膳食模式与社区成人抑郁症的系统回顾以及荟萃分析

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 (澳)Lai JS,Hiles S,Bisquera A,Hure AJ,McEvoy M,Attia J

【编者导读】来自澳大利亚纽卡斯尔大学、亨特医学研究中心、约翰•亨特医院的研究者们利用了6个电子数据库,对截止2013年8月发表的有关总膳食与成人抑郁症之间相关性的文章进行了筛选,对其中21项系统回顾与荟萃分析,汇总了其中13项观察性研究的结果,发现健康的膳食模式:多摄入蔬菜、水果和全谷类食品可能降低罹患抑郁症的风险。

 

摘要(Abstract)

背景(Backgroud):

抑郁症中对单一营养素的研究并未得到一致的结果,这些研究者们未对各种营养素间复杂的相互作用加以分析研究。而近年来,越来越多的研究开始探索总膳食模式与抑郁症之间的相关性。

 

目的(Objective):

本研究旨在对现有的文献进行系统回顾(systematically review)并进行荟萃分析(meta-analyses),藉此研究膳食模式与抑郁症之间的相关性。

 

设计(Design):

选用6个电子数据库,搜索了截止2013年8月前所发表的有关总膳食与成人抑郁症之间相关性的文章。仅采用方法学上严谨的研究。两个完全独立的审核员完成研究的选择,质量评价和数据提取。纳入研究的效应量(effect sizes)采用随机效应模式(random-effects models)。不能进行荟萃分析的研究则展示研究结果的总结。

 

结果(Results):

最终总共确定了21项研究,汇总了来自13项观察性研究的结果,确定了两种饮食模式。健康的饮食模式与降低罹患抑郁症几率呈显著相关(比值比OR:0.84,95%可信区间CI:0.76,0.92,P<0.001)。西方饮食模式与抑郁症之间未发现统计学上显著性相关(OR:1.17,95%CI:0.97,1.68,P=0.094),然而,由于有关西方饮食模式的研究极少,所以难以对该模式的作用做出精确估计。

 

结论(Conclusion):

结果显示摄入大量的水果(fruit)、蔬菜(vegetables)以及全谷类(whole grains)食品可能与降低罹患抑郁症风险相关。然而,为了证实该发现,特别是该种时序相关性还需要更多高质量的随机对照试验(randomized controlled trials)和队列研究(cohort studies)。

 

来源:澳大利亚纽卡斯尔大学性别、健康与衰老重点研究中心,纽卡斯尔大学转化神经学与心理健康重点研究中心,纽卡斯尔大学临床流行病学与生物统计学中心,亨特医学研究中心,约翰•亨特医院

在线发表于2013年11月6日《美国临床营养期刊》杂志

doi:10.3945/ajcn.113.069880.

PMID:24196402

翻译:悠悠步行者

http://www.ncbi.nlm.nih.gov/pubmed/24196402

Am J Clin Nutr. 2014 Jan;99(1):181-97. doi: 10.3945/ajcn.113.069880. Epub 2013 Nov 6.

A systematic review and meta-analysis of dietary patterns and depression in community-dwelling adults.

Lai JS, Hiles S, Bisquera A, Hure AJ, McEvoy M, Attia J.

Priority Research Centre for Gender, Health and Ageing (JSL and AJH), the Priority Research Centre for Translational Neuroscience and Mental Health (SH), and the Centre for Clinical Epidemiology and Biostatistics (MM and JA), University of Newcastle, New South Wales, Australia; the Hunter Medical Research Institute, Newcastle, New South Wales, Australia (AB, AJH, and JA); and the John Hunter Hospital, Newcastle, New South Wales, Australia (JA).

Abstract

BACKGROUND:

Studies of single nutrients on depression have produced inconsistent results, and they have failed to consider the complex interactions between nutrients. An increasing number of studies in recent years are investigating the association of overall dietary patterns and depression.

OBJECTIVE:

This study aimed to systematically review current literature and conduct meta-analyses of studies addressing the association between dietary patterns and depression.

DESIGN:

Six electronic databases were searched for articles published up to August 2013 that examined the association of total diet and depression among adults. Only studies considered methodologically rigorous were included. Two independent reviewers completed study selection, quality rating, and data extraction. Effect sizes of eligible studies were pooled by using random-effects models. A summary of the findings was presented for studies that could not be meta-analyzed.

RESULTS:

A total of 21 studies were identified. Results from 13 observational studies were pooled. Two dietary patterns were identified. The healthy diet pattern was significantly associated with a reduced odds of depression (OR: 0.84; 95% CI: 0.76, 0.92; P < 0.001). No statistically significant association was observed between the Western diet and depression (OR: 1.17; 95% CI: 0.97, 1.68; P = 0.094); however, the studies were too few for a precise estimate of this effect.

CONCLUSIONS:

The results suggest that high intakes of fruit, vegetables, fish, and whole grains may be associated with a reduced depression risk. However, more high-quality randomized controlled trials and cohort studies are needed to confirm this finding, specifically the temporal sequence of this association.