Associations between Depression, Nutritional Status and Mediterranean Diet in Dalmatian Kidney Transplant Recipients

Abstract

Depression has been addressed as a predictor of worse outcomes in kidney transplant recipients (KTRs). Nutritional status plays a great role in treatment of this population. The Mediterranean diet (MeDi) has been associated with lower levels of depressive symptoms. The aim of this cross-sectional study was to determine the rate of depression and its correlations to nutritional status and dietary habits according to the MeDi in Dalmatian KTRs. We included 115 KTRs, and data about body composition and anthropometric, laboratory and clinical parameters were obtained for each study participant. The Beck Depression Inventory-II (BDI-II) questionnaire was used to assess depressive symptoms and the Mediterranean Diet Serving Score (MDSS) was used to assess adherence to the MeDi. We found the presence of depressive symptoms in 21.73% of the Dalmatian KTRs. BDI-II score was reciprocally associated with fat mass, trunk visceral fat, anthropometric parameters of obesity, triglyceride levels and olive oil consumption. Inverse associations were found between BDI-II score and skeletal muscle mass, handgrip strength, MCV, hemoglobin levels and consumption of fish and white meat, as suggested by the MeDi. Our results showed the interconnections between nutritional status, dietary habits and depression in Dalmatian KTRs.

Depression in transplantation

“…In liver transplant candidates, there were no differences in depression between patients with low MELD score (<15) and those with high MELD score (>15) [44]. Protective factors associated with lower rates of depression were: higher ejection fraction after heart transplantation [41], skeletal muscle mass, handgrip strength, consumption of fish and white meat and MCV for kidney recipients [25].…”

“…Laboratory values associated with increased risk of depression in kidney recipients were parathyroid hormone level, ferritin levels [43] and triglyceride levels [25]. Other medical factors associated with depression include biliary complications and hepatocellular carcinoma for liver transplant recipients [42], New York Heart Associations class II, III/IV and steroid treatment for heart recipients [41], fat mass and anthropometric parameters of obesity for kidney recipients [25]. In liver transplant candidates, there were no differences in depression between patients with low MELD score (<15) and those with high MELD score (>15) [44].…”

Donor obesity and weight gain after transplantation: two still overlooked threats to long-term graft survival

“…The Mediterranean diet includes consumption of greater amounts of fish, fruit, vegetables, legumes, nuts and olive oil, together with a low intake of dairy and meat products, while the DASH diet includes consumption of vegetables, fruits, legumes and low-fat dairy products [ 65 , 66 ]. Adherence to the Mediterranean diet in renal transplant recipients has been linked to better nutritional status and lower risk for metabolic syndrome in long-term follow-up, along with better preservation of allograft function [ 67–71 ]. Similarly, the DASH diet is also linked to better long-term renal allograft function preservation [ 72 , 73 ].…”

Nutrition Disturbances and Metabolic Complications in Kidney Transplant Recipients: Etiology, Methods of Assessment and Prevention—A Review

“…The predominance of unsaturated fats over saturated fats found in red meat reduces oxidative stress, chronic inflammation, and atherosclerosis [ 92 , 93 ]. Vučković et al explored the links between sticking to a Mediterranean diet, body composition, and depression symptoms and found an association between low muscle mass and depression symptoms [ 94 ].…”