1.
Shared Dysregulation of Homeostatic Brain-Body Pathways in Depression and Type 2 Diabetes.
Hoogendoorn, CJ, Roy, JF, Gonzalez, JS
Current diabetes reports. 2017;17(10):90
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Plain language summary
Depression and type 2 diabetes (T2D) appear to have a bidirectional relationship, with the two diseases possibly being linked through emotional and biological changes. This review paper aimed to discuss this bidirectional relationship and in particular the biological changes that may be involved. The authors started by stating that two biological systems may be influenced in depression and T2D, the hypothalamic-pituitary-adrenal axis (HPA), which is responsible for many systems in the body involved in the stress response and emotional and physical health. The second is the brain-gut-microbiome axis (BGM), which is related to the microorganisms in the gut and how they communicate with the brain. The immune system, sleep and blood sugar balance may be influenced by the HPA and BGM and are all dysregulated in both depression and T2D indicating a link between the two diseases. However causal relationships need further research. Dietary and lifestyle changes may be of benefit in these individuals. It was concluded that the disruption of shared biological systems in T2D and depression may be an important target for treatments, however further research is warranted. This study could be used by healthcare practitioners to understand the relationship between T2D and depression and the potential therapeutic areas to target. However, although research is optimistic, it is still in its infancy.
Abstract
PURPOSE OF REVIEW The purpose of this review is to provide an overview of shared dysregulation of the hypothalamic-pituitary-adrenal (HPA) and brain-gut-microbiome (BGM) axes associated with depression and type 2 diabetes (T2D). Clinical implications and future research are also discussed. RECENT FINDINGS Both depression and T2D are associated with dysregulation of the HPA and BGM axes. These pathways regulate immune function, glucose metabolism, and sleep, which are altered in both illnesses. Dysregulation of homeostatic brain-body pathways may be positively influenced through different therapeutic actions, including psychotherapy, healthy eating, physical activity, sleep promotion, and certain anti-inflammatory or antidepressant medications. While the causal nature of the relationship between depression and T2D remains unclear, these conditions share dysregulation of homeostatic brain-body pathways that are central to mental and physical health. Better understanding of this dysregulation may provide opportunities for interventions that could benefit both conditions. Future research should examine the additive burden of depression and T2D on HPA and BGM dysregulation and better differentiate depression from emotional distress.
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Short sleep duration and dietary intake: epidemiologic evidence, mechanisms, and health implications.
Dashti, HS, Scheer, FA, Jacques, PF, Lamon-Fava, S, Ordovás, JM
Advances in nutrition (Bethesda, Md.). 2015;6(6):648-59
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Short sleep duration is associated with various cardio-metabolic parameters that contribute to chronic disease. While the underlying mechanism is multifactorial, the link may be mediated through changes in dietary intake. This review provides an overview of the relationship between chronic short sleep duration and dietary intake. This review indicates that short sleep duration is associated with higher total caloric intake, higher fat intake and diets with relatively higher fat and lower protein composition. Further epidemiological studies are required to better establish the relationship between chronic short sleep and dietary patterns, and improvements in sleep should be an added factor in weight management programmes.
Abstract
Links between short sleep duration and obesity, type 2 diabetes, hypertension, and cardiovascular disease may be mediated through changes in dietary intake. This review provides an overview of recent epidemiologic studies on the relations between habitual short sleep duration and dietary intake in adults from 16 cross-sectional studies. The studies have observed consistent associations between short sleep duration and higher total energy intake and higher total fat intake, and limited evidence for lower fruit intake, and lower quality diets. Evidence also suggests that short sleepers may have irregular eating behavior deviating from the traditional 3 meals/d to fewer main meals and more frequent, smaller, energy-dense, and highly palatable snacks at night. Although the impact of short sleep duration on dietary intake tends to be small, if chronic, it may contribute to an increased risk of obesity and related chronic disease. Mechanisms mediating the associations between sleep duration and dietary intake are likely to be multifactorial and include differences in the appetite-related hormones leptin and ghrelin, hedonic pathways, extended hours for intake, and altered time of intake. Taking into account these epidemiologic relations and the evidence for causal relations between sleep loss and metabolism and cardiovascular function, health promotion strategies should emphasize improved sleep as an additional factor in health and weight management. Moreover, future sleep interventions in controlled studies and sleep extension trials in chronic short sleepers are imperative for establishing whether there is a causal relation between short sleep duration and changes in dietary intake.