Objectives Increasing evidence supports a bidirectional relationship between major depressive disorder (MDD) and obesity, but the role of visceral adipose tissue (VAT) as a measure of obesity in relation to MDD is not well understood. Here we review literature investigating the link between MDD and VAT in terms of biomarkers, sex differences, and aging. Methods PubMed, EMBASE, PsycINFO, and CINAHL searches were conducted on December 11, 2020. No date or language limits were imposed. Major concepts searched were Depressive Disorder linked with Adipose Tissue, White, Hypothalmo–Hypophyseal System, and Pituitary–Adrenal System in addition to keywords. A final set of 32 items meeting criteria for inclusion. Results Converging biological evidence suggests a significant bidirectional relationship between VAT and MDD across the lifespan. In adulthood, greater VAT was associated with increased risk for depression, especially in vulnerable groups such as individuals who are overweight/obese, postmenopausal women, and individuals with comorbid medical or psychiatric illness. In older adults, sarcopenia had an impact on the relationship between abnormal VAT and risk of depression. Additionally, sex differences emerged as a potential factor affecting the strength of the association between VAT and depression. Conclusions Elucidating the pathophysiological mechanisms associated with increased rates of depression in obese individuals will be crucial for developing specific treatment strategies that seek to improve outcomes in individuals with comorbid depression and obesity. Moreover, identifying age‐ and sex‐specific risk factors may contribute to a more personalized medicine approach, thereby improving the quality of clinical care.
Human intervention trials aimed at reducing weight gain and body fat using soy protein and isoflavones are few in number and show equivocal results. The objective of this study was to compare the effects of a daily isoflavone‐rich soy‐based meal replacement versus a casein‐based control on body weight and fat gain over 16 weeks in 18–19 year old female college freshmen (N = 120). Participants were randomized to treatment group (soy or casein) in this double‐blind, placebo‐controlled trial. Fat mass (FM), fat‐free soft tissue mass (FFST) and % body fat (%BF) were measured using dual energy X‐ray absorptiometry (Delphi 4500). A 2 x 3 RM‐ANOVA was used to measure the response of the dependent variables (body weight, FM, FFST, %BF, and waist circumference) to the intervention. No significant group by time interactions were observed. Body weight, FM, FFST, and %BF increased significantly in both groups over time (i.e., time effects; p < 0.05). Average weight gain was 50–75% less than reported in previous studies of college freshmen. Both soy and milk‐based meal replacements may be beneficial with respect to slowing weight gain in healthy premenopausal women; however, further study is needed to determine the effects of soy and casein meal replacements using a non‐intervention control group. Funded by The University of Georgia Research Foundation.
Background Vitamin D deficiency (VDD) is highly prevalent and increases the risk of osteoporosis, falls, and fractures. Patients in acute inpatient rehabilitation have several risk factors for VDD, the adverse effects of which may hinder long‐term functional gain. Objective To evaluate the prevalence of and risk factors for VDD in patients admitted to acute inpatient rehabilitation and to evaluate the efficacy of a standardized vitamin D screening and supplementation protocol. Design Prospective cohort study as part of a quality improvement initiative. Setting An academic, freestanding acute inpatient rehabilitation hospital. Participants Patients consecutively admitted over a 4‐month period between November 2014 and February 2015 (n=128 pre‐intervention and n=129 post‐intervention). Intervention Universal screening of vitamin D level on admission followed by utilization of a standard supplementation protocol. Main Outcome Measures Vitamin D insufficiency (VDI) and VDD prevalence along with screening, and supplementation rates. Results Preintervention, 10.2% of patients were screened for VDD, with 23.1% VDI and 46.2% VDD. Postintervention, 89.9% were screened, with 31.9% VDI and 47.4% VDD. 6.3% of all patients were supplemented on vitamin D preintervention compared to 53.5% postintervention. In multivariate analyses, the odds of VDD was significantly associated with African American race (OR 7.30, 95% CI, 1.56‐34.20, P = .12) and age younger than 65 (OR 13.62 95% CI, 2.51‐73.83, P = .002). Diagnoses in the “other neurologic” category were associated with decreased odds of VDD (OR 0.01, 95% CI, 0.001‐0.193, P = .002). Conclusions Given the high prevalence of VDD in an acute inpatient rehabilitation hospital, a routine screening and standardized supplementation protocol may improve quality of care. Level of Evidence III
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