Medical Bulletin 06/ April/ 2024

A recent study published in the journal Nutrients discovered the interactions between depression and nutrition, coupled with exercise.

Obesity and depression frequently co-occur, along with anxiety disorders, sharing a bidirectional relationship. Depression often leads to comfort eating and inactivity, increasing the risk of obesity by 40% during emotional stress. Conversely, obesity can heighten the likelihood of anxiety or depression due to negative self-image and societal stigma. While antidepressants effectively treat depression, they may contribute to weight gain.

In this study, researchers explored the potential of gut microbes in treating both obesity and depression, focusing on the role of probiotics and prebiotics. They found that dietary patterns influence around 57% of gut microbiota composition. Probiotics enhance the gut barrier and immune system, improving depressive symptoms. Additionally, supplementation with fatty acids and vitamins E and D, along with specific diets like the Mediterranean or DASH diets, may help counter severe depression and reduce neuroinflammation.

The findings suggested that depression and obesity risk could be reduced with both the DASH and the MD. High-quality vegetarian diets were protective against depression, underlining the pivotal role of diet quality. Furthermore, some clinical trials in humans suggested a positive effect of probiotics on depressive disorders as well as on obesity and related metabolic conditions like insulin resistance, type 2 diabetes, and non-alcoholic fatty liver disease (NAFLD).

Reference: Klaudia Sochacka,Agata Kotowska and Sabina Lachowicz-Wiśniewska; The Role of Gut Microbiota, Nutrition, and Physical Activity in Depression and Obesity—Interdependent Mechanisms/Co-Occurrence; Journal: Nutrients; https://doi.org/10.3390/nu16071039

A register-based study from Finland identified three distinct BMI trajectory groups among patients with newly diagnosed type 2 diabetes.

The study was carried out by researchers at the University of Eastern Finland, and was published in the journal Clinical Epidemiology.

Most type 2 diabetes (T2D) patients live with obesity, and weight loss is one of the therapeutic objectives in T2D management. Clinical trials have demonstrated that modest weight loss, i.e, 5‒10%, in T2D patients with high BMI improves the risk factors of diabetes complications, such as hyperglycaemia, hyperlipidaemia, and hypertension. Complications of type 2 diabetes (T2D) can be classified into microvascular (retinopathy, neuropathy, nephropathy) and macrovascular (cardiovascular disease, cerebrovascular disease, peripheral vascular disease) categories. Observational studies exploring the association between BMI and these complications have yielded mixed results, with some showing positive, inverse, or no associations.

In this cohort study, electronic health records from public primary and specialized healthcare services were utilized and included a total of 889 adults with newly diagnosed T2D between 2011 or 2012 (mean age at baseline 62.0 years). Individual BMI trajectories from the T2D diagnosis until 2014 were estimated. Data was collected on patients’ birth year, sex, measurements of BMI, fasting plasma glucose (FPG), glycated haemoglobin (HbA1c) and low-density lipoprotein (LDL), diagnosis codes and dates for T2D and complications, as well as the date of death.

The results revealed that in a four-year follow-up, most patients followed a stable trajectory without much weight change. Only 10% of patients lost weight, whereas 3% gained weight. Mean BMI exceeded the threshold of obesity in all groups at baseline. Patients belonging to each trajectory group were followed up for another eight years for diabetes complications. During the follow-up, 13% of all patients developed microvascular complications, 21% developed macrovascular complications and 20% of patients deceased. The risk of microvascular complications was 2.9 times higher and the risk of macrovascular complications 2.5 times higher among patients with an increasing BMI compared to those with a stable BMI.

“These results underscore the significance of continuous BMI monitoring and weight management in patients with type 2 diabetes. Tailored treatments and support with lifestyle changes are crucial for efficiently preventing weight gain and reducing the risk of diabetes complications,” said Doctoral Researcher Zhiting Wang of the University of Eastern Finland.

Reference: Zhiting Wang, Piia Lavikainen, Katja Wikström, Tiina Laatikainen; Trajectories of Body Mass Index and Risk for Diabetes Complications and All-Cause Mortality in Finnish Type 2 Diabetes Patients; Journal: Clinical Epidemiology; https://doi.org/10.2147/CLEP.S450455

In a recent review published in the journal Nutrients, researchers discussed the possible associations between the consumption of soy products and the risk of developing cancer.

Soy products are rich in compounds like isoflavones, phytosterols, and dietary fibre, all of which may mitigate cancer risk. However, research has suggested these effects vary with soy products and cancer types. Cancer rates continue to rise globally, with breast, lung, colorectal, prostate, and stomach cancers leading in terms of both new cases and deaths. Researchers have observed variations in cancer prevalence, which may be attributed to different dietary habits, particularly soy product consumption.

The study analyzed 28 studies involving 24,090 cases and 5,53,282 participants to examine the link between soy product consumption and cancer risk. High soy intake was associated with a 31% reduced risk of cancer, particularly in case-control studies, showing a 24% reduction in women but not men. Additionally, analyzing 7 cohort and 19 case-control studies with 18,729 cases and 3,12,770 participants revealed that high tofu consumption was found to significantly reduce cancer risk by 22% in both males and females.

The results observed a notable risk reduction in gynaecological cancers, including ovarian cancers, as well as cancers affecting the gastrointestinal and upper aerodigestive tract, prostate, and lungs. The dose-response analysis indicated non-linear relationships, with increased soy consumption and tofu associated with a reduced cancer risk.

The findings revealed that higher consumption of total soy foods, tofu was associated with a reduced risk of cancer, particularly gastrointestinal and gynaecological cancers. However, evidence regarding other soy products is insufficient, thus necessitating the need for additional well-designed prospective cohort studies.

Reference: Chenting Wang, Keqing Ding, Xuanzhen Xie, Jinyue Zhou,Pengju Liu,Shuang Wang, Ting Fang,Guozhang Xu, Chunlan Tang, Hang Hong; Soy Product Consumption and the Risk of Cancer: A Systematic Review and Meta-Analysis of Observational Studies; Journal: Nutrients; https://doi.org/10.3390/nu16070986