We’ve all experienced anxiety or depression at one time or another in our lives. According to the CDC, 11.7% of adults over 18 experience anxiety or worry regularly while 4.8% have feelings of depression.1 These numbers grew even higher during and after the pandemic. Estimates as high as 25% of adults have been recorded for the prevalence of anxiety. 2

Chronic worrying and stress may have long-term effects on your physical health. According to the American Psychological Association, constant anxiety and stress may raise your risk for cardiovascular disease, infertility, arthritis, and metabolic disorders such as diabetes and obesity.3

A Western-style diet is considered more pro-inflammatory and may impact mental health. A meta-analysis of studies of 157,409 participants found that those in the highest inflammatory diet group had a significant association with the incidence of depression and anxiety. Those in the lowest inflammatory diet group experienced a lower risk for anxiety and depression. 4

The good news is that a Mediterranean-style diet may put you in a better state of mind. One study in over 150 adults with depression found that individuals attending a 3-month Med-diet cooking class along with the use of fish oil supplements had better fruit, vegetable, legume, nuts, and whole grain intake and reduced intake of red meat and unhealthy snacks. Depressive symptoms were kept at bay for 6 months after the intervention. 5

In addition, a randomized control trial in young men with depression (aged 18 to 25 years) also indicates that a Mediterranean-style diet may alleviate depressive symptoms. A 12-week intervention of a Mediterranean diet or “befriending” (control group), found better adherence to a Mediterranean diet and more change in the Beck Depression Inventory Scale. Quality of life scores was also higher in the Mediterranean group. 6

While vegetables, legumes, and whole grains are a big part of the Mediterranean diet, a vegetarian diet was not correlated with a reduced risk of depression, anxiety, or stress. A recent systematic review and meta-analysis of observational studies found no link between a vegetarian diet and depression or anxiety. Further research is needed in this area. 7

A Mediterranean diet has plenty of delicious food to feed your brain. Check out the list below.

Top 8 Foods to Eat to Improve Mental Health

There are lots of great foods to consume to reduce the risk of depression. Here are my top 8:

·         Whole grains like rolled oats, brown rice, or whole wheat couscous. These provide complex carbohydrates as well as tryptophan, a neurotransmitter associated with good mood.

·         Add fruits and vegetables to all meals. Higher intakes of fruits and vegetables have been found to be beneficial in reducing the incidence of depression in middle-aged and older adults in a recent systematic review and meta-analysis. 8

·         Beans, including soybeans. Beans contain plenty of dietary fiber, which has been found to reduce the risk of depression. 9

·         Fatty fish. Salmon, tuna, and mackerel are sources of omega-3 fatty acids, a healthy fat linked with a reduction in inflammation. A meta-analysis of studies indicates that fish higher fish intake is linked with reduced rates of depression. 10

·         Leafy, green vegetables. Leafy greens provide the B vitamin folate. One study found that subjects with normal levels of folate and B12 (versus low levels) had lower rates of depression. 11

·         Nuts and seeds, especially walnuts. Walnuts are a plant source of omega-3 fatty acids. A recent study found that nut eaters had lower depression scores than non-nut eaters. The impact was strongest in women. 12

·         Yogurt and other fermented dairy foods. A recent meta-analysis of cohort studies indicated that fermented dairy intake was associated with lower rates of depression. The authors believe this is related to the gut-brain axis. 13

·         Extra virgin olive oil. It’s not just good for your heart. The use of EVOO was found to reduce symptoms of depression in those dealing with severe depression, but not mild to moderate depression. It certainly can’t hurt to use it in place of other oils. 14

Lisa Andrews, MEd, RD, LD

References:

1.    FastStats - Mental Health (cdc.gov)

2.    Santabárbara J, Lasheras I, Lipnicki DM, Bueno-Notivol J, Pérez-Moreno M, López-Antón R, De la Cámara C, Lobo A, Gracia-García P. Prevalence of anxiety in the COVID-19 pandemic: An updated meta-analysis of community-based studies. Prog Neuropsychopharmacol Biol Psychiatry. 2021 Jul 13;109:110207. doi: 10.1016/j.pnpbp.2020.110207. Epub 2020 Dec 15. PMID: 33338558; PMCID: PMC7834650.

3.    Stress effects on the body (apa.org)

4.    Li X, Chen M, Yao Z, Zhang T, Li Z. Dietary inflammatory potential and the incidence of depression and anxiety: a meta-analysis. J Health Popul Nutr. 2022 May 28;41(1):24. doi: 10.1186/s41043-022-00303-z. PMID: 35643518; PMCID: PMC9148520.

5.    Parletta N, Zarnowiecki D, Cho J, Wilson A, Bogomolova S, Villani A, Itsiopoulos C, Niyonsenga T, Blunden S, Meyer B, Segal L, Baune BT, O'Dea K. A Mediterranean-style dietary intervention supplemented with fish oil improves diet quality and mental health in people with depression: A randomized controlled trial (HELFIMED). Nutr Neurosci. 2019 Jul;22(7):474-487. doi: 10.1080/1028415X.2017.1411320. Epub 2017 Dec 7. PMID: 29215971.

6.    Bayes J, Schloss J, Sibbritt D. The effect of a Mediterranean diet on the symptoms of depression in young males (the "AMMEND: A Mediterranean Diet in MEN with Depression" study): a randomized controlled trial. Am J Clin Nutr. 2022 Aug 4;116(2):572-580. doi: 10.1093/ajcn/nqac106. PMID: 35441666.

7.    Askari M, Daneshzad E, Darooghegi Mofrad M, Bellissimo N, Suitor K, Azadbakht L. Vegetarian diet and the risk of depression, anxiety, and stress symptoms: a systematic review and meta-analysis of observational studies. Crit Rev Food Sci Nutr. 2022;62(1):261-271. doi: 10.1080/10408398.2020.1814991. Epub 2020 Sep 4. PMID: 32885996.

8.    Matison AP, Mather KA, Flood VM, Reppermund S. Associations between nutrition and the incidence of depression in middle-aged and older adults: A systematic review and meta-analysis of prospective observational population-based studies. Ageing Res Rev. 2021 Sep;70:101403. doi: 10.1016/j.arr.2021.101403. Epub 2021 Jul 8. PMID: 34246793.

9.    Somaye Fatahi, Shakiba Shoaee Matin, Mohammad Hassan Sohouli, Mihnea-Alexandru Găman, Pourya Raee, Beheshteh Olang, Vaani Kathirgamathamby, Heitor O. Santos, Nathalia Sernizon Guimarães, Farzad Shidfar, Association of dietary fiber and depression symptom: A systematic review and meta-analysis of observational studies, Complementary Therapies in Medicine, Volume 56, 2021, 102621

10. Li F, Liu X, Zhang D Fish consumption and risk of depression: a meta-analysis J Epidemiol Community Health 2016;70:299-304

11. Khosravi, M., Sotoudeh, G., Amini, M. et al. The relationship between dietary patterns and depression mediated by serum levels of Folate and vitamin B12. BMC Psychiatry 20, 63 (2020). https://doi.org/10.1186/s12888-020-2455-2

12. Arab L, Guo R, Elashoff D. Lower Depression Scores among Walnut Consumers in NHANES. Nutrients. 2019 Jan 26;11(2):275. doi: 10.3390/nu11020275. PMID: 30691167; PMCID: PMC6413101.

13. Luo Y, Li Z, Gu L, Zhang K. Fermented dairy foods consumption and depressive symptoms: A meta-analysis of cohort studies. PLoS One. 2023 Feb 6;18(2):e0281346. doi: 10.1371/journal.pone.0281346. PMID: 36745637; PMCID: PMC9901789.

14. Foshati S, Ghanizadeh A, Akhlaghi M. Extra-Virgin Olive Oil Improves Depression Symptoms Without Affecting Salivary Cortisol and Brain-Derived Neurotrophic Factor in Patients With Major Depression: A Double-Blind Randomized Controlled Trial. J Acad Nutr Diet. 2022 Feb;122(2):284-297.e1. doi: 10.1016/j.jand.2021.07.016. Epub 2021 Aug 3. PMID: 34358723.