The importance of anti-inflammatory diet in depression: a literature review and recommendations

Authors

  • Zuzanna Joanna Wingralek Student Research Group at the I Department of Psychiatry, Psychotherapy, and Early Intervention, Medical University of Lublin, Poland Author https://orcid.org/0000-0003-3253-9345
  • Paweł Miś Medical University of Lublin, Poland Author https://orcid.org/0000-0002-2342-8419
  • Hubert Wróblewski Student Research Group at the I Department of Psychiatry, Psychotherapy, and Early Intervention, Medical University of Lublin, Poland Author
  • Aleksandra Zimna Independent Public Hospital of the Ministry of Interior and Administration in Lublin, Poland Author
  • Joanna Rog Laboratory of Human Metabolism Research, Department of Dietetics, Institute of Human Nutrition Science, Warsaw University of Life Sciences (WULS-SGGW), Poland Author https://orcid.org/0000-0003-4057-9507

DOI:

https://doi.org/10.12923/2353-8627/2023-0013

Keywords:

nutritional psychiatry, depression, anti-inflammatory diet

Abstract

Introduction: The etiopathogenesis of depression consists of genetic, metabolic, hormonal and psychogenic factors. The pathological process increases the risk and worsens the course of the disorder in chronic low-grade inflammation. Nutrition affects the pro-/anti-inflammatory state, and an anti-inflammatory diet is a proposed form supporting the therapy of inflammatory diseases. The review aimed to determine the importance of an anti-inflammatory diet in supporting the treatment of mood disorders.

Materials and methods: The available literature was reviewed by searching the PubMed and Google Scholar databases using the following keywords: nutritional psychiatry, depression, anti-inflammatory diet from the inception to 10th February 2023. We characterized the anti-inflammatory diet, potential mechanisms of action, the epidemiological and intervention studies conducted so far focusing on this topic, as well as barriers to implementation and potentially harmful effects of its implementation.

Results: Observational studies show a link between the anti-inflammatory potential of diet and a lower risk of developing mood disorders. The pro-inflammatory profile of the diet is associated with higher severity of depressive symptoms. On the other hand, an anti-inflammatory diet has a beneficial effect on the brain-gut axis and the intestinal microbiota, which are involved in the development of depressive disorders.

Conclusions: It is necessary to increase clinical practitioners' and patients' knowledge of the impact of nutrition on mental health. Our team developed recommendations for an anti-inflammatory diet adapted to Polish conditions based on the guidelines. In the case of patients' barriers to implementation, encouraging partial implementation of the recommendations is advised.

References

1. Miller AH, Raison CL. The role of inflammation in depression: from evolutionary imperative to modern treatment target. Nat Rev Immunol. 2016;16:22–34.

2. Miller AH, Maletic V, Raison CL. Inflammation and Its Discontents: The Role of Cytokines in the Pathophysiology of Major Depression. Biol Psychiatry. 2009;65:732-41.

3. Tolkien K, Bradburn S, Murgatroyd C. An anti-inflammatory diet as a potential intervention for depressive disorders: A systematic review and meta-analysis. Clin Nutr. 2019;38:2045–52.

4. Głąbska D, Guzek D, Groele B, Gutkowska K. Fruit and Vegetable Intake and Mental Health in Adults: A Systematic Review. Nutrients. 2020;12:115.

5. Thangaleela S, Sivamaruthi BS, Kesika P, Chaiyasut C. Role of Probiotics and Diet in the Management of Neurological Diseases and Mood States: A Review. microorganisms. 2022;10:2268.

6. Dinan TG, Stanton C, Cryan JF. Psychobiotics: a novel class of psychotropic. Biol Psychiatry. 2013;74:720-6.

7. Liao Y, Xie B, Zhang H, He Q, Guo L, Subramanieapillai M, et al. Efficacy of omega-3 PUFAs in depression: A meta-analysis. Psychiatry. 2019;9:1–9.

8. Galland L. Diet and inflammation. Nutr Clin Pract Off Publ Am Soc Parenter Enter Nutr. 2010;25:634–40.

9. Polak-Szczybyło E. Low-Grade Inflammation and Role of Anti-Inflammatory Diet in Childhood Obesity. Int J Environ Res Public Health. 2023;20:1682.

10. Rondanelli M, Faliva MA, Miccono A, Naso M, Nichetti M, Riva A, et al. Food pyramid for subjects with chronic pain: foods and dietary constituents as anti-inflammatory and antioxidant agents. Nutr Res Rev. 2018;31:131–51.

11. Arsenyadis F, Ahmad E, Redman E, Yates T, Davies M, Khunti K. The Effects of Omega-3 Supplementation on Depression in Adults with Cardiometabolic Disease: A Systematic Review of Randomized Control Trials. Nutrients. 2022;14:1827.

12. Sawicki KB, Skawiński W. Vitamin D3 – a fundamental component of human health and a potential supplement for COVID-19 prevention and therapy. Med General Health Sciences. 2021;27:227–34.

13. Shakya PR, Melaku YA, Shivappa N, Hebert JR, Adams RJ, Page AJ, et al. Dietary inflammatory index (DII®) and the risk of depression symptoms in adults. Clin Nutr. 2021;40:3631–42.

14. Shivappa N, Steck SE, Hurley TG, Hussey JR, Hebert JR. Designing and developing a literature-derived, population-based dietary inflammatory index. Public Health Nutr. 2014;17:1689–96.

15. Tabung FK, Giovannucci EL, Giulianini F, Liang L, Chandler PD, Balasubramanian R, et al. An Empirical Dietary Inflammatory Pattern Score Is Associated with Circulating Inflammatory Biomarkers in a Multi-Ethnic Population of Postmenopausal Women in the United States. J Nutr. 2018;148:771-80.

16. Laclaustra M, Rodriguez-Artalejo F, Guallar-Castillon P, Banegas JR, Graciani A, Garcia-Esquinas E, et al. The inflammatory potential of diet is related to incident frailty and slow walking in older adults. Clin Nutr Edinb Scotl. 2020;39:185–91.

17. Kaluza J, Harris H, Melhus H, Michaëlsson K, Wolk A. Questionnaire-Based Anti-Inflammatory Diet Index as a Predictor of Low-Grade Systemic Inflammation. Antioxidant Redox Signal. 2018;28:78–84.

18. Bahr LS, Franz K, Mähler A. Assessing the (anti)-inflammatory potential of diets. Curr Opin Clin Nutr Metab Care. 2021;24:402.

19. Dowlati Y, Herrmann N, Swardfager W, Liu H, Sham L, Reim EK, et al. A Meta-Analysis of Cytokines in Major Depression. Biol Psychiatry. 2010;67:446–57.

20. Akbaraly T, Kerlau C, Wyart M, Chevallier N, Ndiaye L, Shivappa N, et al. Dietary inflammatory index and recurrence of depressive symptoms: Results from the Whitehall II Study. Clin Psycho Sci J Assoc Psycho Sci. 2016;4:1125–34.

21. Phillips CM, Shivappa N, Hebert JR, Perry IJ. Dietary inflammatory index and mental health: A cross-sectional analysis of the relationship with depressive symptoms, anxiety and well-being in adults. Clin Nutr. 2018;37:1485–91.

22. 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 Population Nutr. 2022;41:24.

23. Açik M, Çakiroğlu FP. Evaluating the Relationship between Inflammatory Load of a Diet and Depression in Young Adults. Ecol Food Nutr. 2019;58:366–78.

24. Adjibade M, Andreeva VA, Lemogne C, Touvier M, Shivappa N, Hébert JR, et al. The Inflammatory Potential of the Diet Is Associated with Depressive Symptoms in Different Subgroups of the General Population. J Nutr. 2017;147:879–87.

25. Wang J, Zhou Y, Chen K, Jing Y, He J, Sun H, et al. Dietary inflammatory index and depression: a meta-analysis. Public Health Nutr. 2019;22:654–60.

26. Eskandarzadeh S, Effatpanah M, Khosravi-Darani K, Askari R, Hosseini AF, Reisian M, et al. Efficacy of a multispecies probiotic as adjunctive therapy in generalized anxiety disorder: a double blind, randomized, placebo-controlled trial. Nutr Neurosci. 2021;24:102-8.

27. Musazadeh V, Zarezadeh M, Faghfouri AH, Keramati M, Jamilian P, Jamilian P, et al. Probiotics as an effective therapeutic approach in alleviating depression symptoms: an umbrella meta-analysis. Crit Rev Food Sci Nutr. 2022;0:1-9.

28. Bambling M, Edwards SC, Hall S, Vitetta L. A combination of probiotics and magnesium orotate attenuate depression in a small SSRI resistant cohort: an intestinal anti-inflammatory response is suggested. Inflammopharmacology. 2017;25:271–4.

29. Nikolova VL, Cleare AJ, Young AH, Stone JM. Updated Review and Meta-Analysis of Probiotics for the Treatment of Clinical Depression: Adjunctive vs. Stand-Alone Treatment. J Clin Med. 2021;10:647.

30. Misera A, Liśkiewicz P, Łoniewski I, Skonieczna-Żydecka K, Samochowiec J. Effect of Psychobiotics on Psychometric Tests and Inflammatory Markers in Major Depressive Disorder: Meta-Analysis of Randomized Controlled Trials with Meta-Regression. Pharmaceuticals. 2021;14:952.

31. Kotemori A, Sawada N, Iwasaki M, Yamaji T, Shivappa N, Hebert JR, et al. Dietary Inflammatory Index Is Associated With Inflammation in Japanese Men. Nutr front. 2021;8.

32. Shivappa N, Schoenaker DAJM, Hebert JR, Mishra GD. Association between inflammatory potential of diet and risk of depression in middle-aged women: the Australian Longitudinal Study on Women's Health. Br J Nutr. 2016;116:1077–86.

33. Bergmans RS, Malecki KM. The association of dietary inflammatory potential with depression and mental well-being among US adults. Prev Med. 2017;99:313-9.

34. Hébert JR, Shivappa N, Wirth MD, Hussey JR, Hurley TG. Perspective: The Dietary Inflammatory Index (DII)—Lessons Learned, Improvements Made, and Future Directions. Adv. Nutr. 2019;10:185–95.

35. Haghighatdoost F, Feizi A, Esmaillzadeh A, Feinle-Bisset C, Keshteli AH, Afshar H, et al. Association between the dietary inflammatory index and common mental health disorders profile scores. Clin Nutr. 2019;38:1643–50.

36. Parletta N, Zarnowiecki D, Cho J, Wilson A, Bogomolova S, Villani A, et al. 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;22:474–87.

37. Mousavi-Shirazi-Fard Z, Mazloom Z, Izadi S, Fararouei M. The effects of modified anti-inflammatory diet on fatigue, quality of life, and inflammatory biomarkers in relapsing-remitting multiple sclerosis patients: a randomized clinical trial. Int J Neurosci. 2021;131:657–65.

38. Dolatkhah N, Toopchizadeh V, Barmaki S, Salekzamani Y, Najjari A, Farshbaf-Khalili A, et al. The effect of an anti-inflammatory in comparison with a low caloric diet on physical and mental health in overweight and obese women with knee osteoarthritis: a randomized clinical trial. Eur J Nutr. 2023;62:659–72.

39. Kenđel Jovanović G, Mrakovcic-Sutic I, Pavičić Žeželj S, Šuša B, Rahelić D, Klobučar Majanović S. The Efficacy of an Energy-Restricted Anti-Inflammatory Diet for the Management of Obesity in Younger Adults. Nutrients. 2020;12:3583.

40. Stegmann ME, Ormel J, de Graaf R, Haro JM, de Girolamo G, Demyttenaere K, et al. Functional disability as an explanation of the associations between chronic physical conditions and 12-month major depressive episode. J Affect Discord. 2010;124:38–44.

41. D.J. Kupfer, E. Phillips, M.L. Phillips. Major depressive disorder: new clinical, neurobiological, and treatment perspectives. The Lancet. 2012;379:1045–55.

42. Olivan-Blázquez B, Montero-Marin J, García-Toro M, Vicens-Pons E, Serrano-Ripoll MJ, Castro-Gracia A, et al. Facilitators and barriers to modifying dietary and hygiene behaviors as adjuvant treatment in patients with depression in primary care: a qualitative study. BMC Psychiatry. 2018;18:205.

43. Zurynski Y, Smith C, Siette J, Easpaig BNG, Simons M, Knaggs GT. Identifying enablers and barriers to referral, uptake and completion of lifestyle modification programmes: a rapid literature review. BMJ Open. 2021;11:e045094.

44. Husk K, Blockley K, Lovell R, Bethel A, Lang I, Byng R, et al. What approaches to social prescribing work, for whom, and in what circumstances? A realistic review. Health Social Care Community. 2020;28:309–24.

45. Ljungberg T, Bondza E, Lethin C. Evidence of the Importance of Dietary Habits Regarding Depressive Symptoms and Depression. Int J Environ Res Public Health. 2020;17:1616.

46. Jack FN, O'Neil A, Opie R, Itsiopoulos C, Cotton S, Mohebbi M, et al. A randomized controlled trial of dietary improvement for adults with major depression (the “SMILES” trial). BMC Med. 2017;15:23.

47. Shafiee NH, Manaf ZA, Mokhtar NM, Raja Ali RA. Antiinflammatory diet and inflammatory bowel disease: what clinicians and patients should know? Intest Res. 2021;19:171-85.

48. Taetzsch A, Das SK, Brown C, Krauss A, Silver RE, Roberts SB. Are Gluten-Free Diets More Nutritious? An Evaluation of Self-Selected and Recommended Gluten-Free and Gluten-Containing Dietary Patterns. Nutrients. 2018;10:1881.

49. Skowrońska-Jóźwiak E, Jaworski M, Lorenc R, Lewiński A. Influence of dietary calcium intake on quantitative and qualitative parameters of bone tissue in Polish adults. Ann Agric Environ Med AAEM. 2016;23:495–501.

50. Wajszczyk B, Charzewska J. Zawartość wapnia w dietach Polaków - przegląd piśmiennictwa. Żyw Człowieka Metab. 2013;3.

51. Lotfaliany M, Bowe SJ, Kowal P, Orellana L, Berk M, Mohebbi M. Depression and chronic diseases: Co-occurrence and communality of risk factors. J Affect Discord. 2018;241:461-8.

52. COVID-19 pandemic triggers 25% increase in prevalence of anxiety and depression worldwide. https://www.who.int/news/item/02-03-2022-covid-19-pandemic-triggers-25-increase-in-prevalence-of-anxiety-and-depression-worldwide. Accessed 20 Feb 2023.

53. Mosleh H, Alenezi M, Al johani S, Alsani A, Fairaq G, Bedaiwi R. Prevalence and Factors of Anxiety and Depression in Chronic Kidney Disease Patients Undergoing Hemodialysis: A Crosssectional Single-Center Study in Saudi Arabia. Cureus. 12:e6668.

54. Szponar, Lucjan, Ewa Rychlik, and Katarzyna Wolnicka. Album fotografii produktów i potraw: album of photographs of food products and dishes. Instytut Żywności i Żywienia, 2008.

55. IleWazy.pl - Baza produktów spożywczych i zestaw narzędzi przydatnych przy gotowaniu i dietach. https://www.ilewazy.com. Accessed 15 Feb 2023.

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Published

2023-07-20