Depression and Diabetes: More in Common Than You Think!
Depression and Diabetes: More in Common Than You Think!
Almost one in ten Americans reports having depression. The numbers are higher among the young, among women and among those with low household income (Columbia University, 2022).
According to the CDC, over 37 million Americans have diabetes, which includes the diagnosed and the undiagnosed. Another 96 million Americans have pre-diabetes. Almost half of all Americans over the age of 65 have pre-diabetes (2022).
Did you know that there is an association between diabetes and depression?
People with diabetes are 2-3 times more likely to also suffer from depression as individuals with normal blood sugar levels. Anxiety rates are 40% higher in people with diabetes.
It’s a chicken and egg problem because having depression increases a person’s chances of having type 2 diabetes and having type 2 diabetes makes depression more likely (Bădescu et al., 2016).
What factors increase the risk of having diabetes or depression?
Low household income
Poor sleep
Lack of exercise
Chronic stress (Bădescu et al., 2016).
Living with chronic stress increases the stress hormone cortisol, which in turn leads to insulin resistance, visceral (belly) fat, and a diagnosis of diabetes. High levels of cortisol interferes with neurogenesis in the hippocampus. Neurogenesis refers to the growth of new neurons or brain cells. The hippocampus is the part of the brain responsible for learning, memory, and spacial awareness.
Why do so many people “choose” to eat unhealthy food?
Lack of time to prepare healthy meals
Lack of basic nutrition information
Food deserts
Junk food is much cheaper than healthy food
Depressed individuals may self medicate with high sugar, high salt foods
Major Study Confirms Power of Food to Reduce Depression Symptoms
The “SMILES” trial ran for 12 weeks with 166 participants all diagnosed with moderate to severe depression. Participants were divided into two groups. Once group received dietary support and the other group received non-dietary support. Those with dietary support reported a significant decline in depressive symptoms at the end of the trial.
“These results indicate that dietary improvement may provide an efficacious and accessible treatment strategy for the management of this highly prevalent mental disorder, the benefits of which could extend to the management of common co-morbidities” (Jacka et al., 2017).
The dietary recommendations of the SMILES trial resembled the Mediterranean diet. Participants were encouraged to consume the following:
olive oil
lots of vegetables
lean proteins including lots of fish
raw nuts
Participants in the dietary intervention group were discouraged from eating processed foods and sugary foods (Jacka et al., 2017).
It should be noted that the SMILES trial has been criticized for issues related to both recruitment and to imperfect “blinding,” which means that those in the dietary intervention group may have been aware of the expectation that their group would show the most promising results.
Eat Your Carrots!
There are other studies demonstrating the depression-fighting abilities of healthy food. The limitation is that they are mostly observational in nature. For example, there is a study demonstrating the inverse relationship between vitamin A and beta-carotene.
Beta-carotene is mostly plant derived. It is what gives carrots and other vegetable their orange-red colors. Beta-carotene is a powerful antioxidant, allowing it to fight free radicals. A free radical refers to an atom which is missing an electron. Free radicals lead to oxidative stress as they attack healthy cells and attempt to steal electrons.
Both depression and diabetes involve oxidative stress which leads to inflammation.
Beta-carotene is able to decrease inflammatory markers such as TNF-a and IL-6.
TNF-a stands for tumor necrosis factor - alpha. The body uses a small amount to suppress tumors. But having too much leads to inflammatory and autoimmune conditions. If you watch TV, you’ll quickly notice quite a few ads for medications to suppress TNF-a, such as Humira and Enbril, all of which have the potential for serious side effects.
In addition to naturally suppressing TNF-a, beta-carotene in such common foods as carrots, sweet potatoes, apricots and cantaloupe can also stimulate the production of BDNF, or brain-derived neutrophic factor, a molecule known for promoting a healthy brain (Zhang, Ding & Liang, 2022).
What About Supplements?
There are numerous vitamins, minerals and botanicals that may help with either diabetes or depression. Improvements to one condition should improve the other. However, it is always best to consult with a trained nutritionist to ensure you are taking products best suited to your bio individuality, medical and pharmaceutical history as well as budget.
But in the meantime, here is one suggestion…
Almost everyone with either diabetes or depression can benefit from magnesium supplementation, which is safe and inexpensive. Taking magnesium glycinate with each meal as well as before dinner has been shown to help promote the recovery from major depression (Eby & Eby, 2006). Furthermore, in studies with lab animals, magnesium was shown to help improve insulin sensitive (Liu et al., 2020).
While there are many quality forms of magnesium, I suggest avoiding magnesium oxide because it is poorly absorbed and helpful mostly as a laxative.
Conclusion
Both type 2 diabetes and depression are major debilitating conditions, which often go hand in hand. Treating one should improve the other. Healthy food choices have been shown to make a significant difference. Sadly, many people in this country lack access to healthy food choices. While supplementation is a broad and complex topic best discussed with a licensed professional nutritionist, magnesium is safe and affordable for most people.
Disclaimer
The included information is not meant to or should not be used to replace or substitute medical treatment, recommendations, or the advice of your physician or health care provider. The information contained within is strictly for educational purposes and is based on evidence-based nutrition. If you believe you have a medical problem or condition, please contact your physician or healthcare provider.
References
Bădescu, S. V., Tătaru, C., Kobylinska, L., Georgescu, E. L., Zahiu, D. M., Zăgrean, A. M., & Zăgrean, L. (2016). The association between Diabetes mellitus and Depression. Journal of medicine and life, 9(2), 120–125. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4863499/
CDC (2022) Diabetes Basics https://www.cdc.gov/diabetes/basics/index.html
Columbia University Mailman School of Public Health (2022). Nearly one in ten Americans reports having depression. https://www.publichealth.columbia.edu/news/nearly-one-ten-americans-reports-having-depression
Eby, G. A., & Eby, K. L. (2006). Rapid recovery from major depression using magnesium treatment. Medical hypotheses, 67(2), 362–370. https://doi.org/10.1016/j.mehy.2006.01.047
Jacka, F.N., O’neil, A., Opie, R., Itsiopoulos, C., Cotton, S., Mohebbi, M., Castle, D., Dash, S., Mihalapoulous, C., Chatterton, M.l., Brazionis, L., Dean, O.M., Hodge, A.M. & Berk, M. (2017) BMC Medicine (2017). https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0791-y
Liu, H., Li, N., Jin, M., Miao, X., Zhang, X., & Zhong, W. (2020). Magnesium supplementation enhances insulin sensitivity and decreases insulin resistance in diabetic rats. Iranian journal of basic medical sciences, 23(8), 990–998. https://doi.org/10.22038/ijbms.2020.40859.9650
Zhang, Y., Ding, J., & Liang, J. (2022). Associations of Dietary Vitamin A and Beta-Carotene Intake With Depression. A Meta-Analysis of Observational Studies. Frontiers in nutrition, 9, 881139. https://doi.org/10.3389/fnut.2022.881139