乳及乳制品与抑郁症关联的研究进展

膳食营养与抑郁症的关联已在研究中得到证实，而乳及乳制品作为人类膳食中重要组成部分，其与抑郁症的关系，也开始得到学界的关注，主要包括牛奶、酸奶、发酵及甜味乳制品，但乳及乳制品与抑郁症之间的关联尚未得出明确的结论。乳及乳制品与抑郁症关联的内在机制涉及表观遗传修饰、炎症反应和肠道-脑轴功能紊乱等。本文将分类介绍不同乳及乳制品与抑郁症关联的流行病学研究进展，并探讨其与抑郁症的关联机制，为从膳食营养方面对抑郁症的干预治疗提供循证医学依据。[营养学报，2022,44(3):301-307]     

老年营养状况、膳食因素评估及其与认知障碍相关性的研究进展

膳食因素、营养状况与老年人认知障碍的发生密切相关, 膳食中的脂类、碳水化合物等营养成分过量摄入与认知障碍发生具有一定相关性, 但膳食中的某些微量元素对认知障碍则具有预防作用。本文通过对膳食因素、营养状况与老年人认知障碍的相关性及具体作用机制进行文献综述, 以期为改变认知障碍老年人生活方式以改善其生活质量提供一定理论依据。     

大连市居民健康生活方式行动示范区知识知晓的变化

目的了解大连市城区居民对合理膳食、规律锻炼等基本知识知晓情况及全民健康生活方式行动工作对示范点人群产生的效果，为有效开展全民健康生活方式工作提供科学依据。方法2009年在市卫生局与爱国卫生运动办公室领导下，启动了“全民健康生活方式行动”。各示范点通过张贴宣传画，向居民发放宣传资料、控油壶、控盐勺等支持工具及开展健康知识讲座等多种途径，向示范点居民倡导合理膳食、规律运动等健康生活方式。2012年，在大连市12个区（市、县）20个示范点，对3852名14岁以上的居民进行效果评估问卷调查。结果对膳食知识与身体活动知识共调查13项，居民总体知识总知晓率为62．2％，与2009年比较提高46．0％；其中膳食知识知晓率为71．0％，与2009年比较提高62．8％；身体活动知识知晓率为52．7％，与2009年比较提高55．0％，差异均有统计学意义（P〈0．01）。结论通过在示范点开展的多种形式健康生活方式知识宣传，对提高居民健康生活方式的知识知晓率有一定的促进作用。     

动脉硬化性心脑血管疾病的非药物预防

随着人们生活水平的提高，生活方式也发生着很多转变，其中不良的生活方式对国民健康造成了很大的危害，与吸烟、酗酒、缺乏活动、膳食不合理等生活方式密切相关的高脂血症、高血压、高血糖、肥胖正成为影响我国人民健康素质的重要危险因素。世界卫生组织指出，在控制了吸烟、不合理膳食和缺乏体力活动等危险因素之后，     

抑郁症患者的生活方式与心理控制源特征研究

目的探究抑郁症患者生活方式与心理控制源的特征,并分析心理控制源和生活方式不同层面抑郁症的影响。方法从2011年3—4月来该院就诊的门诊和住院的首发抑郁症患者中,选取抑郁症患者42例及正常对照42例,并进行一般资料、抑郁自评量表、心理控制源量表和生活方式等问卷测查,将其中的抑郁自评量表转换为标准分,采用SPSS 11.5软件对心理控制源和生活方式的不同层面对抑郁的影响进行统计分析。结果共获取有效问卷84份,其中检出抑郁症患者42例,正常对照42份。受检抑郁症患者SDS平均分值为(67.82±9.56)分,具有随其生活方式各层面质量的下降而加重的趋势,其抑郁程度在生活满意度和人际关系方面低于正常受试者(P<0.05)。结论抑郁症患者表现为外控性特征,症状的严重程度与生活方式关系密切。     

生活方式与抑郁症状的关联性研究：TCLSIH研究

目的 选取2013－2016年天津慢性低度炎症与健康（TCLSIH）队列人群为研究对象,探讨生活方式各因素与抑郁症状的关系,为开展生活方式干预和防治抑郁症提供参考依据。方法 采用横断面研究,对24 256名研究对象进行抑郁自评量表（SDS）评估抑郁症状、生活方式调查问卷以及体格检查。采用SAS 9.3软件,将SDS评分按总分<45和≥45分为无抑郁症状组和抑郁症状组,分析生活方式各因素与抑郁症状的关系。结果 研究对象中SDS≥45分占16.59%。基线调查显示：与无抑郁症状组人群相比,抑郁症状组人群有较高中性粒细胞计数与淋巴细胞计数比（NLR）水平（P<0.01）、有较低的BMI、总能量摄入和身体活动量（P<0.000 1）;并倾向于少吃植物性膳食模式、较多的食用动物性食物膳食模式及甜食和水果膳食模式（P<0.000 1）。抑郁症状组人群中吸烟者的比例较高、偶尔饮酒者比例较低（P<0.01）;有较多的女性、独居者、文化程度低、家庭月总收入低;每日室外时间>5 h者比例较高;而管理人员、已婚者和喜欢与亲友来往者比例较低。logistic回归多因素分析结果显示：男性、年龄、NLR、吸烟（OR=1.14,95% CI：1.03~1.26）、已戒酒状态、动物性食物膳食模式（OR=1.41,95% CI：1.35~1.46）、甜食和水果膳食模式（OR=1.17,95% CI：1.13~1.22）、睡眠时间>7.5 h/d、室外活动时长3~5 h/d、室外活动时长>5 h/d与抑郁症状呈正相关（P<0.05）;而BMI（OR=0.98,95% CI：0.97~0.99）、文化程度（OR=0.76,95% CI：0.70~0.82）、管理人员、家庭月总收入（OR=0.63,95% CI：0.58~0.68）、总能量摄入、身体活动量（OR=0.86,95% CI：0.84~0.89）、已婚状态、喜欢与亲友来往与抑郁症状呈负相关（P<0.05）。结论 生活方式各因素与抑郁症状密切相关,开展生活方式干预抑郁症将成为抑郁症防治的新途径。     

科学生活 健康延寿

人的寿命60％取决于自己的生活方式。如果有了较好的遗传因素和医疗条件，又有良好的生活方式，延缓衰老以至健康长寿就有可能。良好的生活方式要讲究科学，科学的生活方式有四项：就是心理平衡，合理膳食．适量运动，健康生活。限于篇幅，这里只说说合理膳食和健康生活。     

骨密度与营养状况和生活方式的关系

[目的]探讨我院门诊部分体检人员营养状况、生活方式与骨密度关系。[方法]整群抽取无内分泌和影响钙磷代谢的疾病以及影响钙磷代谢的药物史的骨密度检查志愿者551例，比较其膳食营养与生活方式等情况；对35～64岁年龄段女性按骨质正常与骨质异常分组，并进行膳食营养及其相关因素比较。膳食调查采用3日回顾法营养软件统一处理：对户外锻炼、喝酒等生活方式采用问卷方式登记处理。骨密度测定运用美国产骨密度仪，采用X线放射数字吸收法。[结果]随着年龄增长，骨质异常总体发生率增高，女性高于男性。但35～54年龄段，骨质异常率出现反转现象。男性高于女性，其中35～44年龄段，两组差异有统计学意义；35～64岁年龄段女性骨质正常与骨质异常膳食情况,两组钙与蛋白质摄入水平均略低于DRIs；两组比较，正常组在补钙、运动以及奶制品、大豆制品的摄食频度等均好于异常组,其中补钙时闻和大豆摄食频度以及雌激素等应用比率两组差异有统计学意义。[结论]骨密度与膳食营养和现代生活方式密切相关。中年男性轻（含极轻）体力劳动者骨质疏松的预防应引起足够重视；女性围绝经期补钙和健康生活方式的建立为该时期骨质疏松防治的良好补救措施。     

某校大学生抑郁症患者社会心理影响因素的调查

目的探讨重点大学学生抑郁症患者的社会心理影响因素,为当代大学生的心理健康教育工作提供一定的依据,以有效改变现状。方法采用社会支持评定量表,简易应对方式问卷,生活事件自评量表和一般情况调查问卷,对61名大学生抑郁症患者进行测评,用统计学方法分析影响学生抑郁的相关因素。结果大学生抑郁症患者社会支持总分与国内常模相比较差异存在统计学意义(P<0.05或P<0.01);社会支持与应对方式总分呈正相关;负性生活事件调查中得分较高的选项为受人歧视或冷遇、学习就业压力、家庭经济条件、失恋等生活事件的影响可加重抑郁症状。结论关注正视重点高校大学生抑郁症的存在,提供必要的社会支持,帮助他们健康的成长。     

调控血脂 重在调整生活方式

血脂异常在一定意义上属于生活方式疾病。包括摄入过多高胆固醇食物、．运动减少等。患者应积极与医生沟通，决定是否需要药物治疗。同时，从改善生活方式做起，合理膳食、适量运动、控制体重、戒烟限酒，以减少促使血脂升高的危险因素。     

Dietary Patterns Are Differentially Associated with Atypical and Melancholic Subtypes of Depression

Diet has been associated with the risk of depression, whereas different subtypes of depression have been linked with different cardiovascular risk factors (CVRFs). In this study, our aims were to (1) identify dietary patterns with exploratory factor analysis, (2) assess cross-sectional associations between dietary patterns and depression subtypes, and (3) examine the potentially mediating effect of dietary patterns in the associations between CVRFs and depression subtypes. In the first follow-up of the population-based CoLaus|PsyCoLaus study (2009–2013, 3554 participants, 45.6% men, mean age 57.5 years), a food frequency questionnaire assessed dietary intake and a semi-structured interview allowed to characterize major depressive disorder into current or remitted atypical, melancholic, and unspecified subtypes. Three dietary patterns were identified: Western, Mediterranean, and Sweet-Dairy. Western diet was positively associated with current atypical depression, but negatively associated with current and remitted melancholic depression. Sweet-Dairy was positively associated with current melancholic depression. However, these dietary patterns did not mediate the associations between CVRFs and depression subtypes. Hence, although we could show that people with different subtypes of depression make different choices regarding their diet, it is unlikely that these differential dietary choices account for the well-established associations between depression subtypes and CVRFs.     

Overweight and depressive symptoms among African-American women

BACKGROUND: In a national survey, a correlation between overweight and depression was explained by dieting and poor health. This study examines overweight and depressive symptoms among urban African-American women, taking into account demographic factors, health status and practices, and psychosocial constructs. METHODS: Respondents are 429 participants in a pilot for a culturally tailored intervention promoting healthful eating and exercising. Anthropomorphic and self-administered questionnaire data were collected at a community health club site. RESULTS: Controlling for demographic factors, overweight is associated with symptoms of depression, a relationship that is partially explained by health status, but not by dietary restraint. Using multiple regression, poor health status, alcohol intake, hostility, and low levels of ethnic identity (connectedness with the African-American community) are independent predictors of depressed mood. In this study, dietary restraint reflects healthful eating and is inversely related to depression. The overweight/depression association is stronger among women with high levels of education and high levels of ethnic identity (statistical interactions). CONCLUSION: Poor health likely contributes over time to both overweight and depressed mood. Ethnic identity enhancement strategies should be studied for their effectiveness in strengthening identity and for their potential in attracting individuals especially likely to benefit from lifestyle change programs.     

The relationship between dietary quality,serum brain-derived neurotrophic factor (BDNF) level,and the Val66met polymorphism in predicting depression

Background: Brain-derived neurotrophic factor (BDNF), a neurotrophic factor implicated in the pathogenesis of depression, may be influenced by dietary quality. Both dietary quality and serum BDNF have been researched independently in regard to their effect on depression; however, there is limited research investigating the relationship between the two factors and how they interact in depression. Additionally, a single-nucleotide polymorphism (SNP) (Val66Met) in the BDNF gene, which has been implicated in BDNF levels and depression, may contribute to the complex relationship between depression, dietary quality, and BDNF level.

Methods: One hundred and eighty-seven participants with major depressive disorder and 55 non-depressed healthy controls were recruited for this case–control analysis. The relationship between dietary quality and depression was assessed via a novel dietary quality score (the Australian Dietary Quality Score). Serum BDNF levels were measured and the Val66Met SNP was genotyped.

Results: Healthy controls had a significantly higher diet quality than depressed participants (t?=?2.435, P?=?0.016). A logistic regression model investigating age, sex, serum BDNF levels, dietary quality and depression, as well as any interactions, found that lower dietary quality, and surprisingly, higher BDNF levels, were associated with increased depression risk, P?=?0.037 and P?<?0.001, respectively. Neither seasonality (at the time of recruitment) nor the Val66Met polymorphism was associated with BDNF levels in this sample. Furthermore, there was no evidence of interaction between the Val66Met polymorphism, BDNF levels, dietary quality, and depression.

Conclusion: Higher dietary quality was associated with both decreased depression incidence and severity in this cross-sectional analysis. The Val66Met polymorphism did not appear to predict BDNF levels, depression incidence, or modify the relationship between dietary quality and BDNF. Further studies utilizing a larger sample size are needed to confirm this finding.     

Dietary patterns during pregnancy and the risk of postpartum depression in Japan: the Osaka Maternal and Child Health Study

Although several nutrients and foods are suggested to be preventive against postpartum depression, all previous studies have primarily focused on single nutrients or foods. In contrast, studies on dietary patterns, namely the measurement of overall diet by considering the cumulative effects of nutrient, may provide new insights into the influence of diet on postpartum depression. We prospectively examined the association between dietary patterns during pregnancy and the risk of postpartum depression among 865 Japanese women. Diet was assessed with a validated, self-administered diet history questionnaire. Dietary patterns from thirty-three predefined food groups (energy-adjusted food (g/d)) were extracted by factor analysis. Postpartum depression was defined as present when the subjects had an Edinburgh Postnatal Depression Scale score of ≥?9 at 2-9 months postpartum. A total of 121 women (14·0?%) were classified as having postpartum depression. Three dietary patterns were identified: 'Healthy', 'Western' and 'Japanese' patterns. After adjustment for potential confounders, neither the 'Healthy' nor the 'Japanese' pattern was related to the risk of postpartum depression. Compared with the first quartile of the 'Western' pattern, only the second quartile was independently related to a decreased risk of postpartum depression (multivariate OR 0·52, 95?% CI 0·30, 0·93), although no evident exposure-response associations were observed (P for trend?=?0·36). The present study failed to substantiate clear associations between dietary patterns and the risk of postpartum depression. Further studies with more accurate measurements are warranted to confirm the relationship between dietary patterns and the risk of postpartum depression.     

Patient versus general practitioner perception of problems with treatment adherence in type 2 diabetes: From adherence to concordance

Abstract

Objectives: To determine the prevalence of problems with treatment adherence among type-2 diabetic patients with regards to medication, dietary advice, and physical activity; to identify the associated clinical and psychosocial factors; and to investigate the degree of agreement between patient-perceived and GP-perceived adherence. Methods: Consecutive patients were solicited during visits to 39 GPs. In total, 521 patients self-reported on treatment adherence, anxiety and depression, and disease perception. The GPs reported clinical and laboratory data and patients' adherence. A multivariate analysis identified the factors associated with adherence problems. Results: Problems of adherence to medication, dietary advice, and physical activity recommendations were reported by 17%, 62%, and 47% of the patients, respectively. Six independent factors were found associated with adherence problems: young age, body-mass index (BMI) > 30 kg/m², glycosylated haemoglobin (HbA_1c) > 8%, single life, depression, and perception of medication as a constraint. Agreement between patients’ and GPs’ assessments of treatment problems reached 70%. Conclusion: In type 2 diabetes, problems with dietary advice or physical activity are far more frequent than problems with medication, and not all physicians are fully aware of patients’ problems. More active listening and shared decision-making should enhance adherence and improve outcomes.     

Comparison of Dietary Intake and Physical Activity between Women with and without Polycystic Ovary Syndrome: A Review

Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder affecting women of reproductive age worldwide. In addition to deleterious effects on fertility imparted by PCOS, women with PCOS are at increased risk of obesity, diabetes, cardiovascular disease, depression, and certain cancers. Hormonal and metabolic aberrations in PCOS have the potential to influence dietary intake and physical activity levels. There are emerging global data that women with PCOS have different baseline dietary energy intakes compared with women without PCOS. These alterations in diet may exacerbate clinical symptoms and compound risk of chronic disease in patients. Few studies have compared baseline physical activity levels between women with and without PCOS. Although comparisons between studies are confounded by several factors, the data point to no differences in activity levels among PCOS and non-PCOS groups. This review provides an assessment of the current literature on baseline dietary intake and physical activity levels in women with PCOS. Future recommendations to strengthen research in this area are provided, given the implications to aid in the development of effective nutrition-focused interventions for PCOS.     

A healthy body, a healthy mind: long-term impact of diet on mood and cognitive function

Certain dietary risk factors for physical ill health are also risk factors for depression and cognitive impairment. Although cholesterol lowering has been suggested to increase vulnerability to depression, there is better support for an alternative hypothesis that intake of n-3 long-chain polyunsaturated fatty acids can affect mood (and aggression). Possible mechanisms for such effects include modification of neuronal cell membrane fluidity and consequent impact on neurotransmitter function. Stronger evidence exists concerning a role for diet in influencing cognitive impairment and cognitive decline in older age, in particular through its impact on vascular disease. For example, cognitive impairment is associated with atherosclerosis, type 2 diabetes and hypertension, and findings from a broad range of studies show significant relationships between cognitive function and intakes of various nutrients, including long-chain polyunsaturated fatty acids, antioxidant vitamins, and folate and vitamin B12. Further support is provided by data on nutrient status and cognitive function. Almost all this evidence, however, comes from epidemiological and correlational studies. Given the problem of separating cause and effect from such evidence, and the fact that cognitive impairment and cognitive decline (and depression) are very likely to be significant factors contributing to the consumption of a poor diet, greater emphasis should now be placed on conducting intervention studies. An efficient approach to this problem could be to include assessments of mood and cognitive function as outcome measures in studies designed primarily to investigate the impact of dietary interventions on markers of physical health.     

Foods,Nutrients and Dietary Patterns in Relation to Irrational Beliefs and Related Psychological Disorders: The ATTICA Epidemiological Study

We explored the differences in dietary habits and dietary patterns between individuals characterized by irrational beliefs with no or low anxiety and depressive symptoms and individuals characterized by irrational beliefs with high anxiety and depressive symptomatology. Within the context of the ATTICA cohort study (2002–2012), 853 participants without evidence of cardiovascular disease (453 men (45 ± 13 years) and 400 women (44 ± 18 years)) underwent mental health assessment through the irrational beliefs inventory (IBI), the Zung self-rating depression scale (ZDRS) and the state–trait anxiety inventory (STAI). Demographic characteristics, a thorough medical history, dietary behaviour and other lifestyle behaviours were also evaluated and analysed using factor analysis. Five main factors related to dietary patterns were extracted for the high-IBI/low-STAI group of participants (explaining the 63% of the total variation in consumption), whereas four factors were extracted for the high-IBI/high-STAI participants, the high-IBI/low-ZDRS participants and the high-IBI/high-ZDRS participants, explaining 53%, 54% and 54% of the total variation, respectively. A Western-type dietary pattern was the most dominant factor for individuals reporting irrational beliefs and anxiety or depressive symptomatology. The high refined carbohydrates and fats dietary pattern was the most dominant factor for individuals with irrational beliefs but without psychopathology. Linear regression analysis showed that irrational beliefs, in combination with anxiety or depression, age, sex and BMI, were important predictors of adherence to the Mediterranean diet. Dietary habits interact with irrational beliefs and, in association with the consequent psychological disorders, are associated with overall diet, and presumably may affect the health status of individuals.     

Analysis of the Effects of Nutrient Intake and Dietary Habits on Depression in Korean Adults

While several studies have explored nutrient intake and dietary habits associated with depression, few studies have reflected recent trends and demographic factors. Therefore, we examined how nutrient intake and eating habits are associated with depression, according to gender and age. We performed simple and multiple regressions using nationally representative samples of 10,106 subjects from the Korea National Health and Nutrition Examination Survey. The results indicated that cholesterol, dietary fiber, sodium, frequency of breakfast, lunch, dinner, and eating out were significantly associated with depression (p-value < 0.05). Moreover, depression was associated with nutrient intake and dietary habits by gender and age group: sugar, breakfast, lunch, and eating out frequency in the young women’s group; sodium and lunch frequency among middle-age men; dietary fibers, breakfast, and eating out frequency among middle-age women; energy, moisture, carbohydrate, lunch, and dinner frequency in late middle-age men; breakfast and lunch frequency among late middle-age women; vitamin A, carotene, lunch, and eating out frequency among older age men; and fat, saturated fatty acids, omega-3 fatty acid, omega-6 fatty acid, and eating out frequency among the older age women’s group (p-value < 0.05). This study can be used to establish dietary strategies for depression prevention, considering gender and age.     

Depressive Symptoms in Middle-Aged and Elderly Women Are Associated with a Low Intake of Vitamin B6: A Cross-Sectional Study

This study investigated the nutritional factors that are associated with anxiety and depressive symptoms in Japanese middle-aged and elderly women. We conducted a cross-sectional study with 289 study participants aged ≥40 years (mean age = 52.0 ± 6.9 years). Their dietary habits, menopausal status and symptoms, and varied background factors, such as body composition, lifestyle factors, and cardiovascular parameters, were assessed. Their anxiety and depressive symptoms were evaluated using the Hospital Anxiety and Depression Scale (HADS), where scores of 0–7 points, 8–10 points, and 11–21 points on either the anxiety or depression subscales were categorized as mild, moderate, and severe, respectively. The dietary consumption of nutrients was assessed using a brief self-administered diet history questionnaire. The relationships between the moderate-to-severe anxiety/depressive symptoms and the dietary intake of 43 major nutrients were investigated using multivariate logistic regression analyses. After adjusting for age, menopausal status, and the background factors that were significantly related to depressive symptoms, moderate and severe depression was significantly inversely associated with only vitamin B6 (adjusted odds ratio per 10 μg/MJ in vitamin B6 intake = 0.89, 95% confidence interval = 0.80–0.99). A higher intake of vitamin B6 could help relieve depressive symptoms for this population.