Diet & depression Wall Street Journal

MadisonMolly2017

https://www.wsj.com/articles/the-food-that-helps-battle-depression-1522678367?mod=e2fb

Interesting new field. What do you think?

siobhanaoife

I think it's behind a paywall.

Tacklewasher

siobhanaoife wrote: »

I think it's behind a paywall.

Yup. Can't read it.

CSARdiver

Correlation and not causation. Similar to the link between flossing your teeth and increased heart health.

Good health is largely an output of behavior. Healthy behaviors influence other aspects of one's life.

French_Peasant

If anyone wants to read the WSJ article, I was able to access it by cutting and pasting the title into my browser. It links to several studies--I just quickly skimmed things and haven't pored over them.

With "nutritional psychiatry" you're getting a mash-up of two very soft sciences, with all kinds of problems with research methodology, replication and such. So I just take a very skeptical view on such claims. As I skimmed the research, red flags just kept on popping up, like how the 2nd study (the Australian one) excluded anyone who was depressed and already eating a healthy diet. I also didn't note any socioeconomic controls, which could play a powerful role in depression. And achieving a clinical definition of depression is a pretty squirrelly process anyway based on a questionnaire, I believe.

I did like that the 2nd study provided cooking classes and biweekly food hampers.

I would be really interested in seeing something based on not just providing the food, but also analyzing microbiome changes and brain scans, just so it could be linked to something a little more substantive than self-reporting.

To me it makes sense that a great diet would help reduce depression, but I would like to see a biological mechanism established for this. How do you rule out a placebo effect? When my diet is really on-point, I'm pretty proud and happy about that; would that lessen any depression?

At the same time, my n=1 experience has shown that greatly increasing my veg intake and reducing my sugar intake gives me skin as clear as a bell; if this can affect skin surely it can affect other aspects of health as well.

Here are the 3 studies cited:

https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0791-y?mod=article_inline

https://www.tandfonline.com/doi/full/10.1080/1028415X.2017.1411320?mod=article_inline&

https://www.sciencedaily.com/releases/2018/02/180225191804.htm?mod=article_inline

lemurcat2

Interesting -- it's actually consistent with my experience, although depression also tends to make me eat worse, so that's an issue.

It's not a longitudinal study, but comparing two interventions, one diet-based and one with social support.

The diet one could have a variety of reasons for it, though. I find that having small things to focus on, be able to control, and accomplish can help a lot, and this would fit that bill.

lemurcat2

For those who don't subscribe to the WSJ, here's the actual study: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0791-y?mod=article_inline

lorrainequiche59

Nutrition is one piece of the puzzle but not the total picture. Poor nutrition may be a contributing factor but not the only factor. You may have excellent nutritional intake, but poor absorption. I know people who eat crap and have never been depressed and the opposite is also true. SO, is there a link between diet & depression....maybe and maybe not!!!!!! Depends on the person and their life experience more than what they put in their mouth...just an unscientific and anecdotal viewpoint!!

lemurcat2

I don't think the takeaway is depression is caused by poor diet. It's that diet can be part of the treatment.

GottaBurnEmAll

I think, in my personal experience with depression and anxiety, anything relating to self care helps with treating depression. This includes a healthy diet, exercise, good hygiene, good sleep hygiene, keeping an organized home, pursuing interests to keep yourself engaged, etc.

lorrainequiche59

GottaBurnEmAll wrote: »

I think, in my personal experience with depression and anxiety, anything relating to self care helps with treating depression. This includes a healthy diet, exercise, good hygiene, good sleep hygiene, keeping an organized home, pursuing interests to keep yourself engaged, etc.

lemurcat2 wrote: »

I don't think the takeaway is depression is caused by poor diet. It's that diet can be part of the treatment.

YES, nutrition is "one piece" of the puzzle. But there are many, many other pieces: Genetics, environment, childhood trauma, tragedy etc etc. Depression is a multi-layered condition. And as the above quotes state, can be used as part of the treatment. I dislike studies that focus on one component. It can be misleading.

lemurcat2

lorrainequiche59 wrote: »

GottaBurnEmAll wrote: »

I think, in my personal experience with depression and anxiety, anything relating to self care helps with treating depression. This includes a healthy diet, exercise, good hygiene, good sleep hygiene, keeping an organized home, pursuing interests to keep yourself engaged, etc.

lemurcat2 wrote: »

I don't think the takeaway is depression is caused by poor diet. It's that diet can be part of the treatment.

YES, nutrition is "one piece" of the puzzle. But there are many, many other pieces: Genetics, environment, childhood trauma, tragedy etc etc. Depression is a multi-layered condition. And as the above quotes state, can be used as part of the treatment. I dislike studies that focus on one component. It can be misleading.

Typically, studies will isolate one factor to see if it makes a difference. No one is saying this is the only relevant factor.

shaumom

One issue that comes up in mental health studies that I wish was considered more is that most people diagnosed with mental health issues are not given a good, head to toe, health evaluation before being diagnosed.

As a result, you can often have people diagnosed as, say, depressed, when they have not been properly evaluated to see if they DO have completely psychological depression, rather than something entirely different that is completely physiological - and that may skew results.

Which is funny. Because studies like this are positing that perhaps something that impacts the whole body - nutrition - could be an effective treatment. But doing that without first examining if something that impacts the whole body was a potential cause of depression (by having a full health evaulation) in some people seems odd.

I'm not trying to say I think poor nutrition causes depression, mind.

However, I have seen depression that disappeared when someone tested positive for a nutrient deficiency and started getting enough of that nutrient. Depression that went away when a celiac was diagnosed and went gluten free. Depression that disappeared when someone was diagnosed with food allergies and avoided those foods. I've seen multiple people have this happen within each category, even. And all of these could, potentially, be impacted by a 'diet alterations help depression symptoms.'

When for all of these, the actual answer was: an underlying health issue caused depression-like symptoms and was finally taken care of.

missmince

I read the whole study, including the background section, and am really unimpressed due to a number of things I noticed. One thing is that they said, for their statistical analysis that they wanted 88 people per group, but they actually ended up recruiting 67 total. This may be partly because they excluded bipolar I and II (why?) and treatment resistant depression (2 or more failed treatments). They talk about the control group getting "befriending" sessions in lieu of nutritional counseling, and I note that the drop out rate is much, much higher for the "befriended" group. I don't blame them; it sounds dreary and was clearly not successful. Since they had an unimpressive sample size, excluded a lot of depressed people inappropriately (in my opinion), and did a bad job with their "control", I don't think it's worth putting in the WSJ. Maybe a slow day for financial news? Running data through statistical software can make it sound impressive, but the actual data seems pretty weak.

BTW, you have to poke through all the sections of the article to find weak points. Abstracts always brush over the flaws.

My own experience is that I eat poorly, and in small quantities, when I'm down, and better when I'm more energetic. Correlation, not causation. If I was supposed to chat with the people assigned as "befrienders" when doing a study, I'd feel like my time was being wasted. Being reminded to eat healthily might remind me to eat the stuff that I already know is good for me, but I suspect the benefits would end when the personal reminders (sessions) ended.

neugebauer52

Depression and weight loss / weight gain (among other symptoms): nothing new, has been observed in Western societies for hundreds of years. But how does one break the destructive circle?

lemurcat2

missmince wrote: »

Since they had an unimpressive sample size, excluded a lot of depressed people inappropriately (in my opinion), and did a bad job with their "control", I don't think it's worth putting in the WSJ.

Many studies have smaller sample sizes, and focusing on a single condition and excluding others that could be considered different in some way or less likely to be affected by what they are trying to to test is important for any study. The idea with the "befriending" is likely to make sure the effect they perceive is not just from someone taking interest and intervening in that way, as that would be a normal explanation for why the nutritional intervention might work.

Therefore, I think your criticism here aren't really strong ones. I suspect if you wanted to know why they excluded certain kinds of diagnoses you could email and ask them, however.

One study is never all that compelling about anything (pretty much all have shortcomings, and yet people don't complain that they get written about), you need more research. With depression, I think clearly there is a correlation with poorer eating -- as I noted above I tend to eat badly at such times, both because it's a way of self-medicating and because I stop caring. But I also find that eating better (doing the kinds of things discussed in the study) helps some, so am intrigued by a study that suggests it might play a role as a possible intervention. No one is saying it's the one and only solution.