Time Magazine, Erin Skarda, November 24, 2010

Two common conditions — depression and diabetes — frequently appear together, and a new study by researchers from the Harvard School of Public Health suggests that each illness may be both a consequence and a contributor to the other.

The 10-year study followed 65,381 women, ages 50 to 75, who were participating in the Nurses’ Health Study. Over the course of the research, depression and new cases of Type 2 diabetes were monitored: 2,844 women from the group were diagnosed with diabetes and 7,415 women developed depression — unsurprising numbers based on the prevalence of both illnesses.

Researchers also found a correlation between the conditions: women who suffered from depression were 17% more likely to develop Type 2 diabetes during the study period than women who weren’t depressed; women with diabetes were 29% more likely to develop depression than women without diabetes, even after adjusting for other mood disorders and risk factors, such as weight and lack of frequent exercise.

Additionally, the more severe the depression or diabetes was, the more likely that women would develop the other disease. Women whose diabetes was serious enough to require insulin, for instance, were 53% more likely to develop depression during the 10-year time frame, compared with women without diabetes. And women who took antidepressants to manage their depression were 25% more likely than undepressed women to develop diabetes.

Lead researcher Dr. Frank Hu, professor of nutrition and epidemiology, told WebMD that factors such as physical activity and body mass index (BMI) might partially explain the connection between the two illnesses, but that the more likely common denominator is stress.

High levels of stress hormones, which are often found in people who are depressed, can lead to problems with glucose and blood sugar metabolism, increased insulin resistance and an accumulation of stomach fat — all risk factors for diabetes. Depression also tends to lead to unhealthy lifestyle behaviors, such as eating a poor diet and not exercising, which may further up the risk of diabetes.

Conversely, people with diabetes must deal with managing a chronic disease, which requires changing diet and lifestyle and adjusting to various prescription medications, so it’s easy to see how the disease could increase stress levels and risk of depression.

The study’s authors say, therefore, that doctors should take care to address the psychological aspects of disease management with diabetes patients, and pay attention to blood sugar levels and other signs of diabetes in patients diagnosed with clinical depression.

The new study was published this week in the Archives of Internal Medicine.

via Study: The Link Between Diabetes and Depression Goes Both Ways – TIME Healthland.

By RONI CARYN RABIN, The New York Times, October 8, 2009

Eating a Mediterranean-style diet — packed with fruits, vegetables, legumes, nuts, olive oil and fish — is good for your heart, many studies have found. Now scientists are suggesting the diet may be good for your mental health, too.

A study of over 10,000 Spaniards followed for almost four and half years on average found that those who reported eating a healthy Mediterranean diet at the beginning of the study were about half as likely to develop depression than those who said they did not stick to the diet.

All of the participants were free of depression when they were recruited to the study, and each filled out a 136-item food frequency questionnaire when they joined. Based on their self-reported dietary habits, they were assigned a score between 0 and 9, with the highest score reflecting the closest adherence to a Mediterranean diet.Over time, those who had scored between 5 and 9 on the Mediterranean diet were 42 percent to 51 percent less likely to develop depression, the study found, than those who scored between 0 and 2.

The study, which was funded by the Spanish government’s official medical research agency, Instituto de Salud Carlos III, does not prove a cause-and-effect relationship between the Mediterranean diet and a lower risk for depression, only an association between the two. Still, many scientists are convinced that some damaging inflammatory and metabolic processes involved in cardiovascular disease may also play a role in mental health.

The study, which was funded by the Spanish government’s official medical research agency, Instituto de Salud Carlos III, does not prove a cause-and-effect relationship between the Mediterranean diet and a lower risk for depression, only an association between the two. Still, many scientists are convinced that some damaging inflammatory and metabolic processes involved in cardiovascular disease may also play a role in mental health.

“Both cardiovascular disease and depression share common mechanisms related to endothelium function and inflammation,” said Dr. Miguel Angel Martinez-Gonzalez, professor of preventive medicine at University of Navarra in Pamplona, Spain, and senior author of the paper, published in the October issue of Archives of General Psychiatry.

“The membranes of our neurons are composed of fat, so the quality of fat that you are eating definitely has an influence on the quality of the neuron membranes, and the body’s synthesis of neurotransmitters is dependent on the vitamins you’re eating,” Dr. Martinez-Gonzalez added. “We think those with lowest adherence to the Mediterranean dietary plan have a deficiency of essential nutrients.”

The elements of the diet most closely linked to a lower risk of depression were fruits and nuts, legumes and a high ratio of monounsaturated to saturated fats, the study found.

via Vital Signs – Nutrition – Lower Depression Risk Linked to Mediterranean Diet – NYTimes.com.

The study looked at more than 14,000 high school students to determine the relationship between body mass index (BMI) and suicide attempts, as well as the relationship between believing one is overweight — whether true or not —and suicide attempts.

“Our findings show that both perceived and actual overweight increase risk for suicide attempt,” said lead study author Monica Swahn, Ph.D. That association was as strong for boys as for girls, contrary to what the researchers had originally expected.

Teens who believed they were overweight were at greater risk for suicide attempts compared to those who did not believe they were overweight. Similarly, teens with a BMI that indicated they were indeed overweight were more likely to be at risk for suicide attempts. Those who perceived themselves as overweight and who actually had BMIs that put them into the “overweight” or “obese” category also were at greater risk.

“This is a major concern since more and more children and youth are becoming overweight and obese,” said Swahn, an associate dean for research at the College of Health and Human Sciences and an associate professor in the Institute of Public Health at Georgia State University.

Hatim Omar, M.D., chief of the Division of Adolescent Medicine at the University of Kentucky, said his own experience has led him to believe that perceived obesity does increase both depression and suicide risk. “Teens are vulnerable because of their development and any actual or perceived changes in their lives, including weight issues, can potentially increase the risk of depression or suicide,” he said.

Understanding these associations can help in the development of appropriate strategies for suicide prevention, the authors said. “We cannot only focus prevention strategies on those who are overweight and who are concerned about their weight,” Swahn said, “but we also need to include youth who feel that they are overweight even though they may not be.”

“Youth feel very pressured to fit in and to fit certain limited ideals of beauty,” Swahn said.

“This study adds another wake-up call to providers, parents, teachers and society about the need for screening for depression and suicide risk in all teens, with special attention to teens with perceived or actual obesity,” Omar said.

1. Swahn M, et al. Perceived and actual overweight and risk for suicide attempts: findings from the 2007 Youth Risk Behavior Survey. Journal of Adolescent Health, 2009

Teens Who Think They’re Overweight More Likely To Try Suicide.