The Effects of Dietary Improvement on Symptoms of Depression and Anxiety: A Meta-Analysis of Randomized Controlled Trials - PubMed (original) (raw)
Meta-Analysis
The Effects of Dietary Improvement on Symptoms of Depression and Anxiety: A Meta-Analysis of Randomized Controlled Trials
Joseph Firth et al. Psychosom Med. 2019 Apr.
Erratum in
- The Effects of Dietary Improvement on Symptoms of Depression and Anxiety: A Meta-Analysis of Randomized Controlled Trials: Erratum.
[No authors listed] [No authors listed] Psychosom Med. 2020 Jun;82(5):536. doi: 10.1097/PSY.0000000000000807. Psychosom Med. 2020. PMID: 32310838 Free PMC article. No abstract available. - The Effects of Dietary Improvement on Symptoms of Depression and Anxiety: A Meta-Analysis of Randomized Controlled Trials: Second Erratum.
[No authors listed] [No authors listed] Psychosom Med. 2021 Feb-Mar 01;83(2):196. doi: 10.1097/PSY.0000000000000914. Psychosom Med. 2021. PMID: 33534436 No abstract available.
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.
Methods: Major electronic databases were searched through March 2018 for all randomized controlled trials of dietary interventions reporting changes in symptoms of depression and/or anxiety in clinical and nonclinical populations. Random-effects meta-analyses were conducted to determine effect sizes (Hedges' g with 95% confidence intervals [CI]) for dietary interventions compared with control conditions. Potential sources of heterogeneity were explored using subgroups and meta-regression analyses.
Results: Results: Sixteen eligible randomized controlled trials (published in English) with outcome data for 45,826 participants were included; the majority of which examined samples with nonclinical depression (n = 15 studies). Nonetheless, dietary interventions significantly reduced depressive symptoms (g = 0.162, 95% CI = 0.055 to 0.269, p = 0.003). Similar effects were observed among high-quality trials (g = 0.171, 95% C.I.=0.057 to 0.286, p=0.003) and when compared with both inactive (g = 0.114, 95% C.I.=0.008 to 0.219, p=0.035) and active controls (g = 0.224, 95% C.I.= 0.052 to 0.397, p = 0.011). No effect of dietary interventions was observed for anxiety (k = 11, n = 2270, g = 0.085, 95% C.I. = -0.031 to 0.202, p=0.151). 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.
Registration: PROSPERO Online Protocol: CRD42018091256.
Figures
FIGURE 1
Meta-analysis of the effects of dietary interventions on depressive symptoms. Box size represents study weighting. Diamond represents overall effect size and 95% CIs.
FIGURE 2
Meta-analysis showing differential effects of dietary interventions in male versus female samples, on (A) a symptoms of depression and (B) symptoms of anxiety. Box size represents study weighting. Diamond represents overall effect size and 95% CIs.
FIGURE 3
Meta-analysis of the effects of dietary interventions on symptoms of anxiety. Box size represents study weighting. Diamond represents overall effect size and 95% CIs.
Comment in
- Editorial Comment on Firth et al. (2019).
Kop WJ, Chapman BP. Kop WJ, et al. Psychosom Med. 2020 Jun;82(5):532-533. doi: 10.1097/PSY.0000000000000805. Psychosom Med. 2020. PMID: 32265373 Free PMC article. - Authors' Response.
Firth J, Marx W, Carney R, Teasdale SB, Solmi M, Stubbs B, Schuch FB, Carvalho AF, Jacka F, Sarris J. Firth J, et al. Psychosom Med. 2020 Jun;82(5):534-535. doi: 10.1097/PSY.0000000000000806. Psychosom Med. 2020. PMID: 32265374 No abstract available.
Similar articles
- Psychological and pharmacological interventions for posttraumatic stress disorder and comorbid mental health problems following complex traumatic events: Systematic review and component network meta-analysis.
Coventry PA, Meader N, Melton H, Temple M, Dale H, Wright K, Cloitre M, Karatzias T, Bisson J, Roberts NP, Brown JVE, Barbui C, Churchill R, Lovell K, McMillan D, Gilbody S. Coventry PA, et al. PLoS Med. 2020 Aug 19;17(8):e1003262. doi: 10.1371/journal.pmed.1003262. eCollection 2020 Aug. PLoS Med. 2020. PMID: 32813696 Free PMC article. - Behavioral and Pharmacotherapy Weight Loss Interventions to Prevent Obesity-Related Morbidity and Mortality in Adults: An Updated Systematic Review for the U.S. Preventive Services Task Force [Internet].
LeBlanc EL, Patnode CD, Webber EM, Redmond N, Rushkin M, O’Connor EA. LeBlanc EL, et al. Rockville (MD): Agency for Healthcare Research and Quality (US); 2018 Sep. Report No.: 18-05239-EF-1. Rockville (MD): Agency for Healthcare Research and Quality (US); 2018 Sep. Report No.: 18-05239-EF-1. PMID: 30354042 Free Books & Documents. Review. - Behavioral Counseling to Promote a Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults Without Known Cardiovascular Disease Risk Factors: Updated Systematic Review for the U.S. Preventive Services Task Force [Internet].
Patnode CD, Evans CV, Senger CA, Redmond N, Lin JS. Patnode CD, et al. Rockville (MD): Agency for Healthcare Research and Quality (US); 2017 Jul. Report No.: 15-05222-EF-1. Rockville (MD): Agency for Healthcare Research and Quality (US); 2017 Jul. Report No.: 15-05222-EF-1. PMID: 29364620 Free Books & Documents. Review. - The impact of whole-of-diet interventions on depression and anxiety: a systematic review of randomised controlled trials.
Opie RS, O'Neil A, Itsiopoulos C, Jacka FN. Opie RS, et al. Public Health Nutr. 2015 Aug;18(11):2074-93. doi: 10.1017/S1368980014002614. Epub 2014 Dec 3. Public Health Nutr. 2015. PMID: 25465596 Free PMC article. Review. - Telephone interventions for symptom management in adults with cancer.
Ream E, Hughes AE, Cox A, Skarparis K, Richardson A, Pedersen VH, Wiseman T, Forbes A, Bryant A. Ream E, et al. Cochrane Database Syst Rev. 2020 Jun 2;6(6):CD007568. doi: 10.1002/14651858.CD007568.pub2. Cochrane Database Syst Rev. 2020. PMID: 32483832 Free PMC article.
Cited by
- Clinical and cost-effectiveness of remote-delivered, online lifestyle therapy versus psychotherapy for reducing depression: results from the CALM non-inferiority, randomised trial.
O'Neil A, Perez J, Young LM, John T, Turner M, Saunders D, Mahoney S, Bryan M, Ashtree DN, Jacka FN, Bruscella C, Pilon M, Mohebbi M, Teychenne M, Rosenbaum S, Opie R, Hockey M, Peric L, De Araugo S, Banker K, Davids I, Tembo M, Davis JA, Lai J, Rocks T, O'Shea M, Mundell NL, McKeon G, Yucel M, Absetz P, Versace V, Manger S, Morgan M, Chapman A, Bennett C, Speight J, Berk M, Moylan S, Radovic L, Chatterton ML. O'Neil A, et al. Lancet Reg Health West Pac. 2024 Jul 31;49:101142. doi: 10.1016/j.lanwpc.2024.101142. eCollection 2024 Aug. Lancet Reg Health West Pac. 2024. PMID: 39381019 Free PMC article. - Gut-Brain Axis: Role of Microbiome, Metabolomics, Hormones, and Stress in Mental Health Disorders.
Verma A, Inslicht SS, Bhargava A. Verma A, et al. Cells. 2024 Aug 27;13(17):1436. doi: 10.3390/cells13171436. Cells. 2024. PMID: 39273008 Free PMC article. Review. - Probiotics and Fecal Microbiota Transplantation in Major Depression: Doxa or Episteme?
Evrensel A. Evrensel A. Adv Exp Med Biol. 2024;1456:67-83. doi: 10.1007/978-981-97-4402-2_4. Adv Exp Med Biol. 2024. PMID: 39261424 Review. - Testing the causal relationship of fat and sugar intake with depression and cortisol: a Mendelian Randomisation study.
Buczkowska M, Iob E. Buczkowska M, et al. Transl Psychiatry. 2024 Sep 10;14(1):368. doi: 10.1038/s41398-024-03089-2. Transl Psychiatry. 2024. PMID: 39256365 Free PMC article. - Score of fear of COVID-19 and physical activity level are related to the habitual consumption of dietary supplements.
Tavares da Silva W, Castelo PM, Pereira LJ, Pardi V, Murata RM, Andrade EF, Pereira AC. Tavares da Silva W, et al. PLoS One. 2024 Sep 6;19(9):e0307870. doi: 10.1371/journal.pone.0307870. eCollection 2024. PLoS One. 2024. PMID: 39241015 Free PMC article.
References
- Hawton K, Casañas I Comabella C, Haw C, Saunders K. Risk factors for suicide in individuals with depression: a systematic review. J Affect Disord 2013;147:17–28. - PubMed
- McCrone PR, Dhanasiri S, Patel A, Knapp M, Lawton-Smith S. Paying the price: the cost of mental health care in England to 2026. London, UK: King's Fund; 2008.
- Casacalenda N, Perry JC, Looper K. Remission in major depressive disorder: a comparison of pharmacotherapy, psychotherapy, and control conditions. Am J Psychiatry 2002;159:1354–60. - PubMed
- Johnson J, Weissman MM, Klerman GL. Service utilization and social morbidity associated with depressive symptoms in the community. JAMA 1992;267:1478–83. - PubMed