Depression linked to the consumption of an inflammatory diet and increased risk of frailty

Summary: Middle-aged and older adults with depression may be more vulnerable to the effects of food inflammation, which increases the risk of frailty and other health conditions.

Source: Hebrew SeniorLife Hinda and Arthur Marcus Institute for Aging Research

A new study published in The Journal of Gerontology: Medical Sciences found a link between depression, diet and the development of frailty.

Frailty, defined as a recognizable state of heightened vulnerability resulting from a decline in function in multiple physiological systems, affects 10-15% of older adults and often coexists with other health conditions, such as depression. Diet is believed to be a major contributor to the development of frailty.

While previous studies have linked an inflammatory diet — including artificial trans fats (like partially hydrogenated oil), refined carbohydrates and saturated fats — to the risk of developmental frailty, this is the one of the first studies to attempt to understand the impact of depression on dietary inflammation and frailty.

Titled “Association of a pro-inflammatory diet with the onset of frailty in adults with and without depressive symptoms: results from the Framingham Offspring Study,” the study attempted to determine whether people with depressive symptoms are more vulnerable to the development of frailty in response to food inflammation.

The study used data from the Framingham Heart Study Offspring cohort. The 1,701 non-frail participants reported their diet and depressive symptoms at baseline and were followed for approximately 11 years when frailty status was reassessed.

The study found that an association between an inflammatory diet and an increased likelihood of frailty appeared somewhat stronger in people with depressive symptoms.

The researchers hypothesize that since people with depressive symptoms generally have higher levels of inflammation, adding dietary inflammation to this accelerates the development of frailty.

Courtney L Millar, Ph.D., postdoctoral fellow, Marcus Institute of Aging Research, Hebrew SeniorLife, and Harvard Medical School, is lead author. “This study found that depressive symptoms can exacerbate the development of frailty in response to consuming an inflammatory diet. This suggests that a diet high in anti-inflammatory compounds (for example, fiber and plant-based compounds called flavonoids) may help prevent the development of frailty,” Dr. Millar said.

“Our exploratory data also suggest that when middle-aged and older adults consume a pro-inflammatory diet, they are more likely to develop new depressive and frailty symptoms at the same time rather than developing either other condition alone,” she added.

This research follows two previous studies conducted by Dr. Millar, one published in May in the American Journal of Clinical Nutrition which showed that eating a Mediterranean-type diet can prevent the development of frailty, and one published in February in the American Journal of Clinical Nutrition who showed that a pro-inflammatory diet increased the risk of developing frailty.

This shows an old man with his head in his hands
Diet is believed to be a major contributor to the development of frailty. Image is in public domain

“This study contributes to the understanding of the relationship between dietary inflammation, depression and frailty,” Dr. Millar said.

“For people with depression, it may be even more important to increase their intake of fruits and vegetables that are high in fiber, flavonoids, and other dietary antioxidants.”

The Framingham Heart Study, Massachusetts General Hospital and the University of South Carolina collaborated on this observational study.

Funding: This study was primarily funded by the National Institute of Aging (NIA) (Grant No. T32-AG023480), the Beth and Richard Applebaum Research Fund, and the Boston Claude D. Pepper Center OAIC (OAIC; 1P30AG031679).

Other authors included: Alyssa B. Dufour, Ph.D., Scientific Assistant II, Hinda and Arthur Marcus Institute for Research in Aging; James R. Hebert, D.Sc. Emeritus Professor of Health Sciences and Director, South Carolina State Cancer Prevention and Control Program, Department of Epidemiology and Biostatistics and Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC and Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC; Nitin Shivappa, MBBS, MPH, Ph.D., Adjunct Assistant Professor, Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC; Olivia I. Okereke, MD, MS, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School and Department of Epidemiology, Harvard TH Chan School of Public Health; Douglas P. Kiel, MD, MPH, Director, Center for Musculoskeletal Research and Senior Scientist, Hinda and Arthur Marcus Institute for Research in Aging; Marian T. Hannan, D.Sc., MPH, Co-Director, Center for Musculoskeletal Research and Senior Scientist, Hinda and Arthur Marcus Institute for Research in Aging; and Shivani Sahni, Ph.D., director, nutrition program and research associate, Hinda and Arthur Marcus Institute for Aging Research.

About this depression and aging research news

Author: Marguerite Bonilla
Source: Hebrew SeniorLife Hinda and Arthur Marcus Institute for Aging Research
Contact: Margaret Bonilla – Hebrew SeniorLife Hinda and Arthur Marcus Institute for Aging Research
Image: Image is in public domain

Original research: Access closed.
“Association of a pro-inflammatory diet with the onset of frailty in adults with and without depressive symptoms: results from the Framingham Offspring Study” by Courtney L Millar et al. Journal of Gerontology


Summary

See also

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Association of a pro-inflammatory diet with the onset of frailty in adults with and without depressive symptoms: results from the Framingham Offspring Study

Background

Food inflammation is associated with an increased risk of frailty. People with depressive symptoms may be at higher risk for frailty because they typically have higher levels of inflammation. The aim of the study was to determine the association between a pro-inflammatory diet and the onset of frailty in people with and without clinically relevant depressive symptoms.

Methods

This prospective study included 1,701 non-frail individuals with self-reported baseline data (1998-2001) available for assessment of energy-adjusted dietary inflammatory index (E-DII MT) (calculated from food frequency questionnaires), depressive symptoms (from the Center for Epidemiological Studies on Depression; CES-D) and follow-up measures of frailty (2011-2014). Frailty was defined as fulfilling ≥3 Fried frailty criteria. Outcomes are presented by baseline CES-D scores <16 or ≥16 points, which denotes the absence or presence of clinically relevant depressive symptoms, respectively. Logistic regression estimated odds ratios (ORs) and 95% confidence intervals (95% CI) between E-DII and frailty onset, adjusting for confounders.

Results

Among all study participants, the mean age (standard deviation; SD) was 58 (8) years and the E-DII was -1.95 (2.20; range: -6.71 to +5.40, higher scores denote a more pro-inflammatory diet) and 45% were men. In those without clinically relevant depressive symptoms, a one unit higher E-DII score was associated with a 14% (95% CI: 1.05-1.24) increased likelihood of frailty. In people with depressive symptoms, an E-DII score one unit higher was associated with a 55% increased likelihood of frailty (95% CI: 1.13-2.13).

conclusion

The association between an inflammatory diet and an increased likelihood of frailty appeared somewhat stronger in people with depressive symptoms. This preliminary finding warrants further investigation.

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