Abstract
This systematic literature review examined whole food or whole diet interventions to treat depression. The inclusion criteria encompassed adults, depression, a recognized depression scale and a whole food or diet intervention. APA PsychINFO, CINAHL, the Cochrance Central Register of Controlled Trails, MEDLINE and Scopus were searched for original research addressing diet as a treatment for depression in adult populations. The quality of the study was assessed using the Academy of Nutrition and Dietetics Quality Criteria Checklist. Seven studies; with 49,156 participants; met the eligibility criteria. All these studies found positive outcomes with depression levels decreasing after dietary intervention. The calculated effect size varied from small (Cohen’s d = 0.32) to very large (Cohen’s d = 1.82). The inconsistent nature of the studies limited the synthesis of the data. Recommendations are provided to enhance future study design and measurement outcomes. Overall, the findings show a positive result for diets that promote an increased intake of fresh produce, wholegrains, low-fat dairy and lean protein sources, while also decreasing the intake of processed and high-fat foods. No funding was provided for this review. The protocol for this review is registered with PROSPERO (CRD42020210426).
5. Conclusions
The current review provides some support for whole diet and whole food interventions as an adjunctive treatment to improve depression symptomology. The available studies are limited by factors such as duration and small sample sizes, and are inconsistent in design. However, all studies showed a reduction in scores assessing depression. This suggests that whole food and whole diet interventions should be further investigated to identify the mechanisms and durations required for improved outcomes. Further studies in wider population groups are required, as is a greater control of confounding factors and their impacts on depression, along with a greater care of selection of the depression scales used to measure outcomes.
Acknowledgments
The authors are grateful to Andrew Woodward, statistical consultant at the University of Canberra, for his advice re data analysis and presentation.
Author Contributions
S.O. and M.M. were first and second reviewers. C.R.K.-A. was third reviewer. M.T. contributed to the conception and design of the review, acquisition and management of data and review of the manuscript for publication. S.O., M.M. and C.R.K.-A. contributed to the conception and design of the review, acquisition, analysis and interpretation of data and preparation of the manuscript for publication. All authors have read and agreed to the published version of the manuscript.
Funding
This research received no external funding.
Conflicts of Interest
The authors declare no conflict of interest.
Footnotes
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.
References
2.
Schofield D., Cunich M., Shrestha R., Tanton R., Veerman L., Kelly S., Passey M. Indirect costs of depression and other mental and behavioural disorders for Australia from 2015 to 2030. BJPsych Open. 2019;5:1–7. doi: 10.1192/bjo.2019.26. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
6.
Low Dog T. The role of nutrition in mental health. Altern. Ther. Health Med. 2010;16:42–46. [PubMed] [Google Scholar]
7.
Casacalenda N., Perry J.C., Looper K. Remission in Major Depressive Disorder: A Comparison of Pharmacotherapy, Psychotherapy, and Control Conditions. Am. J. Psychiatry. 2002;159:1354–1360. doi: 10.1176/appi.ajp.159.8.1354. [PubMed] [CrossRef] [Google Scholar]
8.
Machmutow K., Meister R., Jansen A., Kriston L., Watzke B., Härter M.C., Liebherz S., Liebherz S. Comparative effectiveness of continuation and maintenance treatments for persistent depressive disorder in adults. Cochrane Libr. 2019;2019:CD012855. doi: 10.1002/14651858.CD012855.pub2. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
9.
Adan R.A.H., van der Beek E.M., Buitelaar J.K., Cryan J.F., Hebebrand J., Higgs S., Schellekens H., Dickson S.L. Nutritional psychiatry: Towards improving mental health by what you eat. Eur. Neuropsychopharmacol. 2019;29:1321–1332. doi: 10.1016/j.euroneuro.2019.10.011. [PubMed] [CrossRef] [Google Scholar]
10.
Lassale C., Batty G.D., Baghdadli A., Jacka F., Sánchez-Villegas A., Kivimäki M., Akbaraly T. Healthy dietary indices and risk of depressive outcomes: A systematic review and meta-analysis of observational studies. Mol. Psychiatry. 2018;24:965–986. doi: 10.1038/s41380-018-0237-8. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
11.
Molendijk M., Molero P., Ortuño Sánchez-Pedreño F., Van der Does W., Angel Martínez-González M. Diet quality and depression risk: A systematic review and dose-response meta-analysis of prospective studies. J. Affect. Disord. 2018;226:346–354. doi: 10.1016/j.jad.2017.09.022. [PubMed] [CrossRef] [Google Scholar]
12.
Wu P.-Y., Lin M.-Y., Tsai P.-S. Alternate healthy eating index and risk of depression: A meta-analysis and systemematic review. Nutr. Neurosci. 2020;23:101–109. doi: 10.1080/1028415X.2018.1477424. [PubMed] [CrossRef] [Google Scholar]
13.
Marx W., Lane M., Hockey M., Aslam H., Berk M., Walder K., Borsini A., Firth J., Pariante C.M., Berding K., et al. Diet and depression: Exploring the biological mechanisms of action. Mol. Psychiatry. 2021;26:134–150. doi: 10.1038/s41380-020-00925-x. [PubMed] [CrossRef] [Google Scholar]
16.
Lai J.S., Hiles S., Bisquera A., Hure A.J., McEvoy M., Attia J. A systematic review and meta-analysis of dietary patterns and depression in community-dwelling adults. Am. J. Clin. Nutr. 2014;99:181–197. doi: 10.3945/ajcn.113.069880. [PubMed] [CrossRef] [Google Scholar]
17.
Psaltopoulou T., Sergentanis T.N., Panagiotakos D.B., Sergentanis I.N., Kosti R., Scarmeas N. Mediterranean diet, stroke, cognitive impairment, and depression: A meta-analysis. Ann. Neurol. 2013;74:580–591. doi: 10.1002/ana.23944. [PubMed] [CrossRef] [Google Scholar]
18.
Firth J., Marx W., Dash S., Carney R., Teasdale S.B., Solmi M., Stubbs B., Schuch F.B., Carvalho A.F., Jacka F., et al. The Effects of Dietary Improvement on Symptoms of Depression and Anxiety: A Meta-Analysis of Randomized Controlled Trials. Psychosom. Med. 2019;81:265–280. doi: 10.1097/PSY.0000000000000673. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
19.
Page M.J., McKenzie J.E., Bossuyt P.M., Boutron I., Hoffmann T.C., Mulrow C.D., Shamseer L., Tetzlaff J.M., Akl E.A., Brennan S.E., et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. doi: 10.1136/bmj.n71. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
20.
Monteiro C.A., Moubarac J.C., Cannon G., Ng S.W., Popkin B. Ultra-processed products are becoming dominant in the global food system. Obes. Rev. 2013;14:21–28. doi: 10.1111/obr.12107. [PubMed] [CrossRef] [Google Scholar]
21.
Busch A.M., Whited M.C., Appelhans B.M., Schneider K.L., Waring M.E., DeBiasse M.A., Oleski J.L., Crawford S.L., Pagoto S.L. Reliable change in depression during behavioral weight loss treatment among women with major depression. Obesity. 2013;21:E211–E218. doi: 10.1002/oby.20113. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
22.
Snaith P. What Do Depression Rating Scales Measure? Br. J. Psychiatry. 1993;163:293–298. doi: 10.1192/bjp.163.3.293. [PubMed] [CrossRef] [Google Scholar]
23.
Nezu A.M., Ronan G.F., Meadows E.A. Practitioner’s Guide to Empirically Based Measures of Depression. 2000th ed. Kluwer Academic/Plenum Publishers; New York, NY, USA: 2000. Measures of depression, depressive symptomatology, and depressive mood. Chapter 4. [Google Scholar]
24.
Giglio M.G., Huttenhower C., Gevers D., Petrosino J.F., Lobos E.A., Madupu R., Mitreva M., Versalovic J., Wollam A.M., Abolude O.O., et al. A framework for human microbiome research. Nature. 2012;486:215–221. doi: 10.1038/nature11209. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
25.
Crutzen R. Adding effect sizes to a systematic review on interventions for promoting physical activity among European teenagers. Int. J. Behav. Nutr. Phys. Act. 2010;7:29. doi: 10.1186/1479-5868-7-29. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
26.
Assaf A.R.P., Beresford S.A.A.P., Risica P.M.D.R.D., Aragaki A., Brunner R.L.P., Bowen D.J.P., Naughton M.P., Rosal M.C.P., Snetselaar L.P., Wenger N.M.D. Low-Fat Dietary Pattern Intervention and Health-Related Quality of Life: The Women’s Health Initiative Randomized Controlled Dietary Modification Trial. J. Acad. Nutr. Diet. 2016;116:259–271. doi: 10.1016/j.jand.2015.07.016. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
27.
Francis H.M., Stevenson R.J., Chambers J.R., Gupta D., Newey B., Lim C.K. A brief diet intervention can reduce symptoms of depression in young adults – A randomised controlled trial. PLoS ONE. 2019;14:e0222768. doi: 10.1371/journal.pone.0222768. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
28.
Jacka F.N., O’Neil A., Opie R., Itsiopoulos C., Cotton S., Mohebbi M., Castle D., Dash S., Mihalopoulos C., Chatterton M.L., et al. A randomised controlled trial of dietary improvement for adults with major depression (the ‘SMILES’ trial) BMC Med. 2017;15:23. doi: 10.1186/s12916-017-0791-y. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
29.
Kontogianni M.D., Vijayakumar A., Rooney C., Noad R.L., Appleton K.M., McCarthy D., Donnelly M., Young I.S., McKinley M.C., McKeown P.P., et al. A High Polyphenol Diet Improves Psychological Well-Being: The Polyphenol Intervention Trial (PPhIT) Nutrients. 2020;12:2445. doi: 10.3390/nu12082445. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
30.
Lindseth G., Helland B., Caspers J. The Effects of Dietary Tryptophan on Affective Disorders. Arch. Psychiatr. Nurs. 2015;29:102–107. doi: 10.1016/j.apnu.2014.11.008. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
31.
McMillan L., Owen L., Kras M., Scholey A. Behavioural effects of a 10-day Mediterranean diet. Results from a pilot study evaluating mood and cognitive performance. Appetite. 2011;56:143–147. doi: 10.1016/j.appet.2010.11.149. [PubMed] [CrossRef] [Google Scholar]
32.
Park M., Choi J., Lee H.-J. Flavonoid-Rich Orange Juice Intake and Altered Gut Microbiome in Young Adults with Depressive Symptom: A Randomized Controlled Study. Nutrients. 2020;12:1815. doi: 10.3390/nu12061815. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
33.
Jacka F.N., Kremer P.J., Berk M., de Silva-Sanigorski A.M., Moodie M., Leslie E.R., Pasco J.A., Swinburn B.A. A Prospective Study of Diet Quality and Mental Health in Adolescents. PLoS ONE. 2011;6:e24805. doi: 10.1371/journal.pone.0024805. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
34.
Cezary C., Tomasz P., Jan C., Michał F., Paulina K., Janusz B. Tryptophan Intake and Metabolism in Older Adults with Mood Disorders. Nutrients. 2020;12:3183. doi: 10.3390/nu12103183. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
35.
Bayes J., Schloss J., Sibbritt D. Effects of Polyphenols in a Mediterranean Diet on Symptoms of Depression: A Systematic Literature Review. Adv. Nutr. 2020;11:602–615. doi: 10.1093/advances/nmz117. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
36.
Godos J., Castellano S., Ray S., Grosso G., Galvano F. Dietary Polyphenol Intake and Depression: Results from the Mediterranean Healthy Eating, Lifestyle and Aging (MEAL) Study. Molecules. 2018;23:999. doi: 10.3390/molecules23050999. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
37.
Tiwari U., Cummins E. Factors influencing levels of phytochemicals in selected fruit and vegetables during pre- and post-harvest food processing operations. Food Res. Int. 2013;50:497–506. doi: 10.1016/j.foodres.2011.09.007. [CrossRef] [Google Scholar]
38.
Hoffman R., Gerber M. The Mediterranean Diet: Health and Science. 1st ed. Wiley-Blackwell; Chichester, UK: 2012. Constituents and physiological effects of Mediterranean plant foods. Chapter 2. [Google Scholar]
39.
Saffel-Shrier S., Johnson M.A., Francis S.L. Position of the Academy of Nutrition and Dietetics and the Society for Nutrition Education and Behavior: Food and Nutrition Programs for Community-Residing Older Adults. J. Acad. Nutr. Diet. 2019;119:1188–1204. doi: 10.1016/j.jand.2019.03.011. [PubMed] [CrossRef] [Google Scholar]
40.
Holmes A.L., Sanderson B., Maisiak R., Brown A., Bittner V. Dietitian Services Are Associated with Improved Patient Outcomes and the MEDFICTS Dietary Assessment Questionnaire Is a Suitable Outcome Measure in Cardiac Rehabilitation. J. Am. Diet. Assoc. 2005;105:1533–1540. doi: 10.1016/j.jada.2005.08.001. [PubMed] [CrossRef] [Google Scholar]
41.
Sánchez-Villegas A., Henríquez-Sánchez P., Ruiz-Canela M., Lahortiga F., Molero P., Toledo E., Martínez-González M.A. A longitudinal analysis of diet quality scores and the risk of incident depression in the SUN Project. BMC Med. 2015;13:197. doi: 10.1186/s12916-015-0428-y. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
42.
Trabulsi J., Schoeller D.A. Evaluation of dietary assessment instruments against doubly labeled water, a biomarker of habitual energy intake. Am. J. Physiol. Endocrinol. Metab. 2001;281:E891–E899. doi: 10.1152/ajpendo.2001.281.5.E891. [PubMed] [CrossRef] [Google Scholar]
43.
Barnaba L., Intorre F., Azzini E., Ciarapica D., Venneria E., Foddai M.S., Maiani F., Raguzzini A., Polito A. Evaluation of adherence to Mediterranean diet and association with clinical and biological markers in an Italian population. Nutrition. 2020;77:110813. doi: 10.1016/j.nut.2020.110813. [PubMed] [CrossRef] [Google Scholar]
44.
McMartin S.E., Jacka F.N., Colman I. The association between fruit and vegetable consumption and mental health disorders: Evidence from five waves of a national survey of Canadians. Prev. Med. 2013;56:225–230. doi: 10.1016/j.ypmed.2012.12.016. [PubMed] [CrossRef] [Google Scholar]
45.
Santor D.A., Gregus M., Welch A. FOCUS ARTICLE: Eight Decades of Measurement in Depression. Measurement. 2006;4:135–155. doi: 10.1207/s15366359mea0403_1. [CrossRef] [Google Scholar]
46.
Fried E.I., Nesse R.M. Depression sum-scores don’t add up: Why analyzing specific depression symptoms is essential. BMC Med. 2015;13:72. doi: 10.1186/s12916-015-0325-4. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
47.
Fried E.I., Nesse R.M., Zivin K., Guille C., Sen S. Depression is more than the sum score of its parts: Individual DSM symptoms have different risk factors. Psychol. Med. 2014;44:2067–2076. doi: 10.1017/S0033291713002900. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
48.
Antony M.M., Barlow D.H. Handbook of Assessment and Treatment Planning for Psychological Disorders. 2nd ed. Guilford Publications; New York, NY, USA: 2010. [Google Scholar]
49.
Salk R.H., Hyde J.S., Abramson L.Y. Gender Differences in Depression in Representative National Samples: Meta-Analyses of Diagnoses and Symptoms. Psychol. Bull. 2017;143:783–822. doi: 10.1037/bul0000102. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
50.
Akincigil A., Olfson M., Siegel M., Zurlo K.A., Walkup J.T., Crystal S. Racial and Ethnic Disparities in Depression Care in Community-Dwelling Elderly in the United States. Am. J. Public Health. 2012;102:319–328. doi: 10.2105/AJPH.2011.300349. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
51.
Schuch F.B., Vancampfort D., Firth J., Rosenbaum S., Ward P.B., Silva E.S., Hallgren M., Ponce De Leon A., Dunn A.L., Deslandes A.C., et al. Physical Activity and Incident Depression: A Meta-Analysis of Prospective Cohort Studies. Am. J. Psychiatry. 2018;175:631–648. doi: 10.1176/appi.ajp.2018.17111194. [PubMed] [CrossRef] [Google Scholar]
52.
Robinson R.L., Grabner M., Palli S.R., Faries D., Stephenson J.J. Covariates of depression and high utilizers of healthcare: Impact on resource use and costs. J. Psychosom. Res. 2016;85:35–43. doi: 10.1016/j.jpsychores.2016.04.002. [PubMed] [CrossRef] [Google Scholar]
53.
Munafò M.R., Araya R. Cigarette smoking and depression: A question of causation. Br. J. Psychiatry. 2018;196:425–426. doi: 10.1192/bjp.bp.109.074880. [PubMed] [CrossRef] [Google Scholar]
54.
Staudacher H.M., Irving P.M., Lomer M.C.E., Whelan K. The challenges of control groups, placebos and blinding in clinical trials of dietary interventions. Proc. Nutr. Soc. 2017;76:203–212. doi: 10.1017/S0029665117000350. [PubMed] [CrossRef] [Google Scholar]
55.
Cumming G. The New Statistics: Why and How. Psychol. Sci. 2014;25:7–29. doi: 10.1177/0956797613504966. [PubMed] [CrossRef] [Google Scholar]
56.
Vasishth S., Mertzen D., Jäger L.A., Gelman A. The statistical significance filter leads to overoptimistic expectations of replicability. J. Mem. Lang. 2018;103:151–175. doi: 10.1016/j.jml.2018.07.004. [CrossRef] [Google Scholar]
57.
van der Pols J.C. Nutrition and mental health: Bidirectional associations and multidimensional measures. Public Health Nutr. 2018;21:829–830. doi: 10.1017/S1368980017003974. [PubMed] [CrossRef] [Google Scholar]
58.
McDowell I. Measuring Health: A Guide to Rating Scales and Questionnaires. 3rd ed. Oxford University Press; New York, NY, USA: 2006. [Google Scholar]
Plaats een reactie ...
Reageer op "Dieet met veelal onbewerkt voedsel met verse producten en volkoren granen, magere zuivel en magere eiwitbronnen blijkt depressiviteit te kunnen voorkomen."