title: Changes in endothelial function and depression scores are associated following long-term dietary intervention: a secondary analysis.
abstract: OBJECTIVE
  Cross-sectional studies show associations between depression and endothelial function (as measured by endothelium-dependent brachial artery flow-mediated dilatation [FMD]); but it is not known whether changes in these parameters are associated following dietary management. We have previously reported that compared with consumption of a high-carbohydrate (HC) diet, despite comparable weight loss, a very low-carbohydrate (LC diet) impaired FMD and increased depression. The purpose of this study was to conduct a secondary analysis to examine whether there was an association between changes in FMD and depression.
  
  
  METHODS
  Forty-seven overweight men and women (body mass index 26-43 kg/m(2) and ages 24-64 y) completed a 12-mo randomized controlled trial during which participants consumed either an energy-restricted, isocaloric LC or HC diet. Weight, body composition, Homeostasis Assessment of Insulin Resistance (HOMA), depression (Beck Depression Inventory [BDI]), Anxiety (Spielberger State-Trait Anxiety Inventory [STAI]) and FMD were assessed before and after the intervention. This secondary analysis focused on multiple regression analysis of these parameters.
  
  
  RESULTS
  Changes in BDI were independently predicted by changes in FMD (β = -0.356; P = 0.026) but not by diet intervention assignment or changes in weight or HOMA. No variables were significant predictors of the change in STAI.
  
  
  CONCLUSIONS
  Over time, impairments in FMD were independently associated with increased depression, independent of diet composition, or changes in weight and insulin resistance. This data supports a mechanistic association between depression and endothelial function, which may influence long-term health.
authors.affiliation: Robinson Institute, Discipline of Obstetrics and Gynaecology, University of Adelaide, and South Australian Health and Medical Research Institute, Adelaide, Australia. lisa.moran@adelaide.edu.au
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Moran
authors.forename: Carlene J
authors.initials: CJ
authors.lastname: Wilson
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Buckley
authors.forename: Manny
authors.initials: M
authors.lastname: Noakes
authors.forename: Peter M
authors.initials: PM
authors.lastname: Clifton
authors.forename: Grant D
authors.initials: GD
authors.lastname: Brinkworth
mesh_terms: D000328:Adult; D001007:Anxiety / Q000503:physiopathology / Q000523:psychology; D001823:Body Composition; D015992:Body Mass Index; D001916:Brachial Artery / Q000503:physiopathology*; D003863:Depression / Q000503:physiopathology* / Q000523:psychology; D050528:Diet, Carbohydrate-Restricted / Q000523:psychology; D004038:Diet, Reducing / Q000523:psychology; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000178:diet therapy / Q000523:psychology; D015431:Weight Loss; D055815:Young Adult
chemical_list: D004040:Dietary Carbohydrates
keywords: Depression; Diet; Endothelial function