从性别视角看与重度抑郁症相关的营养不良问题。

The Problem of Malnutrition Associated with Major Depressive Disorder from a Sex-Gender Perspective.

机构信息

Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcalá de Henares, Spain.

Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain.

出版信息

Nutrients. 2022 Mar 6;14(5):1107. doi: 10.3390/nu14051107.

Abstract

Major depressive disorder (MDD) is an incapacitating condition characterized by loss of interest, anhedonia and low mood, which affects almost 4% of people worldwide. With rising prevalence, it is considered a public health issue that affects economic productivity and heavily increases health costs alone or as a comorbidity for other pandemic non-communicable diseases (such as obesity, cardiovascular disease, diabetes, inflammatory bowel diseases, etc.). What is even more noteworthy is the double number of women suffering from MDD compared to men. In fact, this sex-related ratio has been contemplated since men and women have different sexual hormone oscillations, where women meet significant changes depending on the age range and moment of life (menstruation, premenstruation, pregnancy, postpartum, menopause…), which seem to be associated with susceptibility to depressive symptoms. For instance, a decreased estrogen level promotes decreased activation of serotonin transporters. Nevertheless, sexual hormones are not the only triggers that alter neurotransmission of monoamines and other neuropeptides. Actually, different dietary habits and/or nutritional requirements for specific moments of life severely affect MDD pathophysiology in women. In this context, the present review aims to descriptively collect information regarding the role of malnutrition in MDD onset and course, focusing on female patient and especially macro- and micronutrient deficiencies (amino acids, ω3 polyunsaturated fatty acids (ω3 PUFAs), folate, vitamin B12, vitamin D, minerals…), besides providing evidence for future nutritional intervention programs with a sex-gender perspective that hopefully improves mental health and quality of life in women.

摘要

重度抑郁症(MDD)是一种使人丧失能力的疾病,其特征是失去兴趣、快感缺失和情绪低落,全球约有 4%的人患有这种疾病。随着患病率的上升,它被认为是一个公共卫生问题,不仅会影响经济生产力,而且还会单独或作为其他大流行非传染性疾病(如肥胖、心血管疾病、糖尿病、炎症性肠病等)的合并症而大大增加医疗费用。更值得注意的是,女性患 MDD 的人数是男性的两倍。事实上,自从男性和女性的性荷尔蒙波动不同以来,人们就一直在考虑这种与性别相关的比例,女性会根据年龄范围和生命阶段(月经、经前期、怀孕、产后、更年期等)发生重大变化,这些变化似乎与易患抑郁症状有关。例如,雌激素水平降低会促进血清素转运体的活性降低。然而,性荷尔蒙并不是改变单胺类神经递质和其他神经肽神经传递的唯一触发因素。实际上,不同的饮食习惯和/或特定生命阶段的特殊营养需求会严重影响女性的 MDD 病理生理学。在这种情况下,本综述旨在描述性地收集有关营养不良在 MDD 发病和病程中的作用的信息,重点关注女性患者,特别是宏量和微量营养素缺乏症(氨基酸、ω3 多不饱和脂肪酸(ω3 PUFAs)、叶酸、维生素 B12、维生素 D、矿物质等),并为未来具有性别观点的营养干预计划提供证据,希望改善女性的心理健康和生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02e9/8912662/b0682bd5ef4e/nutrients-14-01107-g001.jpg

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