Glycemic index, glycemic load, and depression: a systematic review and meta-analysis
Abstract
Background/objectives Although several studies have investigated the association between dietary Glycemic Index (GI), glycemic load (GL) and depression, results are inconsistent. This systematic review and meta-analysis was performed to summarize earlier evidence on the association between dietary GI, GL, and depression.Subjects/methods We searched in PubMed/Medline, ISI Web of Knowledge, Scopus, EMBASE, and Google Scholar to identify related articles published until April 2018. Publications that fulfilled the following criteria were included in the current study: (1) publications with participants aged ≥ 18 years; (2) studies that considered GI or GL as the exposure; (3) studies that considered depression as the main outcome or as one of the outcomes; and (4) publications in which odds ratios (ORs) or mean difference were reported as the effect size. Finally, 11 studies, including 6 cross-sectional studies, 2 cohort studies, and 3 clinical trials were considered for inclusion in the systematic review, and 5 cross-sectional studies, 2 cohort studies, and 2 clinical trials (out of 11 studies included in the systematic review) were included in the meta-analysis. The quality of cross-sectional and cohort studies examined by the Newcastle-Ottawa Scale (NOS) and the quality of clinical trials examined using Cochrane Collaboration Risk of Bias tool. We also assessed the quality of evidence with the GRADE system.Results Sample sizes of the included cross-sectional studies ranged from 140 to 87,618 participants, and in total 101,389 participants were included in 6 studies. In total, 85,500 participants were included in 2 cohort studies. Sample sizes of the included clinical trials ranged from 40 to 82 participants, and in total 164 participants were included in three studies. Combining seven effect sizes from five cross-sectional studies, no significant association was observed between dietary GI and odds of depression (OR: 1.01; 95% CI: 0.94, 1.08; I 2 = 80.2%; n = 5). We also failed to find any significant association between dietary GL and odds of depression (OR: 0.93; 95% CI: 0.84, 1.04; I 2 = 42%; n = 5). Combining two effects sizes from two cohort studies, there was a significant positive association between dietary GI and depression (HR: 1.13; 95% CI: 1.02, 1.25; I 2 = 86.1%, n = 2). In addition, combining two effect sizes from two clinical trials, we found a significant change in depression score after consumption of a high-GL diet (weighted mean difference (WMD): 0.66; 95% CI: 0.28, 1.04; I 2 = 0.0%, n = 2).Conclusions Summarizing earlier findings, we found no significant association between either dietary GI or GL and odds of depression in cross-sectional studies. However, a significant positive association was observed between dietary GI and depression in cohort studies. In addition, a significant effect of a high-GL diet consumption on risk of depression was seen in clinical trials.
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Dietary glycaemic index, legumes/pulses, and nuts/seeds/soy are not significantly associated with prospective risk of depression.
“No significant prospective associations with depression were found for dietary glycaemic index (n=2, HR=1.05, 95% CI: 0.76-1.44, I²=86.1%) 69 , legumes/pulses (n=4, OR=0.93, 95% C.I: 0.79-1.10, I²= 43.1%) 60 , or nuts/seeds/soy (n=2, OR=0.92, 95% C.I: 0.84-1.02, I²= 0.1%) 60 .”
From A meta-review of "lifestyle psychiatry": the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders (2020) · cites this paper as [69]
The hypothesis that repeated and rapid increases and decreases in blood glucose explain how consumption of refined carbohydrate could affect psychological state appears to be a good fit given the relatively fast effect of diets with a high glycaemic index or load on depressive symptoms observed in human studies.
“The hypothesis that repeated and rapid increases and decreases in blood glucose explain how consumption of refined carbohydrate could affect psychological state appears to be a good fit given the relatively fast effect of diets with a high glycaemic index or load on depressive symptoms observed in human studies.7”
From Food and mood: How do diet and nutrition affect mental wellbeing? (2020) · cites this paper as [7]
Experimental exposure to diets with a high glycaemic load in controlled settings increases depressive symptoms in healthy volunteers, with a moderately large effect.
“Clinical studies have also shown potential causal effects of refined carbohydrates on mood; experimental exposure to diets with a high glycaemic load in controlled settings increases depressive symptoms in healthy volunteers, with a moderately large effect.7”
From Food and mood: How do diet and nutrition affect mental wellbeing? (2020) · cites this paper as [7]
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Additional file 2 of The association between dietary insulin index and load with mental health
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Additional file 1 of The association between dietary insulin index and load with mental health
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Dietary protein, anxiety and psychological stress: A scoping review
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- Authors
- Salari-Moghaddam, A., Saneei, P., Larijani, B., & Esmaillzadeh, A.
- Affiliations
- Tehran University of Medical Sciences (IR)
- Isfahan University of Medical Sciences (IR)
- Endocrinology and Metabolism Clinical Sciences Institute (IR)
- Corresponding author
- Esmaillzadeh, Ahmad
- Venue
- European Journal of Clinical Nutrition
- Published
- 2018-07-27
- Volume
- 73
- Issue
- 3
- Pages
- 356-365
- ISSN
- 0954-3007 (ISSN-L)
- 1476-5640
- OpenAlex
- W2884956145
- Cited by
- 73
- References
- 34
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 14 · 2023: 13 · 2022: 16 · 2021: 5 · 2020: 11 · 2019: 4
- FWCI
- 0.91
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- European Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Nursing › Nutrition and Dietetics › Food composition and properties
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Consumer Attitudes and Food Labeling
- Keywords
- glycemic index, glycemic load, depression, depression risk, diet and mental health, carbohydrate intake, dietary fat, dietary protein, dietary fiber to protein ratio, dietary sodium, dietary calcium, dietary magnesium, potassium intake, dietary iron, dietary zinc, dietary copper, dietary selenium, vitamin C intake, vitamin D intake
- MeSH terms
- Glycemic Load, Depressive Disorder, Humans, Glycemic Index
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