Clinician's Digest - Page 5

Diet and Depression

By now the relationship between diet and physical health has been thoroughly established, particularly the connection between fried and highly processed foods, refined grains, high fat, and sugar and higher incidences of obesity, cancer, and cardiovascular and neurodegenerative diseases. But despite thousands of books and articles in health and fitness magazines, the links between diet and mental health have been more difficult to prove. Gold standard research in this area requires large budgets for extensive and costly longitudinal studies, but searching for dietary solutions to mental health isn't a promising revenue stream for pharmaceutical companies, currently the major research financiers. Nevertheless, well-controlled, long-term studies are the only way to clarify the essential questions of causality: does better diet improve mental health, or do people who are mentally healthy tend to make better food choices? Despair, depression, and anxiety tend to drive all kinds of unhealthy lifestyle choices, including dietary ones.

Psychiatric research has been slow to investigate the connection, but that's changing, and it's beginning to look as if the health magazines and mind-body thinkers and practitioners like Andrew Weil have been right. A study in the March 2010 issue of the American Journal of Psychiatry finds an association between diet and depression, and the journal underlines the study's importance by publishing an editorial in the same issue by psychiatrist Marlene Freeman saying it's time to direct more research money toward the impact of diet on mental health. "It's both compelling and daunting to consider that dietary intervention at an individual or population level could reduce rates of psychiatric disorders," she writes.

The study, led by Research Fellow Felice Jacka of Australia's University of Melbourne, claims to be the first to look at diets broadly. She investigated three habitual dietary patterns: traditional, comprised mainly of vegetables, fruit, beef, lamb, fish, and whole-grain foods; Western, consisting mostly of processed meats, pizza, chips, hamburgers, white bread, flavored milk, sugar, and beer; and modern, which includes mainly fruit, salad, fish, tofu, beans, nuts, yogurt, and red wine. The study showed that, of the three, the Western dietary pattern was most likely to be accompanied by dysthymia or major depression and increased psychological issues. The traditional dietary pattern was associated with a significantly reduced likelihood of both depressive and anxiety disorders, and in general, a higher healthy diet score was associated with fewer psychological symptoms.

Another study of overall dietary patterns and the incidence of depression, reported in last year's British Journal of Psychiatry, led by epidemiologist Tasnime Akbaraly of London's University College, found the same thing. Of 3,486 middle-aged participants, those with a diet similar to Jacka's Western diet were significantly likelier to develop depression over time than those with a diet similar to her traditional example. They also found evidence of a protective effect of a healthy dietary pattern.

The studies certainly don't nail down the connection between a high-fat, high-processed, low-nutrition diet and depression, but they're enough for Marlene Freeman to suggest that therapists focus more on their clients' eating habits. Even if improving their diets proves to have only a minimal impact on psychiatric disorders, she says, contributing to their physical health will still represent a valuable contribution to their overall well-being.

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