- Over the last few years, we’ve been accumulating evidence hinting that improving nutrition for depression treatment and prevention might be effective. But until recently, we still had no proof.
- Enter: The SMILES trial. It’s the first trial specifically designed to test the relationship between diet and depression, and it’s managed to establish a link between switching to a healthier diet and reducing symptoms of depression (cray cray)!
- The diet, called the Mod/Med diet, is pretty easy to follow and combines Greece and Australia’s food guidelines. Learn more about the Mod/Med diet here.
- Want some easy recipes, which will help you follow the Mod/Med diet guidelines? Check them out here.
The Time We Accidentally Discovered Using Nutrition For Depression Treatment
Some of our most important scientific discoveries are happy accidents. Like penicillin, the antibiotic powerhouse that was accidentally discovered by Alexander Fleming in 1928. Fleming went on vacation and left his lab a hot mess (my Jewish mom would not be proud). When he returned from his R&R sesh, and started sorting through his petri dishes, he discovered that mould growing in one of his samples seemed to be killing bacteria. This was the beginning of the antibiotic age, meaning eventually people with insurance would no longer have to worry about gonorrhea, and some other deadly shit too (until the rise of the superbug).
Now, many of you might be wondering why I am yammering on about penicillin and gonorrhea; I swear I have a point. Another happy accident led us to start studying how we might use nutrition for depression treatment. The authors of this study were trying to prove that five hours of CBT (cognitive behavioural therapy) could help prevent depression in elderly patients. These badass, brain researchers recruited 247 participants and broke them into two groups, test and control. The test group received CBT, the control group received nutritional counselling. It was expected that nutritional counselling wouldn’t have any impact on depression (while the therapy would). When the study concluded, the results came as a surprise – both groups displayed a reduced risk of depression (say what?). When the researchers reviewed the data, every patient scored on average 40 to 50 percent lower on the Beck Depression Inventory test (commonly used to measure of depression) 15 months after their sessions ended. Plus, only about 8 percent (as opposed to the usual 20-25%), in both groups, had fallen into major depression.
Some other studies had previously alluded to the importance of considering improving nutrition for depression treatment. In these studies, measures of depression were just collected along the way in a trial looking at something else (such as heart disease). To be clear, depression was never the endpoint in these studies and the participants were not specifically depressed patients. Beyond observational studies, there’s a large body of evidence that points to the fact that depression might correlate with diet in animals. But despite the fact that there’s evidence suggesting a link, no one had actually proved anything in humans.
The SMILES Trial: Building The Case For Nutrition For Depression Treatment
Then came the SMILES (Supporting the Modification of lifestyle In Lowered Emotional States) trial, the wordiest named trial of all time (not a genuine fact, there are many insanely wordy science things). This was the first trial designed to study using nutrition for depression treatment. Australian researchers recruited participants that already met the criteria for depression, and some were even receiving treatments (meds and/or therapy). They purposely recruited participants who ate a Western style diet, for both the test group and the control, and excluded healthy eaters. The researchers then split the participants up into test and control groups. The test group was given dietary advice, and nutritional counselling (including goal setting and mindful eating). The counselling was aimed at helping these adults eat a version of the Mediterranean diet called the Mod/Med diet, which combined the Australian Dietary Guidelines and the Dietary Guidelines for Adults in Greece. The control group had the same numbers of support sessions, but didn’t receive dietary advice.
The results were cool AF. The dietary group showed significant improvements on the MARDS (Montgomery–Åsberg Depression Rating Scale, a test used to measure depression) after 12 weeks. Remission of depression symptoms occurred in 32.3 percent of the diet group as opposed to 8 percent of the control group. Meaning, according to this one study, it fucking worked. Also, when the researchers looked at the cost of the Med/Mod diet, compared with test participants regular diets, they found that the Med/Mod diet was AU$26 cheaper/week (AU $112 vs $138). All in all, the case for using nutrition for depression treatment is building.
All that being said (Debbie downer time), don’t break out the veggies and put away the tissues just yet. There are some things to consider before we decide this study is absolute fact. First of all, there were only 33 people in the test group and 34 in the control, which is pretty small for a study. The study was actually designed for a larger group, but they failed to meet recruitment goals. The study also only looked at a 12 week period, which is a pretty short amount of time. Plus, it’s the first study of its kind to try to establish a causal link between depression and food, so we really should wait and see if this study can be replicated (many can’t).
In summary, this research looks promising, and I think we’ll see a lot more people investigating the link between brain health and what we feed it. As more studies come to light, I’ll try to update this article, so stay tuned!
So you might have been thinking, this seems cool, but how do I actually apply it. Well, lucky for you (and unlucky for me) I spent some time scouring the details of the SMILES study, looking for the specifics of the diet. See below.
12 key food groups (recommended servings in brackets)
- whole grains (5–8 servings per day)
- vegetables (6 per day)
- fruit (3 per day)
- legumes (3–4 per week)
- low-fat and unsweetened dairy foods (2–3 per day)
- raw and unsalted nuts (1 per day)
- fish (at least 2 per week)
- lean red meats (3–4 per week)
- chicken (2–3 per week)
- eggs (up to 6 per week)
- olive oil (3 tablespoons per day)
Things to avoid: sweets, refined cereals, fried food, fast-food, processed meats and sugary drinks (no more than three per week). Red or white wine consumption beyond two standard drinks per day and all other alcohol (e.g. spirits, beer). Individuals were advised to select red wine preferably and only drink with meals.