High adherence to the Mediterranean diet (MD) has been associated with a reduced risk of depression in prospective cohort studies, but whether MD interventions are effective among adults with depression is uncertain. This study aimed to synthesize findings on the effects of MD interventions on the severity of depressive symptoms in adults with depression. PubMed, Cochrane CENTRAL, PsycINFO, Scopus, and Web of Science were systematically searched from database inception to March 2023. The Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines and the Cochrane recommendations were followed. We included randomized controlled trials (RCTs) comparing outcomes after MD interventions with outcomes for control conditions in adults with depressive disorders or depressive symptoms. Two authors extracted the data independently. The Sidik-Jonkman estimator, the I² metric, and the prediction interval were used to estimate between-study heterogeneity. To determine the risk of bias and the certainty of evidence from RCTs, we used the Cochrane Collaboration’s Risk of Bias 2 and Grades of Recommendation, Assessment, Development, and Evaluation tools, respectively. In total, 1507 participants (mean age range: 22.0 years–53.3 years) with depression were initially included in the 5 RCTs of this review. Compared with control conditions, MD interventions significantly reduced depressive symptoms among young and middle-aged adults with major depression or mild to moderate depressive symptoms (standardized mean difference: –0.53; 95% confidence interval: –0.90 to –0.16; I² = 87.1%). The prediction interval ranged from –1.86 to 0.81. The overall risk of bias was within the range of “some concerns” to “high,” while the certainty of evidence was low. MD interventions appear to have substantial potential for alleviating depressive symptoms in people experiencing major or mild depression. However, to establish robust recommendations, there remains a need for high-quality, large-scale, and long-term RCTs. PROSPERO registration no. CRD42022341895.

Context: Emerging evidence suggests the quality of plant-based diets may play a pivotal role in the primary prevention of certain nonfatal diseases. However, its impact on mental and neurocognitive health conditions remains to be elucidated. Objective: To synthesize the available evidence on the cross-sectional and prospective associations of adherence to overall, healthy, and unhealthy plant-based diets with mental and neurocognitive health outcomes in the general adult population (aged ≥18 years). Data sources: The PubMed, Scopus, and Web of Science databases were searched from inception through March 13, 2024. Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Meta-analyses of Observational Studies in Epidemiology guidelines were followed for this study. Data extraction: Random-effects meta-analyses were performed using the Sidik–Jonkman estimator. Pooled odds ratios (ORs) and risk ratios (RRs) with their 95% CIs were estimated for cross-sectional and prospective associations between the highest (vs lowest) adherence to plant-based diets and the likelihood of adverse mental and neurocognitive health outcomes (ie, anxiety, depression, psychological distress, cognitive decline, and dementia). Data analyses: A total of 23 studies involving 709 703 adults (mean age range: 31.4-102.3 years; 52.8% female) were included. The highest (vs lowest) adherence to healthy plant-based diets was significantly associated with a lower likelihood of anxiety (OR = 0.67; 95% CI, 0.46-0.96), depression (OR = 0.74; 95% CI, 0.57-0.96), and psychological distress (OR = 0.51; 95% CI, 0.39-0.65) in cross-sectional studies and with a lower risk of cognitive decline (RR = 0.74; 95% CI, 0.64-0.85), dementia (RR = 0.85; 95% CI, 0.76-0.96), and depression (RR = 0.77; 95% CI, 0.67-0.88) in cohort studies. Conversely, greater adherence to unhealthy plant-based diets was significantly associated with an increased likelihood of anxiety and depression. When the data were subjected to a standardized effect size correction (Hedges g) to mitigate potential biases, the results remained consistent. Conclusion: High-quality plant-based diets could play an important role in the primary prevention of mental and neurocognitive health conditions. Systematic review registration: PROSPERO registration no. CRD42024524053.

Fernández-Rodríguez R, et al. World J Mens Health. 2024 Feb;42:e23. https://doi.org/10.5534/wjmh.230257

Objectives: Eating disorders (EDs) have emerged as a growing public health concern. However, the role of sleep in this context remains underexplored. The aim of this cross-sectional study was to determine the associations between sleep parameters and chronotype with ED risk in a sample of university students in Spain. Methods: ED risk was assessed via the Sick, Control, One stone, Fat, Food Questionnaire, and sleep quality was assessed via the Pittsburgh Sleep Quality Index. Other sleep parameters and chronotypes were self-reported. Sociodemographic, body composition, lifestyle, and depressive symptom data were collected. Logistic and linear regression models adjusted for the main confounders were used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) of the study associations. Results: A total of 403 students (70.2% female) aged 18 to 30 years participated in the study. Those reporting poor sleep quality (OR = 1.85, 95% CI 1.08–3.17, p = 0.025) and ≤6 h of night-time sleep duration (OR = 4.14, 95% CI 2.00–8.57, p < 0.01) were more likely to be at risk of EDs in the adjusted analyses. The association between night-time sleep duration and the risk of ED did not remain significant when we adjusted for sleep quality. In addition, an evening chronotype was associated with an increased risk of EDs (OR = 1.68, 95% CI 1.07–2.66, p = 0.039) only before adjustment for confounders. Conclusions: Among university students, poorer sleep quality was cross-sectionally associated with EDs. Future prospective studies are needed to examine whether promoting sleep quality may serve as an effective strategy for preventing the risk of EDs.

Time-restricted eating (TRE) has emerged as a dietary strategy that restricts food consumption to a specific time window and is commonly applied to facilitate weight loss. The benefits of TRE on adipose tissue have been evidenced in human trials and animal models; however, its impact on bone tissue remains unclear. To systematically synthesize and examine the evidence on the impact of TRE on bone health (bone mineral content (BMC), bone mineral density (BMD), and bone turnover factors), PubMed, Scopus, Cochrane CENTRAL, and Web of Science databases were systematically explored from inception to 1 October 2023 searching for randomized controlled trials (RCTs) aimed at determining the effects of TRE on bone health in adults (≥18 years). The Cochrane Handbook and the PRISMA recommendations were followed. A total of seven RCTs involving 313 participants (19 to 68 years) were included, with an average length of 10.5 weeks (range: 4 to 24 weeks). Despite the significant weight loss reported in five out of seven studies when compared to the control, our meta-analysis showed no significant difference in BMD (g/cm²) between groups (MD = −0.009, 95% CI: −0.026 to 0.009, p = 0.328; I² = 0%). BMC and bone turnover markers between TRE interventions and control conditions were not meta-analyzed because of scarcity of studies (less than five). Despite its short-term benefits on cardiometabolic health, TRE did not show detrimental effects on bone health outcomes compared to those in the control group. Nevertheless, caution should be taken when interpreting our results due to the scarcity of RCTs adequately powered to assess changes in bone outcomes.

Purpose: The 20‐item Center for Epidemiological Studies Depression Scale for Children and Adolescents (CES‐DC) is an instrument for screening of depression with good psychometric properties. This study aimed to examine the construct validity in terms of structural and convergent validity, the internal consistency, and the concurrent validity of a shorter 10‐item version of this scale.Methods: This was a cross‐sectional validation study including 671 schoolchildren aged 9–11, from Cuenca, Spain. Depression was assessed using the 20‐item CES‐DC scale. We selected the 10 items with the highest factorial loading for a shorter version. Sociodemographic, anthropometric, fitness, and quality of life variables were considered to analyse convergent and discriminant validity.Results: For the structural validity, confirmatory factor analyses revealed a three‐factor latent structure for the 20‐item CES‐DC and a single factor in the 10‐item version. Internal consistency measured by Cronbach’s α and ω statistic were 0.85 for 20‐item CES‐DC and 0.84 for 10‐item CES‐DC. Intraclass correlation coefficient between the two scales was 0.94. Convergent validity was tested through the correlation coefficients and regression models between both either CES‐DC versions with body mass index, waist circumference, fitness, and quality of life measures, which were similar. For the concurrent validity, concordance analysis and the ROC curve showed an equivalent cut‐off point for the 10‐item CES‐DC. The 20‐item CES‐DC classified a total of 33.1% of the sample as at risk of depression, while the 10‐item CES‐DC classified 30.4%.Conclusion: This study indicates that both the 20‐item and 10‐item versions of the CES‐DC have good internal consistency and structural validity in schoolchildren. Therefore, this short version can be used as a reliable and valid instrument for screening depression that is less time consuming and easy to use in clinical and scholarly contexts, potentially improving early detection and intervention for depression.Trial Registration: ClinicalTrials.gov identifier: NCT03236337.