Diet Overall and Hypocaloric Diets Are Associated With Improvements in Depression but Not Anxiety in People With Metabolic Conditions: A Systematic Review and Meta-Analysis

IF 8 1区医学 Q1 NUTRITION & DIETETICS Advances in Nutrition Pub Date : 2024-02-01 DOI:10.1016/j.advnut.2024.100169

Tonya Paris , Robin M Daly , Gavin Abbott , Surbhi Sood , Christine L Freer , Marno C Ryan , Elena S George

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Abstract

The risk of depression and anxiety is higher in people with metabolic conditions, but whether dietary approaches, which are central to the management of metabolic conditions, can also improve depression and anxiety is uncertain. The primary aim of this systematic review and meta-analysis was to evaluate the effects of dietary interventions on depression and anxiety in adults with metabolic conditions. The secondary aim was to evaluate the effects of hypocaloric and isocaloric dietary interventions on these outcomes. Four databases (MEDLINE, PsychINFO, EMBASE, and CINAHL) were searched from inception to March 2023. Randomized controlled trials (RCTs) including dietary interventions in adults with metabolic conditions (type 2 diabetes mellitus, hyperlipidemia, hypertension, and/or overweight/obesity) that assessed depression and/or anxiety as outcomes were included. Overall, 13 RCTs were included in the systematic review, ≤13 of which were included in the meta-analysis. Estimates were pooled using random-effect meta-analysis for dietary interventions compared with controls. Improvements in depression scores were found in meta-analytic models including all dietary interventions [pooled estimate for the standardized mean difference (SMD) = −0.20 (95% CI: −0.35, −0.05); P = 0.007] and hypocaloric only diets [SMD = −0.27 (95% CI: −0.44, −0.10); P = 0.002]. There were no improvements in depression scores with isocaloric dietary interventions only [SMD = −0.14 (95% CI: −0.38, 0.10); P = 0.27]. In addition, there were no significant effects of any dietary interventions on anxiety scores. In adults with metabolic conditions, all dietary interventions and hypocaloric diets improved depression, but not anxiety. These findings suggest that dietary interventions including hypocaloric diets can play an important role in the management of depression in people with metabolic conditions.

This systematic review and meta-analysis has been registered with PROSPERO (CRD42021252307).

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整体饮食和低热量饮食与代谢性疾病患者抑郁状况的改善有关，但与焦虑状况无关：系统回顾和荟萃分析。

患有代谢性疾病的人患抑郁症和焦虑症的风险较高，但作为代谢性疾病治疗核心的饮食方法是否也能改善抑郁症和焦虑症还不确定。本系统综述和荟萃分析的主要目的是评估饮食干预对患有代谢性疾病的成年人抑郁和焦虑的影响。次要目的是评估低热量和等热量饮食干预对这些结果的影响。研究人员检索了从开始到 2023 年 3 月的四个数据库（MEDLINE、PsychINFO、EMBASE 和 CINAHL）。纳入的随机对照试验（RCT）包括对患有代谢性疾病（2 型糖尿病 (T2DM)、高脂血症、高血压和/或超重/肥胖）的成人进行饮食干预，并将抑郁和/或焦虑作为评估结果。共有 13 项研究性试验被纳入系统综述，其中多达 13 项被纳入荟萃分析。采用随机效应荟萃分析法对饮食干预与对照组的比较进行了汇总。在荟萃分析模型中发现，包括所有膳食干预在内的抑郁评分均有改善[标准化均值差异（SMD）的集合估计值=-0.20（95% 置信区间（CI），-0.35 至-0.05），概率（p）=0.007]，而仅低热量膳食[SMD=-0.27（95%CI，-0.44 至-0.10），p=0.002]。仅采用等热量饮食干预对抑郁评分没有改善[SMD=-0.14 (95%CI -0.38 to 0.10)，p=0.27]。此外，任何饮食干预对焦虑评分均无明显影响。在患有代谢性疾病的成年人中，所有饮食干预和低热量饮食都能改善抑郁，但不能改善焦虑。这些研究结果表明，包括低热量饮食在内的饮食干预措施可在代谢性疾病患者的抑郁治疗中发挥重要作用。临床试验注册：本系统综述和荟萃分析已在 PROSPERO 注册（CRD42021252307）。

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来源期刊

Advances in Nutrition 医学-营养学

CiteScore

17.40

自引率

2.20%

发文量

117

审稿时长

56 days

期刊介绍： Advances in Nutrition (AN/Adv Nutr) publishes focused reviews on pivotal findings and recent research across all domains relevant to nutritional scientists and biomedical researchers. This encompasses nutrition-related research spanning biochemical, molecular, and genetic studies using experimental animal models, domestic animals, and human subjects. The journal also emphasizes clinical nutrition, epidemiology and public health, and nutrition education. Review articles concentrate on recent progress rather than broad historical developments. In addition to review articles, AN includes Perspectives, Letters to the Editor, and supplements. Supplement proposals require pre-approval by the editor before submission. The journal features reports and position papers from the American Society for Nutrition, summaries of major government and foundation reports, and Nutrient Information briefs providing crucial details about dietary requirements, food sources, deficiencies, and other essential nutrient information. All submissions with scientific content undergo peer review by the Editors or their designees prior to acceptance for publication.

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