Association of dietary total antioxidant capacity with depression, anxiety, and sleep disorders: A systematic review of observational studies
Background and aim: We aimed to systematically review observational studies that evaluated the potential association of the dietary total antioxidant capacity (dTAC) with common mental disorders (depression and anxiety) and sleep disorders.
Methods: Studies with an observational design that evaluated the association between the dTAC and common mental disorders and sleep disorders were identified using the PubMed and Scopus databases. The Meta-analysis Guideline of Observational Studies in Epidemiology and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis were used to conduct and report the data of this systematic review.
Results: Of the 439 records, seven studies were included in this review. There was a sample variation of 41–3,297 participants. We highlight that five of the studies analyzed were conducted in the Iranian population. Four studies analyzed only women, and three studies were conducted with postmenopausal or climacteric women. Four cross-sectional studies showed inverse associations between the dTAC and depression, anxiety, and sleep disorders in Iranians.
Conclusions: The consumption of a diet rich in antioxidants, characterized by high dTAC scores, seems to be inversely associated with depression, anxiety, and sleep disorders. However, further studies with different populations and designs are necessary for a better understand this relationship.
Relevance to patients: This review assesses the association of the dTAC with common mental disorders (depression and anxiety) and sleep disorders. These knowledge will help guide further studies on the relationship between diet and mental disorders and sleep disorders. Knowledge about these relationships is essential for the creation of non-pharmacological practices for the prevention of these disorders.
[1] World Health Organization. Depression and Other Common Mental Disorders. Geneva: World Health Organization; 2017. Available from: https://www.who.int/publications/i/ item/depression-global-health-estimates Last accessed on 2021 Apr 03.
[2] World Health Organization. Depression. Geneva: World Health Organization; 2020. Available from: https://www. who.int/en/news-room/fact-sheets/detail/depression. Last accessed on 2021 Apr 03.
[3] Spoorthy MS, Chakrabarti S, Grover S. Comorbidity of Bipolar and Anxiety Disorders: An Overview of Trends in Research. World J Psychiatry 2019;9:7-29.
[4] Okun ML, Mancuso RA, Hobel CJ, Schetter CD, CoussonsRead M. Poor Sleep Quality Increases Symptoms of Depression and Anxiety in Postpartum Women. J Behav Med 2018;41:703-10.
[5] Thorpy MJ. Classification of Sleep Disorders. Neurotherapeutics 2012;9:687-701.
[6] Perlis ML, Vargas I, Ellis JG, Grandner MA, Morales KH, Gencarelli A, et al. The Natural History of Insomnia: The Incidence of Acute Insomnia and Subsequent Progression to Chronic Insomnia or Recovery in Good Sleeper Subjects. Sleep 2020;43:zsz299.
[7] Han RH, Schmidt MN, Waits WM, Bell AK, Miller TL. Planning for Mental Health Needs during COVID-19. Curr Psychiatry Rep 2020;22:66.
[8] Vindegaard N, Benros ME. COVID-19 Pandemic and Mental Health Consequences: Systematic Review of the Current Evidence. Brain Behav Immun 2020;89:531-42.
[9] Humer E, Pieh C, Brandmayr G. Metabolomics in Sleep, Insomnia and Sleep Apnea. Int J Mol Sci 2020;21:7244.
[10] LeBlanc M, Mérette C, Savard J, Ivers H, Baillargeon L, Morin CM. Incidence and Risk Factors of Insomnia in a Population-Based Sample. Sleep 2009;32:1027-37.
[11] Bajpai A. Oxidative Stress and Major Depression. J Clin Diagn Res 2014;8:CC04-7.
[12] Bhatt S, Nagappa AN, Patil CR. Role of Oxidative Stress in Depression. Drug Discov Today 2020;25:1270-6.
[13] Ng F, Berk M, Dean O, Bush AI. Oxidative Stress in Psychiatric Disorders: Evidence Base and Therapeutic Implications. Int J Neuropsychopharmacol 2008;11:851-76.
[14] Wilking M, Ndiaye M, Mukhtar H, Ahmad N. Circadian Rhythm Connections to Oxidative Stress: Implications for Human Health. Antioxid Redox Signal 2013;19:192-208.
[15] Jimenez-Fernandez S, Gurpegui M, Diaz-Atienza F, Perez-Costillas L, Gerstenberg M, Correll CU. Oxidative Stress and Antioxidant Parameters in Patients with Major Depressive Disorder Compared to Healthy Controls before and after Antidepressant Treatment: Results from a MetaAnalysis. J Clin Psychiatry 2015;76:1658-67.
[16] Kruk J, Aboul-Enein HY, Kładna A, Bowser JE. Oxidative Stress in Biological Systems and its Relation with Pathophysiological Functions: The Effect of Physical Activity on Cellular Redox Homeostasis. Free Radic Res 2019;53:497-521.
[17] Park JY, You JS, Chang KJ. Dietary Taurine Intake, Nutrients Intake, Dietary Habits and Life Stress by Depression in Korean Female College Students: A CaseControl Study. J. Biomed Sci 2010;17 Suppl 1:S40.
[18] Gomez-Pinilla F, Nguyen TT. Natural Mood Foods: The Actions of Polyphenols Against Psychiatric and Cognitive Disorders. Nutr Neurosci 2012;15:127-33.
[19] Payne ME, Steck SE, George RR, Steffens DC. Fruit, Vegetable, and Antioxidant Intakes Are Lower in Older Adults with Depression. J Acad Nutr Diet 2012;112:2022-7.
[20] Hermsdorff HH, Puchau B, Volp AC, Barbosa KB, Bressan J, Zulet MÁ, et al. Dietary Total Antioxidant Capacity is Inversely Related to Central Adiposity as Well as to Metabolic and Oxidative Stress Markers in Healthy Young Adults. Nutr Metab (Lond) 2011;8:59.
[21] Puchau B, Zulet MÁ, de Echávarri AG, Hermsdorff HH, Martínez JA. Dietary Total Antioxidant Capacity: A Novel Indicator of Diet Quality in Healthy Young Adults. J Am Coll Nutr 2009;28:648-56.
[22] Serafini M, Del Rio D. Understanding the Association between Dietary Antioxidants, Redox Status and Disease: Is the Total Antioxidant Capacity the Right Tool? Redox Rep 2004;9:145-52.
[23] Carlsen MH, Halvorsen BL, Holte K, Bøhn SK, Dragland S, Sampson L, et al. The Total Antioxidant Content of More than 3100 Foods, Beverages, Spices, Herbs and Supplements used Worldwide. Nutr J 2010;9:3.
[24] Nascimento-Souza MA, Paiva PG, Martino HS, RibeiroAQ. Dietary Total Antioxidant Capacity as a Tool in Health Outcomes in Middle-Aged and Older Adults: A Systematic Review. Crit Rev Food Sci Nutr 2018;58:905-12.
[25] Abshirini M, Siassi F, Koohdani F, Qorbani M, Mozaffari H, Aslani Z, et al. Dietary Total Antioxidant Capacity is Inversely Associated with Depression, Anxiety and Some Oxidative Stress Biomarkers in Postmenopausal Women: A Cross-Sectional Study. Ann Gen Psychiatry 2019;18:3.
[26] Daneshzad E, Keshavarz SA, Qorbani M, Larijani B, Azadbakht L. Dietary Total Antioxidant Capacity and its Association with Sleep, Stress, Anxiety, and Depression Score: A Cross-Sectional Study among Diabetic Women. Clin Nutr ESPEN 2020;37:187-94.
[27] Miki T, Eguchi M, Kochi T, Akter S, Hu H, Kashino I, et al. Prospective Study on the Association between Dietary Non-Enzymatic Antioxidant Capacity and Depressive Symptoms. Clin Nutr ESPEN 2020;36:91-8.
[28] Milajerdi A, Keshteli AH, Afshar H, Esmaillzadeh A, Adibi P. Dietary Total Antioxidant Capacity in Relation to Depression and Anxiety in Iranian Adults. Nutrition 2019;65:85-90.
[29] de Oliveira NG, Teixeira IT, Theodoro H, Branco CS. Dietary Total Antioxidant Capacity as a Preventive Factor Against Depression in Climacteric Women. Dement Neuropsychol 2019;13:305-11.
[30] Prohan M, Amani R, Nematpour S, Jomehzadeh N, Haghighizadeh MH. Total Antioxidant Capacity of Diet and Serum, Dietary Antioxidant Vitamins Intake, and Serum hs-CRP Levels in Relation to Depression Scales in University Male Students. Redox Rep 2014;19:133-9.
[31] Abshirini M, Siassi F, Koohdani F, Qorbani M, Khosravi S, Hedayati M, et al. Dietary total Antioxidant Capacity is Inversely Related to Menopausal Symptoms: A CrossSectional Study among Iranian Postmenopausal Women. Nutrition 2018;55-56:161-7.
[32] Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, et al. Meta-Analysis of Observational Studies in Epidemiology: A Proposal for Reporting. JAMA 2000;283:2008-12.
[33] Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 Statement: An Updated Guideline for Reporting Systematic Reviews. BMJ 2021;372:n71.
[34] NHLBI, NIH. Study Quality Assessment Tools; 2014. Available from: https://www.nhlbi.nih.gov/healthtopics/study-quality-assessment-tools [Last accessed on 2021 Jan 19].
[35] Balmus IM, Ciobica A, Antioch I, Dobrin R, Timofte D. Oxidative Stress Implications in the Affective Disorders: Main Biomarkers, Animal Models Relevance, Genetic Perspectives, and Antioxidant Approaches. Oxid Med Cell Longev 2016;2016:3975101.
[36] Visentin AP, Colombo R, Scotton E, Fracasso DS, da Rosa AR, Branco CS, et al. Targeting InflammatoryMitochondrial Response in Major Depression: Current Evidence and Further Challenges. Oxid Med Cell Longev 2020;2020:2972968.
[37] Lehtinen M, Bonni A. Modeling Oxidative Stress in the Central Nervous System. Curr Mol Med 2006;6:871-81.
[38] Villafuerte G, Miguel-Puga A, Rodríguez EM, Machado S, Manjarrez E, Arias-Carrión O. Sleep Deprivation and Oxidative Stress in Animal Models: A Systematic Review. Oxid Med Cell Longev 2015;2015:234952.
[39] Bouayed J. Polyphenols: A Potential New Strategy for the Prevention and Treatment of Anxiety and Depression. Curr Nutr Food Sci 2010;6:13-8.
[40] Milaneschi Y, Bandinelli S, Penninx BW, Corsi AM, Lauretani F, Vazzana R, et al. The Relationship between Plasma Carotenoids and Depressive Symptoms in Older Persons. World J Biol Psychiatry 2012;13:588-98.
[41] Bawaked RA, Schröder H, Ribas-Barba L, IzquierdoPulido M, Pérez-Rodrigo C, Fíto M, et al. Association of Diet Quality with Dietary Inflammatory Potential in Youth. Food Nutr Res 2017;61:1328961.
[42] Brighenti F, Valtuena S, Pellegrini N, Ardigo D, Del Rio D, Salvatore S, et al. Total antioxidant Capacity of the Diet is Inversely and Independently Related to Plasma Concentration of High-Sensitivity C-Reactive Protein in Adult Italian Subjects. Br J Nutr 2005;93:619-25.
[43] Valtueña S, Pellegrini N, Franzini L, Bianchi MA, Ardigo D, Del Rio D, et al. Food Selection Based on Total Antioxidant Capacity Can Modify Antioxidant Intake, Systemic Inflammation, and Liver Function without Altering Markers of Oxidative Stress. Am J Clin Nutr 2008;87:1290-7.
[44] Saghafian F, Malmir H, Saneei P, Milajerdi A, Larijani B, Esmaillzadeh A. Fruit and Vegetable Consumption and Risk of Depression: Accumulative Evidence from an Updated Systematic Review and Meta-Analysis of Epidemiological Studies. Br J Nutr 2018;119:1087-101.
[45] Jacka FN, Kremer PJ, Berk M, de Silva-Sanigorski AM, Moodie M, Leslie ER, et al. A Prospective Study of Diet Quality and Mental Health in Adolescents. PLoS One 2011;6:e24805.
[46] Pereira GA, Domingos AL, de Aguiar AS. Relationship between Food Consumption and Improvements in Circulating Melatonin in Humans: An Integrative Review. Crit Rev Food Sci Nutr 2020. Doi: 10.1080/10408398.2020.1825924.
[47] Domingos AL, Hermsdorff HH, Bressan J. Melatonin Intake and Potential Chronobiological Effects on Human Health. Crit Rev Food Sci Nutr 2019;59:133-40.
[48] Garrido M, Paredes SD, Cubero J, Lozano M, ToribioDelgado AF, Muñoz JL, et al. Jerte Valley CherryEnriched Diets Improve Nocturnal Rest and Increase 6-Sulfatoxymelatonin and Total Antioxidant Capacity in the Urine of Middle-Aged and Elderly Humans. J Gerontol A 2010;65:909-14.
[49] Garrido M, Gonzalez-Gomez D, Lozano M, Barriga C, Paredes SD, Moratinos AB. A Jerte Valley Cherry Product Provides Beneficial Effects on Sleep Quality. Influence on Aging. J Nutr Health Aging 2013;17:553-60.
[50] Howatson G, Bell PG, Tallent J, Middleton B, McHugh MP, Ellis J. Effect of Tart Cherry Juice (Prunus cerasus) on Melatonin Levels and Enhanced Sleep Quality. Eur J Nutr 2011;51:909-16.
[51] Parohan M, Anjom-Shoae J, Nasiri M, Khodadost M, Khatibi SR, Sadeghi O. Dietary Total Antioxidant Capacity and Mortality from All Causes, Cardiovascular disease and Cancer: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies. Eur J Nutr 2019;58:2175-89.
[52] Nayak B, Liu RH, Tang J. Effect of Processing on Phenolic Antioxidants of Fruits, Vegetables, and Grains-a Review. Crit Rev Food Sci Nutr 2015;55:887-918.
[53] Kravitz HM, Kazlauskaite R, Joffe H. Sleep, Health, and Metabolism in Midlife Women and Menopause: Food for Thought. Obstet Gynecol Clin North Am 2018;45:679-94.
[54] Jehan S, Jean-Louis G, Zizi F, Auguste E, PandiPerumal SR, Gupta R, et al. Sleep, Melatonin, and the Menopausal Transition: What are the Links? Sleep Sci 2015;10:11-8.
[55] Lin J, Jiang Y, Wang G, Meng M, Zhu Q, Mei H, et al. Associations of Short Sleep Duration with AppetiteRegulating Hormones and Adipokines: A Systematic Review and Meta-Analysis. Obes Rev 2020;21:13051.
[56] Singh M. Mood, Food and Obesity. Front Psychol 2014;5:1-35.
[57] Fisberg RM, Marchioni DM, Colucci AC. Assessment of Food Consumption and Nutrient Intake in Clinical Practice. Arq Bras Endocrinol Metabol 2009;53:617-24.
[58] Lettieri-Barbato D, Tomei F, Sancini A, Morabito G, Serafini M. Effect of Plant Foods and Beverages on Plasma Non-Enzymatic Antioxidant Capacity in Human Subjects: A Meta-Analysis. Br J Nutr 2013;109:1544-56.