Diet and depression: A systematic review of whole dietary interventions as treatment in patients with depression.

Background & Rationale: Depression is a common mental illness that afflicts over 300 million individuals worldwide. Despite a variety of therapeutic options available, a significant number of depressed patients fail to respond to treatment. Current guidelines for treating depression suggest that supplementation of essential nutrients may be an appropriate adjunctive to treatment, but research investigating full dietary interventions for depressed patients is scarce.

Study Objective: The primary aim of this study was to systematically review published scientific literature investigating full dietary interventions as treatment for individuals with a diagnosis of depression. In doing so, we assessed existing evidence for recommendation of a dietary intervention and reviewed theory of how diet may be important in this context.

Methods: A systematic search was conducted using OVID to search Medline, PsychINFO, and EMBASE, and PubMed for relevant publications. Only studies including full dietary interventions for patients with Major Depressive Episode, Major Depressive Disorder, Persistent Depressive Disorder, Seasonal Affective Disorder, or Dysthymia, as diagnosed using criteria defined in the chapter of "Depressive Disorders" in the DSM, were included.

Results: Only five studies met the inclusion criteria for this review. All five studies included in this review reported improvements in mood following dietary intervention as compared to the comparison group. However, heterogeneity in both the dietary intervention and the outcome(s) measured made it difficult to compare these studies against each other and to generalize them to larger populations.

Conclusion: The findings of this review provide preliminary evidence for the positive impact of dietary interventions in the treatment of depressed patients. However, the mechanism by which particular diets induce positive changes in mood, be it through anti-inflammatory mechanisms or via weight loss in overweight patients, is unclear. Future research investigating the impact of dietary interventions on a large-scale is warranted and needed.