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A brief diet intervention can reduce symptoms of depression in young adults—a randomised controlled trial
Open accessAbstract
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 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]
Experimental — accuracy not yet measuredIn the citing paper
“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]
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“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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“Thus, weight and fat loss noted in this study could support mood improvement or reduction in depressive symptoms, especially for individuals with comorbid obesity, although we did not detect a signi fi cant association between weight loss and improvement in depression.”
Evolution, adaptation, and new applications of the FODMAP diet
O’Brien, L., Kasti, A. N., Halmos, E. P., Tuck, C. J., & Varney, J. E. (2024) · JGH Open · doi:10.1002/jgh3.13066 · Cited by 21
“53,54 Among the wide-ranging effects of this dietary pattern, numerous studies have highlighted the anti-in fl ammatory properties of the diet and shown that adherence alleviates symptoms of depression and anxiety 55 – 57 and leads to favorable changes in the gut microbiota.”
BackgroundOn the Importance of Mental Health in STEM
Pester, C. W., Noh, G. A., & Fu, A. (2023) · ACS Polymers Au · doi:10.1021/acspolymersau.2c00062 · Cited by 26
Sleep deprivation-induced shifts in gut microbiota: Implications for neurological disorders
Wankhede, N. L., Kale, M. B., Kyada, A., Rekha, M. M., Chaudhary, K., Naidu, K. S., Rahangdale, S. R., Shende, P. V., Taksande, B. G., Khalid, M., et al. (2024) · Neuroscience · doi:10.1016/j.neuroscience.2024.11.070 · Cited by 21
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Hu, W., Mao, H., Guan, S., Jin, J., & Xu, D. (2024) · ALPHA PSYCHIATRY · doi:10.5152/alphapsychiatry.2024.231336 · Cited by 20
Lugon, G., Hernáez, Á., Jacka, F. N., Marrugat, J., Ramos, R., Garre‐Olmo, J., Elosúa, R., & Lassale, C. M. (2024) · European Journal of Nutrition · doi:10.1007/s00394-024-03466-z · Cited by 19
Patalano, R., Luca, V. D., Vogt, J., Birov, S., Giovannelli, L., Carruba, G., Pivonello, C., Stroetmann, V. N., Triassi, M., Colao, A., et al. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18020579 · Cited by 19
“Surprisingly, some interesting data have demonstrated that symptoms of depression, anxiety, and stress started to drop significantly after adopting a Mediterranean lifestyle for three weeks [45], or participants stated they felt better emotionally and physically after participating in dietary counseling sessions that…”
BackgroundRaufu, I. A., Ahmed, A. O., Aremu, A., Ameh, J. A., Timme, R., Hendriksen, R. S., & Ambali, A. G. (2021) · International Journal of Food Microbiology · doi:10.1016/j.ijfoodmicro.2021.109245 · Cited by 20
Lee, M. F., Bradbury, J., Yoxall, J., & Sargeant, S. J. E. (2022) · British Journal Of Nutrition · doi:10.1017/s0007114522002410 · Cited by 19
Lee, M. F., Bradbury, J., Yoxall, J., & Sargeant, S. J. E. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20021476 · Cited by 19
A Possible Antidepressive Effect of Dietary Interventions: Emergent Findings and Research Challenges
Ceolin, G., Breda, V., Koning, E., Chinna‐Meyyappan, A., Gomes, F. A., Moreira, J. D., Gerchman, F., & Brietzke, E. M. (2022) · Current Treatment Options in Psychiatry · doi:10.1007/s40501-022-00259-1 · Cited by 21
Chen, T., Chen, C., Fang, C., Cheng, Y., & Lin, K. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.09.109 · Cited by 18
Diet and depression: future needs to unlock the potential
Marx, W., Lane, M. M., Hockey, M., Aslam, H., Walder, K. R., Borsini, A., Firth, J., Pariante, C. M., Berding, K., Cryan, J. F., et al. (2021) · Molecular Psychiatry · doi:10.1038/s41380-021-01360-2 · Cited by 18
The Gut Microbiome in Anxiety Disorders
Butler, M., Kittel‐Schneider, S., Wagner‐Skacel, J., Mörkl, S., & Clarke, G. A. (2025) · Current Psychiatry Reports · doi:10.1007/s11920-025-01604-w · Cited by 21
“Several subsequent clinical trials, also in Australia, demonstrated similar findings in depressed patients [77–79].”
Lee, M. F., Bradbury, J., Yoxall, J., & Sargeant, S. J. E. (2023) · British Journal of Health Psychology · doi:10.1111/bjhp.12656 · Cited by 18
Antenatal Depression and its Associated Factors: Findings from Kuwait Birth Cohort Study
Al‐Sabah, R., Al‐Taiar, A., Ziyab, A. H., Akhtar, S., & Hammoud, M. S. (2024) · Journal of Epidemiology and Global Health · doi:10.1007/s44197-024-00223-7 · Cited by 22
“Also, a brief intervention with diet that includes fruits and vegetable has been shown to reduce depressive symptoms in adults [74 ].”
BackgroundImmunological Interfaces: The COVID-19 Pandemic and Depression
Perlmutter, A. (2021) · Frontiers in Neurology · doi:10.3389/fneur.2021.657004 · Cited by 18
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“, a healthy diet) showed significantly reduced symptoms of depression compared with the habitual diet control group [48].”
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“Finally, a three-week controlled trial in young adults with a total of 76 participants, found similar results than previous studies [14].”
Reducing whale-ship collisions by better estimating damages to ships
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Young, C., Mohebbi, M., Staudacher, H. M., Berk, M., Jacka, F. N., & O'Neil, A. E. (2021) · International Review of Psychiatry · doi:10.1080/09540261.2020.1854193 · Cited by 16
“(Lassale et al., 2019) These extensive data are now supported by three randomized controlled trials of people with depression (Francis et al., 2019; Jacka et al., 2017; Parletta et al., 2019); showing that improving diet quality through a Mediterranean diet can improve depressive symptoms.”
BackgroundRizzo, G., Baroni, L., Bonetto, C., Visaggi, P., Orazzini, M., Solinas, I., Guidi, G., Pugliese, J., Scaramuzza, G., Ovidi, F., et al. (2023) · Nutrients · doi:10.3390/nu15224725 · Cited by 17
“Accordingly, some randomized control trials described an improvement in depression-related symptom scores when subjects changed from an unhealthy diet (Western) to a healthy diet based on plant foods [63,67,68].”
Logan, A. C., D’Adamo, C. R., Pizzorno, J. E., & Prescott, S. L. (2023) · EXPLORE · doi:10.1016/j.explore.2023.12.014 · Cited by 20
Young, C., Mohebbi, M., Staudacher, H. M., KAY‐LAMBKIN, F. J., Berk, M., Jacka, F. N., & O'Neil, A. E. (2021) · JMIR Mental Health · doi:10.2196/24871 · Cited by 14
“This evidence is now supported by intervention studies [10-12] showing that intervening to improve diet quality can improve depressive symptoms.”
Brandley, E. T., Kirkland, A. E., Baron, M. I., Baraniuk, J. N., & Holton, K. F. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.926688 · Cited by 15
“Another group conducted an RCT and analyzed data from the intervention group consuming a Mediterranean-style diet and identified reduced consumption of processed food as the most impactful component for the improvements in depression observed among this group (124).”
BackgroundChemometrics unraveling nutrient dynamics during soybean seed germination
Romeu, S. L. Z., Marques, J. P. R., Montanha, G. S., de Carvalho, H. W. P., & Pereira, F. M. V. (2021) · Microchemical Journal · doi:10.1016/j.microc.2021.106045 · Cited by 15
The Relationship between Diet, Depression, and Alzheimer's Disease: A Narrative Review
Shamsi, H. S. S. A., Rainey‐Smith, S. R., Gardener, S. L., Sohrabi, H. R., Cánovas, R., Martins, R. N., & Fernando, W. M. A. D. B. (2024) · Molecular Nutrition & Food Research · doi:10.1002/mnfr.202300419 · Cited by 17
Crime and Nourishment: A Narrative Review Examining Ultra-Processed Foods, Brain, and Behavior
Prescott, S. L., Logan, A. C., LaFata, E. M., Naik, A., Nelson, D. H., Robinson, M. B., & Soble, L. (2024) · Dietetics · doi:10.3390/dietetics3030025 · Cited by 19
Lacruz-Pleguezuelos, B., Bazán, G. X., Romero-Tapiador, S., Freixer, G., Tolosana, R., Daza, R., Fernández-Díaz, C. M., Molina, S., Crespo, M. C., Laguna, T., et al. (2025) · Clinical Nutrition · doi:10.1016/j.clnu.2025.03.003 · Cited by 13
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Melguizo-Ibáñez, E., Ortega, F. Z., Bădicu, G., Ubago-Jiménez, J. L., Grosz, W. R., & González-Valero, G. (2022) · Journal of Men s Health · doi:10.31083/j.jomh1804100 · Cited by 13
“Also, a higher intake of nuts, vegetables and fruits in their dietary habits reflects an improvement in performance towards academic tasks, with better results obtained by those who follow a healthy dietary pattern compared to students who have a higher intake of precooked meals with a high calorie level and a higher…”
BackgroundWarren, M., O’Connor, C. P., Lee, J. E., Burton, J. P., Walton, D. M., Keathley, J., Wammes, M., & Osuch, E. A. (2024) · Frontiers in Nutrition · doi:10.3389/fnut.2024.1339269 · Cited by 15
Healthy Eating as a New Way of Life: A Qualitative Study of Successful Long-Term Diet Change
James, A., Lawrence, B. J., & O’Connor, M. (2022) · INQUIRY The Journal of Health Care Organization Provision and Financing · doi:10.1177/00469580221090397 · Cited by 24
Kasujja, I., Lund, C., & Salisbury, T. T. (2025) · Children and Youth Services Review · doi:10.1016/j.childyouth.2025.108493 · Cited by 14
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“Further robust evidence from randomised controlled trial (RCT) designs, such as Jacka et al.’s (2017) “SMILES” trial, along with Francis and colleagues’ intervention with young adults (Francis et al., 2019), demonstrate the benefit of Mediterranean diet patterns in reducing depression.”
BackgroundThe gut-derived metabolites as mediators of the effect of healthy nutrition on the brain
Leyrolle, Q., Prado-Perez, L., & Layé, S. (2023) · Frontiers in Nutrition · doi:10.3389/fnut.2023.1155533 · Cited by 13
“Moreover, the Medi-diet alleviated depression risks or symptoms in two interventional studies (42, 43) while another intervention based on dietary advice resulting in increased consumption of fibers and polyunsaturated fatty acids (PUFAs) led to a decrease in perceived stress (44).”
BackgroundMaternal Dietary Patterns and Risk of Postpartum Depression: A Systematic Review
Sun, Y., Ferguson, M., Reeves, M. M., & Kelly, J. T. (2023) · Maternal and Child Health Journal · doi:10.1007/s10995-023-03781-7 · Cited by 12
“In order to detect the impact of dietary patterns, it is more effective to monitor over many years, as has been conducted in prior research (Francis et al., 2019; Khosravi et al., 2015).”
Result
Metadata
- 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.
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2019-10-09
- Volume
- 14
- Issue
- 10
- Pages
- e0222768
- ISSN
- 1932-6203 (ISSN-L)
- 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
- gold
- doi.org
- 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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