A decline in inflammation is associated with less depressive symptoms after a dietary intervention in metabolic syndrome patients: a longitudinal study

Nutrition Journal

M Angeles Zulet²  J Alfredo Martinez²  Miguel A Martinez-Gonzalez³  Francisca Lahortiga¹  Clara I Lacunza¹  Santiago Navas-Carretero²  Itziar Abete⁶  Patricia Lopez-Legarrea⁴  Rocio de la Iglesia⁵  Aurora Perez-Cornago⁵ 

[1] Department of Psychiatry and Medical Psychology, University Clinic of Navarra, Pio XII 36, Pamplona 31008, Spain;Carlos III Health Research Institute, CIBERobn, Physiopathology of Obesity and Nutrition, Madrid, Spain;Department of Preventive Medicine and Public Health, University of Navarra, Irunlarrea 1, Pamplona 31008, Spain;Faculty of Health Science, Universidad Autonoma de Chile, Santiago, Chile;Department of Nutrition, Food Science and Physiology, University of Navarra, Irunlarrea 1, Pamplona 31008, Spain;Biodonostia Health Research Institute, Doctor Begiristain (no number), 20014, San Sebastian, Spain

关键词: Adiposity;    Hypocaloric diet;    Leptin;    Inflammation;    Depression;    Metabolic syndrome;   

Others  :  801536
DOI  :  10.1186/1475-2891-13-36

 received in 2014-03-02, accepted in 2014-04-15,  发布年份 2014

【 摘 要 】

Background

Metabolic syndrome (MetS) and depression have become two prevalent diseases worldwide, whose interaction needs further investigation. Dietary treatment for weight loss in patients with MetS may improve depressive manifestations, however, the precise interactive pathways remain uncertain. Therefore, the aim of this study was to examine the effects of a hypocaloric diet designed to reduce MetS features on self-perceived depression and the possible underlying factors.

Methods

Sixty subjects (Age: 50 ± 1 y; BMI: 36.1 ± 0.6 kg/m²) with MetS were selected from the RESMENA study (control and intervention) after they completed the 6-months hypocaloric treatment and rated for depressive symptoms using the Beck Depression Inventory (BDI). Anthropometric and biochemical measurements including leptin, C-reactive protein (CRP) and insulin levels were evaluated.

Results

Depressive symptoms decreased during the weight loss intervention, with no differences between both dietary groups (control group −4.2 ± 0.8 vs RESMENA group −3.2 ± 0.6, P = 0.490). The number of criteria of the MetS was higher among subjects with more somatic-related depressive symptoms at baseline (B = 1.032, P-trend = 0.017). After six months of dietary treatment, body weight decreased in all subjects (−8.7%; confidence interval (95% CI) = 7.0-9.7) and also self-perceived depression (−37.9%; 95% CI = 2.7-4.9), as well as circulating leptin (−20.1%; 95% CI = 1.8-6.8), CRP (−42.8%; 95% CI = 0.6-3.0) and insulin (−37.7%; 95% CI = 4.1-7.2) concentrations. The decrease in BDI was significantly associated with declines in body fat mass (B = 0.34, 95% CI = 0.11-0.56) and also with the decrease in leptin (B = 0.16, 95% CI = 0.04-0.28) and CRP (B = 0.24, 95% CI = 0.01-0.46) concentrations.

Conclusions

The decrease in depressive manifestations after a weight loss intervention was related with adiposity, CRP and leptin in subjects with MetS.

Trial registration

ClinicalTrials.gov: NCT01087086.

【 授权许可】

   
2014 Perez-Cornago et al.; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Yamaoka K, Tango T: Effects of lifestyle modification on metabolic syndrome: a systematic review and meta-analysis. BMC Med 2012, 10:138. BioMed Central Full Text
• [2]Yanai H, Tomono Y, Ito K, Furutani N, Yoshida H, Tada N: The underlying mechanisms for development of hypertension in the metabolic syndrome. Nutr J 2008, 7:10. BioMed Central Full Text
• [3]Murabito JM, Massaro JM, Clifford B, Hoffmann U, Fox CS: Depressive symptoms are associated with visceral adiposity in a community-based sample of middle-aged women and men. Obesity 2013, 21:1713-1719.
• [4]Ustun TB, Ayuso-Mateos JL, Chatterji S, Mathers C, Murray CJ: Global burden of depressive disorders in the year 2000. Br J Psychiatry 2004, 184:386-392.
• [5]Sanchez-Villegas A, Martinez-Gonzalez MA: Diet, a new target to prevent depression? BMC Med 2013, 11:3. BioMed Central Full Text
• [6]Pan A, Keum N, Okereke OI, Sun Q, Kivimaki M, Rubin RR, Hu FB: Bidirectional association between depression and metabolic syndrome: a systematic review and meta-analysis of epidemiological studies. Diabetes Care 2012, 35:1171-1180.
• [7]Kraja AT, Province MA, Arnett D, Wagenknecht L, Tang W, Hopkins PN, Djousse L, Borecki IB: Do inflammation and procoagulation biomarkers contribute to the metabolic syndrome cluster? Nut Metab 2007, 4:28. BioMed Central Full Text
• [8]Daly M: The relationship of C-reactive protein to obesity-related depressive symptoms: a longitudinal study. Obesity 2013, 21:248-250.
• [9]Morris AA, Ahmed Y, Stoyanova N, Hooper WC, De Staerke C, Gibbons G, Quyyumi A, Vaccarino V: The association between depression and leptin is mediated by adiposity. Psychosom Med 2012, 74:483-488.
• [10]Swislocki AL, Siegel D, Jialal I: Pharmacotherapy for the metabolic syndrome. Curr Vasc Pharmacol 2012, 10:187-205.
• [11]Salas-Salvado J, Bullo M, Babio N, Martinez-Gonzalez MA, Ibarrola-Jurado N, Basora J, Estruch R, Covas MI, Corella D, Aros F, Ruiz-Gutierrez V, Ros E: Reduction in the incidence of type 2 diabetes with the Mediterranean diet: results of the PREDIMED-Reus nutrition intervention randomized trial. Diabetes Care 2011, 34:14-19.
• [12]Sanchez-Villegas A, Delgado-Rodriguez M, Alonso A, Schlatter J, Lahortiga F, Serra Majem L, Martinez-Gonzalez MA: Association of the Mediterranean dietary pattern with the incidence of depression: the Seguimiento Universidad de Navarra/University of Navarra follow-up (SUN) cohort. Arch Gen Psychiatry 2009, 66:1090-1098.
• [13]Fabricatore AN, Wadden TA, Higginbotham AJ, Faulconbridge LF, Nguyen AM, Heymsfield SB, Faith MS: Intentional weight loss and changes in symptoms of depression: a systematic review and meta-analysis. Int J Obes 2011, 35:1363-1376.
• [14]de la Iglesia R, Lopez-Legarrea P, Abete I, Bondia-Pons I, Navas-Carretero S, Forga L, Martinez JA, Zulet MA: A new dietary strategy for long-term treatment of the metabolic syndrome is compared with the American heart association (AHA) guidelines: the MEtabolic syndrome REduction in NAvarra (RESMENA) project. Bri J Nutr 2014, 111:643-652.
• [15]Lopez-Legarrea P, de la Iglesia R, Abete I, Bondia-Pons I, Navas-Carretero S, Forga L, Martinez JA, Zulet MA: Short-term role of the dietary total antioxidant capacity in two hypocaloric regimes on obese with metabolic syndrome symptoms: the RESMENA randomized controlled trial. Nutr Metab 2013, 10:22. BioMed Central Full Text
• [16]de la Iglesia R, Lopez-Legarrea P, Celada P, Sanchez-Muniz FJ, Martinez JA, Zulet MA: Beneficial effects of the RESMENA dietary pattern on oxidative stress in patients suffering from metabolic syndrome with hyperglycemia are associated to dietary TAC and fruit consumption. Int J Mol Sci 2013, 14:6903-6919.
• [17]Perez-Cornago A, Lopez-Legarrea P, de la Iglesia R, Lahortiga F, Martinez JA, Zulet MA: Longitudinal relationship of diet and oxidative stress with depressive symptoms in patients with metabolic syndrome after following a weight loss treatment: the RESMENA project. Clin Nutr 2013. http://dx.doi.org/10.1016/j.clnu.2013.11.011 webcite
• [18]Alberti KG, Zimmet P, Shaw J: The metabolic syndrome–a new worldwide definition. Lancet 2005, 366:1059-1062.
• [19]Schulz KF, Altman DG, Moher D: CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ 2010, 340:c332.
• [20]Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC Jr, Spertus JA, Costa F: Diagnosis and management of the metabolic syndrome: an American heart association/national heart, lung, and blood institute scientific statement. Circulation 2005, 112:2735-2752.
• [21]Food and Nutrition Board NRC: Recommended dietary allowances. 10th edition. Washington, DC: The National Academy Press; 1989.
• [22]Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC: Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985, 28:412-419.
• [23]Conde C, Useros E: Adaptación castellana de la escala de evaluación conductual para la depresión de Beck. Rev Psiqiat Psicol Med 1975, 12:217-236.
• [24]Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J: An inventory for measuring depression. Arch Gen Psychiatry 1961, 4:561-571.
• [25]Davidson KW, Kupfer DJ, Bigger JT, Califf RM, Carney RM, Coyne JC, Czajkowski SM, Frank E, Frasure-Smith N, Freedland KE, Froelicher ES, Glassman AH, Katon WJ, Kaufmann PG, Kessler RC, Kraemer HC, Krishnan KR, Lesperance F, Rieckmann N, Sheps DS, Suls JM: Assessment and treatment of depression in patients with cardiovascular disease: national heart, lung, and blood institute working group report. Ann Behav Med 2006, 32:121-126.
• [26]Katcher HI, Legro RS, Kunselman AR, Gillies PJ, Demers LM, Bagshaw DM, Kris-Etherton PM: The effects of a whole grain-enriched hypocaloric diet on cardiovascular disease risk factors in men and women with metabolic syndrome. Am J Clin Nutr 2008, 87:79-90.
• [27]Brinkworth GD, Buckley JD, Noakes M, Clifton PM, Wilson CJ: Long-term effects of a very low-carbohydrate diet and a low-fat diet on mood and cognitive function. Arch Intern Med 2009, 169:1873-1880.
• [28]Somerset SM, Graham L, Markwell K: Depression scores predict adherence in a dietary weight loss intervention trial. Clin Nutr 2011, 30:593-598.
• [29]Kupper N, Widdershoven JW, Pedersen SS: Cognitive/affective and somatic/affective symptom dimensions of depression are associated with current and future inflammation in heart failure patients. J Affect Disord 2012, 136:567-576.
• [30]Skilton MR, Moulin P, Terra JL, Bonnet F: Associations between anxiety, depression, and the metabolic syndrome. Biol Psychiatry 2007, 62:1251-1257.
• [31]Morrison CD: Leptin signaling in brain: a link between nutrition and cognition? Biochim Biophys Acta 2009, 1792:401-408.
• [32]Milaneschi Y, Simonsick EM, Vogelzangs N, Strotmeyer ES, Yaffe K, Harris TB, Tolea MI, Ferrucci L, Penninx BW: Leptin, abdominal obesity, and onset of depression in older men and women. J Clin Psychiatry 2012, 73:1205-1211.
• [33]Kullmann S, Heni M, Veit R, Ketterer C, Schick F, Haring HU, Fritsche A, Preissl H: The obese brain: association of body mass index and insulin sensitivity with resting state network functional connectivity. Hum Brain Mapp 2012, 33:1052-1061.
• [34]Silva N, Atlantis E, Ismail K: A review of the association between depression and insulin resistance: pitfalls of secondary analyses or a promising new approach to prevention of type 2 diabetes? Curr Psychiatry Rep 2012, 14:8-14.
• [35]Clement K, Viguerie N, Poitou C, Carette C, Pelloux V, Curat CA, Sicard A, Rome S, Benis A, Zucker JD, Vidal H, Laville M, Barsh GS, Basdevant A, Stich V, Cancello R, Langin D: Weight loss regulates inflammation-related genes in white adipose tissue of obese subjects. FASEB J 2004, 18:1657-1669.
• [36]Perez-Cornago A, Zulet MA, Martinez JA: Association between mood and diet quality in subjects with metabolic syndrome participating in a behavioural weight-loss program; a cross-sectional assessment. Nutr Neurosci 2014. http://dx.doi.org/10.1179/1476830514Y.0000000116 webcite
• [37]Swenne I, Rosling A, Tengblad S, Vessby B: Omega-3 polyunsaturated essential fatty acids are associated with depression in adolescents with eating disorders and weight loss. Acta Paediatr 2011, 100:1610-1615.
• [38]Bertone-Johnson ER, Powers SI, Spangler L, Brunner RL, Michael YL, Larson JC, Millen AE, Bueche MN, Salmoirago-Blotcher E, Liu S, Wassertheil-Smoller S, Ockene JK, Ockene I, Manson JE: Vitamin D intake from foods and supplements and depressive symptoms in a diverse population of older women. Am J Clin Nutr 2011, 94:1104-1112.
• [39]Amr M, El-Mogy A, Shams T, Vieira K, Lakhan SE: Efficacy of vitamin C as an adjunct to fluoxetine therapy in pediatric major depressive disorder: a randomized, double-blind, placebo-controlled pilot study. Nutr J 2013, 12:31. BioMed Central Full Text
• [40]Rosenberg DE, Bombardier CH, Artherholt S, Jensen MP, Motl RW: Self-reported depression and physical activity in adults with mobility impairments. Arch Phys Med Rehabil 2013, 94:731-736.
• [41]Appelhans BM, Whited MC, Schneider KL, Ma Y, Oleski JL, Merriam PA, Waring ME, Olendzki BC, Mann DM, Ockene IS, Pagoto SL: Depression severity, diet quality, and physical activity in women with obesity and depression. J Acad Nutr Diet 2012, 112:693-698.