Mengxiao Ren, Huaiyu Zhang, Jindan Qi, Anni Hu, Qing Jiang, Yunying Hou, Qianqian Feng, Omorogieva Ojo, Xiaohua Wang
Journal: Nutrients 2021;12(10):3036
PMID: 33022991
Associations between type 2 diabetes (T2D) and depression may exist, with depression increasing the risk of T2D and T2D increasing risk of depression. Nutritional changes such as a low carbohydrate diet (LCD) are a large part of T2D management, however the effects on depression remain controversial. Almonds as part of a LCD may have additional benefits to individuals with T2D and those with depression, potentially through its ability to modify gut microbiota. This three-month randomised control trial of 50 individuals with T2D aimed to determine if an almond based LCD (a-LCD) would affect depression and T2D through modulation of gut microbiota and associated gut-brain signalling molecules compared to a low-fat diet (LFD). The results showed that although measures of blood glucose control improved in both groups, those on the a-LCD had better blood glucose control. Symptoms of depression were reduced in participants on the a-LCD compared to the LFD. Gut-brain signalling molecules were maintained in the a-LCD but decreased in the LFD after three months. Several species of gut bacteria were changed by a-LCD. It was concluded that an a-LCD diet may improve symptoms of depression in individuals with T2D through the modulation of gut bacteria and maintenance of gut-brain signalling molecules. This study could be used by healthcare professionals to recommend a low carbohydrate diet rich in almonds for the improvement of symptoms of depression and blood glucose control in individuals with T2D. Low fat diets may also be of benefit to blood glucose control individuals with T2D.
BACKGROUND
Alow carbohydrate diet (LCD) is more beneficial for the glycometabolism in type 2 diabetes (T2DM) and may be effective in reducing depression. Almond, which is a common nut, has been shown to effectively improve hyperglycemia and depression symptoms. This study aimed to determine the effect of an almond-based LCD (a-LCD) on depression and glycometabolism, as well as gut microbiota and fasting glucagon-like peptide 1 (GLP-1) in patients with T2DM.
METHODS
This was a randomized controlled trial which compared an a-LCD with a low-fat diet (LFD). Forty-five participants with T2DM at a diabetes club and the Endocrine Division of the First and Second Affiliated Hospital of Soochow University between December 2018 to December 2019 completed each dietary intervention for 3 months, including 22 in the a-LCD group and 23 in the LFD group. The indicators for depression and biochemical indicators including glycosylated hemoglobin (HbA1c), gut microbiota, and GLP-1 concentration were assessed at the baseline and third month and compared between the two groups.
RESULTS
A-LCD significantly improved depression and HbA1c ( <0.01). Meanwhile, a-LCD significantly increased the short chain fatty acid (SCFAs)-producing bacteria , and . The GLP-1 concentration in the a-LCD group was higher than that in the LFD group ( <0.05).
CONCLUSIONS
A-LCD could exert a beneficial effect on depression and glycometabolism in patients with T2DM. We speculate that the role of a-LCD in improving depression in patients with T2DM may be associated with it stimulating the growth of SCFAs-producing bacteria, increasing SCFAs production and GPR43 activation, and further maintaining GLP-1 secretion. In future studies, the SCFAs and GPR43 activation should be further examined.
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