Depression and Diets: The Interconnected Relationship Between Lifestyle and Depression Status-An Updated Review
Abstract
Background: Depression is a widespread and debilitating mental health condition affecting millions globally. Despite the availability of first-line antidepressant treatments, a significant portion of individuals with major depressive disorder (MDD) fails to respond to conventional therapies. Additionally, lifestyle factors such as stress, sleep patterns, exercise, and diet play a critical role in the development and progression of depression. While stressful life events are common triggers, individual resilience influenced by lifestyle choices is a key area for intervention.
Aim: This review aims to explore the interconnected relationship between lifestyle factors—specifically diet—and depression. By analyzing existing research on dietary patterns and their association with depressive symptoms, the review seeks to understand how dietary interventions might serve as alternative or complementary treatments for depression.
Methods: The review synthesizes evidence from various studies, including original research and meta-analytic investigations, focusing on the links between diet, obesity, metabolic syndrome, and depression. Studies covering meal timing, nutrient deficiencies, and dietary patterns such as the Mediterranean diet were also examined for their impact on depression.
Results: Research highlights that poor dietary habits, including excessive caloric intake and the consumption of ultra-processed foods, are associated with an increased risk of depression. Diets rich in omega-3 fatty acids, vegetables, and fruits, such as the Mediterranean diet, show protective effects against depression. Furthermore, meal timing, such as skipping breakfast or late eating patterns, also correlates with higher depressive symptoms. Additionally, interventions targeting obesity and metabolic disorders, such as calorie restriction or bariatric surgery, have shown improvements in both physical health and depressive symptoms.
Conclusion: Lifestyle modifications, particularly diet, play a crucial role in the prevention and management of depression. The evidence supports the implementation of nutritional interventions, including adopting healthier eating patterns, reducing the intake of ultra-processed foods, and maintaining balanced meal timings, to alleviate depressive symptoms and improve overall well-being.
Full text article
References
1 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th edn. American Psychiatric Association, Arlington, 2013.
2Ferrari AJ, Charlson FJ, Norman RE et al. Burden of depressive disorders by country, sex, age, and year: Findings from the global burden of disease study 2010. PLoS Med. 2013; 10: e1001547.
3Rush AJ, Trivedi MH, Wisniewski SR et al. Bupropion-SR, sertraline, or venlafaxine-XR after failure of SSRIs for depression. N. Engl. J. Med. 2006; 354: 1231–1242.
4Rush AJ, Thase ME. Improving depression outcome by patient-centered medical management. Am. J. Psychiatry 2018; 175: 1187–1198.
5Munce SE, Weller I, Robertson Blackmore EK et al. The role of work stress as a moderating variable in the chronic pain and depression association. J. Psychosom. Res. 2006; 61: 653–660.
6Vrshek-Schallhorn S, Stroud CB, Mineka S et al. Chronic and episodic interpersonal stress as statistically unique predictors of depression in two samples of emerging adults. J. Abnorm. Psychol. 2015; 124: 918–932.
7Pemberton R, Fuller Tyszkiewicz MD. Factors contributing to depressive mood states in everyday life: A systematic review. J. Affect. Disord. 2016; 200: 103–110.
8Wu G, Feder A, Cohen H et al. Understanding resilience. Front Behav. Neurosci. 2013; 7: 10.
9Wang X, Arafa A, Liu K, Eshak ES, Hu Y, Dong JY. Combined healthy lifestyle and depressive symptoms: A meta-analysis of observational studies. J. Affect. Disord. 2021; 289: 144–150.
10Molendijk 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.
11Milaneschi Y, Simmons WK, van Rossum EFC, Penninx BW. Depression and obesity: Evidence of shared biological mechanisms. Mol. Psychiatry 2019; 24: 18–33.
12Milano W, Ambrosio P, Carizzone F et al. Depression and obesity: Analysis of common biomarkers. Diseases 2020; 8: 23.
13Luppino FS, de Wit LM, Bouvy PF et al. Overweight, obesity, and depression: A systematic review and meta-analysis of longitudinal studies. Arch. Gen. Psychiatry 2010; 67: 220–229.
14Mannan M, Mamun A, Doi S, Clavarino A. Is there a bidirectional relationship between depression and obesity among adult men and women? Systematic review and bias-adjusted meta analysis. Asian J. Psychiatr. 2016; 21: 51–66.
15Toups MS, Myers AK, Wisniewski SR et al. Relationship between obesity and depression: Characteristics and treatment outcomes with antidepressant medication. Psychosom. Med. 2013; 75: 863–872.
16Hidese S, Ota M, Matsuo J et al. Association of obesity with cognitive function and brain structure in patients with major depressive disorder. J. Affect. Disord. 2018; 225: 188–194.
17Yim CY, Soczynska JK, Kennedy SH, Woldeyohannes HO, Brietzke E, McIntyre RS. The effect of overweight/obesity on cognitive function in euthymic individuals with bipolar disorder. Eur. Psychiatry 2012; 27: 223–228.
18Ali S, Stone MA, Peters JL, Davies MJ, Khunti K. The prevalence of co-morbid depression in adults with type 2 diabetes: A systematic review and meta-analysis. Diabet. Med. 2006; 23: 1165–1173.
19Yoshida S, Hirai M, Suzuki S, Awata S, Oka Y. Neuropathy is associated with depression independently of health-related quality of life in Japanese patients with diabetes. Psychiatry Clin. Neurosci. 2009; 63: 65–72.
20Graham EA, Deschênes SS, Khalil MN, Danna S, Filion KB, Schmitz N. Measures of depression and risk of type 2 diabetes: A systematic review and meta-analysis. J. Affect. Disord. 2020; 265: 224–232.
21Beran M, Muzambi R, Geraets A et al. The bidirectional longitudinal association between depressive symptoms and HbA1c: A systematic review and meta-analysis. Diabet. Med. 2022; 39: e14671.
22Kawakami N, Takatsuka N, Shimizu H, Ishibashi H. Depressive symptoms and occurrence of type 2 diabetes among Japanese men. Diabetes Care 1999; 22: 1071–1076.
23Pan A, Keum N, Okereke OI et al. Bidirectional association between depression and metabolic syndrome: A systematic review and meta-analysis of epidemiological studies. Diabetes Care 2012; 35: 1171–1180.
24Wilson JE, Blizzard L, Gall SL et al. An eating pattern characterised by skipped or delayed breakfast is associated with mood disorders among an Australian adult cohort. Psychol. Med. 2020; 50: 2711–2721.
25Hidese S, Asano S, Saito K, Sasayama D, Kunugi H. Association of depression with body mass index classification, metabolic disease, and lifestyle: A web-based survey involving 11,876 Japanese people. J. Psychiatr. Res. 2018; 102: 23–28.
26Kito K, Kuriyama A, Takahashi Y, Nakayama T. Impacts of skipping breakfast and late dinner on the incidence of being overweight: A 3-year retrospective cohort study of men aged 20–49 years. J. Hum. Nutr. Diet. 2019; 32: 349–355.
27Okada C, Imano H, Muraki I, Yamada K, Iso H. The association of having a late dinner or bedtime snack and skipping breakfast with overweight in Japanese women. J. Obes. 2019; 2019: 2439571–2439575.
28Takebe N, Tanno K, Ohmomo H et al. Weight gain after 20 years of age is associated with unfavorable lifestyle and increased prevalence of metabolic disorders. Diabetes Metab. Syndr. Obes. 2021; 14: 2065–2075.
29Ma X, Chen Q, Pu Y et al. Skipping breakfast is associated with overweight and obesity: A systematic review and meta-analysis. Obes. Res. Clin. Pract. 2020; 14: 1–8.
30Zahedi H, Djalalinia S, Sadeghi O et al. Breakfast consumption and mental health: A systematic review and meta-analysis of observational studies. Nutr. Neurosci. 2022; 25: 1250–1264.
31Zeng L, Li HR, Liu MW, Rao WM, He QQ. Effects of intermittent fasting on cardiometabolic risk factors in patients with metabolic syndrome: A systematic review and meta-analysis of randomized controlled trials. Asia Pac. J. Clin. Nutr. 2022; 31: 642–659.
32Fernández-Rodríguez R, Martínez-Vizcaíno V, Mesas AE, Notario-Pacheco B, Medrano M, Heilbronn LK. Does intermittent fasting impact mental disorders? A systematic review with meta-analysis. Crit. Rev. Food Sci. Nutr. 2022. https://doi.org/10.1080/10408398.2022.2088687
33Ali AM, Kunugi H. Intermittent fasting, dietary modifications, and exercise for the control of gestational diabetes and maternal mood dysregulation: A review and a case report. Int. J. Environ. Res. Public Health 2020; 17: 9379.
34Berthelot E, Etchecopar-Etchart D, Thellier D, Lancon C, Boyer L, Fond G. Fasting interventions for stress, anxiety and depressive symptoms: A systematic review and meta-analysis. Nutrients 2021; 13: 3947.
35Zhang Y, Liu C, Zhao Y, Zhang X, Li B, Cui R. The effects of calorie restriction in depression and potential mechanisms. Curr. Neuropharmacol. 2015; 13: 536–542.
36Manchishi SM, Cui RJ, Zou XH, Cheng ZQ, Li BJ. Effect of caloric restriction on depression. J. Cell. Mol. Med. 2018; 22: 2528–2535.
37Igwe O, Sone M, Matveychuk D, Baker GB, Dursun SM. A review of effects of calorie restriction and fasting with potential relevance to depression. Prog. Neuropsychopharmacol. Biol. Psychiatry 2021; 111: 110206.
38Gill H, Kang S, Lee Y et al. The long-term effect of bariatric surgery on depression and anxiety. J. Affect. Disord. 2019; 246: 886–894.
39Loh HH, Francis B, Lim LL, Lim QH, Yee A, Loh HS. Improvement in mood symptoms after post-bariatric surgery among people with obesity: A systematic review and meta-analysis. Diabetes Metab. Res. Rev. 2021; 37: e3458.
40Fu R, Zhang Y, Yu K, Mao D, Su H. Bariatric surgery alleviates depression in obese patients: A systematic review and meta-analysis. Obes. Res. Clin. Pract. 2022; 16: 10–16.
41Alyahya RA, Alnujaidi MA. Prevalence and outcomes of depression after bariatric surgery: A systematic review and meta-analysis. Cureus 2022; 14: e25651.
42McIntyre RS, Powell AM, Kaidanovich-Beilin O et al. The neuroprotective effects of GLP-1: Possible treatments for cognitive deficits in individuals with mood disorders. Behav. Brain Res. 2013; 237: 164–171.
43Nibber A, Singh H, Burnet P, Lennox B, Minichino A. Investigating the pro-cognitive and anti-depressant efficacy of metformin: A systematic review and meta-analysis of randomised controlled trials. J. Affect. Disord. 2022; 310: 52–59.
44Guo M, Mi J, Jiang QM et al. Metformin may produce antidepressant effects through improvement of cognitive function among depressed patients with diabetes mellitus. Clin. Exp. Pharmacol. Physiol. 2014; 41: 650–656.
45Kok JL, Williams A, Zhao L. Psychosocial interventions for people with diabetes and co-morbid depression. A systematic review. Int. J. Nurs. Stud. 2015; 52: 1625–1639.
46Serretti A, Mandelli L. Antidepressants and body weight: A comprehensive review and meta-analysis. J. Clin. Psychiatry 2010; 71: 1259–1272.
47Jha MK, Wakhlu S, Dronamraju N, Minhajuddin A, Greer TL, Trivedi MH. Validating pre-treatment body mass index as moderator of antidepressant treatment outcomes: Findings from CO-MED trial. J. Affect. Disord. 2018; 234: 34–37.
48Singh RB, Fedacko J, Fatima G, Magomedova A, Watanabe S, Elkilany G. Why and how the indo-Mediterranean diet may be superior to other diets: The role of antioxidants in the diet. Nutrients 2022; 14: 898.
49Lassale C, Batty GD, Baghdadli A et al. Healthy dietary indices and risk of depressive outcomes: A systematic review and meta-analysis of observational studies. Mol. Psychiatry 2019; 24: 965–986.
50Shivappa N, Steck SE, Hurley TG, Hussey JR, Hébert JR. Designing and developing a literature-derived, population-based dietary inflammatory index. Public Health Nutr. 2014; 17: 1689–1696.
51Juul F, Parekh N, Martinez-Steele E, Monteiro CA, Chang VW. Ultra-processed food consumption among US adults from 2001 to 2018. Am. J. Clin. Nutr. 2022; 115: 211–221.
52Bhutani S, van Dellen MR, Cooper JA. Longitudinal weight gain and related risk behaviors during the COVID-19 pandemic in adults in the US. Nutrients 2021; 13: 671.
53Mazloomi SN, Talebi S, Mehrabani S et al. The association of ultra-processed food consumption with adult mental health disorders: A systematic review and dose-response meta-analysis of 260,385 participants. Nutr. Neurosci. 2022. https://doi.org/10.1080/1028415X.2022.2110188
54Malmir H, Mahdavi FS, Ejtahed HS et al. Junk food consumption and psychological distress in children and adolescents: A systematic review and meta-analysis. Nutr. Neurosci. 2022. https://doi.org/10.1080/1028415X.2022.2094856
55Opie RS, Itsiopoulos C, Parletta N et al. Dietary recommendations for the prevention of depression. Nutr. Neurosci. 2017; 20: 161–171.
56Nanri A, Kimura Y, Matsushita Y et al. Dietary patterns and depressive symptoms among Japanese men and women. Eur. J. Clin. Nutr. 2010; 64: 832–839.
57Mozaffarian D, Wu JH. Omega-3 fatty acids and cardiovascular disease: Effects on risk factors, molecular pathways, and clinical events. J. Am. Coll. Cardiol. 2011; 58: 2047–2067.
58Li F, Liu X, Zhang D. Fish consumption and risk of depression: A meta-analysis. J. Epidemiol. Community Health 2016; 70: 299–304.
59Lin P-Y, Huang S-Y, Su K-P. A meta-analytic review of polyunsaturated fatty acid compositions in patients with depression. Biol. Psychiatry 2010; 68: 140–147.
60Sublette ME, Ellis SP, Geant AL, Mann JJ. Meta-analysis of the effects of eicosapentaenoic acid (EPA) in clinical trials in depression. J. Clin. Psychiatry 2011; 72: 1577–1584.
61Grosso G, Pajak A, Marventano S et al. Role of omega-3 fatty acids in the treatment of depressive disorders: A comprehensive meta-analysis of randomized clinical trials. PLoS One 2014; 9: e96905.
62Sarris J, Murphy J, Mischoulon D et al. Adjunctive nutraceuticals for depression: A systematic review and meta-analyses. Am. J. Psychiatry 2016; 173: 575–587.
63Liao Y, Xie B, Zhang H et al. Efficacy of omega-3 PUFAs in depression: A meta-analysis. Transl. Psychiatry 2019; 9: 190.
64Wolters M, von der Haar A, Baalmann AK, Wellbrock M, Heise TL, Rach S. Effects of n-3 polyunsaturated fatty acid supplementation in the prevention and treatment of depressive disorders-a systematic review and meta-analysis. Nutrients 2021; 13: 1070.
65Bloch MH, Hannestad J. Omega-3 fatty acids for the treatment of depression: Systematic review and meta-analysis. Mol. Psychiatry 2012; 17: 1272–1282.
66Guu TW, Mischoulon D, Sarris J et al. International Society for Nutritional Psychiatry Research Practice Guidelines for Omega-3 fatty acids in the treatment of major depressive disorder. Psychother. Psychosom. 2019; 88: 263–273.
67Freeman MP, Hibbeln JR, Wisner KL et al. Omega-3 fatty acids: Evidence basis for treatment and future research in psychiatry. J. Clin. Psychiatry 2006; 67: 1954–1967.
68Koga N, Ogura J, Yoshida F et al. Altered polyunsaturated fatty acid levels in relation to proinflammatory cytokines, fatty acid desaturase genotype, and diet in bipolar disorder. Transl. Psychiatry 2019; 9: 208.
69Aizawa E, Ota M, Ishida I et al. Eicosapentaenoic acid intake associated with reduced risk of posttraumatic stress disorder after the Great East Japan Earthquake and Tsunami. In: A Starcevic (ed.). Psychological Trauma. IntechOpen, London, 2019; 29–42.
70Kalinić D, Borovac Štefanović L, Jerončić A, Mimica N, Dodig G, Delaš I. Eicosapentaenoic acid in serum lipids could be inversely correlated with severity of clinical symptomatology in Croatian war veterans with posttraumatic stress disorder. Croat. Med. J. 2014; 55: 27–37.
71Bender A, Hagan KE, Kingston N. The association of folate and depression: A meta-analysis. J. Psychiatr. Res. 2017; 95: 9–18.
72Nanri A, Mizoue T, Matsushita Y et al. Serum folate and homocysteine and depressive symptoms among Japanese men and women. Eur. J. Clin. Nutr. 2010; 64: 289–296.
73Coppen A, Bailey J. Enhancement of the antidepressant action of fluoxetine by folic acid: A randomised, placebo controlled trial. J. Affect. Disord. 2000; 60: 121–130.
74Resler G, Lavie R, Campos J et al. Effect of folic acid combined with fluoxetine in patients with major depression on plasma homocysteine and vitamin B12, and serotonin levels in lymphocytes. Neuroimmunomodulation 2008; 15: 145–152.
75Bedson E, Bell D, Carr D et al. Folate Augmentation of Treatment-Evaluation for Depression (FolATED): Randomised trial and economic evaluation. Health Technol. Assess. 2014; 18: vii–159.
76Maruf AA, Poweleit EA, Brown LC, Strawn JR, Bousman CA. Systematic review and meta-analysis of L-Methylfolate augmentation in depressive disorders. Pharmacopsychiatry 2022; 55: 139–147.
77Duc HN, Oh H, Yoon IM, Kim MS. Association between levels of thiamine intake, diabetes, cardiovascular diseases and depression in Korea: A national cross-sectional study. J. Nutr. Sci. 2021; 10: e31.
78Melchionda D, Martino T, Carapelle E, Lalla A, Cologno D, Avolio C. Wernicke's encephalopathy following reduced food intake due to depressive disorders. Nutr. Neurosci. 2018; 21: 373–376.
79Holick MF. Vitamin D deficiency. N. Engl. J. Med. 2007;
Authors
Copyright (c) 2024 Mohammed Ahmed M Moafa, Mona Abolghith Umar Qdaimi, Reem Abdu Alqadri, Abdulmujib Ali Kaabi , Basmh Abdulaziz Alsulaiman, Waad Ali Hawsawi, Saleh Salem Abdullah Alazmi, Zainab Muhammed Ali Muharraq , Abdullah Suwailem Salem Alrashdi, Abada Awaji Y Hakami , Fahad Muzil O Al Harbi, Nasser Yahya Atran Alyami, Khaled Saad Alahmari

This work is licensed under a Creative Commons Attribution 4.0 International License.
