Background & aims: Overall diet quality may partially mediate the detrimental effects of stress and neuroticism on common mental health problems: stressed and/or neurotic individuals may be more prone to unhealthy dietary habits, which in turn may contribute to depression and anxiety. Lifestyle interventions for depressed, anxious or at-risk individuals hinge on this idea, but evidence to support such pathway is missing. Here, we aim to prospectively evaluate the role of overall diet quality in common pathways to developing depression and anxiety. Methods: At baseline, N ¼ 121,008 individuals from the general population (age 18e93) completed an extensive food frequency questionnaire, based on which overall diet quality was estimated. Participants also reported on two established risk factors for mental health problems, i.e. past-year stress exposure (long-term difficulties, stressful life-events) and four neuroticism traits (anger-hostility, selfconsciousness, impulsivity, vulnerability). Depression and anxiety were assessed at baseline and follow-up (n ¼ 65,342, þ3.6 years). Overall diet quality was modeled as a mediator in logistic regression models predicting the development of depression and anxiety from common risk factors. Results: High stress and high neuroticism scores were -albeit weakly -associated with poorer diet quality. Poor diet quality, in turn, did not predict mental health problems. Overall diet quality did not mediate the relationship between stress/neuroticism and common mental health problems: effects of stress, neuroticism and stress-by-neuroticism interactions on mental health problems at follow-up consisted entirely of direct effects (98.6%e100%). Conclusions: Diet quality plays no mediating role in two established pathways to common mental health problems. As overall diet quality was reduced in stressed and neurotic individuals, these groups may benefit from dietary interventions. However, such interventions are unlikely to prevent the onset or recurrence of depression and anxiety.
Excessive alcohol intake compromises cognitive functioning. At the same time, moderate alcohol consumption is reported to protect against Alzheimer’s disease among elderly. Little is known about dose-dependent effects of alcohol consumption on higher-order cognitive functioning among generally healthy adults. Here, we applied propensity weighted analyses to investigate associations between habitual drinking patterns and executive functioning in the general population.A community sample of N=78,832 Dutch adults (age 18-65, 40.9% male) completed the Ruff Figural Fluency Task of executive functioning (range 1-165), and self-reported their past month consumption of alcoholic beverages on a food frequency questionnaire. Participants were stratified according to drinking level (abstinent [22.0%], occasional [<2.5 g/day, 21.4%], light [2.5–14.9 g/day, 42.9%], moderate [15–29.9 g/day, 11.4%], or heavy [>30 g/day, 2.3%]) and binge-drinking (yes [10.6%] vs. no [89.4%]). Groups were equivalised using multinomial propensity score weighing based on demographic, socioeconomic, health-related and psychosocial factors influencing drinking behaviour.Compared to abstinent participants, task performance was better among light drinkers (β[95% CI]=0.056[0.033-0.078] or +1.3 points, p<0.0001) and moderate drinkers (β[95% CI]=0.111[0.079-0.143] or +2.5 points, p<0.0001), but not among occasional drinkers (β[95% CI]=0.018[-0.006-0.043], p=0.1432) or heavy drinkers (β[95% CI]=0.075[-0.009-0.158], p=0.0791). No difference was found between binge-drinkers and non-binge-drinkers (β[95% CI]=0.032[-0.002-0.066], p=0.0654).In conclusion, we observed better executive functioning in light-moderate drinkers compared to abstainers, but not in occasional drinkers, heavy drinkers or binge-drinkers. This non-linear association is reminiscent of the dose-dependent effect of alcohol consumption on cardiovascular risk. Further studies may determine whether cardiovascular, inflammatory and/or other somatic factors mediate the association between moderate drinking and higher-order cognitive functions. Although analyses were adjusted for observed factors that influence drinking behaviours, we cannot exclude a contribution from unobserved residual confounding.
Background and aimsBehavioural disinhibition is a prominent feature of multiple psychiatric disorders, and has been associated with poor long-term somatic health outcomes. Modifiable lifestyle factors including diet and moderate-to-vigorous physical activity (MVPA) may be associated with behavioural disinhibition, but their shared and unique contributions have not previously been quantified.MethodsN=157,354 UK Biobank participants who completed the online mental health assessment were included (age 40-69, 2006-2010). Using principal component analyses, we extracted a single disinhibition score and four dietary component scores (prudent diet, elimination of wheat/dairy/eggs, meat consumption, full-cream dairy consumption). In addition, latent profile analysis assigned participants to one of five empirical dietary groups: moderate-healthy, unhealthy, restricted, meat-avoiding, low-fat dairy. Participants self-reported MVPA in minutes/week. Disinhibition was regressed on the four dietary components, the dietary grouping variable and MVPA.Resultsin men and women, behavioural disinhibition was negatively associated with prudent diet scores, and positively associated with wheat/dairy/eggs elimination. In men only, disinhibition was associated with consumption of meat and full-cream dairy products. Comparing groups, disinhibition was lower in the moderate-and-prudent diet (reference) group compared to all other groups. Absolute βs ranged from 0.02-0.13 indicating very weak effects. Disinhibition was not associated with MVPA.ConclusionsAmong middle-aged and older adults, behavioural disinhibition is associated with multiple features of diet. While the observational nature of UK Biobank does not allow causal inference, our findings foster specific hypotheses (e.g. early malnutrition, elevated immune-response, dietary restraint) to be tested in alternative study designs.
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