Probiotics for the treatment of depression and anxiety: A systematic review and meta-analysis of randomized controlled trials

Dib, Regina El; P, Aravind Gandhi; Barros, Jessica Lima de; França, Carolina Gonzales; Senefonte, Fernanda Labiapari; Vesentini, Giovana; Alves, Mônica Ghislaine Oliveira; Rodrigues, João Vitor da Silva; Gomaa, Huda; Júnior, José Reinaldo Gomes; Costa, Lucas Fernandes; Ancken, Thainá de Souza Von; Toneli, Carla; Suzumura, Érica Aranha; Kawakami, Claudio Pereira; Faustino, Eliseu Gabriel; Jorge, Eliane Chaves; Almeida, Janete Días; Kapoor, Anil

doi:10.1016/j.clnesp.2021.07.027

Cited by 31 publications

(19 citation statements)

References 61 publications

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“…The link is likely independent of overall diet quality and other potentially confounding factors. This result is in contrast with the majority of probiotic intervention studies (58)(59)(60)(61)(62)(63) and correlational research assessing the frequency of fermented food intake (64,65). Although such result is intriguing, it is not completely isolated.…”

Section: Discussionmentioning

confidence: 66%

“…The former possibility has some literature support. Although probiotic preparations present some mental health benefits (58)(59)(60)(61)(62), fermented food is not necessarily probiotic (91). Fermented food may contain pathogenic microorganisms and viruses with opposite roles, and the adverse effects of fermented food may be under-reported (98).…”

Section: Discussionmentioning

confidence: 99%

“…Modulation of the gut microbiota may beneficially affect not only cognitive function, but also mood and anxiety symptoms. Numerous interventional studies have found probiotic and prebiotic preparations to have somewhat positive overall effects on alleviation of depressive and anxiety symptoms in humans (58)(59)(60)(61)(62)(63). Commonly-consumed fermented food has been also linked with lowering depressive (64) and anxiety (65) symptoms.…”

Section: Introductionmentioning

confidence: 99%

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Association Between Consumption of Fermented Food and Food-Derived Prebiotics With Cognitive Performance, Depressive, and Anxiety Symptoms in Psychiatrically Healthy Medical Students Under Psychological Stress: A Prospective Cohort Study

et al. 2022

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BackgroundGut microbiota-based therapeutic strategies, such as probiotic and prebiotic preparations, may benefit mental health. However, commonly consumed fermented and prebiotic-containing foods have not been well-tested. The aim of the present study was to determine whether consumption of fermented food and food-derived prebiotics is associated with cognitive performance, depressive, and anxiety symptoms in psychiatrically healthy medical students under psychological stress.MethodsThe study protocol with data analysis plan was prospectively registered. Food consumption was evaluated with a 7-day dietary record. Cognitive performance was modeled with academic examination performance in relation to subject knowledge. Pre-exam depressive and anxiety symptoms were assessed with the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7, respectively.ResultsIn total, 372 medical students (22.7 ± 1.1 years of age, 66% female) completed the study. No relationship was observed between cognitive performance under stress and either fermented food (adjusted β 0.02, 95% CI −0.07–0.11, p = 0.63) or food-derived prebiotics consumption (adjusted β −0.00, 95% CI −0.09–0.09, p = 0.99). High intake of fermented food was associated with more severe depressive (adjusted β 0.11, 95% CI 0.01–0.20, p = 0.032) and anxiety symptoms under stress (adjusted β 0.13, 95% CI 0.04–0.22, p = 0.0065); however, no such link was observed for food-derived prebiotics (adjusted β 0.03, 95% CI −0.07–0.13, p = 0.50 and −0.01, 95% CI −0.11–0.08, p = 0.83, for depression and anxiety, respectively).ConclusionsUnder psychological stress in medical students, consumption of fermented food and food-derived prebiotics appears to be not associated with cognitive performance. High intake of fermented food, but not food-derived prebiotics, may be associated with severity of depressive and anxiety symptoms. The safety of fermented food in this regard therefore requires further clarification.

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Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Association Between Consumption of Fermented Food and Food-Derived Prebiotics With Cognitive Performance, Depressive, and Anxiety Symptoms in Psychiatrically Healthy Medical Students Under Psychological Stress: A Prospective Cohort Study

et al. 2022

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“…Mental health plays an important role in endurance athletes and mental illnesses such as depression and anxiety may influence performance. Although studies on the use of probiotics as an alternative treatment have been published, further research is needed because the existing evidence is of low to medium scientific quality [ 43 , 44 ], although the current results are very promising.…”

Section: Discussionmentioning

confidence: 99%

Impact of Probiotics on the Performance of Endurance Athletes: A Systematic Review

Díaz-Jiménez

Sánchez-Sánchez²,

Ordóñez

et al. 2021

IJERPH

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Background: Probiotic supplements contain different strains of living microorganisms that promote the health of the host. These dietary supplements are increasingly being used by athletes to improve different aspects such as athletic performance, upper respiratory tract infections (URTIs), the immune system, oxidative stress, gastrointestinal (GI) problems, etc. This study aimed to identify the current evidence on the management of probiotics in endurance athletes and their relationship with sports performance. Methods: A systematic review of the last five years was carried out in PubMed, Scopus, Web of science, Sportdiscus and Embase databases. Results: Nine articles met the quality criteria. Of these, three reported direct benefits on sports performance. The remaining six articles found improvements in the reduction of oxidative stress, increased immune response and decreased incidence of URTIs. There is little scientific evidence on the direct relationship between the administration of probiotics in endurance athletes and sports performance. Conclusions: Benefits were found that probiotics could indirectly influence sports performance by improving other parameters such as the immune system, response to URTIs and decreased oxidative stress, as well as the monitoring of scheduled workouts.

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“…Consequently, gut microbiota-targeted therapies and dietary interventions hold promise for an adjunctive treatment of psychiatric diseases and improving the mental well-being of healthy people [ 2 , 3 , 4 , 5 ]. Several recent systematic reviews of human controlled trials with meta-analyses have suggested some improvement in depressive and anxiety symptoms following the intake of probiotic preparations [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 ]. Similarly, an association between higher consumption of fermented food and improvement in mental health indices has been noted in some observational studies [ 14 , 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Who Benefits from Fermented Food Consumption? A Comparative Analysis between Psychiatrically Ill and Psychiatrically Healthy Medical Students

Karbownik

Mokros

Kowalczyk

2022

IJERPH

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Probiotic therapies and fermented food diets hold promise for improving mental health. Although in this regard psychiatric patients appear to benefit more than healthy individuals, no research has been performed to directly evaluate this hypothesis. The present study examined a cohort of medical students facing a stressful event, and some of the students reported suffering from chronic psychiatric diseases. The amount of fermented food consumption was calculated with the use of seven-day dietary records, while depressive and anxiety symptoms were assessed with the use of the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7, respectively. In psychiatrically healthy medical students under psychological stress (n = 372), higher fermented food consumption was associated with more depressive and anxiety symptoms. In contrast, psychiatrically ill medical students (n = 25, 6.3% of all the participants) were found to present a negative association between the amount of fermented food consumed and the severity of depressive symptoms (adjusted β −0.52, 95% CI −0.85 to −0.19, p = 0.0042); however, this relationship was insignificant for anxiety symptoms (adjusted β −0.22, 95% CI −0.59 to 0.15, p = 0.22). A significant interaction was found between the consumption of fermented food and psychiatric diagnosis in predicting depressive symptoms (p = 0.0001), and a borderline significant interaction for anxiety symptoms (p = 0.053). In conclusion, psychiatrically ill people, but not healthy ones, may benefit from fermented food consumption in terms of alleviation of depressive symptoms. Our findings require cautious interpretation and further investigation.

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Probiotics for the treatment of depression and anxiety: A systematic review and meta-analysis of randomized controlled trials

Cited by 31 publications

References 61 publications

Association Between Consumption of Fermented Food and Food-Derived Prebiotics With Cognitive Performance, Depressive, and Anxiety Symptoms in Psychiatrically Healthy Medical Students Under Psychological Stress: A Prospective Cohort Study

Association Between Consumption of Fermented Food and Food-Derived Prebiotics With Cognitive Performance, Depressive, and Anxiety Symptoms in Psychiatrically Healthy Medical Students Under Psychological Stress: A Prospective Cohort Study

Impact of Probiotics on the Performance of Endurance Athletes: A Systematic Review

Who Benefits from Fermented Food Consumption? A Comparative Analysis between Psychiatrically Ill and Psychiatrically Healthy Medical Students

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