정신신체의학 (Korean Journal of Psychosomatic Medicine)

한국정신신체의학회 (Korean Psychosomatic Society)
권호 표지
DOI QR코드

DOI QR Code

자살과 식단의 연관성

Association Between Suicide and Diet

  • 임은지 (창원경상국립대학교병원 정신건강의학과) ;
  • 김봉조 (경상국립대학교 의학대학 정신건강의학교실) ;
  • 이철순 (창원경상국립대학교병원 정신건강의학과) ;
  • 차보석 (경상국립대학교 의학대학 정신건강의학교실) ;
  • 이소진 (경상국립대학교 의학대학 정신건강의학교실) ;
  • 최재원 (경상국립대학교병원 정신건강의학과) ;
  • 이영지 (창원경상국립대학교병원 정신건강의학과) ;
  • 강누리 (경상국립대학교병원 정신건강의학과) ;
  • 이동윤 (창원경상국립대학교병원 정신건강의학과)
  • Eunji, Lim (Department of Psychiatry, Gyeongsang National University Changwon Hospital) ;
  • Bong-Jo, Kim (Department of Psychiatry, Gyeongsang National University, College of Medicine) ;
  • Cheol-Soon, Lee (Department of Psychiatry, Gyeongsang National University Changwon Hospital) ;
  • Boseok, Cha (Department of Psychiatry, Gyeongsang National University, College of Medicine) ;
  • So-Jin, Lee (Department of Psychiatry, Gyeongsang National University, College of Medicine) ;
  • Jae-Won, Choi (Department of Psychiatry, Gyeongsang National University Hospital) ;
  • Young-Ji, Lee (Department of Psychiatry, Gyeongsang National University Changwon Hospital) ;
  • Nuree, Kang (Department of Psychiatry, Gyeongsang National University Hospital) ;
  • Dongyun, Lee (Department of Psychiatry, Gyeongsang National University Changwon Hospital)
  • 투고 : 2022.10.31
  • 심사 : 2022.11.24
  • 발행 : 2022.12.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

연구목적 자살은 전세계적인 사회적 문제로 자살로 인한 사회적 부담은 점차 증가하고 있다. 자살의 예방을 위해 다양한 시도들이 진행되고 있다. 자살의 위험성이 생활 습관, 그 중 식단의 변화에 의해 증가할 수 있다. 그래서 본 연구는 자살에 대한 보조적 치료로써 식단에 대해 고찰하였다. 방법 본 종설에서는 학술 검색을 통하여 자살의 생화학적 메커니즘을 확인하고 자살에 대한 위험요인으로서 식단, 보호요인으로서 식단에 대해 정리해 보았다. 결과 본 연구에서는 자살의 생화학적 기전을 확인하고, 자살에 대한 위험요인 식단, 보호요인 식단에 대해 조사하였다 신경계통에서 산화스트레스 반응, 염증반응과 같은 신경독성효과가 자살의 위험을 높일 수 있음을 확인하였다. 이들 이전 연구 결과를 바탕으로, 자살과 식단 사이의 이전 연구들을 고찰 해본 결과, 자살에 대한 위험 요인으로 술, 담배, 커피, 탄산음료, 패스트 푸드 등의 과도한 사용 및 섭취가 있었다. 자살에 대한 보호요인으로 비타민 C, 카로틴 등의 항산화 물질 그리고 해산물이 다량 포함하고 있는 오메가 3 지방산 같은 항염증 제재등이 있었다. 결론 자살의 유일한 치료법은 그 예방이다. 그러한 맥락에서 자살의 예방적 치료들의 적용에 있어 효과, 접근성, 안전이 중요할 수 있다. 이런 관점에서 비교적 안전하고, 대중들이 쉽게 섭취할 수 있는 항산화물질 및 항염증 제재들은 자살의 위험을 낮출 수 있는 효과적 보조적 치료가 될 수 있을 것이다. 뿐만 아니라, 자살의 위험을 높일 수 있는 식단을 줄이기 위한 대중들에 대한 교육이 필요할 수 있다

Objectives : Suicide is a global social problem. Social burden caused by suicide is gradually increasing. Various efforts have been made to prevent suicide. Lifestyle changes to western style, especially diet changes, have increased the risk for suicide. Therefore, in this study, we discussed diet as an adjuvant treatment for suicide. Methods : In this review, we summarized the biochemical mechanism of suicide, and diet as a risk factor for suicide and diet as a protective factor through a web search. Results : In this study, biochemical mechanisms for suicide were reviewed and diet as a risk factor and diet as a protective factor for suicide were investigated. It was confirmed that neurotoxic effects such as oxidative stress and inflammation in the neural system could increase the risk of suicide. Based on results of previous studies on the relationship between suicide and diet, it was found that heavy use of alcohol, coffee, carbonated soft drink, and fast food were risk factors for suicide. Protective factors for suicide included antioxidants such as vitamin C, carotene, and anti-inflammatory agents such as omega-3 fatty acids found in seafood in large amounts. Conclusions : The only treatment for suicide is prevention. In this context, effectiveness, accessibility, and safety are important for preventing for suicide. Antioxidants and anti-inflammatory agents that are relatively safe and readily available to the public could be effective adjuvant treatments to decrease the risk of suicide. In addition, it is necessary to educate the public on reducing diets that could increase the risk of suicide

키워드

참고문헌

  1. OECD. OECD Suicide rates (indicator). Available at: https://data.oecd.org/healthstat/suicide-rates.htm. Accessed 28 October, 2022.
  2. Doran CM, Kinchin I. Economic and epidemiological impact of youth suicide in countries with the highest human development index. PLoS One 2020;15:e0232940.
  3. Bolton JM, Gunnell D, Turecki G. Suicide risk assessment and intervention in people with mental illness. BMJ 2015;351:h4978.
  4. Goodwin RD, Marusic A, Hoven CW. Suicide attempts in the United States: the role of physical illness. Soc Sci Med 2003; 56:1783-1788. https://doi.org/10.1016/S0277-9536(02)00174-0
  5. Rehkopf DH, Buka SL. The association between suicide and the socio-economic characteristics of geographical areas: a systematic review. Psychol Med 2006;36:145-157. https://doi.org/10.1017/S003329170500588X
  6. Logan J, Hall J, Karch D. Suicide categories by patterns of known risk factors: a latent class analysis. Arch Gen Psychiatry 2011;68:935-941. https://doi.org/10.1001/archgenpsychiatry.2011.85
  7. Li Y, Li Y, Cao J. Factors associated with suicidal behaviors in mainland China: a meta-analysis. BMC Public Health 2012; 12:1-13. https://doi.org/10.1186/1471-2458-12-1
  8. McGrath-Hanna NK, Greene DM, Tavernier RJ, Bult-Ito A. Diet and mental health in the arctic: is diet an important risk factor for mental health in circumpolar peoples?-a review. Int J Circumpolar Health 2003;62:228-241. https://doi.org/10.3402/ijch.v62i3.17560
  9. Brunner J, Parhofer KG, Schwandt P, Bronisch T. Cholesterol, essential fatty acids, and suicide. Pharmacopsychiatry 2002;35:1-5. https://doi.org/10.1055/s-2002-19834
  10. Berardelli I, Serafini G, Cortese N, Fiasche F, O'connor RC, Pompili M. The involvement of hypothalamus-pituitary-adrenal (HPA) axis in suicide risk. Brain Sci 2020;10:653.
  11. Lindqvist D, Fernstrom J, Grudet C, Ljunggren L, Traskman-Bendz L, Ohlsson L, Westrin A. Increased plasma levels of circulating cell-free mitochondrial DNA in suicide attempters: associations with HPA-axis hyperactivity. Transl Psychiatry 2016;6:e971-e971. https://doi.org/10.1038/tp.2016.236
  12. Pompili M, Serafini G, Innamorati M, Moller-Leimkuhler AM, Giupponi G, Girardi P, Tatarelli R, Lester D. The hypothalamic-pituitary-adrenal axis and serotonin abnormalities: a selective overview for the implications of suicide prevention. Eur Arch Psychiatry Clin Neurosci 2010;260:583-600. https://doi.org/10.1007/s00406-010-0108-z
  13. Sudol K, Mann JJ. Biomarkers of suicide attempt behavior: towards a biological model of risk. Curr Psychiatry Rep 2017;19:1-13. https://doi.org/10.1007/s11920-017-0753-2
  14. Koweszko T, Gierus J, Zalewska A, Maciejczyk M, Waszkiewicz N, Szulc A. The relationship between suicide and oxidative stress in a group of psychiatric inpatients. J Clin Med 2020;9:3462.
  15. Vargas HO, Nunes SOV, de Castro MP, Bortolasci CC, Barbosa DS, Morimoto HK, Venugopal K, Dodd S, Maes M, Berk M. Oxidative stress and lowered total antioxidant status are associated with a history of suicide attempts. J Affect Disord 2013;150:923-930. https://doi.org/10.1016/j.jad.2013.05.016
  16. Vasupanrajit A, Jirakran K, Tunvirachaisakul C, Maes M. Suicide attempts are associated with activated immune-inflammatory, nitro-oxidative, and neurotoxic pathways: a systematic review and meta-analysis. J Affect Disord 2021;295: 80-92. https://doi.org/10.1016/j.jad.2021.08.015
  17. Vasupanrajit A, Jirakran K, Tunvirachaisakul C, Solmi M, Maes M. Inflammation and nitro-oxidative stress in current suicidal attempts and current suicidal ideation: a systematic review and meta-analysis. Mol Psychiatry 2022;27:1350-1361. https://doi.org/10.1038/s41380-021-01407-4
  18. Roy B, Dwivedi Y. Understanding the neuroepigenetic constituents of suicide brain. Prog Mol Biol Transl Sci 2018;157: 233-262. https://doi.org/10.1016/bs.pmbts.2018.01.007
  19. Gibbs HM, Davis L, Han X, Clothier J, Eads LA, Caceda R. Association between C-reactive protein and suicidal behavior in an adult inpatient population. J Psychiatr Res 2016;79: 28-33. https://doi.org/10.1016/j.jpsychires.2016.04.002
  20. Janelidze S, Mattei D, Westrin A, Traskman-Bendz L, Brundin L. Cytokine levels in the blood may distinguish suicide attempters from depressed patients. Brain Behav Immun 2011;25:335-339. https://doi.org/10.1016/j.bbi.2010.10.010
  21. Black C, Miller BJ. Meta-analysis of cytokines and chemokines in suicidality: distinguishing suicidal versus nonsuicidal patients. Biol Psychiatry 2015;78:28-37. https://doi.org/10.1016/j.biopsych.2014.10.014
  22. Ducasse D, Olie E, Guillaume S, Artero S, Courtet P. A meta-analysis of cytokines in suicidal behavior. Brain Behav Immun 2015;46:203-211. https://doi.org/10.1016/j.bbi.2015.02.004
  23. Chen X, Pu J, Liu Y, Tian L, Chen Y, Gui S, Xu S, Song X, Xie P. Increased C-reactive protein concentrations were associated with suicidal behavior in patients with depressive disorders: a meta-analysis. Psychiatry Res 2020;292:113320.
  24. Dowlati Y, Herrmann N, Swardfager W, Liu H, Sham L, Reim EK, Lanctot KL. A meta-analysis of cytokines in major depression. Biol Psychiatry 2010;67:446-457. https://doi.org/10.1016/j.biopsych.2009.09.033
  25. Miller BJ, Buckley P, Seabolt W, Mellor A, Kirkpatrick B. Meta-analysis of cytokine alterations in schizophrenia: clinical status and antipsychotic effects. Biol Psychiatry 2011;70:663-671. https://doi.org/10.1016/j.biopsych.2011.04.013
  26. Munkholm K, Brauner JV, Kessing LV, Vinberg M. Cytokines in bipolar disorder vs. healthy control subjects: a systematic review and meta-analysis. J Psychiatr Res 2013;47:1119-1133. https://doi.org/10.1016/j.jpsychires.2013.05.018
  27. Jacob L, Stubbs B, Firth J, Smith L, Haro JM, Koyanagi A. Fast food consumption and suicide attempts among adolescents aged 12-15 years from 32 countries. J Affect Disord 2020; 266:63-70. https://doi.org/10.1016/j.jad.2020.01.130
  28. Jacob L, Stubbs B, Koyanagi A. Consumption of carbonated soft drinks and suicide attempts among 105,061 adolescents aged 12-15 years from 6 high-income, 22 middle-income, and 4 low-income countries. Clin Nutr 2020;39:886-892. https://doi.org/10.1016/j.clnu.2019.03.028
  29. Park S, Lee Y, Lee JH. Association between energy drink intake, sleep, stress, and suicidality in Korean adolescents: energy drink use in isolation or in combination with junk food consumption. Nutr J 2016;15:1-8.
  30. Lee JW, Kim BJ, Lee CS, Cha B, Lee SJ, LeeD, Seo J, Lee YJ, Lee YJ, Lim E. Association between suicide and drinking habits in adolescents. J Korean Acad Child Adolesc Psychiatry 2021;32:161-169. https://doi.org/10.5765/jkacap.210024
  31. Miller M, Hemenway D, Rimm E. Cigarettes and suicide: a prospective study of 50,000 men. Am J Public Health 2000;90:768.
  32. Li D, Yang X, Ge Z, Hao Y, Wang Q, Liu F, Gu D, Huang J. Cigarette smoking and risk of completed suicide: a metaanalysis of prospective cohort studies. J Psychiatr Res 2012;46: 1257-1266. https://doi.org/10.1016/j.jpsychires.2012.03.013
  33. Park H, Suh BS, Lee K. Relationship between daily coffee intake and suicidal ideation. J Affect Disord 2019;256:468-472. https://doi.org/10.1016/j.jad.2019.06.023
  34. Tanskanen A, Tuomilehto J, Viinamaki H, Vartiainen E, Lehtonen J, Puska P. Joint heavy use of alcohol, cigarettes and coffee and the risk of suicide. Addiction 2000;95:1699-1704. https://doi.org/10.1046/j.1360-0443.2000.9511169910.x
  35. Poorolajal J, Darvishi N. Smoking and suicide: a meta-analysis. PLoS One 2016;11:e0156348
  36. Smith L, Shin JI, Carmichael C, Jacob L, Kostev K, Grabovac I, Barnett Y, Butler L, Lindsay RK, Pizzol D. Association of food insecurity with suicidal ideation and suicide attempts in adults aged ≥50 years from low-and middle-income countries. J Affect Disord 2022;309:446-452. https://doi.org/10.1016/j.jad.2022.04.109
  37. Li Y, Zhang J. Serum concentrations of antioxidant vitamins and carotenoids are low in individuals with a history of attempted suicide. Nutr Neurosci 2007;10:51-58. https://doi.org/10.1080/10284150701250747
  38. Li Y, Zhang J, McKeown RE. Cross-sectional assessment of diet quality in individuals with a lifetime history of attempted suicide. Psychiatry Res 2009;165:111-119. https://doi.org/10.1016/j.psychres.2007.09.004
  39. Holt EM, Steffen LM, Moran A, Basu S, Steinberger J, Ross JA, Hong CP, Sinaiko AR. Fruit and vegetable consumption and its relation to markers of inflammation and oxidative stress in adolescents. J Am Diet Assoc 2009;109:414-421. https://doi.org/10.1016/j.jada.2008.11.036
  40. Nanri A, Mizoue T, Poudel-Tandukar K, Noda M, Kato M, Kurotani K, Goto A, Oba S, Inoue M, Tsugane S. Dietary patterns and suicide in Japanese adults: the Japan public health center-based prospective study. Br J Psychiatry 2013;203:422-427. https://doi.org/10.1192/bjp.bp.112.114793
  41. Olgunoglu I. Review on omega-3 (n-3) fatty acids in fish and seafood. J Biol Agric Healthc 2017;7:37-45.
  42. Calder PC. n-3 Polyunsaturated fatty acids, inflammation, and inflammatory diseases. Am J Clin Nutr 2006;83:1505S-1519S. https://doi.org/10.1093/ajcn/83.6.1505S
  43. Tanskanen A, Hibbeln JR, Hintikka J, Haatainen K, Honkalampi K, Viinamaki H. Fish consumption, depression, and suicidality in a general population. Arch Gen Psychiatry 2001; 58:512-513. https://doi.org/10.1001/archpsyc.58.5.512
  44. Zhang J, Li Y, Torres ME. How does a suicide attempter eat differently from others? Comparison of macronutrient intakes. Nutrition 2005;21:711-717. https://doi.org/10.1016/j.nut.2004.11.009
  45. Sublette ME, Hibbeln JR, Galfalvy H, Oquendo MA, Mann JJ. Omega-3 polyunsaturated essential fatty acid status as a predictor of future suicide risk. Am J Psychiatry 2006;163: 1100-1102. https://doi.org/10.1176/appi.ajp.163.6.1100
  46. Gananca L, Galfalvy HC, Cisneros-Trujillo S, Basseda Z, Cooper TB, Ren X, Figueira ML, Oquendo MA, Mann JJ, Sublette ME. Relationships between inflammatory markers and suicide risk status in major depression. J Psychiatr Res 2021;134:192-199. https://doi.org/10.1016/j.jpsychires.2020.12.029
  47. Poudel-Tandukar K, Nanri A, Iwasaki M, Mizoue T, Matsushita Y, Takahashi Y, Noda M, Inoue M, Tsugane S, Group JPHC-bPS. Long chain n-3 fatty acids intake, fish consumption and suicide in a cohort of Japanese men and women-The Japan Public Health Center-based (JPHC) Prospective Study. J Affect Disord 2011;129:282-288. https://doi.org/10.1016/j.jad.2010.07.014
  48. Tsai AC, Lucas M, Okereke OI, O'Reilly EJ, Mirzaei F, Kawachi I, Ascherio A, Willett WC. Suicide mortality in relation to dietary intake of n-3 and n-6 polyunsaturated fatty acids and fish: equivocal findings from 3 large US cohort studies. Am J Epidemiol 2014;179:1458-1466. https://doi.org/10.1093/aje/kwu086