Nutrition status of primary care patients with depression and anxietyAdrienne K. Forsyth A C , Peter G. Williams A and Frank P. Deane B
A School of Health Sciences, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia.
B Illawarra Institute for Mental Health and School of Psychology, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia.
C Corresponding author. Email: email@example.com
Australian Journal of Primary Health 18(2) 172-176 http://dx.doi.org/10.1071/PY11023
Submitted: 25 February 2011 Accepted: 4 August 2011 Published: 21 November 2011
The objective of this study was to evaluate the nutrition status of people referred to a nutrition and physical activity program for the management of mental health in general practice. Patients currently being treated for depression and/or anxiety were referred by their GPs to a lifestyle intervention program. The nutrition status was assessed during a comprehensive assessment at the commencement of the program. The lifestyle intervention program, including all assessments, was offered at multiple sites including GP clinics in the Illawarra, and in clinic rooms at the University of Wollongong. Thirty-two men and seventy-seven women completed the assessment. Patients were referred with depression (52%), anxiety (19%) or both (28%). Eighty percent of participants were overweight or obese. All participants completed an assessment that included a diet history, anthropometric measurements and the completion of several questionnaires including the Depression, Anxiety and Stress Scale (DASS). Nutrition status was assessed using mean nutrient intakes and Australian modified Healthy Eating Index scores evaluated against the National Nutrition Survey intakes and DASS scores. Participants met the estimated average requirements for all nutrients except folate (17%), magnesium (78%) and calcium (57%). Intakes were similar to those reported in the National Nutrition Survey. Only magnesium intakes were significantly related to depression (r = –0.26). Australian modified Healthy Eating Index scores were significantly negatively correlated with DASS scores (P < 0.01). The associations presented here support the existing body of literature. Nutrition recommendations for patients with depression and anxiety should be based on the Australian Guide to Healthy Eating with particular attention to fruit, vegetables and wholegrains.
ReferencesAstorg P, Couthouis A, de Courcy GP, Bertrais S, Arnault N, Meneton P, Galan P, Hercberg S (2008) Association of folate intake with the occurrence of depressive episodes in middle-aged French men and women. The British Journal of Nutrition 100, 183–187.
| Association of folate intake with the occurrence of depressive episodes in middle-aged French men and women.CrossRef | 1:CAS:528:DC%2BD1cXot1aqsbc%3D&md5=eff05dfd422c0f9cccdb756e7af322f2CAS |
Australian Bureau of Statistics (1999) ‘National Nutrition Survey: Food Eaten, Australia, 1995, ABS Catalogue No. 4804.0.’ (Australian Bureau of Statistics: Canberra)
Australian Institute of Health and Welfare (2007) ‘Australian diet quality index project. AIHW Catalogue No. PHE 85.’ (Australian Institute of Health and Welfare: Canberra)
Begg S, Vos T, Barker B, Stevenson C, Stanley L, Lopez A (2007) ‘The burden of disease and injury in Australia.’ (Australian Institute of Health and Welfare: Canberra)
Cohen JH, Kristal AR, Neumark-Sztainer D, Rock C, Neuhouser ML (2002) Psychological distress is associated with unhealthful dietary practices. Journal of the American Dietetic Association 102, 699–703.
| Psychological distress is associated with unhealthful dietary practices.CrossRef |
Department of Health and Ageing (2007) National Mental Health Report 2007: summary of reform in Australia’s mental health services under the National Mental Health Strategy. (Commonwealth of Australia: Canberra)
Eby GA, Eby KL (2006) Rapid recovery from major depression using magnesium treatment. Medical Hypotheses 67, 362–370.
| Rapid recovery from major depression using magnesium treatment.CrossRef | 1:CAS:528:DC%2BD28XltlelsrY%3D&md5=e96619fc9622f122f96b91d8c940c4a2CAS |
Ellis PM, Hickie I, Smith DAR (2004) Australian and New Zealand clinical practice guidelines for the treatment of depression. The Australian and New Zealand Journal of Psychiatry 38, 389–407.
Food Standards Australia New Zealand (2010) ‘The Food Standards Code.’ Available at http://www.foodstandards.gov.au/foodstandards/foodstandardscode/ [Verified 28 June 2011]
Forsyth A, Deane FP, Williams P (2009) Dietitians and exercise physiologists in primary care: lifestyle interventions for patients with depression and/or anxiety. Journal of Allied Health 38, e63–e68.
Goldberg GR, Black AE, Jebb SA, Cole TJ, Murgatroyd PR, Coward WA, Prentice AM (1991) Critical evaluation of energy intake data using fundamental principles of energy physiology: 1. Derivation of cut-off limits to identify under-recording. European Journal of Clinical Nutrition 45, 569–581.
Jacka FN, Overland S, Stewart R, Tell GS, Bjelland I, Mykletun A (2009) Association between magnesium intake and depression and anxiety in community-dwelling adults: the Hordaland Health Study. The Australian and New Zealand Journal of Psychiatry 43, 45–52.
| Association between magnesium intake and depression and anxiety in community-dwelling adults: the Hordaland Health Study.CrossRef |
Jacobs DR, Tapsell LC (2007) Food, not nutrients, is the fundamental unit in nutrition. Nutrition Reviews 65, 439–450.
| Food, not nutrients, is the fundamental unit in nutrition.CrossRef |
Kim J-M, Stewart R, Kim S-W, Yang S, Shin I, Yoon J (2008) Predictive value of folate, vitamin B12 and homocysteine levels in late-life depression. The British Journal of Psychiatry 192, 268–274.
| Predictive value of folate, vitamin B12 and homocysteine levels in late-life depression.CrossRef |
Korten A, Henderson S (2000) The Australian National Survey of Mental Health and Well-Being - Common psychological symptoms and disablement. The British Journal of Psychiatry 177, 325–330.
| The Australian National Survey of Mental Health and Well-Being - Common psychological symptoms and disablement.CrossRef | 1:STN:280:DC%2BD3M%2FpsF2gtQ%3D%3D&md5=2f58b312971f6bf93aaa15c27110840fCAS |
Kretsch MJ, Fong AKH, Green MW (1999) Behavioural and body size correlates of energy intake underreporting by obese and normal-weight women. Journal of the American Dietetic Association 99, 300–306.
| Behavioural and body size correlates of energy intake underreporting by obese and normal-weight women.CrossRef | 1:STN:280:DyaK1M7nsFyktQ%3D%3D&md5=bb4adea44bdbf2838c30570788288ffcCAS |
Li Y, Zhang J, McKeown RE (2009) Cross-sectional assessment of diet quality in individuals with a lifetime history of attempted suicide. Psychiatry Research 165, 111–119.
| Cross-sectional assessment of diet quality in individuals with a lifetime history of attempted suicide.CrossRef |
Lovibond PF, Lovibond SH (1995) The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy 33, 335–343.
| The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories.CrossRef | 1:STN:280:DyaK2M3ktl2jsA%3D%3D&md5=cc91bfaf1a612e5658b86d6258f415d9CAS |
Martin GS, Tapsell LC, Denmeade S, Batterham MJ (2003) Relative validity of a diet history interview in an intervention trial manipulating dietary fat in the management of Type II diabetes mellitus. Preventive Medicine 36, 420–428.
| Relative validity of a diet history interview in an intervention trial manipulating dietary fat in the management of Type II diabetes mellitus.CrossRef |
Martinsen EW, Raglin JS (2007) Anxiety/depression: lifestyle medicine approaches. American Journal of Lifestyle Medicine 1, 159–166.
| Anxiety/depression: lifestyle medicine approaches.CrossRef |
Maurer J, Taren DL, Teixeira PJ, Thomson CA, Lohman TG, Scott B, Houtkooper LB (2006) The psychosocial and behavioral characteristics related to energy misreporting. Nutrition Reviews 64, 53–66.
| The psychosocial and behavioral characteristics related to energy misreporting.CrossRef |
McLennan W, Podger A (1998) ‘National Nutrition Survey: nutrient intakes and physical measurements. ABS Catalogue No 4805.0.’ (Australian Bureau of Statistics: Canberra)
National Health and Medical Research Council (2006) ‘Nutrient reference values for Australia and New Zealand including recommended dietary intakes.’ (NHMRC: Canberra)
Newland J, Zwar N (2006) General practice and the management of chronic conditions – where to now? Australian Family Physician 35, 16–19.
Payne ME, Hybels CF, Bales CW, Steffens DC (2006) Vascular nutritional correlates of late-life depression. The American Journal of Geriatric Psychiatry 14, 787–795.
| Vascular nutritional correlates of late-life depression.CrossRef |
Pellegrin KL, O’Neil PM, Stellefson EJ, Fossey MD, Ballenger JC, Cochrane CE, Currey HS (1998) Average daily nutrient intake and mood among obese women. Nutrition Research 18, 1103–1112.
| Average daily nutrient intake and mood among obese women.CrossRef | 1:CAS:528:DyaK1cXktFCmsro%3D&md5=79bba8b01d1389732e7a276b49d30ea1CAS |
Sarlio-Lähteenkorva S, Lahelma E, Roos E (2004) Mental health and food habits among employed women and men. Appetite 42, 151–156.
| Mental health and food habits among employed women and men.CrossRef |
Smith A, Kellet E, Schmerlaib Y (1998) ‘Australian Guide to Healthy Eating.’ (Australia Commonwealth Department of Health and Family Services: Canberra)
Stunkard AJ, Faith MS, Allison KC (2003) Depression and obesity. Biological Psychiatry 54, 330–337.
| Depression and obesity.CrossRef |
Taylor MJ, Carney S, Geddes J, Goodwin G (2003) Folate for depressive disorders. Cochrane Database of Systematic Reviews 2, CD003390
Tolmunen T, Hintikka J, Ruusunen A, Voutilainen S, Tanskanen A, Valkonen V, Vlinamaki H, Kaplan GA, Salonen JT (2004) Dietary folate and the risk of depression in Finnish middle-aged men - a prospective follow-up study. Psychotherapy and Psychosomatics 73, 334–339.
| Dietary folate and the risk of depression in Finnish middle-aged men - a prospective follow-up study.CrossRef |
Vines RF, Richards JC, Thomson DM, Brechman-Toussaint M, Kluin M, Vessely L (2004) Clinical psychology in general practice: a cohort study. The Medical Journal of Australia 181, 74–77.
Zhang J, Li Y, Torres M (2005) How does a suicide attempter eat differently from others? Nutrition 21, 711–717.
| How does a suicide attempter eat differently from others?CrossRef |