Healthy dietary indices and risk of depressive outcomes : a systematic review and meta-analysis of observational studies

With depression being the psychiatric disorder incurring the largest societal costs in developed countries, there is a need to gather evidence on the role of nutrition in depression, to help develop recommendations and guide future psychiatric health care. The aim of this systematic review was to synthesize the link between diet quality, measured using a range of predefined indices, and depressive outcomes. Medline, Embase and PsychInfo were searched up to 31st May 2018 for studies that examined adherence to a healthy diet in relation to depressive symptoms or clinical depression. Where possible, estimates were pooled using random effect meta-analysis with stratification by observational study design and dietary score. A total of 20 longitudinal and 21 cross-sectional studies were included. These studies utilized an array of dietary measures, including: different measures of adherence to the Mediterranean diet, the Healthy Eating Index (HEI) and Alternative HEI (AHEI), the Dietary Approaches to Stop Hypertension, and the Dietary Inflammatory Index. The most compelling evidence was found for the Mediterranean diet and incident depression, with a combined relative risk estimate of highest vs. lowest adherence category from four longitudinal studies of 0.67 (95% CI 0.55-0.82). A lower Dietary Inflammatory Index was also associated with lower depression incidence in four longitudinal studies (relative risk 0.76; 95% CI: 0.63-0.92). There were fewer longitudinal studies using other indices, but they and cross-sectional evidence also suggest an inverse association between healthy diet and depression (e.g., relative risk 0.65; 95% CI 0.50-0.84 for HEI/AHEI). To conclude, adhering to a healthy diet, in particular a traditional Mediterranean diet, or avoiding a pro-inflammatory diet appears to confer some protection against depression in observational studies. This provides a reasonable evidence base to assess the role of dietary interventions to prevent depression.Peer reviewe

Nutritional determinants of mental health in two French cohorts : SU.VI.MAX and NutriNet-Santé

La dépression est un trouble mental courant et la première cause d’incapacité dans le monde. Elle a été associée à une mauvaise qualité de vie, un déclin physique, et un risque accru de décès prématuré. De plus, la dépression entraîne un poids économique considérable, faisant d’elle une préoccupation majeure de santé publique. Les facteurs prédisposant ou protecteurs sont divers et inclus des indicateurs de mode de vie modifiables. De nombreuses études ont en effet suggéré que l’alimentation pourrait jouer un rôle important dans la survenue d’une dépression, toutefois peu de ces études se sont intéressées aux scores ou indices nutritionnels définis « a priori ». Ainsi, cette thèse avait pour objectif général d’étudier le lien entre la qualité globale du régime alimentaire (évaluée à l’aide de divers scores et indices nutritionnels « a priori ») et la dépression (plus précisément une symptomatologie dépressive), à partir des données issues des cohortes SU.VI.MAX et NutriNet-Santé. Les résultats de nos travaux ont mis en évidence une association inverse entre l’adéquation à l’alimentation méditerranéenne ou aux recommandations nutritionnelles (françaises et internationales) et le risque de symptômes dépressifs incidents.Toutefois, l’étude portant sur l’adéquation à l’alimentation méditerranéenne ne montrait des résultats significatifs que chez les hommes. Par ailleurs, l’alimentation « pro-inflammatoire » était positivement associée au risque de symptômes dépressifs incidents, mais dans la cohorte SU.VI.MAX, les associations n’étaient significatives que dans des sous-groupes de la population à savoir : les hommes, les fumeurs et les personnes pratiquant peu d’activité physique. Nos travaux ont également permis de mettre en évidence que l’adéquation à un nombre croissant d’indicateurs de mode de vie « sain » était inversement associée au risque de symptômes dépressifs incidents.L’ensemble de ces résultats suggèrent que la promotion des modes de vie « sains » (incluant une alimentation « saine ») serait importante dans une stratégie de prévention primaire des symptômes dépressifs.Depression is a common mental disorder and the leading cause of disability worldwide. It has been associated with poor quality of life, physical decline, and increased risk of premature death. In addition, depression leads to a considerable economic burden, making it a major global public health. Protective and risk factors are diverse and include modifiable lifestyle indicators. Several studies have suggested that diet may play an important role in the risk of depression, but few of these studies have investigated the relationship between « a priori » dietary scores and depression. This thesis thus aims to investigate the relationship between overall diet quality evaluated using various nutritional « a priori » scores and incident depressive symptoms, using the data from SU.VI.MAX and NutriNet-Santé cohorts.Our findings showed an inverse association between adherence to the Mediterranean diet or nutritional recommendations (French and international) and the risk of incident depressive symptoms. However, the study on adherence to the Mediterranean diet showed significant results in men only. Moreover, « pro-inflammatory » diet was positively associated with the risk of incident depressive symptoms, but in the SU.VI.MAX cohort, the associations were significant only in some subgroups of the population: men, smokers and participants with low physical activity. We also showed that an increasing number of « healthy » lifestyle indicators was inversely associated with incident depressive symptoms.All of these findings suggest that promoting « healthy » lifestyles (including « healthy » diet) could be an important strategy in primary prevention of depressive symptoms

Adherence to the 2017 French dietary guidelines and adult weight gain: A cohort study

International audienceBACKGROUND:The French dietary guidelines were updated in 2017, and an adherence score to the new guidelines (Programme National Nutrition Santé Guidelines Score 2 [PNNS-GS2]) has been developed and validated recently. Since overweight and obesity are key public health issues and have been related to major chronic conditions, this prospective study aimed to measure the association between PNNS-GS2 and risk of overweight and obesity, and to compare these results with those for the modified Programme National Nutrition Santé Guidelines Score (mPNNS-GS1), reflecting adherence to 2001 guidelines.METHODS AND FINDINGS:Participants (N = 54,089) were recruited among French adults (≥18 years old, mean baseline age = 47.1 [SD 14.1] years, 78.3% women) in the NutriNet-Santé web-based cohort. Mean (SD) score was 1.7 (3.3) for PNNS-GS2 and 8.2 (1.6) for mPNNS-GS1. Selected participants were those included between 2009 and 2014 and followed up to September 2018 (median follow-up = 6 years). Collected data included at least three 24-hour dietary records over a 2-year period following inclusion, baseline sociodemographics, and anthropometric data over time. In Cox regression models, PNNS-GS2 was strongly and linearly associated with a lower risk of overweight and obesity (HR for quintile 5 versus quintile 1 [95% CI] = 0.48 [0.43-0.54], p < 0.001, and 0.47 [0.40-0.55], p < 0.001, for overweight and obesity, respectively). These results were much weaker for mPNNS-GS1 (HR for quintile 5 versus quintile 1 = 0.90 [0.80-0.99], p = 0.03, and 0.98 [0.84-1.15], p = 0.8, for overweight and obesity, respectively). In multilevel models, PNNS-GS2 was negatively associated with baseline BMI and BMI increase over time (β for a 1-SD increase in score [95% CI] = -0.040 [-0.041; -0.038], p < 0.001, and -0.00080 [-0.00094; -0.00066], p < 0.001, respectively). In "direct comparison" models, PNNS-GS2 was associated with a lower risk of overweight and obesity, lower baseline BMI, and lower BMI increase over time than mPNNS-GS1. Study limitations include possible selection bias, reliance on participant self-report, use of arbitrary cutoffs in data analyses, and residual confounding, but robustness was tested in sensitivity analyses.CONCLUSIONS:Our findings suggest that adherence to the 2017 French dietary guidelines is associated with a lower risk of overweight and obesity. The magnitude of the association and the results of the direct comparison reinforced the validity of the updated recommendations

Characteristics of infant formula consumed in the first months of life and risk of allergy in the EDEN mother-child cohort

International audienc

The Evolution of GX 339-4 in the Low-hard State as Seen by NuSTAR and Swift

International audienc

Prospective association between adherence to the MIND diet and subjective memory complaints in the French NutriNet-Sante cohort

ObjectivesOur objective was to examine whether adherence to the Mediterranean-DASH diet intervention for neurodegenerative delay (MIND) was associated with SMC (as measured by the cognitive difficulties scale; CDS) in the NutriNet-Sante cohort.MethodsThe study sample consisted of 6011 participants aged60years at baseline, without SMC at the beginning. SMC were defined by a CDS score43 (corresponding to the 4th CDS quartile) and SMC cases were participants with SMC at least once during follow-up. The MIND diet score (0-15 points) is a hybrid of the Mediterranean Diet and the Dietary Approaches to Stop Hypertension (DASH) scores, which includes ten brain healthy food groups and five unhealthy food groups. We used Cox proportional hazards models to estimate Hazard Ratios (HR) and 95% confidence intervals (95% CI).ResultsOver a mean follow-up of 6 years, approximately 15% and 30% cases of SMC were identified among participants aged 60-69 and 70 years, respectively. The MIND diet score was not significantly associated with SMC in the full sample and among participants aged 60-69years. Among participants aged70 years, a significant inverse association was observed between adherence to the MIND diet and SMC (HRtertile 3 vs tertile 1=0.69, 95% CI=0.47-0.99). This relationship was strengthened after exclusion of participants with depressive symptoms (HRtertile 2 vs tertile 1=0.69, 95% CI=0.49-0.97; HRtertile 3 vs tertile 1=0.62, 95% CI=0.41-0.93).ConclusionsThese findings suggest that the MIND diet could help to prevent or delay SMC among older adults without depressive symptoms

Association between cured meat intake and asthma symptoms

National audienc

Characteristics of infant formula consumed in the first months of life and risk of allergy in the EDEN mother-child cohort

International audienc

Unsaturated fatty acid intakes during midlife are positively associated with later cognitive function in older adults with modulating effects of antioxidant supplementation

Background: Given the drastic demographic changes characterized as "population aging," the disease burden related to dementia is a major public health problem. The scientific literature documenting the link between mono-and polyunsaturated fatty acids (MUFAs, PUFAs) and cognitive function during aging is plentiful, but findings are inconsistent. Objectives: We aimed to evaluate the association between intakes of unsaturated fatty acids at midlife and cognitive performance 13 y later in French adults, and to test for a modulating effect of antioxidant supplementation. Methods: Fatty acid intakes were estimated with the use of repeated 24-h records (1994-1996) among 3362 subjects (mean +/- SD age: 65.5 +/- 4.6 y) of the SU.VI.MAX (Supplementation with Antioxidant Vitamins and Minerals) study, including an intervention phase (1994-2002) during which participants were randomly assigned to an "antioxidant supplementation" or placebo group. Cognitive performance was assessed at follow-up only (in 2007-2009) via a battery of 6 standardized neuropsychological tests. A global cognitive score was calculated as the sum of T-scores of the 6 tests. Multivariable-adjusted regression analyses were performed to provide regression coefficients and 95% CIs. Results: In multivariable models, total MUFAs, total PUFAs, and n-6 PUFAs (omega-6 PUFAs) were positively associated with overall cognitive functioning. n-3 PUFA (omega-3 PUFA) intakes showed positive associations among supplemented participants only (mean difference (Tertile3 versus Tertile1): 1.40; 95% CI: 0.30, 2.51; P-trend = 0.01, P-interaction = 0.01). A detrimental role of arachidonic acid for cognitive functioning was only detected in the placebo group (mean difference (Tertile3 versus Tertile1): -1.38; 95% CI: -2.57, -0.18; P-trend = 0.02, P-interaction = 0.07). Conclusion: Whereas higher total MUFA and n-6 PUFA intakes may be generally beneficial for maintaining cognitive health during aging, a higher consumption of n-3 fatty acids may only be beneficial among individuals with an adequate antioxidant status. These findings underline the importance of not only focusing on specific nutrients for dementia prevention, but also considering the complex interaction between consumed nutrients