The Effects of Dietary Improvement on Symptoms of Depression and Anxiety: A Meta-Analysis of Randomized Controlled Trials
Joseph Firth, Psychosomatic Medicine. 81(3):265–280, APRIL 2019
Objective: Poor diet can be detrimental to mental health. However, the overall evidence for the effects of dietary interventions on mood
and mental well-being has yet to be assessed. We conducted a systematic review and meta-analysis examining effects of dietary interventions on symptoms of depression and anxiety.
Methods: Major electronic databases were searched through March 2018 for all randomized controlled trials of dietary interventions
reporting changes in symptoms of depression and/or anxiety in clinical and nonclinical populations. Random-effects meta-analyses were
conducted to determine effect sizes (Hedges' g with 95% confidence intervals [CI]) for dietary interventions compared with control conditions. Potential sources of heterogeneity were explored using subgroups and meta-regression analyses.
Results: Sixteen eligible randomized controlled trials (published in English) with outcome data for 45,826 participants were included; the
majority of which examined samples with nonclinical depression (n = 15 studies). Nonetheless, dietary interventions significantly reduced
depressive symptoms (g = 0.275, 95% CI = 0.10 to 0.45, p = .002). Similar effects were observed among high-quality trials (g = 0.321,
95% CI = 0.12 to 0.53, p = .002) and when compared with both inactive (g = 0.308, 95% CI = 0.02 to 0.60, p = .038) and active controls
(g = 0.174, 95% CI = 0.01 to 0.34, p = .035). No effect of dietary interventions was observed for anxiety (k = 11, n = 2270, g = 0.100, 95% CI =
−0.04 to 0.24, p = .148). Studies with female samples observed significantly greater benefits from dietary interventions, for symptoms of
both depression and anxiety.
Conclusions: Dietary interventions hold promise as a novel intervention for reducing symptoms of depression across the population. Future research is required to determine the specific components of dietary interventions that improve mental health, explore underlying mechanisms, and establish effective schemes for delivering these interventions in clinical and public health settings.