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Psychosom Med. 2019 Feb 5. doi: 10.1097/PSY.0000000000000673. [Epub ahead of print]

The effects of dietary improvement on symptoms of depression and anxiety: a meta-analysis of randomized controlled trials.

Firth J1,2, Marx W3, Dash S3,4, Carney R2,5, Teasdale SB6,7, Solmi M8,9, Stubbs B10,11, Schuch FB12,13, Carvalho AF14,15, Jacka F3,16,17, Sarris J1,18.

Author information

1
NICM Health Research Institute, Western Sydney University, Australia.
2
Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, UK.
3
Deakin University, Food & Mood Centre, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Australia.
4
Baker Heart and Diabetes Institute, Metabolic and Vascular Physiology, Australia.
5
Youth Mental Health Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK.
6
School of Psychiatry, Faculty of Medicine, UNSW Sydney, Australia.
7
Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, Australia.
8
University of Padua, Neurosciences Department, Padua, Italy.
9
Padua University Hospital, Psychiatry Unit, Padua, Italy.
10
Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, United Kingdom.
11
Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
12
Post Graduate Program in Health and Human Development, La Salle University, Canoas, Brazil.
13
Hospital de ClĂ­nicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
14
Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
15
Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.
16
Black Dog Institute, Sydney, Australia.
17
Murdoch Childrens Research Institute, Centre for Adolescent Health, Melbourne, Australia.
18
Department of Psychiatry, University of Melbourne, Professorial Unit, The Melbourne Clinic, Melbourne, Australia.

Abstract

OBJECTIVE:

Poor diet can be detrimental to mental health. However, the overall evidence for the effects of dietary interventions on mood and mental well-being has yet to be assessed. We conducted a systematic review and meta-analysis examining effects of dietary interventions on symptoms of depression and anxiety.

METHOD:

Major electronic databases were searched through March 2018 for all randomized controlled trials (RCTs) of dietary interventions reporting changes in symptoms of depression and/or anxiety in clinical and non-clinical populations. Random-effects meta-analyses were conducted to determine effect sizes (Hedges' g with 95% confidence intervals) for dietary interventions compared to control conditions. Potential sources of heterogeneity were explored using subgroups and meta-regression analyses.

RESULTS:

Sixteen eligible RCTs with outcome data for 45,826 participants were included; the majority of which examined samples with non-clinical depression (N=15 studies). Nonetheless, dietary interventions significantly reduced depressive symptoms (g=0.275, 95% C.I.=0.10-0.45, p=0.002). Similar effects were observed among high-quality trials (g=0.321, 95% C.I.=0.12-0.53, p=0.002), and when compared to both inactive (g=0.308, 95% C.I.=0.02-0.60, p=0.038) and active controls (g=0.174, 95% C.I.=0.01-0.34, p=0.035). No effect of dietary interventions was observed for anxiety (k=11, n=2,270, g=0.100, 95% C.I.=-0.04-0.24, p=0.148). Studies with female samples observed significantly greater benefits from dietary interventions, for symptoms of both depression and anxiety.

CONCLUSIONS:

Dietary interventions hold promise as a novel intervention for reducing symptoms of depression across the population. Future research is required to determine the specific components of dietary interventions that improve mental health, explore underlying mechanisms, and establish effective schemes for delivering these interventions in clinical and public health settings.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

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