Many times I am asked in my work with patients on various diets and supplements that are promoted in books and Blogs as miraculous cures for everything from anxiety to autism. As someone who tries to be very careful about drugs, I want to be encouraging about non-pharmacological treatments, but at the same time, it is important to base medical advice on real science rather than exaggerating. After all, pharmaceutical companies are not the only ones likely to make grandiose and exaggerated claims about their products. The manufacturers of supplements and fashion diet promoters do the same thing, but for some reason, there is less public outrage and skepticism about these “natural” interventions.
What happens often is that diets or supplements in particular often sound scientists and even make the physiological sense of why theoretically could be useful for certain mental health problems, but no one seems to have the time (or perhaps the Courage) to put the rubber on the road and actually test the product rigorously in a real human clinical trial.
That’s why I was thrilled to read about a real random trial in Australia’s respected dietary researcher Felice Jacka and colleagues on a specific diet designed to help adults with the major depressive disorder. The official name of the study was smiles, which means to support lifestyle modification in the emotional states lowered. (All clinical trials that want to be important and innovative now need to reach these very applied acronyms.)
Perhaps not unexpectedly, dietary treatment was not a new conspicuous supplement or a bizarre new approach, but rather a healthy diet of general Mediterranean inspiration that urged people to increase the consumption of fruits, vegetables, lean proteins, and Whole grains, reducing the consumption of carbohydrates, sweets and highly processed foods. It is important to note that participants were also allowed to continue the depression treatments they were already doing, mainly psychotherapy, antidepressants medications or some combination. In this way, the study was actually testing the added benefit of dietary modification instead of looking at what happens when the diet is used as a primary intervention.
Articlesonhealth: The 67 individuals in this study suffered from major depression which was classified as being in the moderate to severe range. They also had basic diets that were not particularly healthy in the first place. Half of the sample was randomized for social support (basically friendly conversations with a research assistant), while the other half received 7 sessions of personalized nutritional advice and motivational support for a “ModiMedDiet” that Emphasized healthier food choices as described above. The counselors also concentrated on limiting alcohol consumption in addition to 2 glasses of wine a day.
The results were very encouraging. Individuals in the Diet modification group have generally improved their eating habits and this, in turn, seemed to reduce their depressive symptoms. In its main instrument which traced the severity of the depression, the individuals in the Diet modification group significantly improved more than those in control condition. In terms of gross scores, the average score of depression for the Diet modification group decreased from 26 to 15 for 12 weeks, while for the control group fell from 25 to 20. This would be considered a rather large effect that is comparable–and even surpasses–some antidepressants “increase” studies with other medications, such as antipsychotic agents, that carry with them the potential of some side effects. Serious. At the end of the study, about one third of the dietary group subjects were described as “in remission” of their depression compared to only 8% in the control group. Anxiety scores have also improved with dietary intervention. The improvement in depression was found to be independent of the changes in weight.