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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.

Background: Alow carbohydrate diet (LCD) is more beneficial for the glycometabolism in type 2 diabetes (T2DM) and may be effective in reducing depression. Almond, which is a common nut, has been shown to effectively improve hyperglycemia and depression symptoms. This study aimed to determine the effect of an almond-based LCD (a-LCD) on depression and glycometabolism, as well as gut microbiota and fasting glucagon-like peptide 1 (GLP-1) in patients with T2DM. Methods: This was a randomized controlled trial which compared an a-LCD with a low-fat diet (LFD). Forty-five participants with T2DM at a diabetes club and the Endocrine Division of the First and Second Affiliated Hospital of Soochow University between December 2018 to December 2019 completed each dietary intervention for 3 months, including 22 in the a-LCD group and 23 in the LFD group. The indicators for depression and biochemical indicators including glycosylated hemoglobin (HbA1c), gut microbiota, and GLP-1 concentration were assessed at the baseline and third month and compared between the two groups. Results: A-LCD significantly improved depression and HbA1c (p < 0.01). Meanwhile, a-LCD significantly increased the short chain fatty acid (SCFAs)-producing bacteria Roseburia, Ruminococcus and Eubacterium. The GLP-1 concentration in the a-LCD group was higher than that in the LFD group (p < 0.05). Conclusions: A-LCD could exert a beneficial effect on depression and glycometabolism in patients with T2DM. We speculate that the role of a-LCD in improving depression in patients with T2DM may be associated with it stimulating the growth of SCFAs-producing bacteria, increasing SCFAs production and GPR43 activation, and further maintaining GLP-1 secretion. In future studies, the SCFAs and GPR43 activation should be further examined.

Depressive symptoms may increase the risk of progressing from mild cognitive impairment (MCI) to dementia. Consumption of n-3 PUFA may alleviate both cognitive decline and depression. The aim of the present study was to investigate the benefits of supplementing a diet with n-3 PUFA, DHA and EPA, for depressive symptoms, quality of life (QOL) and cognition in elderly people with MCI. We conducted a 6-month double-blind, randomised controlled trial. A total of fifty people aged >65 years with MCI were allocated to receive a supplement rich in EPA (1·67 g EPA+0·16 g DHA/d; n 17), DHA (1·55 g DHA+0·40 g EPA/d; n 18) or the n-6 PUFA linoleic acid (LA; 2·2 g/d; n 15). Treatment allocation was by minimisation based on age, sex and depressive symptoms (Geriatric Depression Scale, GDS). Physiological and cognitive assessments, questionnaires and fatty acid composition of erythrocytes were obtained at baseline and 6 months (completers: n 40; EPA n 13, DHA n 16, LA n 11). Compared with the LA group, GDS scores improved in the EPA (P = 0·04) and DHA (P = 0·01) groups and verbal fluency (Initial Letter Fluency) in the DHA group (P = 0·04). Improved GDS scores were correlated with increased DHA plus EPA (r 0·39, P = 0·02). Improved self-reported physical health was associated with increased DHA. There were no treatment effects on other cognitive or QOL parameters. Increased intakes of DHA and EPA benefited mental health in older people with MCI. Increasing n-3 PUFA intakes may reduce depressive symptoms and the risk of progressing to dementia. This needs to be investigated in larger, depressed samples with MCI.

Background The Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet is a plant-based and anti-inflammatory diet that has the ability to protect and manage cardiovascular and nervous system diseases. Regarding that insomnia and cardiovascular problems are x`common in type 2 diabetes mellitus (T2DM), the present study will assess the effectiveness of the MIND dietary pattern on sleep quality, cardiometabolic indicators, and other psychological indicators. Methods Forty-four overweight/obese T2DM women with insomnia, aged 30–65 years, will voluntarily participate in this randomized controlled trial and will be randomized to receive either a MIND low-calorie diet (MLCD) or a low-calorie diet (LCD) over a 3-month period. Before and after the study, sleep quality, some biochemical and cardiometabolic indices, cortisol, brain-derived neurotrophic factor (BDNF), high-sensitivity C-reactive protein (hs-CRP), and oxidative stress indicators will be assessed. Discussion The use of dietary interventions in the management of T2DM complications is practical and safe. This research seeks to investigate the capacity of the MIND diet in the management of insomnia and cardiovascular problems of DM. It is expected that the results of this research will provide new perspectives on using an ideal dietary regimen to treat these health conditions. Trial registration IRCT20181111041611N8. Registered on August 7, 2023. https://www.irct.ir/trial/71772

Mental ill health is currently one of the leading causes of disease burden worldwide. A growing body of data has emerged supporting the role of diet, especially polyphenols, which have anxiolytic and antidepressant-like properties. The aim of the present study was to assess the effect of a high polyphenol diet (HPD) compared to a low polyphenol diet (LPD) on aspects of psychological well-being in the Polyphenol Intervention Trial (PPhIT). Ninety-nine mildly hypertensive participants aged 40–65 years were enrolled in a four-week LPD washout period and then randomised to either an LPD or an HPD for eight weeks. Both at baseline and the end of intervention, participants’ lifestyle and psychological well-being were assessed. The participants in the HPD group reported a decrease in depressive symptoms, as assessed by the Beck Depression Inventory-II, and an improvement in physical component and mental health component scores as assessed with 36-Item Short Form Survey. No differences in anxiety, stress, self-esteem or body image perception were observed. In summary, the study findings suggest that the adoption of a polyphenol-rich diet could potentially lead to beneficial effects including a reduction in depressive symptoms and improvements in general mental health status and physical health in hypertensive participants.

Background The present clinical trial examined the efficacy of an anti-inflammatory diet combined with acupuncture compared to an anti-inflammatory diet alone and standard treatment in depressed patients with type 2 diabetes (T2DM). Methods In this 8-week randomized controlled clinical trial, 90 patients with T2DM who were experiencing mild to moderate depression were included. The participants were randomly assigned to one of three groups: (i) acupuncture combined with an anti-inflammatory diet, (ii) an anti-inflammatory diet alone, and (iii) standard treatment. The combination therapy group received acupuncture therapy twice a week. Mental health outcomes, biochemical parameters, dietary intake, and anthropometric indices were assessed at baseline and the end of the trial. Results Of the 90 diabetic patients, 83 completed the intervention. Acupuncture therapy combined with diet resulted in an ~20% reduction in depression and anxiety, 4.28 and 0.82% reduction in waist circumference (WC) and HbA1C levels, respectively at the end of the trial. This combination therapy also significantly decreased WC ( p  = 0.04) and HbA1c levels ( p  = 0.008), while increasing high-density lipoprotein cholesterol concentrations ( p  = 0.02) compared to diet alone. Conclusion Our findings indicate that acupuncture, in conjunction with an anti-inflammatory diet, may be more effective in enhancing mental health, reducing HbA1C levels, and decreasing abdominal obesity compared to an anti-inflammatory diet alone in patients with T2DM experiencing mild-to-moderate depression after 8 weeks. However, further clinical trials with larger sample sizes and extended durations are recommended to confirm the efficacy of this adjunctive therapy.

Depression, stress and diet can all alter inflammation. This double-blind, randomized crossover study addressed the impact of daily stressors and a history of major depressive disorder (MDD) on inflammatory responses to high-fat meals. During two separate 9.5 h admissions, 58 healthy women (38 breast cancer survivors and 20 demographically similar controls), mean age 53.1 years, received either a high saturated fat meal or a high oleic sunflower oil meal. The Daily Inventory of Stressful Events assessed prior day stressors and the Structured Clinical Interview for DSM-IV evaluated MDD. As expected, for a woman with no prior day stressors, C-reactive protein (CRP), serum amyloid A (SAA), intercellular adhesion molecule-1 (sICAM-1) and vascular cell adhesion molecule-1 (sVCAM-1) were higher following the saturated fat meal than the high oleic sunflower oil meal after controlling for pre-meal measures, age, trunk fat and physical activity. But if a woman had prior day stressors, these meal-related differences disappeared—because the stressors heightened CRP, SAA, sICAM-1 and sVCAM-1 responses to the sunflower oil meal, making it look more like the responses to the saturated fat meal. In addition, women with an MDD history had higher post-meal blood pressure responses than those without a similar history. These data show how recent stressors and an MDD history can reverberate through metabolic alterations, promoting inflammatory and atherogenic responses.

Research into managing depression and fatigue, two typical symptoms of multiple sclerosis (MS), is constantly expanding. This study aimed to assess the efficacy of the modified Mediterranean (MED) diet or the Traditional Persian (TP) diet in terms of fatigue and depression severity in patients with MS. In this single-center, single-blind, randomized clinical trial, 90 patients were enrolled. The patients were randomly assigned to either the MED or TP diet intervention and control groups for two months between July 2022 and February 2023, in Shiraz, Iran. The Krupp Questionnaire for Fatigue Severity Scale and the Beck Depression questionnaire were used. The Chi square test, Kruskal-Wallis test, One-way ANOVA, and backward elimination technique were employed. STATA statistical software (version 17) was utilized for data analysis. P≤0.05 was considered statistically significant. The mean age of 90 participants was 35.64±9.12, and 82.2% were women. The analysis revealed a negative correlation between fatigue severity and MED diet intervention (-4.17 [-8.18-0.16]; P=0.04). However, there was no association between fatigue severity and TP diet intervention (-3.82 [-7.96, 0.32]; P=0.07). The analysis showed that there was a statistically significant relationship between lower depression scores and TP diet intervention (-2.89 [-5.59, -0.19]; P=0.03). However, there was no association between depression scores and MED diet intervention (P=0.22). Lower depression score was also associated with older age and higher socioeconomic status (P=0.002 and P=0.006). It was also shown that longer duration of disease (P=0.05) and higher fatigue severity (P=0.001) were associated with higher depression scores. Adhering to the MED diet could reduce fatigue scores in MS patients while having no effect on the depression score. In contrast, adhering to the TP diet recommendation could reduce depression scores without affecting fatigue scores in MS patients. IRCT20181113041641N1.

Background: Depressive symptoms (DepS) are prevalent among patients with breast cancer. Offering an anti-inflammatory diet is a promising strategy for DepS management, but it is costly and difficult to scale up. Instead, anti-inflammatory dietary education is cost-effective and may be more conducive to the promotion of an anti-inflammatory diet strategy. Methods: A prospective, assessor-blinded, two-arm randomized controlled trial was designed to determine the effects of 12-week anti-inflammatory dietary education on DepS in breast cancer patients with depression. Adult female patients with depression and receiving adjuvant chemotherapy were recruited. Participants in the intervention group received anti-inflammatory dietary education, while the control group received routine nursing care. Outcomes included the Center for Epidemiologic Studies Depression Scale (CES-D) score, energy-adjusted dietary inflammatory index (E-DII), plasma inflammatory biomarkers, and quality of life (QoL), which were all assessed at baseline and after a 12-week follow-up. The robustness of the estimates was investigated through sensitivity analyses. A post hoc power analysis was conducted to establish the observed effect sizes for the primary outcomes. Results: A total of 88.6% (62/70) of the participants completed the entire 12-week follow-up. No statistically significant between-group differences were found in the baseline characteristics, including sociodemographic factors, disease-related characteristics, and lifestyle factors. After the intervention, both the CES-D score (p = 0.040) and E-DII (p < 0.001) in the intervention group were significantly lower than in the control group, while the QoL was significantly increased (p < 0.001). Compared with the baseline, the tumor necrosis factor-α (TNF-α) (p = 0.002) and C-reactive protein (CRP) (p = 0.045) levels were significantly lower in the intervention group but not in the control group. Conclusions: Anti-inflammatory dietary education may improve DepS and QoL in breast cancer patients with depression and undergoing chemotherapy by regulating inflammation. Given its acceptability and practicality, this strategy may be incorporated into routine cancer care.

Background It has been shown that the microflora of the gastrointestinal tract undergoes changes in obese individuals. The present study aimed to investigate the effect of kefir fortified with two strains, Lactobacillus helveticus and Bifidobacterium longum, on depression, appetite, oxidative stress, and inflammatory parameters in overweight and obese elderly individuals. Methods This study was a double-blind, randomized, and placebo-controlled clinical trial conducted on 67 elderly men aged over 65, who were randomly divided into two groups. One group ( n  = 35) received one bottle (240 cc) of regular kefir as a placebo, while the intervention group ( n  = 32) received one bottle of probiotic-fortified kefir for eight weeks. Depression and appetite were evaluated using the Geriatric Depression Scale-15 (GDS-15) and a validated Visual Analogue Scale (VAS), respectively. Oxidative stress parameters were assessed using the standard calorimetric method, and inflammatory parameters were measured via the enzyme-linked immunosorbent assay method (ELISA). The differences between the two groups were compared using the independent samples T-test. Results The median age of participant in both groups was 65 years. A significant difference in depression scores and the mean change between the two groups was observed after eight weeks ( p  = 0.001 and p  = 0.042, respectively). Within-group comparison revealed a significant increase in appetite scores in both groups ( p  < 0.05 for both). Moreover, a significant difference in the changes in total antioxidant capacity (TAC) was noted ( p  = 0.009). However, no significant differences were observed in other oxidative and inflammatory parameters between the two groups ( p ˃0.05 for all). Conclusions The results demonstrated the positive impact of two specific strains of Bifidobacterium and Lactobacillus on improving depression in the elderly. However, when comparing the two groups, no significant effects were observed on appetite, inflammation, and oxidative stress parameters, except for TAC.