Patsalos Olivia, Keeler Johanna, Schmidt Ulrike, Penninx Brenda W J H, Young Allan H, Himmerich Hubertus
Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK.
South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK.
J Pers Med. 2021 Mar 3;11(3):176. doi: 10.3390/jpm11030176.
Obesity and depression co-occur in a significant proportion of the population. Mechanisms linking the two disorders include the immune and the endocrine system, psychological and social mechanisms. The aim of this systematic review was to ascertain whether weight loss through dietary interventions has the additional effect of ameliorating depressive symptoms in obese patients.
We systematically searched three databases (Pubmed, Medline, Embase) for longitudinal clinical trials testing a dietary intervention in people with obesity and depression or symptoms of depression.
Twenty-four longitudinal clinical studies met the eligibility criteria with a total of 3244 included patients. Seventeen studies examined the effects of calorie-restricted diets and eight studies examined dietary supplements (two studies examined both). Only three studies examined people with a diagnosis of both obesity and depression. The majority of studies showed that interventions using a calorie-restricted diet resulted in decreases in depression scores, with effect sizes between ≈0.2 and ≈0.6. The results were less clear for dietary supplements.
People with obesity and depression appear to be a specific subgroup of depressed patients in which calorie-restricted diets might constitute a promising personalized treatment approach. The reduction of depressive symptoms may be related to immunoendocrine and psychosocial mechanisms.
肥胖和抑郁在相当一部分人群中同时存在。将这两种疾病联系起来的机制包括免疫和内分泌系统、心理和社会机制。本系统评价的目的是确定通过饮食干预减轻体重是否对改善肥胖患者的抑郁症状有额外作用。
我们系统检索了三个数据库（PubMed、Medline、Embase），以查找对肥胖合并抑郁或有抑郁症状的人群进行饮食干预的纵向临床试验。
24项纵向临床研究符合纳入标准，共纳入3244例患者。17项研究考察了热量限制饮食的效果，8项研究考察了膳食补充剂（两项研究同时考察了两者）。只有三项研究考察了同时诊断为肥胖和抑郁的人群。大多数研究表明，采用热量限制饮食的干预措施可降低抑郁评分，效应大小约为0.2至0.6。膳食补充剂的结果不太明确。
肥胖合并抑郁的人群似乎是抑郁症患者中的一个特定亚组，热量限制饮食可能是一种有前景的个性化治疗方法。抑郁症状的减轻可能与免疫内分泌和心理社会机制有关。
