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Nutrition, Lifestyle and Mood Disorders

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition and Public Health".

Deadline for manuscript submissions: closed (31 December 2020) | Viewed by 76828

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Special Issue Editors

Dr. Eva Reininghaus

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Guest Editor

Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
Interests: affective disorders tryptophan breakdown;somatic comorbidities; physical activity;treatment outcome;nutrition;microbiome;cognitive function;genetics

Prof. Dr. Daniel J. Müller

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Guest Editor

1. Institute of Medical Science, University of Toronto (VSM, BHM, DJM), Toronto, ON, Canada;
2. Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (VSM, FI, MM, BHM, DJM), Toronto, ON, Canada;
3. Department of Pharmacology (FI, DJM), University of Toronto, Toronto, ON, Canada;
4. Department of Psychiatry (BHM, DJM), University of Toronto, Toronto, ON, Canada
Interests: Genetics of Drug Response and Side Effects with Psychotropic Medications (i.e., Psychiatric Pharmacogenetics); Implementation of Pharmacogenetics in Clinical Practice

Special Issue Information

Dear Colleagues,

Affective disorders have a big impact on patients’ daily life, not only due to the mood symptoms but also due to the high number of somatic and psychiatric morbidities. It has been shown that overweight and obesity are more prevalent in individuals with psychiatric disorders than in the general population. A multitude of reasons may be responsible for these high prevalence rates. For example, individuals with BD tend to lead an unhealthy lifestyle, especially in acute affective episodes, which might be partly responsible for increased rates of somatic comorbidities. Furthermore, psychopharmacological-medication-related adverse events might have a negative impact on weight and activity levels in a high proportion of patients. Additionally, the degree of obesity can change the prescribing rates due to the presence of comorbid conditions and may lead to increased risk of drug–drug and drug–disease interactions. Overweight and obesity are not only associated with a more severe course of illness, higher relapse rates and nonrecovery but are also risk factors for the development of cardiovascular disease and metabolic syndrome. The rates of somatic comorbidities tend to increase with the progression of the illness, deteriorate the prognosis of BD (bipolar disorder) and lead to elevated mortality compared to the general population.

Changes in lifestyle concerning physical activity, nutritional factors or further therapeutic strategies might influence psychiatric symptoms via inflammatory pathways, including changes in systemic inflammation, tryptophan breakdown, oxidative stress or changes in microbiota composition. Nutrition and mood are associated in many ways with each other, for example, via the intake of the essential amino acid tryptophan, which is further converted into serotonin and melatonin, thus influencing mood, sleep, and behavior. Inflammatory processes might force tryptophan breakdown away from the production of serotonin into the direction of kynurenine. Furthermore, nutritional supplements might have an influence on oxidative stress and inflammation and thus influence depressive symptoms. In light of the widespread use of nutrient supplements and various diets are tried, it is especially important to evaluate the effects of dietary modifications on the development of psychiatric symptoms on a clinical as well as neurobiological level.

Another important pathway is the brain–gut axis and associated microbiota. In the gut, serotonin is produced to a high amount, and thus, the composition of the gut microbiota might influence affective symptoms.

This Special issue will publish selected documents that deepen our knowledge of specific and innovative aspects of lifestyle, diet, food, nutrition, as well as further therapeutic treatment and associated somatic comorbidities in individuals with mood disorders. We will especially highlight articles with high clinical relevance.

Prof. Eva Reininghaus
Prof. Daniel J. Müller
Guest Editors

Manuscript Submission Information

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Keywords

Nutrition
Lifestyle
Affective disorders
Tryptophan breakdown
Microbiome
Nutrients supplements
Inflammation
Obesity

Published Papers (10 papers)

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26 pages, 1019 KiB

Open AccessArticle

‘An Apple a Day’?: Psychiatrists, Psychologists and Psychotherapists Report Poor Literacy for Nutritional Medicine: International Survey Spanning 52 Countries

by Sabrina Mörkl, Linda Stell, Diana V. Buhai, Melanie Schweinzer, Jolana Wagner-Skacel, Christian Vajda, Sonja Lackner, Susanne A. Bengesser, Theresa Lahousen, Annamaria Painold, Andreas Oberascher, Josef M. Tatschl, Matthäus Fellinger, Annabel Müller-Stierlin, Ana C. Serban, Joseph Ben-Sheetrit, Ana-Marija Vejnovic, Mary I. Butler, Vicent Balanzá-Martínez, Nikola Zaja, Polona Rus-Prelog, Robertas Strumila, Scott B. Teasdale, Eva Z. Reininghaus and Sandra J. Holasek Show full author list Hide full author list

Nutrients 2021, 13(3), 822; https://doi.org/10.3390/nu13030822 - 02 Mar 2021

Cited by 18 | Viewed by 6756

Abstract

Nutritional interventions have beneficial effects on certain psychiatric disorder symptomatology and common physical health comorbidities. However, studies evaluating nutritional literacy in mental health professionals (MHP) are scarce. This study aimed to assess the across 52 countries. Surveys were distributed via colleagues and professional societies. Data were collected regarding self-reported general nutrition knowledge, nutrition education, learning opportunities, and the tendency to recommend food supplements or prescribe specific diets in clinical practice. In total, 1056 subjects participated in the study: 354 psychiatrists, 511 psychologists, 44 psychotherapists, and 147 MHPs in-training. All participants believed the diet quality of individuals with mental disorders was poorer compared to the general population (p < 0.001). The majority of the psychiatrists (74.2%) and psychologists (66.3%) reported having no training in nutrition. Nevertheless, many of them used nutrition approaches, with 58.6% recommending supplements and 43.8% recommending specific diet strategies to their patients. Only 0.8% of participants rated their education regarding nutrition as ‘very good.’ Almost all (92.9%) stated they would like to expand their knowledge regarding ‘Nutritional Psychiatry.’ There is an urgent need to integrate nutrition education into MHP training, ideally in collaboration with nutrition experts to achieve best practice care. Full article

(This article belongs to the Special Issue Nutrition, Lifestyle and Mood Disorders)

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12 pages, 313 KiB

Open AccessArticle

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

by Aurélie M. Lasserre, Marie-Pierre F. Strippoli, Pedro Marques-Vidal, Lana J. Williams, Felice N. Jacka, Caroline L. Vandeleur, Peter Vollenweider and Martin Preisig

Nutrients 2021, 13(3), 768; https://doi.org/10.3390/nu13030768 - 26 Feb 2021

Cited by 9 | Viewed by 2431

Abstract

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. Full article

(This article belongs to the Special Issue Nutrition, Lifestyle and Mood Disorders)

12 pages, 300 KiB

Open AccessArticle

Association between Depression, Lifestyles, Sleep Quality, and Sense of Coherence in a Population with Cardiovascular Risk

by Aina Riera-Sampol, Miquel Bennasar-Veny, Pedro Tauler, Mar Nafría, Miquel Colom and Antoni Aguilo

Nutrients 2021, 13(2), 585; https://doi.org/10.3390/nu13020585 - 10 Feb 2021

Cited by 19 | Viewed by 3130

Abstract

People with cardiovascular risk have more depression than the general population. Depression and cardiovascular risk have been commonly linked to lower sense of coherence (SOC) values, unhealthy lifestyles, and poor sleep quality. The aim of this study was to analyze the association between depression, health-related lifestyles, sleep quality, and SOC in a population with cardiovascular risk. A cross-sectional study was conducted in 310 participants (aged 35–75 years) with cardiovascular risk. Sociodemographic and anthropometric characteristics, cardiovascular risk, SOC score, depression levels, sleep quality, and lifestyles (physical activity, diet quality (measured as the adherence to the Mediterranean diet), and tobacco and alcohol consumption) were determined. The regression analysis showed significant associations between depression levels and sex (odds ratio (OR): 2.29; 95% CI: 1.29, 4.07), diet (OR: 0.85; 95% CI: 0.73, 0.99), body mass index (BMI) (OR: 1.06; 95% CI: 1.01, 1.12), cardiovascular disease (CVD) (OR: 2.55; 95% CI: 1.18, 5.48), sleep quality (OR: 0.26; 95% CI: 0.15, 0.46), and SOC (OR: 0.96; 95% CI: 0.94, 0.98). Protective effects of male sex, a lower BMI, no CVD, a higher adherence to the Mediterranean diet, a high sleep quality, and a higher SOC were found. In conclusion, among lifestyles determined, only diet was associated with depression levels. SOC and sleep quality were also found as significant predictors for depression levels. Full article

(This article belongs to the Special Issue Nutrition, Lifestyle and Mood Disorders)

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13 pages, 467 KiB

Open AccessArticle

The Relationship Between Food Craving, Appetite-Related Hormones and Clinical Parameters in Bipolar Disorder

by Martina Platzer, Frederike T. Fellendorf, Susanne A. Bengesser, Armin Birner, Nina Dalkner, Carlo Hamm, Melanie Lenger, Alexander Maget, René Pilz, Robert Queissner, Bernd Reininghaus, Alexandra Reiter, Harald Mangge, Sieglinde Zelzer, Hans-Peter Kapfhammer and Eva Z. Reininghaus

Nutrients 2021, 13(1), 76; https://doi.org/10.3390/nu13010076 - 29 Dec 2020

Cited by 13 | Viewed by 3972

Abstract

Obesity and weight gain in bipolar disorder (BD) have multifactorial underlying causes such as medication side effects, atypical depressive symptomatology, genetic variants, and disturbances in the neuro-endocrinal system. Therefore, we aim to explore the associations between food craving (FC), clinical parameters, psychotropic medication, and appetite-related hormones. In this cross-sectional investigation, 139 individuals with BD and 93 healthy controls (HC) completed the food craving inventory (FCI). In addition, blood samples (including leptin and acylated ghrelin) were analyzed and sociodemographic and anthropometric data were collected. Individuals with BD reported higher frequencies of total FC as well as craving for fat and fast food than HC. Additionally, we found a significant negative correlation between FC and ghrelin levels in BD. Smokers with BD reported significantly more craving for high fat foods than non-smokers. Age was significantly associated with FC independent of group. Individuals with BD taking olanzapine and quetiapine reported higher frequencies of craving for sweet food, while patients currently taking lithium reported less total FC compared to those without lithium therapy. Likewise, patients currently taking valproate reported less total FC and less craving for sweets than those not taking valproate. FC appears to be of clinical relevance in individuals with BD. Contrary to previous data, this does not seem to be a female phenomenon only and might encompass more than the specific craving for carbohydrates. Although due to the cross sectional design, causality cannot be determined, the association between depressive symptomatology and fast food craving warrants further research. Full article

(This article belongs to the Special Issue Nutrition, Lifestyle and Mood Disorders)

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17 pages, 1458 KiB

Open AccessArticle

PROVIT: Supplementary Probiotic Treatment and Vitamin B7 in Depression—A Randomized Controlled Trial

by Eva Z. Reininghaus, Martina Platzer, Alexandra Kohlhammer-Dohr, Carlo Hamm, Sabrina Mörkl, Susanne A. Bengesser, Frederike T. Fellendorf, Theressa Lahousen-Luxenberger, Birgitta Leitner-Afschar, Helmut Schöggl, Daniela Amberger-Otti, Walter Wurm, Robert Queissner, Armin Birner, Valerie S. Falzberger, Annamaria Painold, Werner Fitz, Martina Brunnmayr, Alexandra Rieger, Jolana Wagner-Skacel, Alexander Maget, Renate Unterweger, Karin Schwalsberger, Bernd Reininghaus, Melanie Lenger, Thomaz F. S. Bastiaanssen and Nina Dalkner Show full author list Hide full author list

Nutrients 2020, 12(11), 3422; https://doi.org/10.3390/nu12113422 - 08 Nov 2020

Cited by 62 | Viewed by 12416

Abstract

Gut microbiota are suspected to affect brain functions and behavior as well as lowering inflammation status. Therefore, an effect on depression has already been suggested by recent research. The aim of this randomized double-blind controlled trial was to evaluate the effect of probiotic treatment in depressed individuals. Within inpatient care, 82 currently depressed individuals were randomly assigned to either receive a multistrain probiotic plus biotin treatment or biotin plus placebo for 28 days. Clinical symptoms as well as gut microbiome were analyzed at the begin of the study, after one and after four weeks. After 16S rRNA analysis, microbiome samples were bioinformatically explored using QIIME, SPSS, R and Piphillin. Both groups improved significantly regarding psychiatric symptoms. Ruminococcus gauvreauii and Coprococcus 3 were more abundant and β-diversity was higher in the probiotics group after 28 days. KEGG-analysis showed elevated inflammation-regulatory and metabolic pathways in the intervention group. The elevated abundance of potentially beneficial bacteria after probiotic treatment allows speculations on the functionality of probiotic treatment in depressed individuals. Furthermore, the finding of upregulated vitamin B6 and B7 synthesis underlines the connection between the quality of diet, gut microbiota and mental health through the regulation of metabolic functions, anti-inflammatory and anti-apoptotic properties. Concluding, four-week probiotic plus biotin supplementation, in inpatient individuals with a major depressive disorder diagnosis, showed an overall beneficial effect of clinical treatment. However, probiotic intervention compared to placebo only differed in microbial diversity profile, not in clinical outcome measures. Full article

(This article belongs to the Special Issue Nutrition, Lifestyle and Mood Disorders)

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15 pages, 476 KiB

Open AccessArticle

C-Reactive Protein as a Possible Predictor of Trail-Making Performance in Individuals with Psychiatric Disorders

by Nina Dalkner, Eva Reininghaus, Karin Schwalsberger, Alexandra Rieger, Carlo Hamm, René Pilz, Melanie Lenger, Robert Queissner, Valerie S. Falzberger, Martina Platzer, Frederike T. Fellendorf, Armin Birner, Susanne A. Bengesser, Elisabeth M. Weiss, Roger S. McIntyre, Harald Mangge and Bernd Reininghaus

Nutrients 2020, 12(10), 3019; https://doi.org/10.3390/nu12103019 - 02 Oct 2020

Cited by 6 | Viewed by 2188

Abstract

Cognitive dysfunction is a prominent feature of psychiatric disorders. Studies have shown that systemic low-grade inflammation is crucial in the development of cognitive deficits across psychiatric disorders. The aim of this study was to further examine the role of inflammation and inflammatory mediators in cognitive function in psychiatric disorders. This study included 364 inpatients (53% females) with International Classification of Diseases (ICD)-10 F3 (affective disorders) and F4 (neurotic, stress-related, and somatoform disorders) diagnoses. The mean age was 52 years (22 to 69 years) and the median body mass index was 27.6. Cognitive function was assessed with the Color–Word Interference Test after Stroop and the Trail-Making Test A/B. Multiple linear regression models were calculated to assess the predictive value of C-reactive protein and the kynurenine/tryptophan ratio on cognitive function controlling for age, sex, education, premorbid verbal intelligence quotient, illness duration, depressive symptoms, and obesity-related parameters (e.g., body mass index, high-density lipoprotein). Our data confirm that in patients with psychiatric disorders, C-reactive protein serum concentration is a relevant and important predictor of Trail-Making Test B performance, measuring cognitive flexibility. The effect size of this association did not change much after adding clinical and metabolic variables into the regression model. The kynurenine/tryptophan ratio was not related to cognitive test scores. The involvement of C-reactive protein as a peripheral inflammatory marker in cognitive flexibility and psychomotor processing speed in psychiatric illness can be concluded. Full article

(This article belongs to the Special Issue Nutrition, Lifestyle and Mood Disorders)

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9 pages, 1229 KiB

Open AccessArticle

Vitamin B1 Intake in Multiple Sclerosis Patients and its Impact on Depression Presence: A Pilot Study

by Jose Enrique de la Rubia Ortí, María Cuerda-Ballester, Eraci Drehmer, Sandra Carrera-Juliá, María Motos-Muñoz, Cristina Cunha-Pérez, María Benlloch and María Mar López-Rodríguez

Nutrients 2020, 12(9), 2655; https://doi.org/10.3390/nu12092655 - 31 Aug 2020

Cited by 12 | Viewed by 4928

Abstract

Vitamin B1, or thiamine, is one of the most relevant vitamins in obtaining energy for the nervous system. Thiamine deficiency or lack of activity causes neurological manifestations, especially symptoms of depression, intrinsic to multiple sclerosis (MS) and related to its pathogenesis. On this basis, the aim of this study was to determine the possible relationship between the nutritional habits of patients with MS and the presence of depression. Therefore, a cross-sectional and observational descriptive study was conducted. An analysis of dietary habits and vitamin B1 consumption in a Spanish population of 51 MS patients was performed by recording the frequency of food consumption. Results showed a vitamin B1 intake within the established range, mainly provided by the consumption of ultra-processed products such as cold meats or pastries, and a total carbohydrate consumption lower than recommended, which stands out for its high content of simple carbohydrates deriving from processed foods such as dairy desserts, juice, snacks, pastries, chocolate bars, soft drinks and fermented alcohol. In addition, a significant negative correlation between depression and the intake of thiamine and total carbohydrates was observed. These findings could explain the influence of MS patients’ eating habits, and consequently vitamin B1 activity, on depression levels. Full article

(This article belongs to the Special Issue Nutrition, Lifestyle and Mood Disorders)

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21 pages, 3844 KiB

Open AccessArticle

Less Animal-Based Food, Better Weight Status: Associations of the Restriction of Animal-Based Product Intake with Body-Mass-Index, Depressive Symptoms and Personality in the General Population

by Evelyn Medawar, Cornelia Enzenbach, Susanne Roehr, Arno Villringer, Steffi G. Riedel-Heller and A. Veronica Witte

Nutrients 2020, 12(5), 1492; https://doi.org/10.3390/nu12051492 - 20 May 2020

Cited by 8 | Viewed by 21805

Abstract

Restricting animal-based products from diet may exert beneficial effects on weight status; however, less is known about such a diet and emotional health. Moreover, personality traits, for example high neuroticism, may contribute to restrictive eating habits and potentially confound diet-health associations. We aim to systematically assess if restrictive dietary intake of animal-based products relates to lower weight and higher depressive symptoms, and if differences in personality traits play a significant role. Cross-sectional data from the baseline LIFE-Adult study were collected from 2011–2014 in Leipzig, Germany (n = 8943). Main outcomes of interest were dietary frequency of animal-derived products in the last year measured using a Food Frequency Questionnaire (FFQ), body-mass-index (BMI) (kg/m²), and the Center of Epidemiological Studies Depression Scale (CES-D). Personality traits were assessed in a subsample of n = 7906 using the Five Factor Inventory (NEO-FFI). Higher restriction of animal-based product intake was associated with a lower BMI, but not with depression scores. Personality, i.e., lower extraversion, was related to lower frequency of animal product intake. Moreover, personality traits were significantly associated with depressive symptoms, i.e., higher neuroticism, lower extraversion, lower agreeableness, lower conscientiousness, and with higher BMI. These findings encourage future longitudinal studies to test the efficacy of restricting animal-based products as a preventive and therapeutic strategy for overweight and obesity. Full article

(This article belongs to the Special Issue Nutrition, Lifestyle and Mood Disorders)

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Review

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21 pages, 339 KiB

Open AccessReview

The Gut Microbiome in Schizophrenia and the Potential Benefits of Prebiotic and Probiotic Treatment

by Jonathan C. W. Liu, Ilona Gorbovskaya, Margaret K. Hahn and Daniel J. Müller

Nutrients 2021, 13(4), 1152; https://doi.org/10.3390/nu13041152 - 31 Mar 2021

Cited by 28 | Viewed by 6343

Abstract

The gut microbiome (GMB) plays an important role in developmental processes and has been implicated in the etiology of psychiatric disorders. However, the relationship between GMB and schizophrenia remains unclear. In this article, we review the existing evidence surrounding the gut microbiome in schizophrenia and the potential for antipsychotics to cause adverse metabolic events by altering the gut microbiome. We also evaluate the current evidence for the clinical use of probiotic and prebiotic treatment in schizophrenia. The current data on microbiome alteration in schizophrenia remain conflicting. Longitudinal and larger studies will help elucidate the confounding effect on the microbiome. Current studies help lay the groundwork for further investigations into the role of the GMB in the development, presentation, progression and potential treatment of schizophrenia. Full article

(This article belongs to the Special Issue Nutrition, Lifestyle and Mood Disorders)

12 pages, 394 KiB

Open AccessReview

The Impact of Nutrition and Intestinal Microbiome on Elderly Depression—A Systematic Review

by Blanka Klimova, Michal Novotny and Martin Valis

Nutrients 2020, 12(3), 710; https://doi.org/10.3390/nu12030710 - 07 Mar 2020

Cited by 26 | Viewed by 11369

Abstract

The aim of this review is to systematically review the evidence whether proper nutrition has a positive impact on the prevention or decline of depressive symptoms among elderly people. In addition, possible connections between nutrition, microbiome, and serotonin molecules and its tryptophan precursor are discussed. The methodology follows the PRISMA guidelines, including the PRISMA flow chart. The authors systematically reviewed peer-review, English-written articles published in Web of Science and PubMed between 2013 and 2018. The findings of six original articles, detected on the set inclusion and exclusion criteria, indicate that there is an association between nutrition and depressive symptoms in the target group, i.e., that proper nutrition has a positive impact on the prevention or reduction of depressive symptoms among elderly people. The findings also reveal that there is a considerable correlation between the intakes of vitamin B and a decrease in the prevalence of depressive symptoms. Furthermore, sufficient nutrient intake of tryptophan appears to be an important factor in terms of nutrition and serotonin levels in the body. The authors consider it important to explore associations between the overall dietary intake and depression since diets are not consumed as individual nutrients. Returning to preventive approaches seems to be a rational way to promote the mental health of seniors. Future studies thus need to include interdisciplinary collaboration: from a good diagnosis of the disease by a psychiatrist, through an analysis of the need for nutrient metabolism by a biochemist to the development of a nutritional plan by a nutritional therapist. The limitations of this review consist in a relatively small number of the studies on this topic, including just few randomized controlled trials, which are a guarantee of efficacy and objectivity in comparison with cross-sectional studies. Full article

(This article belongs to the Special Issue Nutrition, Lifestyle and Mood Disorders)

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