A systematic review and meta-analysis of dietary patterns and depression in community-dwelling adults
Open accessAbstract
Background Studies of single nutrients on depression have produced inconsistent results, and they have failed to consider the complex interactions between nutrients. An increasing number of studies in recent years are investigating the association of overall dietary patterns and depression.Objective This study aimed to systematically review current literature and conduct meta-analyses of studies addressing the association between dietary patterns and depression.Design Six electronic databases were searched for articles published up to August 2013 that examined the association of total diet and depression among adults. Only studies considered methodologically rigorous were included. Two independent reviewers completed study selection, quality rating, and data extraction. Effect sizes of eligible studies were pooled by using random-effects models. A summary of the findings was presented for studies that could not be meta-analyzed.Results A total of 21 studies were identified. Results from 13 observational studies were pooled. Two dietary patterns were identified. The healthy diet pattern was significantly associated with a reduced odds of depression (OR: 0.84; 95% CI: 0.76, 0.92; P < 0.001). No statistically significant association was observed between the Western diet and depression (OR: 1.17; 95% CI: 0.97, 1.68; P = 0.094); however, the studies were too few for a precise estimate of this effect.Conclusions The results suggest that high intakes of fruit, vegetables, fish, and whole grains may be associated with a reduced depression risk. However, more high-quality randomized controlled trials and cohort studies are needed to confirm this finding, specifically the temporal sequence of this association.
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Antidepressant medications show resistance in depression associated with obesity.
“antidepressant medications have been reported to show resistance in depression associated with obesity (14,15)”
From Effects of zinc, vitamin D, and their co-supplementation on mood, serum cortisol, and brain-derived neurotrophic factor in patients with obesity and mild to moderate depressive symptoms: A phase II, 12-wk, 2 × 2 factorial design, double-blind, randomized, placebo-controlled trial (2020) · cites this paper as [15]
The Introduction discusses pharmacologic treatment of depression, and the Discussion table lists antidepressant use and obesity as separate adjustment factors; neither addresses whether depression associated with obesity is resistant to antidepressants. Searches for antidepressant resistance and treatment response in obesity found no supporting passage in our copy. Page numbers were not available. (LLM, conf=0.76)
Experimental — accuracy not yet measuredCurrent modalities for treatment of depression are insufficient.
“Current modalities for treatment of depression are insufficient and expensive (15,16)”
From Effects of zinc, vitamin D, and their co-supplementation on mood, serum cortisol, and brain-derived neurotrophic factor in patients with obesity and mild to moderate depressive symptoms: A phase II, 12-wk, 2 × 2 factorial design, double-blind, randomized, placebo-controlled trial (2020) · cites this paper as [15]
The Introduction (pp. 1–3) calls for more research on preventing depression and says most research has focused on pharmacologic and psychological treatment. It does not assess whether current treatments are insufficient; searches for inadequate or ineffective treatment found no such passage in our copy. (LLM, conf=0.72)
Experimental — accuracy not yet measuredAn analysis of four cohorts and nine cross-sectional studies showed that a reduced likelihood of depression was associated with a higher intake of fruit, vegetables, fish and whole grains.
“An analysis of four cohorts and nine cross-sectional studies showed that a reduced likelihood of depression was associated with a higher intake of fruit, vegetables, fish and whole grains [70].”
From Role of diet and its effects on the gut microbiome in the pathophysiology of mental disorders (2022) · cites this paper as [70]
Poor dietary habits such as the Western-style diet, intake of low-quality, processed, or high-fat/sugar foods, and malnutrition can be related to poorer mental health, impaired cognitive function, and increased risk of developing anxiety, depression, or other mental illnesses.
“On the other hand, poor dietary habits (such as the Westernstyle diet), intake of low-quality, processed, or high-fat/sugar foods and malnutrition (over-and undernutrition) can be related to poorer mental health (305, 306), impaired cognitive function (298), and increased risk of developing anxiety (307), depression (292, 308, 309), or other mental illnesses.”
From Diet and the Microbiota–Gut–Brain Axis: Sowing the Seeds of Good Mental Health (2021) · cites this paper as [306]
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Economic evaluation of a dietary intervention for adults with major depression (the “SMILES” trial)
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- Authors
- Lai, J. S., Hiles, S., Bisquera, A., Hure, A. J., McEvoy, M., & Attia, J.
- Affiliations
- John Hunter Hospital (AU)
- Hunter Medical Research Institute (AU)
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2014-01
- Volume
- 99
- Issue
- 1
- Pages
- 181-197
- ISSN
- 0002-9165 (ISSN-L)
- OpenAlex
- W2128014655
- Cited by
- 786
- References
- 55
- Citations by year
- 2026: 27 · 2025: 84 · 2024: 75 · 2023: 54 · 2022: 69 · 2021: 75 · 2020: 68 · 2019: 77 · 2018: 68 · 2017: 63 · 2016: 52 · 2015: 52 · 2014: 21
- FWCI
- 5.94
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- NOVA (University of Newcastle Australia) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutrition and Health Studies
- Keywords
- dietary habits, depression, healthy eating, Western diet, fruit and vegetable intake, fish consumption, whole grains, community-dwelling adults, depression risk
- MeSH terms
- Adult, Depression, Diet, Feeding Behavior, Humans, Nutrition Assessment, Databases, Factual, Food, Organic, Observational Studies as Topic
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