Abstract
Depression symptoms and lower health-related quality of life (HRQoL) are associated with inflammation. This multicenter dietary intervention was shown to reduce inflammation in older people. This was the main outcome. Here, we describe the effects on HRQoL, anxiety, and depressive symptoms according to inflammation status. Overall, 125 healthy older subjects (65–80 year) were recruited (Italy, France, and Germany) and randomized into four arms (A, Healthy diet (HD); B, HD plus De Simone Formulation probiotic blend; C, HD plus AISA d-Limonene; D, HD plus Argan oil). The HD was weight maintaining, rich in antioxidant vitamins, polyphenols, polyunsaturated fatty acids (n6: n3 ratio = 3:1), and fiber. Data on inflammatory parameters, mental (MCS) and physical (PCS) component summaries of HRQoL (SF−36), anxiety symptoms (STAI state), and depressive symptoms (CES-D) were collected before and after 56 days of intervention. Body fat mass proportion (BFM) was considered a co-variable. A decrease of CES-D score was seen in the four arms (A: −40.0%, p = 0.001; B: −32.5%, p = 0.023; C: −42.8%, p = 0.004; and D: −33.3%, p = 0.21). Within the subgroups of subjects with medium/high inflammation a similar decrease in CES-D score occurred in all groups (A: −44.8%, p = 0.021; B, −46.7%, p = 0.024; C, −52.2%, p = 0.039; D, −43.8%, p = 0.037). The effect of interventions on CES-D was not related to baseline inflammation. MCS-HRQoL improved in A and C. There was no change in anxiety or PCS-HRQoL. In this trial with no control group, a decrease in depressive symptoms in healthy older volunteers was observed after a 2-month healthy diet intervention, independently of inflammation but with possible limitations due to participation.
Highlights
The inflammatory reaction includes, among other changes, behavioral changes such as apathy, lethargy, reduced locomotor activity, inhibition, anhedonia, anxiety, sleepiness, disinterest, hyperalgesia, and failure to concentrate
The present study addresses a secondary objective of this Randomized controlled trials (RCT) with no specific hypothesis for nutraceuticals effect on the outcomes, i.e., was to assess the effect of the dietary intervention on quality of life, depression, and anxiety
We aimed to describe the effect of the RISTOMED intervention on health-related quality of life (HRQoL), depressive symptoms, and anxiety in all participants and, in subjects belonging to the cluster with medium-high inflammatory status
Summary
The inflammatory reaction includes, among other changes, behavioral changes such as apathy, lethargy, reduced locomotor activity, inhibition, anhedonia, anxiety, sleepiness, disinterest, hyperalgesia, and failure to concentrate. Together these symptoms constitute “sickness behavior” and are close to depressive symptoms [1,2]. Subclinical elevation of interleukin−6 (IL-6) and C-reactive protein (CRP) has been associated with lower quality of life and depressive symptoms [3] Another argument for the link between depressive symptomatology and low-grade inflammation is suggested by the improvement in sleep disorders observed with decreases in high-sensitivity CRP (hsCRP) levels in military personnel [4]. In an open-label randomized intervention trial with diet or exercise, weight loss induced a decrease in inflammation and improvement of HRQoL [11]
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