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The impact of whole-of-diet interventions on depression and anxiety: a systematic review of randomised controlled trials

  • Rachelle S Opie (a1), Adrienne O’Neil (a2) (a3), Catherine Itsiopoulos (a1) and Felice N Jacka (a2) (a4)
Abstract
Objective

Non-pharmacological approaches to the treatment of depression and anxiety are of increasing importance, with emerging evidence supporting a role for lifestyle factors in the development of these disorders. Observational evidence supports a relationship between habitual diet quality and depression. Less is known about the causative effects of diet on mental health outcomes. Therefore a systematic review was undertaken of randomised controlled trials of dietary interventions that used depression and/or anxiety outcomes and sought to identify characteristics of programme success.

Design

A systematic search of the Cochrane, MEDLINE, EMBASE, CINAHL, PubMed and PyscInfo databases was conducted for articles published between April 1971 and May 2014.

Results

Of the 1274 articles identified, seventeen met eligibility criteria and were included. All reported depression outcomes and ten reported anxiety or total mood disturbance. Compared with a control condition, almost half (47 %) of the studies observed significant effects on depression scores in favour of the treatment group. The remaining studies reported a null effect. Effective dietary interventions were based on a single delivery mode, employed a dietitian and were less likely to recommend reducing red meat intake, select leaner meat products or follow a low-cholesterol diet.

Conclusions

Although there was a high level of heterogeneity, we found some evidence for dietary interventions improving depression outcomes. However, as only one trial specifically investigated the impact of a dietary intervention in individuals with clinical depression, appropriately powered trials that examine the effects of dietary improvement on mental health outcomes in those with clinical disorders are required.

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Corresponding author
* Corresponding author: Email rsopie@students.latrobe.edu.au
References
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1. Vos, T, Flaxman, AD, Naghavi, M et al. (2012) Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380, 21632196.
2. Bloom, DE, Cafiero, ET, Jane-Llopis, E et al. (2011) The Global Economic Burden of Non-communicable Diseases. Geneva: World Economic Forum.
3. Casacalenda, N, Perry, CJ & Looper, K (2002) Remission in major depressive disorder: a comparison of pharmacotherapy, psychotherapy, and control conditions. Am J Psychiatry 159, 13541360.
4. Sanhueza, C, Ryan, L & Foxcroft, DR (2013) Diet and the risk of unipolar depression in adults: systematic review of cohort studies. J Hum Nutr Diet 26, 5670.
5. Sanchez-Villegas, A & Martinez-Gonzalez, MA (2013) Diet, a new target to prevent depression? BMC Med 11, 3.
6. Akbaraly, TN, Brunner, EJ, Ferrie, JE et al. (2009) Dietary pattern and depressive symptoms in middle age. Br J Psychiatry 195, 408413.
7. Zazpe, I, Sanchez-Tainta, A, Estruch, R et al. (2008) A large randomized individual and group intervention conducted by registered dietitians increased adherence to Mediterranean-type diets: the PREDIMED Study. J Am Diet Assoc 108, 11341144.
8. Framson, C, Kristal, AR, Schenk, JM et al. (2009) Development and validation of the mindful eating questionnaire. J Am Diet Assoc 109, 14391444.
9. Moher, D, Liberati, A, Tetzlaff, J et al. (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement. PLoS Med 6, e1000097.
10. American Dietetic Association, Scientific Affairs & Research (2007) ADA Evidence Analysis Manual, Edition V. Chicago, IL: ADA.
11. Thieszen, CL, Merrill, RM, Aldana, SG et al. (2011) The Coronary Health Improvement Project (CHIP) for lowering weight and improving psychosocial health. Psychol Rep 109, 338352.
12. Scheier, MF, Helgeson, VS, Schulz, R et al. (2007) Moderators of interventions designed to enhance physical and psychological functioning among younger women with early-stage breast cancer. J Clin Oncol 25, 57105714.
13. Scheier, MF, Helgeson, VS, Schulz, R et al. (2005) Interventions to enhance physical and psychological functioning among younger women who are ending nonhormonal adjuvant treatment for early-stage breast cancer. J Clin Oncol 23, 42984311.
14. Merrill, RM, Taylor, P & Aldana, SG (2008) Coronary Health Improvement Project (CHIP) is associated with improved nutrient intake and decreased depression. Nutrition 24, 314321.
15. Garcia-Toro, M, Ibarra, O, Gili, M et al. (2012) Four hygienic–dietary recommendations as add-on treatment in depression: a randomized-controlled trial. J Affect Disord 140, 200203.
16. Endevelt, R, Lemberger, J, Bregman, J et al. (2011) Intensive dietary intervention by a dietitian as a case manager among community dwelling older adults: the EDIT study. J Nutr Health Aging 15, 624630.
17. Ghroubi, S, Elleuch, H, Chikh, T et al. (2009) Physical training combined with dietary measures in the treatment of adult obesity. A comparison of two protocols. Ann Phys Rehabil Med 52, 394413.
18. Andersen, BL, Farrar, WB, Golden-Kreutz, DM et al. (2004) Psychological, behavioral, and immune changes after a psychological intervention: a clinical trial. J Clin Oncol 22, 35703580.
19. Nieman, D, Custer, W, Butterworth, D et al. (2000) Psychological response to exercise training and/or energy restriction in obese women. J Psychosom Res 48, 2329.
20. Forster, SE, Powers, HJ, Foulds, GA et al. (2012) Improvement in nutritional status reduces the clinical impact of infections in older adults. J Am Geriatr Soc 60, 16451654.
21. Wardle, J, Rogers, P, Judd, P et al. (2000) Randomized trial of the effects of cholesterol-lowering dietary treatment on psychological function. Am J Med 108, 547553.
22. Hyyppa, MT, Kronholm, E, Virtanen, A et al. (2003) Does simvastatin affect mood and steroid hormone levels in hypercholesterolemic men? A randomized double-blind trial. Psychoneuroendocrinology 28, 181194.
23. McMillan, L, Owen, L, Kras, M et al. (2011) Behavioural effects of a 10-day Mediterranean diet. Results form a pilot study evaluating mood and cognitive performance. Appetite 56, 143147.
24. Imayama, I, Alfano, CM, Kong, A et al. (2011) Dietary weight loss and exercise interventions effects on quality of life in overweight/obese postmenopausal women: a randomized controlled trial. Int J Behav Nutr Phys Act 8, 118.
25. Jenkinson, CM, Doherty, M, Avery, AJ et al. (2009) Effects of dietary intervention and quadriceps strengthening exercises on pain and function in overweight people with knee pain: randomised controlled trial. BMJ 339, 606609.
26. Kiernan, M, King, A, Stefanick, M et al. (2001) Men gain additional psychological benefits by adding exercise to a weight-loss program. Obes Res 9, 770777.
27. Zigmond, AS & Snaith, RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67, 361370.
28. Glasgow, RE, Nutting, PA, Toobert, DJ et al. (2006) Effects of a brief computer-assisted diabetes self-management intervention on dietary, biological and quality-of-life outcomes. Chronic Illn 2, 2738.
29. Toobert, DJ, Glasgow, RE, Strycker, LA et al. (2007) Long-term effects of the Mediterranean lifestyle program: a randomized clinical trial for postmenopausal women with type 2 diabetes. Int J Behav Nutr Phys Act 4, 1.
30. Pinquart, M, Duberstein, PR & Lyness, JM (2006) Treatments for later-life depressive conditions: a meta-analytic comparison of pharmacotherapy and psychotherapy. Am J Psychiatry 163, 14931501.
31. Holmes, AL, Sanderson, B, Maisiak, R et al. (2005) 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 105, 15331540.
32. Jacka, FN, Pasco, JA, Williams, LJ et al. (2012) Red meat consumption and mood and anxiety disorders. Psychother Psychosom 81, 196198.
33. Engelberg, H (1992) Low serum cholesterol and suicide. Lancet 339, 727729.
34. National Health and Medical Research Council (2009) NHMRC levels of evidence and grades for recommendations for developers guidelines. http://www.nhmrc.gov.au/_files_nhmrc/file/guidelines/developers/nhmrc_levels_grades_evidence_120423.pdf (accessed November 2014).
35. Hoidrup, S, Andreasen, AH, Osler, M et al. (2002) Assessment of habitual energy and macronutrient intake in adults: comparison of a seven day food record with a dietary history interview. Eur J Clin Nutr 56, 105113.
36. Trabulsi, J & Schoeller, DA (2001) Evaluation of dietary assessment instruments against doubly labeled water, a biomarker of habitual energy intake. Am J Physiol Endocrinol Metab 281, E891E899.
37. Bach-Faig, A, Geleva, D, Carrasco, J et al. (2006) Evaluating associations between Mediterranean diet adherence indexes and biomarkers of diet and disease. Public Health Nutr 9, 11101117.
38. Einvik, G, Ekeberg, O, Lavik, JG et al. (2010) The influence of long-term awareness of hyperlipidemia and of 3 years of dietary counseling on depression, anxiety, and quality of life. J Psychosom Res 68, 567572.
39. Sofi, F, Cesari, F, Abbate, R et al. (2008) Adherence to Mediterranean diet and health status: meta-analysis. BMJ 337, a1344.
40. O’Neil, A, Berk, M, Itsiopoulos, C et al. (2013) A randomised, controlled trial of a dietary intervention for adults with major depression (the ‘SMILES’ trial): study protocol. BMC Psychiatry 13, 3744.
41. Jula, A, Marniemi, J, Huupponen, R et al. (2002) Effecs of diet and simvastatin on serum lipids, insulin, and antioxidants in hypercholesterolemic men: a randomized controlled trial. JAMA 287, 598605.
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