Running Head: THE AFFECTS OF DIET ON LEVELS OF DEPRESSION IN ADULTS

The Affects of Diet on Levels of Depression in Adults

Adi Fish
CFS 453
May 9, 2016
Wanda Siu-Chan, MS, RD

THE AFFECTS OF DIET ON LEVELS OF DEPRESSION IN ADULTS

Abstract
Depression is a common and debilitating mental disorder in the United States. It affects
individuals, families, and the overall economy. Dietary changes are a currently acceptable part of
treatment plans for many physical illnesses, but are yet to be practiced in treating mental ones.
Studies have shown that there are some foods that effect levels of depression positively, and
some negatively. The Internet has enabled false claims and misinformation about treatments of
depression to reach anyone with Internet access, therefore it is important for health professionals
to include dietary recommendations in treatment plans for depression. This would clarify what
legitimate dietary changes patients should make, and potentially guide emotional eaters in
making healthier choices. Further research in this topic is needed, but the current studies show
promising results.

THE AFFECTS OF DIET ON LEVELS OF DEPRESSION IN ADULTS

The Affects of Diet on Levels of Depression in Adults

In a song about honey, Winnie the Pooh once sang: If everything is honey, and I am
what I eat/ I must be made of honey And life is very sweet (Cummings et al., 2011). The
notion that what a person eats effects their wellbeing is so ancient that 2,400 years ago in Greece,
Hippocrates said: Let food be thy medicine, and medicine be thy food. It is widely accepted
that following a specific diet can treat certain illnesses, as shown in cases of diabetes and food
sensitivities. In addition, many people use food as medicine for more minor ailments, which they
have learned from cultural practices or personal experiences; some have chicken noodle soup to
treat cold and flu symptoms, others drink Gatorade to relieve hangovers, or a glass of milk to
help beat insomnia.
A disorder that is not as widely accepted to be linked to diet is depression. The Diagnostic
and Statistical Manual of Mental Disorders refers to depression as Major Depressive Disorder,
and in order to receive the diagnosis, one must experience 5 of the 9 given symptoms. The
symptoms listed include: being in a depressed or irritable mood most of the time, and a decline in
interest and enjoyment of activities such as work, household chores, or usual hobbies. Changes
in appetite that are significant enough to cause at least a 5% difference in weight, inability to fall
or stay asleep, or excessive sleepiness. More symptoms include: changes in activity level and
speed in which activity is usually performed, Feeling lethargic or fatigue most days, excessive
guilt or feelings of worthlessness, a decrease in ability to concentrate, and suicidal thoughts or
plans. These symptoms are debilitating and grueling, and unfortunately even more common than
reported, especially in men (Oliffe, J. L., et al., 2011).
More than 16 million Americans suffer from depression every year, and that number does
not account for the loved ones of those affected, who often suffer as well. The World Health

THE AFFECTS OF DIET ON LEVELS OF DEPRESSION IN ADULTS

Organization estimated that by 2020 depression would be the second most burden-causing
disease in the world (Murray & Lopez, 1996). Depression causes physical and emotional pain,
lowers rates of productivity enough to cost the United States $210 billion annually, and can lead
to suicide. Once diagnosed, it is often treated with anti-depressants, which can have side effects
such as anxiety, irritability, and suicide; all symptoms of the depression they are supposed to treat
(CDC, 2013).
Deliberate consumption or avoidance of certain foods can help treat a spectrum of
diseases. To treat type II diabetes, it is common for patients to keep track of their carbohydrate
intake to prevent eating too much and throwing off their insulin levels. It is often recommended
that they also eat less fried foods and added sugar for the same reason. When dealing with heart
disease, patients are typically advised to reduce their intake of trans and saturated fats, and
increase their fruit and vegetable intake, as part of their treatment. Irritable bowel syndrome is
treated partially with avoidance of high fat foods, caffeine, and artificially sweetened foods and
beverages (CDC). The dietary change recommendations made after the diagnosis of physical
illnesses are generally accepted as beneficial, but often times dietary changes are overlooked
when constructing a treatment plan for other types of health problems.
Nowadays in much of the world, the Internet is used as an efficient tool that can relay
information to millions quickly. This has opened up opportunities for people with depression and
has made it easier to find help. Instead of having to go to a doctor, people experiencing signs of
depression can go on websites that are meant to diagnose illnesses such as WebMD.com. Once
the connection has been made that depression may be the cause of symptoms, finding support
groups, virtual or in the physical community, is only a Google search away. While this ease on a
difficult and taboo process of getting help can be beneficial, the Internet has also made it possible

THE AFFECTS OF DIET ON LEVELS OF DEPRESSION IN ADULTS

for the advertising of false claims and treatments for depression that are not backed up by any
kind of science, and are often selling a product. It is crucial to filter out the incorrect information
and focus only on helping people suffering from depression to get the all information and help
they can, from valid scientific research.
Studies suggest evidence that the diet of an individual has the ability to affect mental
health as well as physical health and overall wellbeing. Reviewing previously published studies
and identifying where more research is needed has the potential to save billions of dollars,
increase productivity in the workplace, and save lives.
Recently in mainstream nutrition news, the harmfulness of high sugar consumption has
become a trending topic. Bloggers are giving up sugar and documenting their experience and the
physical and mental changes that follow. Businesses and government agencies have made
changes as well, and the in the newly released dietary guidelines for 2015-2020, the USDA
recommends limiting added sugar consumption (USDA, 2016).
Sugar is said to be addictive, linked to obesity, and the cause of skin blemishes; but it is
important to investigate if consuming higher levels of it is linked to heightened levels of
depression. A cross-national study published in 2002 was ahead of other research of its time in
making the connection between added sugar and mental health. Major depression rates and levels
added sugar consumption were collected from the Food and Agricultural Organization of the
United Nations. Information on Korea, The United States, Germany, Canada, and New Zealand
were collected. The results were a significant correlation between the rates of added sugar
consumed, and levels of major depression reported (Westover & Marangell, 2002).
If depression is so common, and evidence of its link to dietary patterns has been studied,
why is the research not being reflected in medical practice? There is a gap between the literature

THE AFFECTS OF DIET ON LEVELS OF DEPRESSION IN ADULTS

supporting the affects of nutrition, and the lack of dietary guidance provided by doctors and other
health professionals regarding depression. A study conducted in Spain investigated the effects of
specific dietary recommendations on depression by diving 273 participants into two groups. The
control group received general lifestyle change recommendations, and was instructed to try to
eat a healthy and balanced diet. The active group received more specific dietary guidelines,
such as to eat fish 3 times a week and avoid snacking. The active group was also instructed to
avoid sweetened beverages, and to consume fruits and vegetables daily. The participants in the
active group were more likely to report lower rates of depression following the specific
instruction (Ripoll et al., 2015).
When pills are prescribed, not only does the packaging include directions and warnings
regarding how the medicine should be taken, but also a pharmacist is expected to go over the
process of taking the pills in detail. A health professional providing specific instructions
regarding any kind of changes, removes vagueness and confusion out of the recommendation.
The same applies to dietary changes, which are often left out of the process in which patients get
set up and informed about their treatment plan.
One recommendation that could be helpful is to have health professionals explain a
detailed diet plan for patients upon diagnosis of depression. A clear set of dietary guidelines that
should be followed as close as possible, both described in person or over the phone by a health
professional, and in writing so the patient is able to refer back to a copy anytime.
Another way to help the fight against depression is by promoting and doing more
research in the field of diet and depression. While studies have been done, many do not focus on
just depression, or highlight the ways in which the findings could help in medical practice.
Although there is not enough research to confidently replace anti-depressant drugs with dietary

THE AFFECTS OF DIET ON LEVELS OF DEPRESSION IN ADULTS

changes, the changes promoted by research to help decrease rates of depression are some of the
same changes recommended for better overall health. One of the symptoms of depression is a 5%
weight loss or weight gain, which stems from over or under eating. Emotional eating is the link
between depression and weight gain, and guidance regarding how to approach eating with
depression, could possibly help control emotional eating (Strein et al., 2016).
Depression is a painful, underreported illness. It affects the millions of individuals who
suffer from it, whether diagnosed or unrecognized. Additionally, due its symptoms of disinterest
and withdrawal, children and significant others can deeply suffer as well. Depression is also
costly on a larger scale, negatively impacting productivity in the workplace enough to lose
billions of dollars annually. Although there is a lack of clarity due to baseless claims on the
Internet regarding cures and treatments, studies with significant results showing the positive and
negative influences of consuming different foods on depression are available.
There is not enough available evidence to suggest that dietary changes are affective
enough to replace prescription medication in the case for depression, however, it may be able to
help alongside a prescription or aid in preventative care in at-risk patients. Fortunately, the
dietary changes that are promoted by research to help alleviate depression are similar to general
healthy eating recommendations. Thus, adding a specific dietary component to the treatment plan
of depression is not associated with much risk, while providing healthier choices for those who
are engaging in emotional eating.
Receiving clear and specific dietary information from a health professional upon
diagnosis could be beneficial for treating depression. It would also help the connection between
diet and depression become more of a mainstream idea, and ideally, a more popular topic of
research. On a grander scale, this issue could potentially spark an interest in finding links

THE AFFECTS OF DIET ON LEVELS OF DEPRESSION IN ADULTS

between diet and other mental illnesses, perhaps leading to discovering new cures without the
risks and side effects of prescription drugs.

THE AFFECTS OF DIET ON LEVELS OF DEPRESSION IN ADULTS

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