Food & mood: a review of supplementary prebiotic and probiotic interventions in the treatment of anxiety and depression in adults
Open accessAbstract
BACKGROUND: A bidirectional relationship exists between the brain and the gastrointestinal tract. Foods containing bacteria that positively influence the gastrointestinal microbiome are termed, probiotics; compounds that promote the flourishing of these bacteria are termed, prebiotics. Whether microbiome influencing therapies could treat psychiatric conditions, including depression and anxiety, is an area of interest. Presently, no established consensus for such treatment exists. METHODS: This systematic review analyses databases and grey literature sites to investigate pre and/or probiotics as treatments for depression and/or anxiety disorders. Articles included are from within 15 years. Pre-determined inclusion exclusion criteria were applied, and articles were appraised for their quality using a modified-CASP checklist. This review focuses specifically on quantitative measures from patients with clinical diagnoses of depression and/or anxiety disorders. RESULTS: 7 studies were identified. All demonstrated significant improvements in one or more of the outcomes measuring the of effect taking pre/probiotics compared with no treatment/placebo, or when compared to baseline measurements. DISCUSSION: Our review suggests utilising pre/probiotic may be a potentially useful adjunctive treatment. Furthermore, patients with certain co-morbidities, such as IBS, might experience greater benefits from such treatments, given that pre/probiotic are useful treatments for other conditions that were not the primary focus of this discourse. Our results are limited by several factors: sample sizes (adequate, though not robust); short study durations, long-term effects and propensity for remission undetermined. CONCLUSION: Our results affirm that pre/probiotic therapy warrants further investigation. Efforts should aim to elucidate whether the perceived efficacy of pre/probiotic therapy in depression and/or anxiety disorders can be replicated in larger test populations, and whether such effects are maintained through continued treatment, or post cessation. Interventions should also be investigated in isolation, not combination, to ascertain where the observed effects are attributable to. Efforts to produce mechanistic explanations for such effect should be a priority.
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Recent meta-analyses and systematic reviews reported promising, although preliminary, evidence for the potential of probiotics to improve anxiety, depression, and subjective stress in human populations.
“Similarly, recent meta-analyses and systematic reviews reported promising, although preliminary, evidence for the potential of probiotics to improve anxiety, depression, and subjective stress in human populations (225-228).”
From Diet and the Microbiota–Gut–Brain Axis: Sowing the Seeds of Good Mental Health (2021) · cites this paper as [228]
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The Gut-Brain-Microbiome Connection: Can Probiotics Decrease Anxiety and Depression?
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“…2019; Reininghaus, Platzer, et al., 2020; Tran et al., 2019), one was a pilot study (Reininghaus, Platzer, et al., 2020), five were systematic reviews (Noonan et al., 2020; Pirbaglou et al., 2016; Smith et al., 2021; Tremblay et al., 2021; Vaghef-Mehrabany et al., 2020), one was a…”
BackgroundAsbjornsdottir, B., Miranda-Ribera, A., Fiorentino, M. R., Konno, T., Çetinbaş, M., Lan, J., Sadreyev, R. I., Gudmundsson, L. S., Gottfreðsson, M., Lauth, B., et al. (2022) · Biomedicines · doi:10.3390/biomedicines11010091 · Cited by 7 · see citing works
Llopis, I., Miguel, N. S., & Serrano, M. Á. (2025) · Applied Sciences · doi:10.3390/app15084564 · Cited by 8 · see citing works
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Porto, M. C. W., de Azevedo, P. O. D. S., Lourenço, F. R., Converti, A., Vitolo, M., & Oliveira, R. P. D. S. (2022) · Microorganisms · doi:10.3390/microorganisms10101898 · Cited by 4 · see citing works
“Three criteria are usually taken into account to classify a substance as a prebiotic: (i) resistance to gastrointestinal activities under acidic environment including hydrolysis by mammalian enzymes and nutritional absorption; (ii) serving as a carbon source for intestinal bacterial strains, and (iii) acting as a subs…”
BackgroundWu, F., Ding, L., Maloney, S. K., Blache, D., & Wang, M. (2024) · Journal of Integrative Agriculture · doi:10.1016/j.jia.2024.08.020 · Cited by 4 · see citing works
Nutrition is Associated with Violent and Criminal Behaviors
Asil, E., & Erkmen, E. (2025) · Current Nutrition Reports · doi:10.1007/s13668-025-00668-7 · Cited by 4 · see citing works
“Short-chain fatty acids trigger the secretion of cholecystokinin (CCK) and glucagon-like peptide-1 (GLP-1) from enteroendocrine cells in the gastrointestinal tract [27].”
Stefanaki, C., Mastorakos, G. P., & Chrousos, G. P. (2021) · The microbiomes of humans, animals, plants, and the environment · doi:10.1007/978-3-030-59642-2_7 · Cited by 4 · see citing works
Sterrett, J. D., Andersen, N. D., & Lowry, C. A. (2022) · Progress in inflammation research · doi:10.1007/978-3-030-91051-8_10 · Cited by 4 · see citing works
Ren, J., Lian, X.-Y., Ye, W.-Q., Wen, Y., Lu, C., & Cao, X. (2025) · Frontiers in Neuroscience · doi:10.3389/fnins.2025.1599818 · Cited by 3 · see citing works
Neuro-Gastro-Cannabinology: A Novel Paradigm for Regulating Mood and Digestive Health
Turco, F., Brugnatelli, V., & Abalo, R. (2023) · Medical Cannabis and Cannabinoids · doi:10.1159/000534007 · Cited by 3 · see citing works
Highly Palatable Foods Are Addictive
Wilcox, C. E., & Farrar, D. C. (2021) · Springer eBooks · doi:10.1007/978-3-030-83078-6_11 · Cited by 4 · see citing works
Blythe, J., Eden, T., Macaninch, E., Martyn, K., Ray, S., Patel, N. S. A., & Fernandes, K. (2022) · BMJ Nutrition Prevention & Health · doi:10.1136/bmjnph-2022-000513 · Cited by 3 · see citing works
Wang, Y., Chen, Y., Li, H., Sang, J., Chen, C., Xu, L., Zhang, W., Xiong, B., Jiang, R., Ren, X., et al. (2026) · Metabolic Brain Disease · doi:10.1007/s11011-026-01823-x · Cited by 2 · see citing works
Relación entre probióticos - postbióticos y sus principales efectos bioactivos
Bolívar-Jacobo, N. A., Reyes-Villagrana, R. A., & Chávez‐Martínez, A. (2021) · TECNOCIENCIA CHIHUAHUA · doi:10.54167/tecnociencia.v15i2.836 · Cited by 2 · see citing works
Food-gut microbiota interactions
Berding, K., Kaulmann, D., & Cryan, J. (2022) · Probiotics · doi:10.1016/b978-0-323-85170-1.00011-7 · Cited by 3 · see citing works
From observation to intervention: time to put ‘food and mood’ to the test
Bradfield, J., Buckner, L., Amati, F., Burridge, J., & Ray, S. (2021) · BMJ Nutrition Prevention & Health · doi:10.1136/bmjnph-2021-000301 · Cited by 1 · see citing works
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Giri, R., Singh, A., & Sharma, R. K. (2025) · Discover Life · doi:10.1007/s11084-025-09714-4 · Cited by 1 · see citing works
“Moreover, they could play a significant role when administered as probiotics in the treatment of psychological disorders such as depression and anxiety [10].”
Probiotic Bacteria in the Correction of Depression Symptoms, Their Active Genes and Proteins
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Editorial: Nutrition and lifestyle medicine for neurodevelopmental and psychiatric disorders
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Assistance of Gut Microbiota in Depression
Reji, R. T., Krishna, R., & Kumar, R. S. (2021) · Journal of Drug Delivery and Therapeutics · doi:10.22270/jddt.v11i6-s.5202
“Probiotics alone or combined with prebiotics may help in reduction of depression [69].”
BackgroundFood and mood: healthy eating for mental health with chronic kidney disease
Jackson, H. S. (2022) · Journal of Kidney Care · doi:10.12968/jokc.2022.7.4.172
Das Bauchgehirn: neuroanatomische Perspektiven für den Viszeralchirurgen
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Emotion & the autonomic nervous system
Norman, G. J., Faig, K. E., & Berntson, G. G. (2023) · Elsevier eBooks · doi:10.1016/b978-0-12-820480-1.00038-3
Food and mood: healthy eating for mental health with chronic kidney disease
Jackson, H. S. (2023) · Journal of Kidney Care · doi:10.12968/jokc.2023.8.sup6.s22
Lifestyle interventions for treatment-resistant depression
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The Role of Inflammation in the Brain: A Gut-Driven Phenomenon
Mahbub, N. U., Islam, M. M., & Hong, S. T. (2026) · Springer eBooks · doi:10.1007/978-981-95-7494-0_9
- Authors
- Noonan, S., Zaveri, M., Macaninch, E., & Martyn, K.
- Affiliations
- Brighton and Sussex Medical School (GB)
- Brighton, UK
- Brighton and Sussex University Hospitals NHS Trust (GB)
- University of Brighton (GB)
- Corresponding author
- Noonan, Sanjay
- Venue
- BMJ Nutrition, Prevention & Health
- Publisher
- BMJ
- Published
- 2020-07-06
- Volume
- 3
- Issue
- 2
- Pages
- 351-362
- ISSN
- 2516-5542 (ISSN-L)
- PMC
- PMC7841823
- OpenAlex
- W3039354549
- Cited by
- 67
- References
- 41
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 8 · 2023: 9 · 2022: 18 · 2021: 17 · 2020: 4
- FWCI
- 1.01
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMJ Nutrition Prevention & Health (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- University of Brighton Repository (University of Brighton) (publishedVersion, cc-by-nc)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Keywords
- probiotics, prebiotics, depression, anxiety disorders, gut microbiota, gut-brain axis, adjunctive therapy, irritable bowel syndrome, food and mood
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