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Moderate- to Long-Term Effect of Dietary Interventions for Depression and Anxiety : A Systematic Review and
Eman Abukmail1, Neeraj Koloth Pradeep2, Samantha Ahmed1
1Institute for Evidence Based Healthcare and Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia (E.A., S.A., L.A.).
Background:
Dietary interventions are a potential alternative treatment of depression and anxiety.
Purpose:
To evaluate the effects of dietary interventions on depression and anxiety.
Data Sources:
PubMed, Cochrane CENTRAL, EMBASE, CINAHL, and PsycINFO searched from inception until 12 December 2024. Trial registries and forward and backward citation analysis done on 3 January 2025.
Study Selection:
Randomized controlled trials (RCTs) evaluated the effect of dietary advice with or without food provision compared with no specific dietary advice or active interventions for 3 months or longer on depression and/or anxiety.
Data Extraction:
Two authors independently screened articles, extracted data, and assessed risk of bias. Primary outcomes included depression and anxiety symptoms at 3 months or longer. Random-effects meta-analyses were done, and the certainty of evidence was assessed.
Data Synthesis:
Twenty-five RCTs were included. Compared with no specific dietary advice, depressive symptoms might be improved in adults with elevated cardiometabolic risk by dietary advice on calorie restriction (standardized mean difference [SMD], -0.23 [95% CI, -0.38 to -0.09]; low certainty). Low-fat diets may also have very small effects on depressive symptoms in adults with elevated cardiometabolic risk (SMD, -0.03 [CI, -0.04 to -0.01]; low certainty). Evidence on other diets, comparing diets with active comparisons, and on anxiety was limited by study limitations and clinical or methodological heterogeneity.
Limitation:
Limited studies did not allow for adequate exploration of heterogeneity.
Conclusion:
Calorie restrictions and low-fat diets might reduce depressive symptoms among adults with elevated cardiometabolic risk, but the differences were small and confidence in the findings was low. Evidence on other diets, comparisons to active interventions, and other outcomes is limited.
Primary Funding Source:
None. (PROSPERO: CRD42023485953).
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