy intake, education level, race, marital status, physical activity, etc.

This analysis used data from 18,439 participants (see Figure 2).

 

%learn about nutrition mental health %The Center for Nutritional Psychology

Figure 2. Study Procedure (Zhang et al., 2024)

 

Older, wealthier, more educated, partnered, and female participants tend to consume the least sugar

 

Results showed that individuals consuming the least sugar daily tended to be older, female, and wealthy. Their overall energy intake was lower; they smoked less and drank more than the average participant. Participants with the highest daily sugar intake tended to be younger, male, and with lower income. They tended to have never smoked and had a higher energy intake than average.

Depressed individuals tended to consume more sugar


There was a clear association between the prevalence of depression and sugar intake. On average, people consumed around 93 grams of sugar per day, but individuals were consuming quite a bit more than that. One-quarter of participants consumed over 140 grams per day. Statistical analyses showed that for every additional 100 grams of daily sugar consumption, the share of participants with depression increased by 28% (see Figure 3).

 

%learn about nutrition mental health %The Center for Nutritional Psychology

Figure 3. Association between depression prevalence and sugar intake

 

Conclusion


The study shows a clear link between dietary sugar consumption and depression. However, the design of the study does not allow us to conclude whether it is the intake of sugar that contributes to depression or whether it is depression that makes individuals consume more sugary drinks and foods. It is also possible that there is some third factor contributing to both depression and the heightened intake of sugar.

Be that as it may, the link between heightened sugar intake and depression is quite clear. However, it is up to future researchers to identify the underlying mechanism and determine whether limiting dietary sugar intake could help improve symptoms in individuals suffering from this disorder.

The paper “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” was authored by Lu Zhang, Haiyang Sun, Zihui Liu, Jiguo Yang, and Yuanxiang Liu.


References

Dakanalis, A., Mentzelou, M., Papadopoulou, S. K., Papandreou, D., Spanoudaki, M., Vasios, G. K., Pavlidou, E., Mantzorou, M., & Giaginis, C. (2023). The Association of Emotional Eating with Overweight/Obesity, Depression, Anxiety/Stress, and Dietary Patterns: A Review of the Current Clinical Evidence. Nutrients, 15(5), 1173. https://doi.org/10.3390/nu15051173

Greer, S. M., Goldstein, A. N., & Walker, M. P. (2013). The impact of sleep deprivation on food desire in the human brain. Nature Communications, 4. https://doi.org/10.1038/ncomms3259

Hedrih, V. (2023a). Food and Mood: Is the Concept of ‘Hangry’ Real? CNP Articles in Nutritional Psychology. https://www.nutritional-psychology.org/food-and-mood-is-the-concept-of-hangry-real/

Hedrih, V. (2023b). Women Consuming Lots of Artificially Sweetened Beverages Might Have a Higher Risk of Depression, Study Finds. CNP Articles in Nutritional Psychology. https://www.nutritional-psychology.org/women-consuming-lots-of-artificially-sweetened-beverages-might-have-a-higher-risk-of-depression-study-finds/

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

McIntyre, R. S., Alsuwaidan, M., Baune, B. T., Berk, M., Demyttenaere, K., Goldberg, J. F., Gorwood, P., Ho, R., Kasper, S., Kennedy, S. H., Ly-Uson, J., Mansur, R. B., McAllister-Williams, R. H., Murrough, J. W., Nemeroff, C. B., Nierenberg, A. A., Rosenblat, J. D., Sanacora, G., Schatzberg, A. F., … Maj, M. (2023). Treatment-resistant depression: Definition, prevalence, detection, management, and investigational interventions. World Psychiatry, 22(3), 394–412. https://doi.org/10.1002/wps.21120

Samuthpongtorn, C., Nguyen, L. H., Okereke, O. I., Wang, D. D., Song, M., Chan, A. T., & Mehta, R. S. (2023). Consumption of Ultraprocessed Food and Risk of Depression. JAMA Network Open, 6(9), e2334770. https://doi.org/10.1001/jamanetworkopen.2023.34770

Steffen, A., Thom, J., Jacobi, F., Holstiege, J., & Bätzing, J. (2020). Trends in prevalence of depression in Germany between 2009 and 2017 based on nationwide ambulatory claims data. Journal of Affective Disorders, 271, 239–247. https://doi.org/10.1016/J.JAD.2020.03.082

Swami, V., Hochstöger, S., Kargl, E., & Stieger, S. (2022). Hangry in the field: An experience sampling study on the impact of hunger on anger, irritability, and affect. PLOS ONE, 17(7), e0269629. https://doi.org/10.1371/JOURNAL.PONE.0269629

Wang, A., Wan, X., Zhuang, P., Jia, W., Ao, Y., Liu, X., Tian, Y., Zhu, L., Huang, Y., Yao, J., Wang, B., Wu, Y., Xu, Z., Wang, J., Yao, W., Jiao, J., & Zhang, Y. (2023). High-fried food consumption impacts anxiety and depression due to lipid metabolism disturbance and neuroinflammation. Proceedings of the National Academy of Sciences of the United States of America, 120(118). https://doi.org/10.1073/pnas.2221097120

Weinberger, A. H., Gbedemah, M., Martinez, A. M., Nash, D., Galea, S., & Goodwin, R. D. (2018). Trends in depression prevalence in the USA from 2005 to 2015: Widening disparities in vulnerable groups. Psychological Medicine, 48(8), 1308–1315. https://doi.org/10.1017/S0033291717002781

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

 

Can The Quality of Plant-Based Diets Be Unhealthy and Lead to Depression?

Posted on by CNP Staff

This CNP Article is based on the findings from a recent study conducted by Lee, Eather, & Best, (2021).

The consumption of plant-based diets and the rate of depression have both risen within the last decade. While some studies have shown vegan and vegetarian diets to be conducive to mental health problems (e.g., Li et al., 2019), others claim that those who follow a plant-based diet experience higher levels of emotional health and well-being (Beezhold & Johnston, 2012). Still, others suggest that there is no relation (Lavallee, 2019). 

 

Could the lack of conversation around diet quality be cause for conflicting research?

 

Basically, the evidence on the relationship between plant-based dietary patterns and depression is inconsistent and conflicting. One possible explanation for this could be the lack of conversation around diet quality within the realm of plant-based diets. When we think of vegan and vegetarian diets, our brains may automatically conjure up images of health and vitality. And while such diets are associated with decreased risk of obesity, cardiovascular disease, type II diabetes, and other serious health issues, it’s important to discuss the different possible types of plant-based diets (Lee et al., 2021). 

A healthy plant-based dietary pattern is defined by a high intake of fruit, vegetables, nuts, seeds, legumes, whole grains, tofu, tempeh, and other minimally processed soy products. An unhealthy plant-based diet, on the other hand, would be characterized by high consumption of ultra-processed foods, high in fat and refined sugars. While decidedly low in nutrition, such diets can be vegetarian or vegan. You might know someone who falls into this trap — the friend who finds comfort in their decision to eat plant-based, only to consume french fries, donuts, highly processed plant-based meats, and other processed treats habitually. 

%learn about nutrition mental health %The Center for Nutritional Psychology

Noticing the inconsistency within current research when looking at plant-based diets and depression, researchers Lee et al. (2021) took to Facebook, Twitter, and Linkedin to survey the quality of vegans’ and vegetarians’ plant-based diets and their mental health. Of the participants surveyed, 165 self-identified as vegan and 54 as a vegetarian. The participants were aged 18–44, which is the same age group that is at the highest risk for depression (Australian Bureau of Statistics, 2019). The majority (93%) were female. Although this method of data collection and the study’s restricted sample limits our ability to draw sweeping conclusions, it nevertheless adds value to our understanding of the diet-mental health relationship. Let’s take a look at the measurement tools and findings. 

Depression rates of the participants during the week preceding the survey administration were measured using the 20-item Centre for Epidemiological Studies Depression (CESD) scale, with scores of 16 or higher suggesting greater symptoms of depression. Diet quality was assessed using an adapted version of The Dietary Screening Tool (DST), a 20-item questionnaire that asks participants to provide an estimated intake frequency of specific food categories. 

 

As diet quality increased, depressive symptoms decreased.

 

The researchers found that BMI was a significant contributor to the model. In other words, participants with higher depression scores had higher BMIs — a finding that could be a factor of diet quality. Using a multiple linear regression model, it was found that diet quality accounted for 6% of the variation in depressive symptoms, with BMI accounting for a further 3%. Overall, diet quality and BMI accounted for 9% of the variance in depression symptoms. And, notably, as diet quality increased, depressive symptoms decreased. 

With the heightened availability of processed vegan and vegetarian food products, the importance of understanding diet quality should not be understated. This is especially true when considering the rise of research demonstrating that lifestyle changes including diet and exercise have been shown to impact symptoms of depression (e.g., Jacka et al., 2017). In an era where certain diets have sky-rocketed in popularity, it’s worth discussing the quality of plant-Based Diets as opposed to just its label. Only then can we be sure that the type of foods we are consuming is beneficial to both our physical and psychological health.

 

References:

Australian Bureau of Statistics. National health survey: first results, 2017-18 Canberra, act: Commonwealth of Australia, 2019. Available: https://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/4364.0.55.001Main+Features702017-18

Beezhold, B. L., & Johnston, C. S. (2012). Restriction of meat, fish, and poultry in omnivores improves mood: a pilot randomized controlled trial. Nutrition journal, 11, 9. https://doi.org/10.1186/1475-2891-11-9

Jacka, F., O’Neil, A., Opie, R., Itsiopoulos, C., Cotton, S., Mohebbi, M., Castle, D., Dash, S., Mihalopoulos, C., Chatterton, M., Brazionis, L., Dean, O,. Hodge, A., & Berk, M. (2017). A randomised controlled trial of dietary improvement for adults with major depression (the ‘SMILES’ trial). BMC Medicine, 15(23), 1–13. https://doi.org/10.1186/s12916-017-0791-y 

Lavalleea, K.,  Zhanga, X., Michalak, J., Schneider, S., Jürgen, M. (2019). Vegetarian diet and mental health: Cross-sectional and longitudinal analyses in culturally diverse samples. Journal of Affective Disorders, 248, 147–54. https://doi.org/10.1016/j.jad.2019.01.035 

Li, X. D., Cao, H. J., Xie, S. Y., Li, K. C., Tao, F. B., Yang, L. S., Zhang, J. Q., & Bao, Y. S. (2019). Adhering to a vegetarian diet may create a greater risk of depressive symptoms in the elderly male Chinese population. Journal of affective disorders, 243, 182–187. https://doi.org/10.1016/j.jad.2018.09.033

Lee, M. F., Eather, R., & Best, T. (2021). Plant-based dietary quality and depressive symptoms in Australian vegans and vegetarians: A cross-sectional study. BMJ Nutrition, Prevention & Health, e000332. https://doi.org/10.1136/bmjnph-2021-000332

 

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

What is Diet Diversity (DD) and How is it Related to Depression?

Posted on by CNP Staff

Adding various foods to our diet can significantly improve our dietary intake quality, aiding in the prevention of health issues ranging from chronic diseases to behavioral health conditions. The United States Department of Agriculture (USDA) guidelines and the Food Guide Pyramid suggest that eating a diversified diet is health-beneficial. Diet diversity (DD) is defined as the number of different foods or food groups consumed over a given period of time (Ruel, 2003). DD is recognized as a critical element of proper nutrition, as a range of nourishing foods provides a greater abundance of nutrients to support the brain and body.

 

A range of nourishing foods provides a greater abundance of nutrients to support the brain and body.

 

Diet diversity is increasingly associated with numerous factors relating to the diet-mental health relationship (DMHR), including psychological resilience (Yin et al., 2019), memory (Zhang et al., 2020), hippocampal volume (Otsuka et al., 2021), depression (Poorrezaeian et al., 2017), and anxiety (Alenko et al., 2021). 

One method used to measure an individual’s DD involves calculating a Diet Diversity Score (DDS). These scores measure the variability within a person’s diet. In terms of the DMHR, questionnaires can be used to assess the connection between DD with a variety of psychological health and well-being factors.

 

Diet diversity is increasingly associated with numerous factors relating to the diet-mental health relationship.

 

A cross-sectional study examining the connection between DD and mental health was conducted by Poorrezaeian et al. (2017). This study specifically focused on the association of dietary diversity with depression and stress among a sample of 360 randomly selected Iranian women. After conducting interviews to gather information about the participants’ dietary intake, responses were calculated as Diet Diversity Scores. Depression and stress levels were measured through the Depression, Anxiety, and Stress Scales (DASS-42), which is a validated questionnaire designed to capture self-reported scores on these dimensions. 

As expected, participants who ate diets that included a variety of vitamins and minerals ranked higher in terms of DDS. More critically, results showed that a 1 unit increase in DDS was associated with a 39% reduction in the risk of severe depression. In other words, women who had less varied diets had scored lower on DD, and these lower scores were associated with an increased risk of severe depression. 

 

Results showed a 1 unit increase in DDS was associated with a 39% reduction in the risk of severe depression.

 

Although this study found a significant relationship between DDS and severity of depression, no meaningful relationship between mild/moderate depression or stress with DDS was found. The authors note that since the current study findings indicate a relationship between DDS and eating a nutrient-dense diet, future studies examining the specific connection between stress and DDS are important and should be conducted. Some of the existing evidence demonstrating the relationship between stress and unhealthy eating habits can be found in CNP’s Diet and Stress research category). 

 

Thank you to CNP Intern Hashmin Sajjan for contributing this article!

 

References

Alenko, A., Agenagnew, L., Beressa, G., Tesfaye, Y., Woldesenbet, Y. M., & Girma, S. (2021). COVID-19-Related Anxiety and Its Association with Dietary Diversity Score Among Health Care Professionals in Ethiopia: A Web-Based Survey. Journal of Multidisciplinary Healthcare, 14, 987–996. https://doi.org/10.2147/JMDH.S305164

Otsuka, R., Nishita, Y., Nakamura, A., Kato, T., Iwata, K., Tange, C., Tomida, M., Kinoshita, K., Nakagawa, T., Ando, F., Shimokata, H., & Arai, H. (2021). Dietary diversity is associated with longitudinal changes in hippocampal volume among Japanese community dwellers. European Journal of Clinical Nutrition, 75(6), 946–953. https://doi.org/10.1038/s41430-020-00734-z

Poorrezaeian, M., Siassi, F., Milajerdi, A. et al. (2017). Depression is related to dietary diversity score in women: a cross-sectional study from a developing country. Ann Gen Psychiatry, 16, 39. https://doi.org/10.1186/s12991-017-0162-2

Ruel M. T. (2003). Operationalizing dietary diversity: A review of measurement issues and research priorities. The Journal of Nutrition, 133, (11 Suppl 2), 3911S–3926S. https://doi.org/10.1093/jn/133.11.3911S

Yin, Z., Brasher, M. S., Kraus, V. B., Lv, Y., Shi, X., & Zeng, Y. (2019). Dietary Diversity Was Positively Associated with Psychological Resilience among Elders: A Population-Based Study. Nutrients, 11(3), 650. https://doi.org/10.3390/nu11030650

Zhang, J., Zhao, A., Wu, W., Yang, C., Ren, Z., Wang, M., Wang, P., & Zhang, Y. (2020). Dietary Diversity Is Associated With Memory Status in Chinese Adults: A Prospective Study. Frontiers in Aging Neuroscience, 12, 580760. https://doi.org/10.3389/fnagi.2020.580760

 

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