Tip 2 Diyabetli Yetişkinlerde Diyet Lifi Alımı ile Depresyon ve Yaşam Kalitesi Arasındaki İlişki: Birinci Basamak Sağlık Merkezinden Kesitsel Bir Çalışma

Year 2025, Volume: 14 Issue: 3, 886 - 895, 25.09.2025

Aybüke Merve Demirci , Gözde Dumlu Bilgin

https://doi.org/10.37989/gumussagbil.1731997

Abstract

Küresel bir sağlık sorunu olan Tip 2 diyabet, bireylerin yaşam kalitesini (QoL) ve depresyon durumunu etkileyebilmektedir. Diyet lifinin bu konulardaki potansiyel olumlu rolüne rağmen yapılan çalışmalar sınırlıdır. Bu nedenle, bu çalışma tip 2 diyabetli yetişkinlerde diyet lifi alımı ile depresyon ve yaşam kalitesi arasındaki ilişkiyi aydınlatmayı amaçlamıştır.
Bu kesitsel çalışma, İstanbul’da Birinci Basamak Sağlık Hizmeti sunan bir merkeze başvuran tip 2 diyabet tanısı olan hastalarda yürütülmüştür. Demografik veriler, üç günlük besin tüketim kayıtları, Birinci Basamak için Beck Depresyon Envanteri (BDI-PC) ve Kısa form-36 (SF-36) Yaşam Kalitesi Ölçeği gibi araçları içeren veriler yüz yüze görüşmeler yoluyla toplanmıştır. Ağırlık ve boy gibi antropometrik ölçümler alınmıştır.
120 hastanın %68,3'ü kadındı ve yaş ortalaması 56,5 idi. Ortalama beden kütle indeksi (BKI) 31,3 kg/m2 olup katılımcıların çoğunluğu fazla kilolu (%38,3) veya obez (%50) olarak sınıflandırılmıştır. Günlük ortalama diyet lifi alımı 17,3 ± 6,7 g iken ortalama depresyon ölçeği puanı 3,8 idi. SF-36'ya göre ortalama genel sağlık puanı 49,9 ± 22,9 ve canlılık puanı 45,0 ± 20,2 ile en düşük puanlardı. Depresyon ile SF-36'nın tüm farklı alanları arasında anlamlı negatif korelasyonlar kaydedilmiştir. Ancak diyet lifi alımı ile yaşam kalitesi veya depresyon arasında anlamlı bir ilişki gösterilmemiştir
Bu çalışmada diyet lifi alımı ile yaşam kalitesi veya depresyon arasında bir korelasyon olduğunu gösteren bir kanıt bulunmamakla birlikte, bu olgunun daha iyi anlaşılması için daha büyük örneklemlerin kullanıldığı daha kapsamlı çalışmalara ihtiyaç duyulmaktadır.

Keywords

Yaşam kalitesi , Diabetes Mellitus , Depresyon , Diyet lifi

The Relationship Between Dietary Fiber Intake, Depression, and Quality of Life in Adults with Type 2 Diabetes: A Cross-Sectional Study from a Primary Health Care Center

Abstract

Type 2 diabetes, a global health concern, may impact an individuals' quality of life (QoL) and the presence of depression. Despite the potential favorable role of dietary fiber on these issues, studies are limited. Hence, this study aimed to elecudiate association between dietary fiber intake and depression and QoL in adults with type 2 diabetes.
This cross-sectional study was performed on patients diagnosed with type 2 diabetes who applied to the Primary Health Care Center, İstanbul. Data including demographic variables, three-day food records, Beck Depression Inventory for Primary Care (BDI-PC), and short form-36 (SF-36) health related QoL instrument were collected through face-to-face interviews. Anthropometric measurements including weight and height were measured.
Among the 120 patients 68.3% were women, with a mean age of 56.5 years. The mean body mass index (BMI) was 31.3 kg/m2, with the majority of participants classified as overweight (38.3%) or obese (50%). The average daily dietary fiber intake was 17.3 ± 6.7 g, while the mean depression scale score was 3.8. According to the SF-36, the mean general health domain was 49.9 ± 22.9, with vitality being the lowest at 45.0 ± 20.2. Significant negative correlations were noted between depression and all different domains of SF-36. However, no significant relationship was established between dietary fiber intake and QoL or depression.
While there is no evidence indicating a correlation between dietary fiber intake and QoL or depression in present study, further comprehensive studies using larger samples are needed to better understand this phenomenon.

Keywords

Quality of life , Diabetes mellitus , Depression , Dietary fiber

References

• 1. Ong KL, Stafford LK, McLaughlin SA, Boyko EJ, Vollset SE, Smith AE, et al. Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet. 2023;402(10397):203–34.
• 2. Mao Y, Li X, Zhu S, Geng Y. Association Between Dietary Fiber Intake and Risk of Depression in Patients With or Without Type 2 Diabetes. Front Neurosci. 2022;16(July):1–9.
• 3. Anderson R, Freedland K, RE C, Lustman PJ. The Prevalence of Comorbid Depression. Diabetes Care. 2001;24(6):1069–78.
• 4. Nouwen A, Winkley K, Twisk J, Lloyd CE, Peyrot M, Ismail K, et al. Type 2 diabetes mellitus as a risk factor for the onset of depression: A systematic review and meta-analysis. Diabetologia. 2010;53(12):2480–6.
• 5. Siddiqui S. Depression in type 2 diabetes mellitus - A brief review. Diabetes Metab Syndr Clin Res Rev [Internet]. 2014;8(1):62–5. Available from: http://dx.doi.org/10.1016/j.dsx.2013.06.010
• 6. Fatahi S, Matin SS, Sohouli MH, Găman MA, Raee P, Olang B, et al. Association of dietary fiber and depression symptom: A systematic review and meta-analysis of observational studies. Complement Ther Med. 2021;56(November 2020).
• 7. Barber TM, Kabisch S, Pfei AFH, Weickert MO. The Health Benefits of Dietary Fibre. Nutrients. 2020;12(3209):1–17.
• 8. Xu H, Li S, Song X, Li Z, Zhang D. Exploration of the association between dietary fiber intake and depressive symptoms in adults. Nutrition [Internet]. 2018;54:48–53. Available from: https://doi.org/10.1016/j.nut.2018.03.009
• 9. Gangwisch JE, Hale L, Garcia L, Malaspina D, Opler MG, Payne ME, et al. High glycemic index diet as a risk factor for depression: Analyses from the Women’s Health Initiative. Am J Clin Nutr. 2015;102(2):454–63.
• 10. Goldney R, Phillips P, Fisher L, Wilson D. Diabetes, Depression, and Quality of Life. Diabetes Care. 2004;27:1066–70.
• 11. Haraldstad K, Wahl A, Andenæs R, Andersen JR, Andersen MH, Beisland E, et al. A systematic review of quality of life research in medicine and health sciences. Qual Life Res [Internet]. 2019;28(10):2641–50. Available from: https://doi.org/10.1007/s11136-019-02214-9
• 12. Lu A, Li J, Liu Y, Du X, Wang Y, Wang X. Dietary fiber intake is positively associated with health-related quality of life in patients with hypertension: The mediating role of anxiety in mental component summary. Nutr Res. 2023;118:94–103.
• 13. Ramin S, Mysz MA, Meyer K, Capistrant, Benjamin, Lazovich D, Prizment A. A Prospective Analysis of Dietary Fiber Intake and Mental Health Quality of Life in the Iowa Women’s Health Study. Maturitas. 2020;131:1–7.
• 14. Takahashi F, Hashimoto Y, Kaji A, Sakai R, Kawate Y, Kondo Y, et al. Relationship between diabetes diet-related quality of life and dietary fiber intake among people with type 2 diabetes: a cross-sectional study. Endocr J. 2024;71(6):583–92.
• 15. World Health Organization Regional Office for Europe. Body mass index - BMI [Internet]. [cited 2021 Feb 10]. Available from: https://www.euro.who.int/en/health-topics/disease-prevention/nutrition/a-healthy-lifestyle/body-mass-index-bmi#
• 16. Beck A, Steer R. Manual for the Beck Depression Inventory [Internet]. Psychological Corporation. San Antonio, TX; 1993. Available from: http://0-search.ebscohost.com.mercury.concordia.ca/login.aspx?direct=true&db=psyh&AN=2004-12821-005&site=ehost-live
• 17. American Psychological Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. In Washington DC.; 1994.
• 18. AKTÜRK Z, DAĞDEVİREN N, TÜRE M, TUĞLU C. Birinci Basamak İçi̇n Beck Depresyon Tarama Ölçeği̇ni̇n Türkçe Çevi̇ri̇mi̇ni̇n Geçerli̇k Güveni̇rli̇ği̇. Türk Ai̇le Heki̇mli̇ği Dergi̇si̇. 2005;9(3):117–22.
• 19. Ware J, Ware JE, Kosinski M, Bjorner JB, Al E. SF36 Health survey : Manual and Interpretation Guided. Massachusetts. Nimrod Press Boston. 1993. p. 2000.
• 20. Bölükbaş RP. SF 36 Yaşam Kalitesi Ölçeği ve kullanımı: sağlık araştırmalarında yaşam kalitesi kavramı. Sendrom. 1996;8:109–14.
• 21. Diabetes Care [Internet]. American Diabetes Association. 2025 [cited 2025 Jan 10]. Available from: https://diabetesjournals.org/care/issue/48/Supplement_1. Keep
• 22. Takahashi F, Hashimoto Y, Kaji A, Sakai R, Kawate Y, Okamura T, et al. Dietary Fiber Intake Is Related to Skeletal Muscle Mass, Body Fat Mass, and Muscle-to-Fat Ratio Among People With Type 2 Diabetes: A Cross-Sectional Study. Front Nutr. 2022;9(May):1–9.
• 23. Rivellese AA, Boemi M, Cavalot F, Costagliola L, De Feo P, Miccoli R, et al. Dietary habits in type II diabetes mellitus: How is adherence to dietary recommendations? Eur J Clin Nutr. 2008;62(5):660–4.
• 24. Shehatah A, Rabie MA, Al-Shahry A. Prevalence and correlates of depressive disorders in elderly with type 2 diabetes in primary health care settings. J Affect Disord. 2010;123(1–3):197–201.
• 25. Chen L, Liu B, Ren L, Du H, Fei C, Qian C, et al. High-fiber diet ameliorates gut microbiota, serum metabolism and emotional mood in type 2 diabetes patients. Front Cell Infect Microbiol. 2023;13(January):1–9.
• 26. Pera PI. Living with diabetes: Quality of care and quality of life. Patient Prefer Adherence [Internet]. 2011;5:65–72. Available from: https://doi.org/10.2147/PPA.S16551
• 27. Krzemińska S, Bąk E, Polanská A, Hašová K, Laurinc M, Zrubcová D, et al. Does gender affect health-related quality of life in patients with type 2 diabetes (ADDQoL) in Central European countries? Ann Agric Environ Med. 2023;30(2):296–305.
• 28. Esubalew H, Belachew A, Seid Y, Wondmagegn H, Temesgen K, Ayele T. Health-Related Quality of Life Among Type 2 Diabetes Mellitus Patients Using the 36-Item Short Form Health Survey (SF-36) in Central Ethiopia: A Multicenter Study. Diabetes, Metab Syndr Obes. 2024;17(February):1039–49.
• 29. Degu H, Wondimagegnehu A, Yifru Y, Belachew A. Is health related quality of life influenced by diabetic neuropathic pain among type II diabetes mellitus patients in Ethiopia?. PLoS ONE [revista en Internet] 2019 [acceso 21 de marzo de 2022]; 14(2): 1-11. 2019;36:1–11. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6361436/
• 30. Verhulst MJL, Teeuw WJ, Gerdes VEA, Loos BG. Self-reported oral health and quality of life in patients with type 2 diabetes mellitus in primary care: A multi-center cross-sectional study. Diabetes, Metab Syndr Obes. 2019;12:883–99.
• 31. McCoy MA, Theeke LA. A systematic review of the relationships among psychosocial factors and coping in adults with type 2 diabetes mellitus. Int J Nurs Sci [Internet]. 2019;6(4):468–77. Available from: https://doi.org/10.1016/j.ijnss.2019.09.003
• 32. Jing X, Chen J, Dong Y, Han D, Zhao H, Wang X, et al. Related factors of quality of life of type 2 diabetes patients: A systematic review and meta-analysis. Health Qual Life Outcomes. 2018;16(1):1–14.