High BMI Causes Depression – and Both Physical and Social Factors Play a Role

A largescale new study provides further evidence that being overweight causes depression and lowers wellbeing and indicates both social and physical factors may play a role in the effect.

With one in four adults estimated to be obese in the UK, and growing numbers of children affected, obesity is a global health challenge. While the dangers of being obese on physical health is well known, researchers are now discovering that being overweight can also have a significant impact on mental health.

The new study, published in Human Molecular Genetics, sought to investigate why a body of evidence now indicates that higher BMI causes depression. The team used genetic analysis, known as Mendelian Randomisation, to examine whether the causal link is the result of psychosocial pathways, such as societal influences and social stigma, or physical pathways, such as metabolic conditions linked to higher BMI. Such conditions include high blood pressure, type 2 diabetes and cardiovascular disease.

In research led by the University of Exeter and funded by the Academy of Medical Sciences, the team examined genetic data from more than 145,000 participants from the UK Biobank with detailed mental health data available. In a multifaceted study, the researchers analysed genetic variants linked to higher BMI, as well as outcomes from a clinically-relevant mental health questionnaire designed to assess levels of depression, anxiety and wellbeing.

To examine which pathways may be active in causing depression in people with higher BMI, the team also interrogated two sets of previously discovered genetic variants. One set of genes makes people fatter, yet metabolically healthier, meaning they were less likely to develop conditions linked to higher BMI, such as high blood pressure and type 2 diabetes. The second set of genes analysed make people fatter and metabolically unhealthy, or more prone to such conditions. The team found little difference between the two sets of genetic variants, indicating that both physical and social factors play a role in higher rates of depression and poorer wellbeing.

Lead author Jess O’Loughlin, at the University of Exeter Medical School, said: “Obesity and depression are both major global health challenges, and our study provides the most robust evidence to date that higher BMI causes depression. Understanding whether physical or social factors are responsible for this relationship can help inform effective strategies to improve mental health and wellbeing. Our research suggests that being fatter leads to a higher risk of depression, regardless of the role of metabolic health. This suggests that both physical health and social factors, such as social stigma, both play a role in the relationship between obesity and depression.”

Source: University of Exrter

Could Fish Oil Supplements Help Fight Depression?

Robert Preidt wrote . . . . . . . . .

Fish oil supplements are often touted as good for your heart health, but a new study finds they may also help fight depression.

“Using a combination of laboratory and patient research, our study has provided exciting new insight into how omega-3 fatty acids bring about anti-inflammatory effects that improve depression,” said lead author Alessandra Borsini, a postdoctoral neuroscientist at King’s College London.

Borsini said it’s been known that omega-3 polyunsaturated fatty acids have anti-depressant and anti-inflammatory effects, but exactly how that happens has been unclear.

“Our study has helped shine a light on the molecular mechanisms involved in this relationship, which can inform the development of potential new treatments for depression using omega-3 PUFA,” Borsini said in a university news release.

Previous studies have shown that people with major depression have elevated levels of inflammation, but no proven anti-inflammatory treatments for depression exist.

The patient portion of this new study included 22 people with major depression.

Once a day for 12 weeks, they were given one of two omega-3 polyunsaturated fatty acids (PUFAs) — either 3 grams of eicosapentaenoic acid (EPA) or 1.4 grams of docosahexaenoic acid (DHA).

EPA and DHA are omega-3 PUFAs found in oily fish.

Byproducts of EPA and DHA were measured in the patients’ blood before and after treatment, and their depression symptoms were assessed.

Treatment with both omega-3s was associated with a significant improvement in depression, with an average 64% drop in symptoms for the EPA group and 71% in the DHA group. It does not prove cause-and-effect, however.

The findings were published June 16 in the journal Molecular Psychiatry.

The levels of EPA and DHA used in this study can’t be achieved by eating oily fish, the researchers noted.

Senior study author Carmen Pariante, a professor of biological psychiatry, said the research has provided vital information to help shape clinical trials of therapeutic approaches with omega-3 fatty acids.

“It is important to highlight that our research has not shown that by simply increasing omega-3 fatty acids in our diets or through taking nutritional supplements we can reduce inflammation or depression,” she said. “The mechanisms behind the associations between depression and omega-3 PUFA are complicated and require further research and clinical trials to fully understand how they work and inform future therapeutic approaches.”

Source: HealthDay

Beta-blockers Not Likely to Cause Depression Yet May Contribute to Sleep Disturbances

Beta-blockers treat various cardiovascular diseases and were not more likely to cause depression compared to other similar treatments, according to new research published today in Hypertension, an American Heart Association journal. While depression may occur during beta-blocker therapy, the research suggests beta-blockers are not the likely cause.

Beta-blockers are a class of medications that reduce the heart rate, the heart’s workload and the heart’s output of blood, which, together, lower blood pressure. They are a common treatment for cardiovascular diseases, including heart failure, arrhythmias, chest pains and high blood pressure. Researchers have suspected beta-blockers of having negative psychological side effects, including depression, anxiety, drowsiness, insomnia, hallucinations and nightmares.

“The possible mental health side effects of beta-blockers have been the subject of discussion in the scientific community for many decades,” says Reinhold Kreutz, M.D., Ph.D., a professor at the Berlin Institute of Health, Institute of Clinical Pharmacology and Toxicology and the study’s supervising and corresponding author. “So, our results showing beta-blockers are not the cause of so many of these negative side effects are quite consequential.”

The study is the first of its kind to examine the entire spectrum of mental health side effects in relation to beta-blockers. The researchers analyzed data for more than 50,000 individuals from 258 studies including beta-blockers in double-blind, randomized controlled trials. Nearly 70% of the studies were clinical trials focused on high blood pressure treatment, and 31 assessed depression in placebo-controlled trials.

Results from the comprehensive analysis revealed:

  • Despite being the most frequently reported mental health side effect, depression did not occur more frequently during beta-blocker treatment compared to placebo treatment.
  • The rate of discontinuing medication use due to depression was not any different for those taking beta-blockers compared to those on other treatments.
  • Unusual dreams, insomnia and sleep disorders may be linked to beta-blockers.
  • Among the mental health events analyzed, the most common reason for discontinuing beta-blockers was fatigue/tiredness.

“Our results indicate that concerns about adverse mental health events, especially depression, should not affect the decision about beta blockers. Beta-blockers are mostly safe regarding psychological health,” said Kreutz. “We found no indication of an association between beta-blocker use and depression. The same was true for most of the other mental health symptoms, as reported in the studies that were included in our analyses. However, sleep-related symptoms such as unusual dreams or insomnia did emerge during beta‑blocker therapy for some patients.”

Kreutz added, “Patients with a history of cardiovascular events such as a heart attack or stroke were prone to develop psychological complications. Though we found beta-blockers were not causally linked, these patients should be monitored.”

The original studies did not include individual patient data, so for this analysis, researchers were unable to investigate whether sleep-related symptoms were persistent for those taking beta-blockers. Additional research is needed to address this question.

The researchers report there an important limitation to consider when interpreting the results of their analysis: most beta-blocker trials were conducted more than 20 years ago, before a uniform language to describe adverse events was established. Additionally, the authors only considered randomized, double-blind trials for their analysis, which left out some studies that might provide more data on long-term beta-blocker treatment.

Source: American Heart Association

Street Trees Close to the Home May Reduce the Risk of Depression

Depression, especially in urban areas, is on the rise, now more than ever. Mental health outcomes are influenced by, among other things, the type of environment where one lives. Former studies show that urban greenspace has a positive benefit on people experiencing mental ill health, but most of these studies used self-reported measures, which makes it difficult to compare the results and generalise conclusions on the effects of urban greenspace on mental health.

An interdisciplinary research team of UFZ, iDiv and Leipzig University tried to improve this issue by involving an objective indicator: prescriptions of antidepressants. To find out whether a specific type of ‘everyday’ green space – street trees dotting the neighbourhood sidewalks – could positively influence mental health, they focused on the questions, how the number and type of street trees and their proximity close to home correlated to the number of antidepressants prescribed.

The researchers analysed data from almost 10,000 Leipzig inhabitants, a mid-size city in Germany, who took part in the LIFE-Adult health study running at the University of Leipzig Medical Faculty. Combining that with data on the number and species type of street trees throughout the city of Leipzig, the researchers were able to identify the association between antidepressants prescriptions and the number of street trees at different distances from people’s homes. Results were controlled for other factors known to be associated with depression, such as employment, gender, age, and body weight.

More trees immediately around the home (less than 100 meters) was associated with a reduced risk of being prescribed antidepressant medication. This association was especially strong for deprived groups. As these social groups are at the greatest risk for being prescribed antidepressants in Germany, street trees in cities can thereby serve as a nature-based solution for good mental health, the researchers write. At the same time, street trees may also help reduce the ‘gap’ in health inequality between economically different social groups. No association of tree types, however, and depression could be shown in this study.

“Our finding suggests that street trees – a small scale, publicly accessible form of urban greenspace – can help close the gap in health inequalities between economically different social groups,” says lead author of the study Dr Melissa Marselle. “This is good news because street trees are relatively easy to achieve and their number can be increased without much planning effort.” As an environmental psychologist, she conducted the research at UFZ and iDiv and is now based at the De Montford University of Leicester, UK. Marselle hopes that the research “should prompt local councils to plant street trees to urban areas as a way to improve mental health and reduce social inequalities. Street trees should be planted equally in residential areas to ensure those who are socially disadvantaged have equal access to receive its health benefits.”

“Importantly, most planning guidance for urban greenspace is often based on purposeful visits for recreation”, adds Dr Diana Bowler (iDiv, FSU, UFZ), data analyst in the team. “Our study shows that everyday nature close to home – the biodiversity you see out of the window or when walking or driving to work, school or shopping – is important for mental health.” This finding is especially now in times of the COVID-19 lock-downs, Bowler adds.

And it’s not only human health which could benefit. “We propose that adding street trees in residential urban areas is a nature-based solution that may not only promote mental health, but can also contribute to climate change mitigation and biodiversity conservation,” says senior author Prof Aletta Bonn, who leads the department of ecosystem services at UFZ, iDiv and Friedrich-Schiller-University Jena. “To create these synergy effects, you don’t even need large-scale expensive parks: more trees along the streets will do the trick. And that’s a relatively inexpensive measure.”

“This scientific contribution can be a foundation for city planners to save and, possibly, improve the life quality for inhabitants, in particular, in densely populated areas and in central city areas,” adds Prof Toralf Kirsten from Leipzig University. “Therefore, this aspect should be taken into account when city areas are recreated and planned, despite high and increasing land cover costs. A healthy life of all living being is unaffordable.”

Source: EurekAlert!

COVID Lockdown Loneliness Linked to More Depressive Symptoms in Older Adults

Loneliness in adults aged 50 and over during the COVID-19 lockdown was linked to worsening depressive and other mental health symptoms, according to a large-scale online study.

Loneliness emerged as a key factor linked to worsening symptoms of depression and anxiety in a study of more than 3,000 people aged 50 or over led by the University of Exeter and King’s College London, and funded by The National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre (BRC).

Researchers had access to data going back to 2015 for participants of the PROTECT online study. They also found that a decrease in physical activity since the start of the pandemic was associated with worsening symptoms of depression and anxiety during the pandemic. Other factors included being female and being retired.

Dr Byron Creese, of the University of Exeter Medical School, who led the study, said: “Even before the pandemic, loneliness and physical activity levels were a huge issue in society, particularly among older people. Our study enabled us to compare mental health symptoms before and after COVID-19 in a large group of people aged 50 and over. We found that during lockdown, loneliness and decreased physical activity were associated with more symptoms of poor mental health, especially depression. It’s now crucial that we build on this data to find new ways to mitigate risk of worsening mental health during the pandemic.”

The study found that before the pandemic, lonely people would report an average of two symptoms of depression for at least several days over the previous last two weeks. During lockdown, lonely people reported either an increase in frequency of depressive symptoms, to more than half the days in the two week period, or a new symptom for at least several days in that timeframe. In people who were not lonely, levels of depressive symptoms were unaffected.

PROTECT began in 2011, and has 25,000 participants signed up. Designed to understand the factors involved in healthy ageing, the innovative study combines detailed lifestyle questionnaires with cognitive tests that assess aspects of brain function including memory, judgment and reasoning over time. In May, researchers included a new questionnaire designed to assess the impact of COVID-19 on health and wellbeing. Running from May 13 to June 8, the questionnaire was completed by 3,300 people, of which 1,900 were long-standing PROTECT participants. The study is continuing to run so that longer term outcomes can be assessed.

Zunera Khan, Research Portfolio Lead at Institute of Psychiatry, Psychology & Neuroscience said “We’ve found links between loneliness and a drop in physical exercise and worsening mental health symptoms. It should be within our power to find ways of keeping people socially engaged and active. Our online PROTECT platform ultimately aims to find new ways to engage people in their homes, however, technology can only be part of the picture. We need to ensure we can find new ways to help people stay active and social, whether they are online or not.”

Professor Clive Ballard, Executive Dean and Pro-Vice Chancellor of the University of Exeter Medical School, who leads PROTECT, said: “We are only just beginning to learn the impact that COVID-19 is having on the health and wellbeing of older people. For example, the effect of any economic impact may not yet have emerged. Our largescale study will span a number of years, and will help us understand some of the longer-term effects of COVID-19 on mental health and wellbeing, and ultimately, on whether this has any knock-on effect on aspects of ageing, such as brain function and memory. “

The study plans to conduct further analysis on groups at particularly high risk, such as people with cognitive impairment and those with caring roles.

Source: University of Exeter