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A brief diet intervention can reduce symptoms of depression in young adults—a randomised controlled trial

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Francis, Heather M., Stevenson, Richard J., Chambers, Jaime R., Gupta, Dolly, Newey, Brooklyn, Lim, Chai K.·2019·PLOS ONE
DOI 10.1371/journal.pone.0222768PMC PMC6784975
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Abstract

There is strong epidemiological evidence that poor diet is associated with depression. The reverse has also been shown, namely that eating a healthy diet rich in fruit, vegetables, fish and lean meat, is associated with reduced risk of depression. To date, only one randomised controlled trial (RCT) has been conducted with elevated depression symptoms being an inclusion criterion, with results showing that a diet intervention can reduce clinical levels of depression. No such RCTs have been performed in young adults. Young adults with elevated levels of depression symptoms and who habitually consume a poor diet were randomly allocated to a brief 3-week diet intervention (Diet Group) or a habitual diet control group (Control Group). The primary and secondary outcome measures assessed at baseline and after the intervention included symptoms of depression (Centre for Epidemiological Studies Depression Scale; CESD-R; and Depression Anxiety and Stress Scale- 21 depression subscale; DASS-21-D), current mood (Profile of Mood States), self-efficacy (New General Self-Efficacy Scale) and memory (Hopkins Verbal Learning Test). Diet compliance was measured via self-report questionnaires and spectrophotometry. One-hundred-and-one individuals were enrolled in the study and randomly assigned to the Diet Group or the Control Group. Upon completion of the study, there was complete data for 38 individuals in each group. There was good compliance with the diet intervention recommendations assessed using self-report and spectrophotometry. The Diet group had significantly lower self-reported depression symptoms than the Control Group on the CESD-R (p = 0.007, Cohen's d = 0.65) and DASS-21 depression subscale (p = 0.002, Cohen's d = 0.75) controlling for baseline scores on these scales. Reduced DASS-21 depression subscale scores were maintained on follow up phone call 3 months later (p = .009). These results are the first to show that young adults with elevated depression symptoms can engage in and adhere to a diet intervention, and that this can reduce symptoms of depression. The findings provide justification for future research into the duration of these benefits, the impacts of varying diet composition, and their biological basis.

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  • Several recent RCTs not captured in the meta-review have reported significant improvements in clinical depression from Mediterranean diet interventions, with moderately large positive effects.

    “several recent RCTs (not captured in our meta-review) have reported significant improvements in clinical depression from Mediterranean diet interventions, observing moderately large positive effects 102-104 .”

    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 [102]

    The Methods (Intervention; page unavailable) describe a diet designed to align with Mediterranean-style diets. The Results (Primary outcome: Depression symptoms; page unavailable) report a significant improvement versus habitual diet, with Cohen’s d = 0.65. However, participants were recruited for self-reported depressive symptoms, not a clinical diagnosis of depression, so the claim’s 'clinical depression' qualifier overstates what this trial established. (LLM, conf=0.88)

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  • While there is existing evidence from clinical interventions showing improvements in depression and anxiety symptoms following dietary manipulation, these studies have not, to date, collected gut microbiota data.

    “While there is existing evidence from clinical interventions showing improvements in depression and anxiety symptoms following dietary manipulation (199, 311, 326), these studies have not, to date, collected gut microbiota data.”

    From Diet and the Microbiota–Gut–Brain Axis: Sowing the Seeds of Good Mental Health (2021) · cites this paper as [326]

  • Several recent smaller trials in individuals with current depression observed moderately large improvements from interventions based on the Mediterranean diet.

    “On the other hand, several recent smaller trials in individuals with current depression observed moderately large improvements from interventions based on the Mediterranean diet.35 36 37”

    From Food and mood: How do diet and nutrition affect mental wellbeing? (2020) · cites this paper as [35]

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  1. [2]Lai JS, Hiles S, Hure AJ, McEvoy M, Attia J. Systematic Review and Meta-Analysis of Dietary Patterns and Depression: Observational Studies. Ann Nutr Metab. 2013; 63: 428-. 24196402
  2. [28]Wechsler D, Coalson D, Raiford S. WAIS-IV: Wechsler Adult Intelligence Scale, 4th edition San Antonio, TX: Pearson; 2008.
  3. [31]Moul DE, Pilkonis PA, Miewald JM, Carey TJ, Buysse DJ. Preliminary study of the test-retest reliability and concurrent validities of the Pittsburgh Insomnia Rating Scale (PIRS). Sleep. 2002; 25: A246– A7.

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Authors
Francis, H. M., Stevenson, R. J., Chambers, J. R., Gupta, D., Newey, B., & Lim, C. K.
Affiliations
Macquarie University (AU)
Corresponding author
Francis, Heather M.
ORCID
Venue
PLOS ONE
Publisher
Public Library of Science (PLoS)
Published
2019-10-09
Volume
14
Issue
10
Pages
e0222768
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0222768
PMC
PMC6784975
OpenAlex
W2980066052
Cited by
277
References
39
Citations by year
2026: 19 · 2025: 57 · 2024: 51 · 2023: 43 · 2022: 47 · 2021: 37 · 2020: 23
FWCI
24.63
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Figshare (submittedVersion, cc-by)
Funders
Society for Mental Health Research (Project Grant 2016)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
  • Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
Keywords
depression, dietary intervention, young adults, depressive symptoms, dietary adherence, mood, self-efficacy, memory, healthy eating
MeSH terms
Adult, Depression, Diet, Female, Follow-Up Studies, Health Planning Guidelines, Humans, Male, Patient Compliance, Outcome Assessment, Health Care, Young Adult, Intention to Treat Analysis

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