Impact of Gut Microbiota on the Association between Diet and Depressive Symptoms in Breast Cancer

Abstract

Little is known about the relationship between diet and depression through the gut microbiota among breast cancer patients. This study aimed to examine the dietary intake differences between depressed breast cancer (DBC) and non-depressed breast cancer (NBC) patients, and whether the differences could lead to gut microbiota changes that affect depressive symptoms. Participants completed the Center for Epidemiological Studies-Depression Scale (CES-D) and 24 h dietary recall. Fecal samples of 18 DBC patients and 37 NBC patients were collected for next-generation sequencing. A total of 60 out of 205 breast cancer patients reported significant depressive symptoms suggested by a CES-D score ≥ 16, which might be related to lower intakes of energy, protein, dietary fiber, vitamin A, vitamin B2, niacin, calcium, phosphorus, potassium, iron, zinc, selenium, manganese and tryptophan, and a poor diet quality indicated by a lower total Chinese Healthy Eating Index (CHEI) score. Additionally, NBC patients demonstrated greater gut microbiota diversity and a healthier composition, in which the relative abundances of Proteobacteria and Escherichia-Shigella were both lower than in the DBC patients (p < 0.05). Alpha diversity was a significant mediator between diet quality and depression, while calcium, phosphorus and selenium significantly regulated depression independent of the gut microbiota. Breast cancer-related depressive symptoms might be associated with a poor diet quality via gut microbiota-dependent pathways and lower micronutrient intake via microbiota-independent pathways.

Breast Cancer Survivors and Healthy Women: Could Gut Microbiota Make a Difference?—“BiotaCancerSurvivors”: A Case-Control Study

“…Depressed BC patients had an increased relative abundance of Proteobacteria and a lower Firmicutes abundance than non-depressed patients. Since most bacteria that produce SCFAs belong to the Firmicutes, this may lead to a decrease in SCFAs production, such as butyrate, which may be the physiological basis for intestinal barrier dysfunction and low-level inflammation [43,44]. In our sample, we observed a significantly decreased abundance of the Firmicutes phylum, for which the high percentage (43.5%) of women with a history of depression/anxiety may be a contributing factor.…”

Intermediate role of gut microbiota in vitamin B nutrition and its influences on human health

“…Moreover, treatment of vitamin B2 and vitamin C significantly reduced the number of Proteobacteria , and showed a trend to increase the number of Firmicutes and decrease the number of Bacteroidetes ( 70 ). Another study also reported that the relative abundance of Streptococcus was negatively correlated with dietary intake of vitamin B2 ( 74 ). Several groups of Streptococcus are thought to be correlated with strep infection, such as Streptococcus pyogenes and Streptococcus pneumoniae .…”

“…In humans, increased in F. prausnitzii, Roseburia, and decrease in Streptococcus and E. coli (74,75).…”

Scientific opinion on the tolerable upper intake level for manganese

“…Further, no evidence for an adverse effect of dietary intake of manganese was found for the following health outcomes: depression (six studies [Rubio‐López et al., 2016; Miyake et al., 2017; Nakamura et al., 2019; Thi Thu Nguyen et al., 2019; Li et al., 2020; Maitiniyazi et al., 2022]), autism (one study [Moludi et al., 2020]), multiple sclerosis (two studies [Cortese et al., 2019; Venasse et al., 2021]), Parkinson's disease (two studies [Miyake et al., 2011], Fukushima et al., 2010), increased signal intensity on T1‐weighted magnetic resonance images (MRI) (one study [Ahn et al., 2003]) and adverse symptoms during menstrual phase regarding changes in behaviour (one study [Penland & Johnson, 1993]). Therefore, these 13 studies are not further considered in this opinion.…”