Depression is a condition that affects the whole person. It affects the way you think, the way you feel, and your physical health. We’ve known for a while that food and mood are closely linked, but a recent review of more than 40 studies has found strong evidence that eating poorly can actually cause depression. The study found that eating a diet high in sugar and fat leads to systemic inflammation, which directly leads to a greater risk of depression. With systemic inflammation, pro-inflammatory molecules are transported to the brain, where they affect levels of neurotransmitters. An imbalance of the neurotransmitters dopamine and serotonin has long been thought to be a major component of depression. Importantly, this study was able to separate causation from mere correlation. The review included five longitudinal studies of more than 30,000 adults in five different countries. In these studies, people who had depression at the beginning of the study were excluded. Of those who remained, the people who ate the most junk food were the most likely to develop symptoms of depression. This is evidence that poor diet contributes to depression, rather than depression causing people to prefer food high in sugar and fat. The study also found that people who followed a traditional mediterranean diet, comprising fruit, vegetables, whole grains, fish, and nuts were less likely to develop depression. The study’s authors call for doctors to include dietary counselling as a routine part of depression treatment. Another, smaller study from Australia tested dietary interventions among depressed patients and found impressive results. Some participants were assigned to a social support group, in which they regularly met with someone for an informal but supportive conversation. The other group received dietary counselling, in which they were advised to adopt a Mediterranean diet much like the one described above. In addition to the vegetables, fruits, nuts, and whole grains typical of the Mediterranean diet, participants were also asked to limit their alcohol consumption to wine, and not more than two glasses a day. In the course of 12 weeks, the depression scores for participants in the social support group dropped on average from 25 to 20, while the scores for the dietary intervention group dropped from 26 to 15–more than twice the improvement of the social intervention. There are two things worth noting in this study. First, participants continued whatever treatment they were already receiving throughout the study. Typically, this was some mix of medication and psychotherapy. Whatever improvement they experienced was in addition to that treatment. Second, as part of the dietary intervention, they were asked to limit their alcohol intake. Alcohol is a depressant that can lower levels of norepinephrine and serotonin and disturb sleep quality, so limiting alcohol might have led to a significant improvement even without the diet change. However, it may be splitting hairs to say that, for example, ice cream is a dietary item, while alcohol isn’t. Those caveats aside, there is now considerable evidence that diet does make a difference in depression. The more junk food and alcohol you consume, the worse you are likely to feel and the more nutritious, whole food you eat, the better you will feel.
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