The role of diet and nutritional supplementation in perinatal depression: a systematic review

Abstract

This article presents a systematic literature review on whether dietary intake influences the risk for perinatal depression, i.e. depression during pregnancy or post-partum. Such a link has been hypothesized given that certain nutrients are important in the neurotransmission system and pregnancy depletes essential nutrients. PubMed, EMBASE and CINAHL databases were searched for relevant articles until 30 May 2015. We included peer-reviewed studies of any design that evaluated whether perinatal depression is related to dietary intake, which was defined as adherence to certain diets, food-derived intake of essential nutrients or supplements. We identified 4808 studies, of which 35 fulfilled inclusion criteria: six randomized controlled trials, 12 cohort, one case-control and 16 cross-sectional studies, representing 88 051 distinct subjects. Studies were grouped into four main categories based on the analysis of dietary intake: adherence to dietary patterns (nine studies); full panel of essential nutrients (six studies); specific nutrients (including B vitamins, Vitamin D, calcium and zinc; eight studies); and intake of fish or polyunsaturated fatty acids (PUFAs; 12 studies). While 13 studies, including three PUFA supplementation trials, found no evidence of an association, 22 studies showed protective effects from healthy dietary patterns, multivitamin supplementation, fish and PUFA intake, calcium, Vitamin D, zinc and possibly selenium. Given the methodological limitations of existing studies and inconsistencies in findings across studies, the evidence on whether nutritional factors influence the risk of perinatal depression is still inconclusive. Further longitudinal studies are needed, with robust and consistent measurement of dietary intake and depressive symptoms, ideally starting before pregnancy.

Global burden of antenatal depression and its association with adverse birth outcomes: an umbrella review

“…The remaining ten reviews (collectively consisting of 306 primary studies and 877,246 study participants) on antenatal depression prevalence [6,46,[53][54][55][56][57][58][59][60] and six reviews (collectively consisting of 39 primary studies and 75,451 study participants) on the association between antenatal depression association and adverse birth outcomes [14-17, 61, 62] were included in the current review of reviews after assessed for quality. (Fig.…”

Nutritional psychiatry: the present state of the evidence

“…The body of research is relatively smaller compared with adult populations; however, research has identified an inverse relationship between high-quality diet and mental health disturbances, as well as a positive relationship between unhealthy diets and mental symptomatology such as internalising and externalising problems in children and adolescents. Similarly, poor diet quality is associated with antenatal depression; however, evidence for an association between diet quality and postnatal depression and anxiety is inconsistent O'Neil et al (9) Sparling et al (66) Baskin et al (67) Specific dietary patterns, individual nutrients and mental illness Nutrient dense dietary patterns that include plant foods and high-quality sources of protein are inversely associated with mental illness, independent of body weight. There is evidence of an association between depression and dietary patterns, such as a traditional Mediterranean diets, Norwegian diets and Japanese diets Observational data suggest dietary intake of fish, magnesium, iron and zinc may be inversely associated with depression; however, an association with intake of other micronutrients has not been definitively established Quirk et al (62) Murakami and Sasaki (73) Li et al (75) Li et al (76) Evidence from intervention studies While observational studies have reported consistent evidence for an association between diet quality and common mental disorders, relatively few intervention studies have investigated this relationship Present evidence from intervention trials are mixed, with successful trials generally including at least one of the following: single delivery mode (e.g.…”

“…The association between diet and mental health has also been studied in children, adolescents and women in the perinatal period (9,(65)(66)(67) . A systematic review of nine cross-sectional and three prospective studies reported an inverse relationship between high-quality diet and mental health disturbances and a positive relationship between unhealthy diets and poorer mental health outcomes in children and adolescents (9) .…”

Risk of depression in pregnant women with low‐normal serum Vitamin B12

“…Diet, exercise, and pre-pregnancy body mass index (BMI) can also play roles in depressive symptoms. In a recent systematic review of 35 studies, the authors reported that findings from 22 studies demonstrated that women who practice healthy dietary patterns and multivitamin supplementation during pregnancy may avoid depression (Sparling, Henschke, Nesbitt, & Gabrysch, 2017). Exercise contributes to lower depression scores, but overweight and obese pre-pregnancy BMIs are associated with a greater likelihood of depression (Bodnar, Wisner, Moses-Kolko, Sit, & Hanusa, 2009).…”