An anti-inflammatory diet as a potential intervention for depressive disorders: A systematic review and meta-analysis

Abstract

Background & aims: There is a large body of evidence which supports the role of inflammation in the pathophysiology of mental health disorders, including depression. Dietary patterns have been shown to modulate the inflammatory state, thus highlighting their potential as a therapeutic tool in disorders with an inflammatory basis. Here we conduct a systematic review and meta-analysis of current literature addressing whether there is a link between the inflammatory potential of a diet and risk of depression or depressive symptoms. Methods: A systematic literature search was performed to identify studies that reported an association between the inflammatory potential of the diet and risk of depressive symptoms or diagnosis of depression. Random effect models were used to meta-analyse effect sizes. Quality assessment, publication bias, sensitivity and subgroup analyses were also performed. Results: Eleven studies, with a total of 101,950 participants at baseline (age range: 16e72 years old), were eligible for review. A significant association between a pro-inflammatory diet and increased risk of depression diagnosis or symptoms was evident, relative to those on an anti-inflammatory diet (OR: 1.40, 95% confidence intervals: 1.21e1.62, P < 0.001). No publication bias was detected; however, some study heterogeneity was evident (I 2 ¼ 63%, P < 0.001). Subgroup analyses suggested the main source of study heterogeneity was the study design (cross-sectional or longitudinal) and the effect measure used (odds ratio, hazard ratio or relative risk). Conclusion: These results provide an association between pro-inflammatory diet and risk of depression. Thus, adopting an anti-inflammatory diet may be an effective intervention or preventative means of reducing depression risk and symptoms.

A meta‐review of “lifestyle psychiatry”: the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders

“…A lower Dietary Inflammatory Index (an index that quantifies the inflammatory potential of a diet based on up to 45 food parameters) was also found to be associated with reduced risk of depression (n=7, N=32,908, OR=0.76, 95% CI: 0.63-0.92, I 2 =55.3%) 61 . Confirming this, a separate meta-analysis examining the opposite direction of effect found that individuals with pro-inflammatory diets at baseline were at significantly greater risk of depression, with low heterogeneity between stud-ies (n=10, N=77,420, OR=1.31, 95% CI: 1.2-1.44, I 2 =5.1%), with equally large risk observed in studies using >10 year or <10 year follow-up periods 63 .…”

The efficacy and safety of nutrient supplements in the treatment of mental disorders: a meta‐review of meta‐analyses of randomized controlled trials

“…Furthermore, although the metabolic and hormonal side effects of psychotropic medications can affect food intake, inadequate nutrition appears to be present even prior to psychiatric diagnoses. For instance, in depression, it seems that poor diet precedes and acts as a risk factor for illness onset. Similarly, in psychotic disorders, various nutritional deficits are evident even prior to antipsychotic treatment.…”

The Association between Energy Balance-Related Behavior and Burn-Out in Adults: A Systematic Review

“…It has been shown that diet may influence mental health. A systematic review and meta-analysis by Tolkien et al [80] for example, concluded that an anti-inflammatory diet may play an important role in preventing or reducing depression risk and symptoms. Moreover, because of the link between burn-out and neurotransmission and the role diet may play herein, it is important to further investigate the link between dietary behavior and burn-out risk by conducting experimental research using valid and reliable assessment methods (e.g., food diaries, 24-hour recalls or food frequency questionnaires).…”