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The impact of the Mediterranean diet on alleviating depressive symptoms in adults: a systematic review and meta-analysis of randomized controlled trials.
Bizzozero-Peroni, B, Martínez-Vizcaíno, V, Fernández-Rodríguez, R, Jiménez-López, E, Núñez de Arenas-Arroyo, S, Saz-Lara, A, Díaz-Goñi, V, Mesas, AE
Nutrition reviews. 2024
Abstract
CONTEXT High adherence to the Mediterranean diet (MD) has been associated with a reduced risk of depression in prospective cohort studies, but whether MD interventions are effective among adults with depression is uncertain. OBJECTIVE This study aimed to synthesize findings on the effects of MD interventions on the severity of depressive symptoms in adults with depression. DATA SOURCES PubMed, Cochrane CENTRAL, PsycINFO, Scopus, and Web of Science were systematically searched from database inception to March 2023. The Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines and the Cochrane recommendations were followed. We included randomized controlled trials (RCTs) comparing outcomes after MD interventions with outcomes for control conditions in adults with depressive disorders or depressive symptoms. DATA EXTRACTION Two authors extracted the data independently. The Sidik-Jonkman estimator, the I2 metric, and the prediction interval were used to estimate between-study heterogeneity. To determine the risk of bias and the certainty of evidence from RCTs, we used the Cochrane Collaboration's Risk of Bias 2 and Grades of Recommendation, Assessment, Development, and Evaluation tools, respectively. DATA ANALYSIS In total, 1507 participants (mean age range: 22.0 years-53.3 years) with depression were initially included in the 5 RCTs of this review. Compared with control conditions, MD interventions significantly reduced depressive symptoms among young and middle-aged adults with major depression or mild to moderate depressive symptoms (standardized mean difference: -0.53; 95% confidence interval: -0.90 to -0.16; I2 = 87.1%). The prediction interval ranged from -1.86 to 0.81. The overall risk of bias was within the range of "some concerns" to "high," while the certainty of evidence was low. CONCLUSION MD interventions appear to have substantial potential for alleviating depressive symptoms in people experiencing major or mild depression. However, to establish robust recommendations, there remains a need for high-quality, large-scale, and long-term RCTs. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42022341895.
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Does intermittent fasting impact mental disorders? A systematic review with meta-analysis.
Fernández-Rodríguez, R, Martínez-Vizcaíno, V, Mesas, AE, Notario-Pacheco, B, Medrano, M, Heilbronn, LK
Critical reviews in food science and nutrition. 2023;(32):11169-11184
Abstract
Accumulating evidence supports the benefits of intermittent fasting (IF) as a dietary strategy for cardiometabolic health and weight control. However, little is known about the potential implications of IF on mental disorders. The aim of this review was to synthesize evidence regarding the effects of IF on mental disorders (depression, anxiety, and mood state) in the general population. We conducted a systematic search in five databases from inception to January 2022. Randomized and nonrandomized clinical trials (RCTs/nonRCTs) were included. A random effects method was used to pool standardized mean differences (SMDs) and 95% CIs. A total of 14 studies involving 562 individuals were included, of which 8 were RCTs and 6 were nonRCTs. IF showed a moderate and positive effect on depression scores when compared to control groups (SMD: 0.41; 95%CI: 0.05 to 0.76; I2=45%; n = 4). Conversely, within-group analyses did not show any significant effect of IF on anxiety (SMD: 0.10; 95%CI: -0.09 to 0.30; I2=0%; n = 5) or mood state (SMD: 0.14; 95%CI: -0.09 to 0.37; I2=59%; n = 7). IF modalities did not negatively impact mental disorders in the general population. In fact, IF showed a positive influence on diminishing depression scores, and did not modify anxiety or mood.
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Nut Consumption and Depression: Cross-Sectional and Longitudinal Analyses in Two Cohorts of Older Adults.
Fernández-Rodríguez, R, Ortolá, R, Martínez-Vizcaíno, V, Bizzozero-Peroni, B, Rodríguez-Artalejo, F, García-Esquinas, E, López-García, E, Mesas, AE
The journal of nutrition, health & aging. 2023;(6):448-456
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OBJECTIVES To assess the cross-sectional and longitudinal associations between nut consumption and depression in two cohorts of older adults. DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS The first cohort (Seniors-ENRICA-I or SE-I) included a representative sample of Spanish noninstitutionalized adults aged ≥65 years interviewed in 2010 and 2013. The second cohort (SE-II) included individuals from the Madrid region, Spain, aged ≥65 years interviewed in 2017 and in 2019. Nut consumption was estimated with a validated computer-based diet history. Depression was defined as self-reported physician-diagnosed depression or the use of antidepressants. Logistic regression models were adjusted for the main confounders. The DerSimonian and Laird random-effect method was used to meta-analyze the results from both studies. A participant-level pooled analysis was conducted to examine the robustness of our analyses. RESULTS The SE-I included 2278 individuals (233 prevalent cases) in the cross-sectional analysis and 1534 (108 incident cases) in the longitudinal analysis; the corresponding figures for SE-II were 2726 (407 prevalent cases) and 1566 (74 incident cases). In the meta-analysis of cross-sectional results from the two studies, compared to consuming <1 serving (30 g) of nuts/week, the odds ratio (95% confidence interval) for depression was 0.90 (0.64, 1.16) for consuming 1 to <3 servings/week and 0.92 (0.70, 1.13) for consuming ≥3 servings/week; the corresponding figures for the longitudinal results were 0.90 (0.41, 1.38) and 0.66 (0.35, 0.97). CONCLUSION Nut consumption was associated with a lower risk of depression in a pooled longitudinal analysis using data from two cohorts of older adults. Nuts should be recommended as part of a healthy diet in older adults.
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A Cluster Randomized Controlled Trial of the Archena Infancia Saludable Project on 24-h Movement Behaviors and Adherence to the Mediterranean Diet among Schoolchildren: A Pilot Study Protocol.
López-Gil, JF, García-Hermoso, A, Smith, L, Gallego, A, Victoria-Montesinos, D, Ezzatvar, Y, Hershey, MS, Gutiérrez-Espinoza, H, Mesas, AE, Jiménez-López, E, et al
Children (Basel, Switzerland). 2023;(4)
Abstract
Objective: The aim of this paper is to describe the protocol of pilot cluster randomized controlled trial (RCT) that will evaluate the effects of a lifestyle-based intervention. The Archena Infancia Saludable project will have several objectives. The primary objective of this project is to determine the 6-month effects of a lifestyle-based intervention on adherence to 24-h movement behaviors and Mediterranean diet (MedDiet) in schoolchildren. The secondary objective of this project is to test the intervention effects of this lifestyle-based intervention on a relevant set of health-related outcomes (i.e., anthropometric measurements, blood pressure, perceived physical fitness, sleep habits, and academic performance). The tertiary objective is to investigate this intervention's "halo" effect on parents'/guardians' 24-h movement behaviors and adherence to the MedDiet. Methods: The Archena Infancia Saludable trial will be a cluster RCT submitted to the Clinical Trials Registry. The protocol will be developed according to SPIRIT guidelines for RCTs and CONSORT statement extension for cluster RCTs. A total of 153 eligible parents/guardians with schoolchildren aged 6-13 years will be randomized into an intervention group or a control group. This project focuses on two fundamental pillars: 24-h movement behaviors and MedDiet. It will mainly focus on the relationship between parents/guardians and their children. Behavior change strategies for dietary and 24-h movement behaviors in schoolchildren will be based on healthy lifestyle education for parents/guardians through infographics, video recipes, brief video clips, and videos. Conclusions: Most of the current knowledge on 24-h movement behaviors and adherence to the MedDiet is based on cross-sectional or longitudinal cohort studies, warranting a need to design and conduct RCTs to obtain more robust evidence on the effect of a healthy lifestyle program to increase 24-h movement behaviors and to improve adherence to the MedDiet in schoolchildren.
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Organic Egg Consumption: A Systematic Review of Aspects Related to Human Health.
Mesas, AE, Fernández-Rodríguez, R, Martínez-Vizcaíno, V, López-Gil, JF, Fernández-Franco, S, Bizzozero-Peroni, B, Garrido-Miguel, M
Frontiers in nutrition. 2022;9:937959
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Recently, there has been an increase in organic food consumption. Among the specific foods included in worldwide dietary patterns that are organically produced is the chicken egg. The aim of this study was to synthesize the available evidence on the association between organic egg consumption and human health. This study is systematic review of three studies. This study shows that: - two of the studies reported favourable results in terms of higher serum carotenoid levels and lower levels of specific inflammatory markers associated with the consumption of organic eggs. - scientific evidence has thus far not focused on whether organic eggs are directly associated with health benefits but on the nutritional value of organic foods compared to conventional foods which in turn could lead to advantages for human health. Authors conclude organic eggs may have nutritional advantages over conventional or non-organic eggs, possibly related to the higher levels of carotenoids and the reduction in the inflammatory potential of the diet. However, their findings are limited thus no firm conclusions can be drawn about the benefits of organic eggs on human health.
Abstract
Consumption of organic foods has increased recently, but evidence about their potential health benefits is still limited. This systematic review aims to synthesize the available scientific evidence on the association between organic egg consumption and human health. We searched for peer-reviewed articles on this subject indexed in the MEDLINE, EMBASE, Web of Science and Cochrane Library databases from the inception date to April 13, 2022. This review was based on PRISMA guideline recommendations. Three studies on organic egg consumption in humans were included. After 8 weeks of consuming organic eggs, one randomized crossover trial found that participants had higher serum concentrations of the beta-carotene lutein compared to the period without consuming organic eggs. Moreover, in a cross-sectional study with nationally representative data from Americans over the age of 50, it was found that consumption of organic eggs was associated with lower levels of the inflammatory markers C-reactive protein and cystine C compared with conventional eggs. Finally, in a cohort of children aged 0 to 2 years, no significant association was observed between consuming organic eggs and the risk of eczema. In conclusion, the evidence about the potential benefits of organic egg consumption and human health is promising but still requires further research. A human research agenda is proposed based on laboratory studies pointing out that organic eggs have a more desirable nutritional profile than conventional eggs.
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Does the evidence support a relationship between higher levels of nut consumption, lower risk of depression, and better mood state in the general population? A systematic review.
Fernández-Rodríguez, R, Jiménez-López, E, Garrido-Miguel, M, Martínez-Ortega, IA, Martínez-Vizcaíno, V, Mesas, AE
Nutrition reviews. 2022;(10):2076-2088
Abstract
CONTEXT Dietary patterns play a key role in mental health, depression, and mood state. However, the evidence concerning specific foods highly recommended for mental health, such as nuts, has not yet been synthesized. OBJECTIVE The objective of this review was to synthesize the evidence for a relationship between higher levels of nut consumption, lower risk of depression, and better mood state in the general population. DATA SOURCES The MEDLINE, Scopus, Cochrane Central, Web of Science, and PsycInfo databases were systematically searched from each database's inception to March 2021. DATA EXTRACTION Randomized clinical trials (RCTs) and observational studies exploring the association between nut consumption, level of depression, and mood state in the general population were included. The quality of the studies was measured through the Joanna Briggs Institute tool (cross-sectional studies), the NIH Quality Assessment Tool (cohort studies), and the Cochrane Risk-of-Bias tool (RCTs). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. DATA ANALYSIS A total of 10 studies involving 66 418 individuals were included, of which 3 were cross-sectional, 3 were cohort studies, and 4 were RCTs. In studies concerned with depression (n = 6 studies), a higher level of nut consumption was associated with a lower risk of depression in 2 cross-sectional studies and 1 cohort study, while a similar but nonsignificant association was found in another cohort and in two RCTs. In studies concerned with mood state (n = 4), 1 cohort study reported an association between higher nut consumption and significant improvement in mood state, whereas (nonsignificant) associations between higher nut consumption and increased negative feelings were reported in a cross-sectional study and two RCTs. CONCLUSION Despite the small number of studies and the limitations related to them, such as reverse causation bias, overall, the available literature suggests that higher nut consumption could be associated with a lower risk of depression, fewer depressive symptoms, and better mood state in the general population. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42021241070.
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Mediterranean Diet Interventions for Depressive Symptoms in Adults with Depressive Disorders: A Protocol for a Systematic Review and Meta-Analysis.
Bizzozero-Peroni, B, Godoy-Cumillaf, A, Fernández-Rodríguez, R, Rodríguez-Gutiérrez, E, Jiménez-López, E, Giakoni-Ramírez, F, Duclos-Bastías, D, Mesas, AE
International journal of environmental research and public health. 2022;(21)
Abstract
The associations between Mediterranean diet (MD) adherence and depression levels have been synthesized from observational studies. However, a systematic review with meta-analysis including randomized controlled trials (RCTs) on this relationship in adults with depressive disorders remains lacking. This protocol was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis for Protocols statement. MEDLINE (PubMed), Cochrane CENTRAL, PsycINFO, Scopus, and Web of Science databases will be systematically searched to identify studies published from database inception up to 30 September 2022. The inclusion criteria will comprise RCTs reporting pre-post changes in depression status (symptoms or remission) after a MD intervention compared to a control condition in adults over 18 years with depressive disorders. Pooled effect sizes and 95% confidence intervals will be calculated using the DerSimonian random-effects model. This study protocol determines the methodological approach for the systematic review and meta-analysis that will summarize the available evidence on the efficacy of MD interventions on depressive symptoms in adults with depressive disorders. The findings from this review may have implications for public mental health programs. The results will be disseminated through peer-reviewed publication, conference presentation, and infographics. No ethical approval will be required since only published data will be used. PROSPERO registration number: CRD42022341895.
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Egg Consumption and Blood Lipid Parameters According to the Presence of Chronic Metabolic Disorders: The EVIDENT II Study.
Mesas, AE, Garrido-Miguel, M, Fernández-Rodríguez, R, Fernández Franco, S, Lugones-Sánchez, C, García-Ortiz, L, Martínez-Vizcaíno, V
The Journal of clinical endocrinology and metabolism. 2022;(3):e963-e972
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CONTEXT Egg consumption is one of the main dietary sources of cholesterol, but whether individuals who eat more eggs have a worse blood lipid profile remains controversial. OBJECTIVE We examined the relationship between egg consumption and lipid parameters and explored whether this relationship changes according to the presence of chronic metabolic disorders. METHODS A multicenter cross-sectional study was conducted with adult participants in the EVIDENT II trial. Adjusted linear regression models were stratified by the main chronic metabolic disorders. RESULTS Among the 728 participants (61.9% women, mean age 52.1 ± 11.9 years), the mean egg consumption was equivalent to 5 to 6 eggs per week for a 70-kg individual. In the fully adjusted analysis, no association was found of egg consumption with total and high-density lipoprotein cholesterol (HDL-c), and triglyceride levels. Furthermore, compared with the first quartile of consumption, the fourth quartile was associated with lower low-density lipoprotein cholesterol (LDL-c) levels (coefficient -7.01; 95% CI -13.39, -0.62) and a lower LDL-c/HDL-c ratio (coefficient -0.24, 95% CI -0.41, -0.06). In the analyses stratified by chronic metabolic diseases, higher egg consumption was not associated with lipid profile in those with obesity, hypertension, type 2 diabetes, dyslipidemia, or treated with hypolipidemic drugs, and was associated with a better lipid profile in participants without these conditions. CONCLUSION Higher egg consumption was not associated with blood lipids in individuals with chronic metabolic disorders. In individuals without such conditions, the lipid profile was better among those who consumed more eggs. Our findings support current guidelines recommending eggs as part of a healthy diet.
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Napping and cognitive decline: a systematic review and meta-analysis of observational studies.
Álvarez-Bueno, C, Mesas, AE, Reina-Gutierrez, S, Saz-Lara, A, Jimenez-Lopez, E, Martinez-Vizcaino, V
BMC geriatrics. 2022;(1):756
Abstract
BACKGROUND No clear evidence is available for the influence of napping on cognitive function in older adults. This systematic review and meta-analysis aimed to elucidate the cross-sectional and longitudinal relationships between napping and cognitive function (global cognition and memory) and to explore whether some individual characteristics and sleep characteristics can modify this relationship. METHODS We systematically searched Medline (via PubMed), Web of Science, and Scopus. DerSimonian and Lair and Hartung-Knapp-Sidik-Jonkman random effects methods were used to compute pooled estimates of odds ratios (ORs) and their respective 95% confidence intervals (95% CIs) for the association of global cognition and memory with napping. The mean age, the night sleep time (hours), and the percentage of women, no nappers, and people in the less night-time sleep duration category were used for meta-regressions. RESULTS Twenty-five studies were included in this systematic review and meta-analysis, 18 cross-sectional and seven longitudinal studies, including 95,719 participants older than 60 years. The pooled ORs from the cross-sectional analyses were 1.03 (95% CI: 1.01 to 1.06) for global cognition and 1.06 (95%: 0.90 to 1.26) for memory. The pooled ORs from the longitudinal analyses were 1.00 (95% 0.85 to 1.18) for global cognition and 1.08 (95% 0.98 to 1.19) for memory. These associations were not modified by individual or sleep characteristics. CONCLUSION Our data confirm the absence of association between napping and global cognition and memory regardless of the characteristics of the population. This information might be considered when providing lifestyle recommendations to adults with and without cognitive complaints.
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Hybrid and Remote Psychosocial Interventions Focused on Weight and Sedentary Behavior Management Among Patients with Severe Mental Illnesses: a Systematic Review.
Oliveira, ACN, Guariente, SMM, Zazula, R, Mesas, AE, Oliveira, CEC, Reiche, EMV, Nunes, SOV
The Psychiatric quarterly. 2022;(3):813-840
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Severe mental illness could be defined through its diagnosis, disability, and duration, and one of their main characteristics is the high prevalence of some clinical conditions such as obesity and metabolic syndrome. Although the promotion of a healthier lifestyle has been demonstrated as an effective strategy to reduce both body mass index and abdominal circumference in this population, there is a lack of studies focusing on digital intervention in this population. The aim of this systematic review was to evaluate the efficacy of studies that used digital technologies to reduce weight, body mass index (BMI) and abdominal circumference in individuals with severe mental illness. This current review also compared remote and hybrid interventions, the effects of those interventions in metabolic biomarkers as well as in the development of a healthier lifestyle. The main findings included the following: (a) the use of digital devices or strategies might be feasible and useful to reduce sedentary behavior among individuals with severe mental illnesses, 2) most interventions used digital pedometers and mobile phone communication (either text messages or phone calls) as main strategies, 3) all remote interventions and six of nine hybrid interventions found significant outcomes in favor of their interventions. In conclusion, even with a limited number of studies promoting healthier lifestyle through digital interventions among individuals with severe mental illnesses, evidence from studies included in this review showed that they might be useful to improve a healthier lifestyle and increase the frequency of physical activity behavior.