Mediterranean-Style Diet May Be Best to Help Fight Depression

An eating strategy that focuses on whole foods and minimizes added sugars and unhealthy fats may help brighten your outlook.

Recommendations to follow a healthy diet have usually been extended to help reduce the risk of obesity and its accompanying complications, such as heart disease and type 2 diabetes. But recent research finds that your emotional health depends on eating the right kinds of foods and reducing your intake of unhealthy ingredients.

A recent study published in the journal Nature suggests that eating a healthy diet, in particular a Mediteranean-style eating plan, and avoiding foods that may trigger inflammation offer some protection against depression. These were observational studies that didn’t show direct cause-and-effect relationships between food and mood. However, they reaffirm a 2015 report in Lancet Psychiatry that dietary quality and possible nutritional deficiencies play critical roles in both physical and mental health, says Uma Naidoo, MD, director of Nutritional and Lifestyle Psychiatry at Massachusetts General Hospital.

“Many would agree that they feel better when they eat better,” she says. “However, now research is proving to be true. Since depression is a leading cause of disability worldwide, it seems appropriate to consider all suggestions about how to improve one’s mental health.”

Diet and Depression

Depression is a mood disorder characterized by prolonged feelings of sadness and a loss of interest in things you once enjoyed. It can be triggered by a wide range of factors, such as stress, traumatic life events, chronic illness, medication side effects, alcohol or drug abuse, and suffering from anxiety disorders. Certain changes in brain chemistry or hormones can cause depression, as can inherited traits from blood relatives who also have or had depression.

WHAT YOU CAN DO

To help improve your mood with food:

  • Eat five servings each of fruits and vegetables daily rather than rely solely on vegetable and fruit juices.
  • Pay attention to adequate hydration.
  • Include fiber in your diet.
  • Include probiotic and fermented foods in your diet (e.g., yogurt, miso, kefir, kimchi, kombucha, and sauerkraut).
  • Eat whole foods, and avoid packaged or processed foods
  • Be aware of added sugars in what you eat, and try to keep them to a mininum in your diet.

There is still much to be learned about the physiological causes of depression. It continues to be a widely studied condition around the world. Advances in antidepressant medications and psychotherapy are helping to treat people with depression. In addition, a growing body of evidence points to the role of lifestyle as a key component of an overall treatment plan and as a means of prevention. Regular aerobic exercise is associated with a reduction in depressive symptoms, and in recent years diet has gotten more attention for its role in staving off depression or as a complement to more traditional treatments.

“Food as medicine is an interesting concept newer to the medical literature, but gaining new ground,” Dr. Naidoo says. “The Mediterranean-style diet appears from research to be the most protective against depression. This may be due to the diet containing a healthy combination of fresh vegetables, fruit, olive oil, seafood and whole grains, to name a few of the components.”

She points to the 2017 SMILES (Supporting the Modification of lifestyle in Lowered Emotional States) study as one of the first clinical trials to look at whether a Mediterranean-style diet can improve mood in depressed adults. The SMILES trial compared a group of volunteers who followed a modified Mediterranean diet with a group of participants who received social support via group discussions, games and other activities. After 12 weeks, the diet group showed a much greater reduction in symptoms of depression and anxiety than the support group.

In addition, nearly one-third of the people in the diet group achieved depression remission, compared to just 8 percent of individuals in the social support group.

Other research that specifically looked at the protective benefits of the Mediterranean diet against the development of depressive symptoms in older adults found similarly encouraging results.

Make It Mediterranean

The Mediterranean diet doesn’t necessarily follow all the eating patterns of a particular culture around the Mediterranean Sea, as the foods of Spain, Italy, Egypt and other nearby nations vary considerably. Instead, this popular diet incorporates some basic staples that are common to much of the region.

It focuses on daily servings of fruits, vegetables and whole grains. “It is important to note that fresh or frozen fruits, without added sugar or preservatives, are best,” Dr. Naidoo says. “A whole fruit contains the vitamins, minerals and natural fiber we need. Processed fruit and vegetable juices have added sugars, which then add to our daily sugar intake and reduce the health benefit.”

And if raw fruits and vegetables are to your liking, there is evidence that many of them in their uncooked state may be especially helpful for your mental health. A study published in 2018 in Frontiers in Psychology showed that intake of raw fruits and vegetables is associated with better mental health than intake of processed fruits and vegetables. It also outlines that the top 10 raw foods that related to better mental health were carrots, bananas, apples, dark leafy greens (like spinach), grapefruit, and other citrus fruits, fresh berries, cucumber, and kiwifruit.

“The Mediterranean diet is rich in antioxidant and anti-inflammatory foods,” Dr. Naidoo explains. “These characteristics account for reduction of mood symptoms and may be one of the factors making this a diet that can help improve mood.”

The Big Picture

Though a healthy diet may indeed boost your mood and may help deflect the onset of depression, it doesn’t afford guaranteed protection. People who eat right and exercise every day can still battle depression and other mood disorders. As with any mental or physical health concern, a multi-pronged approach is necessary for prevention and treatment.

“It’s important to understand that changing one factor is not sufficient to change how one is feeling emotionally,” Dr. Naidoo says. “Paying attention to lifestyle factors such as adequate sleep, hydration, exercise, practicing mindfulness and working to reduce stress are equally important. Think of it as though you are baking a cake with several ingredients. If you omit one or two ingredients the cake will fail. In a similar way we have to work to adopt healthy habits.”

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