Nutrition-based interventions for mood disorders

ABSTRACT

Introduction: ‘Nutritional Psychiatry’ is an emerging area of research that has great potential as an adjunctive tool for the prevention and treatment of diverse neuropsychiatric disorders. Several nutrition-related aspects, such as obesity, dietary patterns, gut microbiome composition and gut permeability, bioactive food compounds, and nutrients can influence pathways implicated in the pathophysiology of mood disorders.

Areas covered: Here, the authors review the current evidence on nutrition–mood interaction and nutrition-based treatments for the two main mood disorders, i.e., major depressive disorder and bipolar disorder.

Expert opinion: Consistent evidence from observational studies has pointed out the association between a ‘healthy’ diet, generally characterized by a higher intake of fruits, vegetables, legumes, nuts, whole grains, and good quality sources of protein (i.e. fish and/or seafood), and decreased risk of mood disorders and the parallel association between a ‘Western’ diet pattern and increased risk. However, only a few clinical trials have evaluated the effect of nutritional interventions on the treatment of these conditions. The bidirectional interaction between the brain and the gut, named ‘brain-gut-microbiome axis’ or ‘gut-brain axis’, plays a key role in the link between nutrition and mood disorders. Therefore, nutrition-based strategies for gut microbiota modulation are promising fields in mood disorders.

KEYWORDS:

• Nutrition
• mood disorders
• depressive disorder
• bipolar disorder
• diet
• microbiota
• probiotics
• nutrients

Article highlights

• Several nutrients, such as omega-3 polyunsaturated fatty acids, zinc, vitamin D, and folate, and food bioactive compounds, such as polyphenols (e.g. resveratrol), act in pathways implicated in the pathophysiology of mood disorders, including inflammation, oxidative stress, neuroplasticity, and gut microbiota composition. These preclinical data have not been paralleled by robust clinical trial support.

• Obesity can play a role in the exacerbation of inflammatory pathways in patients with a mood disorder.

• Observational studies have consistently pointed out the association between diet composition and the risk of mood disorders. Adherence to a‘healthy’ diet, generally characterized by a higher intake of fruits, vegetables, legumes, nuts, whole grains, and good-quality protein sources (i.e. fish and/or seafood), decreases the risk of psychiatric disorders development. However, few clinical trials have evaluated the effect of diet on the treatment of these conditions and generally support the value of nutritional approaches to the management of mood disorders.

• The bidirectional interaction between the brain and the gut, named ‘brain-gut-microbiome axis’ or ‘gut-brain axis’, plays a key role in the link between nutrition and mood disorders. Nutrition-based strategies for gut microbiota modulation, such as the use of prebiotics and probiotics, have shown promising results in improving depressive symptoms.

Declaration of interest

The Neuropsychiatry Program is partly funded by the UTHealth Houston Department of Psychiatry and Behavioral Sciences. JR Braga Tibães is supported by the Alberta Diabetes Institute. AL Teixeira is funded by CNPq, UTHealth and TARCC. MB is supported by a NHMRC Senior Principal Research Fellowship (1,156,072). MB has received Grant/Research Support from the NIH, Cooperative Research Centre, Simons Autism Foundation, Cancer Council of Victoria, Stanley Medical Research Foundation, Medical Benefits Fund, National Health and Medical Research Council, Medical Research Futures Fund, Beyond Blue, Rotary Health, A2 milk company, Meat and Livestock Board, Woolworths, Avant and the Harry Windsor Foundation, has been a speaker for Abbot, Astra Zeneca, Janssen and Janssen, Lundbeck and Merck and served as a consultant to Allergan, Astra Zeneca, Bioadvantex, Bionomics, Collaborative Medicinal Development, Janssen and Janssen, Lundbeck Merck, Pfizer and Servier – all unrelated to this work. FJ has received Grant/Research support from the Brain and Behavior Research Institute, the National Health and Medical Research Council, Australian Rotary Health, the Geelong Medical Research Foundation, the Ian Potter Foundation, Eli Lilly, Meat and Livestock Australia, Woolworths Limited, Fernwood Foundation, Wilson Foundation, The A2 Milk Company, Be Fit Foods, and The University of Melbourne and has received speakers honoraria from Sanofi-Synthelabo, Janssen Cilag, Servier, Pfizer, Health Ed, Network Nutrition, Angelini Farmaceutica, Eli Lilly and Metagenics. FJ has also written two relevant books for commercial publication. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or conflict with the subject matter or materials discussed in this manuscript apart from those disclosed. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or conflict with the subject matter or materials discussed in this manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.