Fiber intake and fiber intervention in depression and anxiety: a systematic review and meta-analysis of observational studies and randomized controlled trials.

IF 5.9 2区 医学 Q1 NUTRITION & DIETETICS Nutrition reviews Pub Date : 2024-12-01 DOI:10.1093/nutrit/nuad143
Hajara Aslam, Mojtaba Lotfaliany, Daniel So, Kirsten Berding, Michael Berk, Tetyana Rocks, Meghan Hockey, Felice N Jacka, Wolfgang Marx, John F Cryan, Heidi M Staudacher
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Abstract

Context: Dietary fibers hold potential to influence depressive and anxiety outcomes by modulating the microbiota-gut-brain axis, which is increasingly recognized as an underlying factor in mental health maintenance.

Objective: Evidence for the effects of fibers on depressive and anxiety outcomes remains unclear. To this end, a systematic literature review and a meta-analysis were conducted that included observational studies and randomized controlled trials (RCTs).

Data sources: The PubMed, Embase, CENTRAL, CINAHL, and PsychINFO databases were searched for eligible studies.

Data extraction: Study screening and risk-of-bias assessment were conducted by 2 independent reviewers.

Data analysis: Meta-analyses via random effects models were performed to examine the (1) association between fiber intake and depressive and anxiety outcomes in observational studies, and (2) effect of fiber intervention on depressive and anxiety outcomes compared with placebo in RCTs. A total of 181 405 participants were included in 23 observational studies. In cross-sectional studies, an inverse association was observed between fiber intake and depressive (Cohen's d effect size [d]: -0.11; 95% confidence interval [CI]: -0.16, -0.05) and anxiety (d = -0.25; 95%CI, -0.38, -0.12) outcomes. In longitudinal studies, there was an inverse association between fiber intake and depressive outcomes (d = -0.07; 95%CI, -0.11, -0.04). In total, 740 participants were included in 10 RCTs, all of whom used fiber supplements. Of note, only 1 RCT included individuals with a clinical diagnosis of depression. No difference was found between fiber supplementation and placebo for depressive (d = -0.47; 95%CI, -1.26, 0.31) or anxiety (d = -0.30; 95%CI, -0.67, 0.07) outcomes.

Conclusion: Although observational data suggest a potential benefit for higher fiber intake for depressive and anxiety outcomes, evidence from current RCTs does not support fiber supplementation for improving depressive or anxiety outcomes. More research, including RCTs in clinical populations and using a broad range of fibers, is needed.

Systematic review registration: PROSPERO registration no. CRD42021274898.

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纤维摄入和纤维干预抑郁和焦虑:观察性研究和随机对照试验的系统回顾和荟萃分析。
背景:膳食纤维有可能通过调节微生物-肠道-脑轴来影响抑郁和焦虑的结果,这越来越被认为是维持心理健康的一个潜在因素。目的:纤维对抑郁和焦虑结果影响的证据尚不清楚。为此,我们进行了系统的文献综述和荟萃分析,包括观察性研究和随机对照试验(rct)。数据来源:PubMed、Embase、CENTRAL、CINAHL和PsychINFO数据库检索符合条件的研究。资料提取:研究筛选和风险偏倚评估由2名独立审稿人进行。数据分析:通过随机效应模型进行meta分析,检验(1)观察性研究中纤维摄入量与抑郁和焦虑结局之间的关系,以及(2)随机对照试验中纤维干预与安慰剂对抑郁和焦虑结局的影响。23项观察性研究共纳入181 405名参与者。在横断面研究中,观察到纤维摄入量与抑郁症呈负相关(Cohen's效应量[d]: -0.11;95%可信区间[CI]: -0.16, -0.05)和焦虑(d = -0.25;95%CI, -0.38, -0.12)。在纵向研究中,纤维摄入量与抑郁结果呈负相关(d = -0.07;95%ci, -0.11, -0.04)。总共有740名参与者参与了10项随机对照试验,他们都服用了纤维补充剂。值得注意的是,只有1项随机对照试验纳入了临床诊断为抑郁症的个体。纤维补充剂与安慰剂治疗抑郁症无差异(d = -0.47;95%CI, -1.26, 0.31)或焦虑(d = -0.30;95%CI, -0.67, 0.07)。结论:尽管观察数据表明,高纤维摄入对抑郁和焦虑结局有潜在的益处,但目前的随机对照试验证据并不支持纤维补充能改善抑郁或焦虑结局。需要更多的研究,包括临床人群的随机对照试验和使用广泛的纤维。系统评审注册:普洛斯彼罗注册号。CRD42021274898。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Nutrition reviews
Nutrition reviews 医学-营养学
CiteScore
12.20
自引率
1.60%
发文量
121
审稿时长
6-12 weeks
期刊介绍: Nutrition Reviews is a highly cited, monthly, international, peer-reviewed journal that specializes in the publication of authoritative and critical literature reviews on current and emerging topics in nutrition science, food science, clinical nutrition, and nutrition policy. Readers of Nutrition Reviews include nutrition scientists, biomedical researchers, clinical and dietetic practitioners, and advanced students of nutrition.
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