Diet interventions for depression: Review and recommendations for practice

Objective: this paper aims to present the evidence for the role of diet in the prevention and treatment of depression, review the potential underlying mechanisms and provide practice recommendations for mental health clinicians. Methods: A literature review was conducted through searches of PubMed with the search terms ‘depression’, ‘diet’, ‘prevention’, ‘treatment’ and ‘mechanisms’ and combinations thereof. Additional articles were identified through hand searching. Results: Greater adherence to several healthy dietary patterns, traditional diets such as the Mediterranean diet and other diets such as the DASH diet are associated with or can treat symptoms of depression. Several limitations of the research were noted, many of which relate to inherent challenges of studying diet. Mechanisms by which dietary intervention can influence mood include the gut microbiome, modulation of inflammatory processes, reduction in oxidative stress and modulation of hypothalamic-pituitary-adrenal axis function. Recommendations for mental health clinicians to enable translation of the evidence into practice are provided. Conclusion: Diet can play an important role in preventing and treating depression. Mental health clinicians are well placed to provide dietary counselling and to use clinical judgement in choosing the specific approach that reflects the needs of the patient but are encouraged to refer to a specialist dietitian where necessary.