A brief diet intervention can reduce symptoms of depression in young adults – A randomised controlled trial

Autoři: Heather M. Francis aff001;  Richard J. Stevenson aff001;  Jaime R. Chambers aff002;  Dolly Gupta aff001;  Brooklyn Newey aff001;  Chai K. Lim aff004
Působiště autorů: Psychology Department, Macquarie University, Sydney, NSW, Australia aff001;  Sydney Integrative Medicine, Level 1, Sydney, NSW, Australia aff002;  Cooper St Clinic, Sydney, NSW, Australia aff003;  Biomedical Sciences, Macquarie University, Sydney, NSW, Australia aff004
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0222768


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.

Klíčová slova:

Anxiety – Depression – Diet – Emotions – Neuropsychological testing – Psychological stress – Randomized controlled trials – Young adults


1. Drewnowski A, Popkin BM. The nutrition transition: new trends in the global diet. Nutr Rev. 1997;55(2):31–43. doi: 10.1111/j.1753-4887.1997.tb01593.x 9155216

2. Lai JS, Hiles S, Hure AJ, McEvoy M, Attia J. Systematic Review and Meta-Analysis of Dietary Patterns and Depression: Observational Studies. Ann Nutr Metab. 2013;63:428-.

3. Quirk SE, Williams LJ, O'Neil A, Pasco JA, Jacka FN, Housden S, et al. The association between diet quality, dietary patterns and depression in adults: a systematic review. Bmc Psychiatry. 2013;13.

4. Lai JS, Hiles S, Bisquera A, Hure AJ, McEvoy M, Attia J. A systematic review and meta-analysis of dietary patterns and depression in community-dwelling adults. American Journal of Clinical Nutrition. 2014;99(1):181–97. doi: 10.3945/ajcn.113.069880 24196402

5. Molendijk M, Molero P, Sanchez-Pedreno FO, Van der Does W, Martinez-Gonzalez MA. Diet quality and depression risk: A systematic review and dose-response meta-analysis of prospective studies. J Affect Disorders. 2018;226:346–54. doi: 10.1016/j.jad.2017.09.022 29031185

6. Rahe C, Unrath M, Berger K. Dietary patterns and the risk of depression in adults: a systematic review of observational studies. Eur J Nutr. 2014;53(4):997–1013. doi: 10.1007/s00394-014-0652-9 24468939

7. O'Neil A, Quirk SE, Housden S, Brennan SL, Williams LJ, Pasco JA, et al. Relationship Between Diet and Mental Health in Children and Adolescents: A Systematic Review. Am J Public Health. 2014;104(10):E31–E42. doi: 10.2105/AJPH.2014.302110 25208008

8. Okubo R, Matsuoka YJ, Sawada N, Mimura M, Kurotani K, Nozaki S, et al. Diet quality and depression risk in a Japanese population: the Japan Public Health Center (JPHC)-based Prospective Study. Sci Rep-Uk. 2019;9.

9. Firth J, Marx W, Dash S, Carney R, Teasdale SB, Solmi M, et al. The effects of dietary improvement on symptoms of depression and anxiety: a meta-analysis of randomized controlled trials. Psychosom Med. 2019;81(3):265–80. doi: 10.1097/PSY.0000000000000673 30720698

10. Opie RS, O'Neil A, Itsiopoulos C, Jacka FN. The impact of whole-of-diet interventions on depression and anxiety: a systematic review of randomised controlled trials. Public Health Nutr. 2015;18(11):2074–93. doi: 10.1017/S1368980014002614 25465596

11. Jacka FN, O'Neil A, Opie R, Itsiopoulos C, Cotton S, Mohebbi M, et al. A randomised controlled trial of dietary improvement for adults with major depression (the 'SMILES' trial). Bmc Med. 2017;15.

12. McMillan L, Owen L, Kras M, Scholey A. Behavioural effects of a 10-day Mediterranean diet. Results from a pilot study evaluating mood and cognitive performance. Appetite. 2011;56(1):143–7. doi: 10.1016/j.appet.2010.11.149 21115083

13. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the national comorbidity survey replication.(vol 62, pg 593, 2005). Arch Gen Psychiat. 2005;62(7):768-.

14. Jahns L, Johnson LK, Mayne ST, Cartmel B, Picklo MJ, Ennakov IV, et al. Skin and plasma carotenoid response to a provided intervention diet high in vegetables and fruit: uptake and depletion kinetics. American Journal of Clinical Nutrition. 2014;100(3):930–7. doi: 10.3945/ajcn.114.086900 25008856

15. Cooper H, Maxwell S, Stone A, Sher KJ, Board APC. Reporting Standards for Research in Psychology Why Do We Need Them? What Might They Be? Am Psychol. 2008;63(9):839–51. doi: 10.1037/0003-066X.63.9.839 19086746

16. Lovibond S, Lovibond P. Manual for the Depression Anxiety and Stress Scales. 2nd ed. Sydney: Psychology Foundation; 1995.

17. Francis H, Stevenson R. Validity and testretest reliability of a short dietary questionnaire to assess intake of saturated fat and free sugars: a preliminary study. J Hum Nutr Diet. 2013;26(3):234–42. doi: 10.1111/jhn.12008 23190372

18. Dietary Guidelines for Australian Adults. A guide to healthy eating. Canberra, Australia: National Health and Medical Research Council (NHMRC); 2003.

19. Francis HM, Stevenson RJ. Potential for diet to prevent and remediate cognitive deficits in neurological disorders. Nutrition Reviews. 2018;76(3):204–17. doi: 10.1093/nutrit/nux073 29346658

20. Janssen DGA, Caniato RN, Verster JC, Baune BT. A psychoneuroimmunological review on cytokines involved in antidepressant treatment response. Hum Psychopharm Clin. 2010;25(3):201–15.

21. Radloff L. The CES-D scale: a self-report depression scale for research in the general population. Applied Psychological Measurement. 1977;1:385–401.

22. Eaton W, Muntaner C, Smith C, Tien A, Ybarra M. Center for Epidemiologic Studies Depression Scale: Review and revision (CESD and CESD-R). In: Maruish M, editor. The Use of Psychological Testing for Treatment Planning and Outcomes Assessment. 3rd ed. Mahwah, NJ: Lawrence Erlbaum; 2004. p. 363–77.

23. Murphy J. Symptom scales and diagnostic schedules in adult psychiatry. In: Tsuang MT TM, editor. Textbook in Psychiatric Epidemiology. New York: Wiley-Liss; 2002. p. 273–332.

24. Terry PC, Lane AM, Lane HJ, Keohane L. Development and validation of a mood measure for adolescents. J Sport Sci. 1999;17(11):861–72.

25. Chen G, Gully SM, Eden D. Validation of a new general self-efficacy scale. Organ Res Methods. 2001;4(1):62–83.

26. Brandt J, Benedict R. Hopkins Verbal Learning Test-Revised (HVLT-R). Lutz, FL: Psychological Assessment Resources; 1991.

27. Randolph C. RBANS Repeatable Battery for the Assessment of Neuropsychological Status: Manual: Psychological Corporation; 1999.

28. Wechsler D, Coalson D, Raiford S. WAIS-IV: Wechsler Adult Intelligence Scale, 4th edition. San Antonio, TX: Pearson; 2008.

29. Stephen ID, Coetzee V, Perrett DI. Carotenoid and melanin pigment coloration affect perceived human health. Evol Hum Behav. 2011;32(3):216–27.

30. Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sport Exer. 2003;35(8):1381–95.

31. Moul DE, Pilkonis PA, Miewald JM, Carey TJ, Buysse DJ. Preliminary study of the test-retest reliability and concurrent validities of the Pittsburgh Insomnia Rating Scale (PIRS). Sleep. 2002;25:A246–A7.

32. Rausch JR, Maxwell SE, Kelley K. Analytic methods for questions pertaining to a randomized pretest, posttest, follow-up design. J Clin Child Adolesc. 2003;32(3):467–86.

33. Cohen J. Statistical power analysis for behavioral sciences. 2nd ed. New York, NY: Academic Press; 1988.

34. Jacobson NS, Truax P. Clinical-Significance—a Statistical Approach to Defining Meaningful Change in Psychotherapy-Research. J Consult Clin Psych. 1991;59(1):12–9.

35. Gupta S. Intention-to-treat concept: a review. Perspectives in Clinical Research. 2011;2(3):109–12. doi: 10.4103/2229-3485.83221 21897887

36. Sofi F, Macchi C, Abbate R, Gensini GF, Casini A. Mediterranean diet and health status: an updated meta-analysis and a proposal for a literature-based adherence score. Public Health Nutr. 2014;17(12):2769–82. doi: 10.1017/S1368980013003169 24476641

37. Hendrie G, Baird D, Golley S, Noakes M. CSIRO Healthy Diet Score. 2016.

38. Sanchez-Villegas A, Henriquez-Sanchez P, Ruiz-Canela M, Lahortiga F, Molero P, Toledo E, et al. A longitudinal analysis of diet quality scores and the risk of incident depression in the SUN Project. Bmc Med. 2015;13.

39. Teasdale SB, Ward PB, Rosenbaum S, Watkins A, Curtis J, Kalucy M, et al. A nutrition intervention is effective in improving dietary components linked to cardiometabolic risk in youth with first-episode psychosis. Brit J Nutr. 2016;115(11):1987–93. doi: 10.1017/S0007114516001033 27153205

Článek vyšel v časopise


2019 Číslo 10

Nejčtenější v tomto čísle

Tomuto tématu se dále věnují…


Zvyšte si kvalifikaci online z pohodlí domova

Léčba bolesti v ordinaci praktického lékaře
nový kurz
Autoři: MUDr. PhDr. Zdeňka Nováková, Ph.D.

Revmatoidní artritida: včas a k cíli
Autoři: MUDr. Heřman Mann

Jistoty a nástrahy antikoagulační léčby aneb kardiolog - neurolog - farmakolog - nefrolog - právník diskutují
Autoři: doc. MUDr. Štěpán Havránek, Ph.D., prof. MUDr. Roman Herzig, Ph.D., doc. MUDr. Karel Urbánek, Ph.D., prim. MUDr. Jan Vachek, MUDr. et Mgr. Jolana Těšínová, Ph.D.

Léčba akutní pooperační bolesti
Autoři: doc. MUDr. Jiří Málek, CSc.

Nové antipsychotikum kariprazin v léčbě schizofrenie
Autoři: prof. MUDr. Cyril Höschl, DrSc., FRCPsych.

Všechny kurzy
Kurzy Doporučená témata Časopisy
Zapomenuté heslo

Nemáte účet?  Registrujte se

Zapomenuté heslo

Zadejte e-mailovou adresu se kterou jste vytvářel(a) účet, budou Vám na ni zaslány informace k nastavení nového hesla.


Nemáte účet?  Registrujte se