Eating a Mediterranean diet ‘may lower your risk of depression’

Mediterranean diet

Mediterranean diet

“Eating a Mediterranean diet may help prevent depression, research suggests,” BBC News reports.

The headline was prompted by a new review of previously conducted studies into the impact of diet on depression. A main finding of the review was that there seemed to be a strong association between eating a Mediterranean-style diet and a reduced risk of developing symptoms of depression or being diagnosed with clinical depression.

There are no strict criteria as to what constitutes a Mediterranean diet, but it normally refers to a diet that includes plenty of vegetables, fruit, pulses and olive oil, but little red or processed meat. Such a diet has long been recognised as being good for heart health, so it could also be the case that what is “good for the body is also good for the mind”.

But there are limitations to the review that mean we can’t be sure diet actually protects against depression.

People may be less likely to prepare and eat healthy meals when they are feeling depressed, so the study could just show that people prone to depression have less healthy diets. Also, people who eat healthy diets tend to have generally healthier lifestyles, including taking more exercise, which is thought to protect against depression. While some of the studies included in this review took account of this, others did not.

Although we should be cautious about the study findings, they represent another potential reason to adopt a Mediterranean diet. We already know the diet is good for our hearts – adopting a healthy diet and lifestyle may well be good for our mood, too.

Read more advice about how to make your diet more Mediterranean.

Where did the story come from?

The researchers who carried out the study are an international team from University College London in the UK, the University of Montpellier in France, Deakin University in Australia and the University of Las Palmas de Gran Canaria, Spain.

The research was funded by the Medical Research Council, Nordforsk and the Academy of Finland. It was published in the peer-reviewedjournal Molecular Psychiatry.

The study was widely reported in the UK media. Most reports were fairly uncritical, with headlines such as The Daily Telegraph’s “Mediterranean diet cuts depression risk by reducing inflammation, major new study finds.” The suggestion that inflammation increases depression risk is reported as fact when the association between inflammation and depression is a fairly recent hypothesis, described by one expert in metabolic medicine as “highly tenuous”.

The Guardian also suggested that “Eating junk food raises risk of depression”. But the review did not look at the impact of unhealthy foods on mental health.

BBC News provided a good, balanced overview of the study, which included an analysis of other factors that might have influenced the results.

What kind of research was this?

This was a systematic review and meta-analysis that pooled the findings of observational studies that had looked at links between diet and depression.

Systematic reviews are a good way of assessing the evidence on a topic. While observational studies can show links between factors, they cannot show that one (such as diet) directly causes another (such as depression).

What did the research involve?

Researchers looked for studies that assessed people’s diet, and also their mental health. In most cases people filled out food frequency questionnaires, which provide information about their recent diet.

The questionnaires were assessed against a variety of “healthy eating” measures, including how closely they resembled:

the Mediterranean diet

a healthy diet based on the Healthy Eating Index (HEI)

a diet aimed at reducing high blood pressure

an anti-inflammatory diet

Most of the studies assessed people’s depression by asking about depression symptoms, although a few studies defined depression as clinical depression diagnosed by a doctor.

A total of 41 studies were identified, 20 were longitudinal studies, which assess diet and then follow people up to see if they get depression symptoms over a period of years.

The other 21 were cross sectional studies, which assess people’s diet and whether they had depression symptoms at one point in time.

The researchers presented the results of these types of studies separately. Cross-sectional studies are more likely to be inaccurate.

Because of this, we have only reported the longitudinal results here.

Longitudinal studies that exclude people with depression at the start should provide more reliable results, though there is still the potential that other confounding factors may be influencing the results.

Most but not all of the studies adjusted figures to take account of the following factors:

age

sex

smoking

physical activity and body mass index (BMI)

total energy intake from diet

socioeconomic factors

What were the basic results?

The Mediterranean diet had the strongest link to a protective effect against depression symptoms, although there were also signs that people eating a healthy diet based on the healthy eating index or an anti-inflammatory diet were less likely to get depression.

Each result compares the people who stuck closest to the diet in question with those whose diet least resembled the diet in question.

Mediterranean diet

Based on 4 studies including 36,556 people, those who ate a diet closest to the Mediterranean diet were 33% less likely to get depression symptoms (odds ratio (OR) 0.67, 95% confidence interval (CI) 0.55 to 0.82).

Anti-inflammatory diet

Based on 5 studies including 32,908 people, those who stuck closest to an anti-inflammatory diet were 24% less likely to get depression symptoms (OR 0.76, 95% CI 0.63 to 0.92).

Healthy eating

Based on 3 studies including 45,533 people, there was suggestion that those who stuck closest to a Healthy Eating Index diet may be less likely to get depression symptoms. But this result fell just short of statistical significance so may have come about by chance (OR 0.76, 95% CI 0.57 to 1.02).

Diet to reduce high blood pressure

Studies looking at the diet aimed at reducing high blood pressure had conflicting results and did not show an overall effect.

How did the researchers interpret the results?

The researchers said their “exhaustive overview” of the evidence showed a “robust association between both higher adherence to a Mediterranean diet and lower adherence to a pro-inflammatory diet, and a lower risk of depression.”

Conclusion

Depression is a complex condition, with many and varied causes or influencing factors. These may include hereditary, health-related, personal and social factors. It is often difficult to pin down an exact cause.

While any insight into diet or lifestyle factors that might improve mental wellbeing and help reduce the numbers of people affected by the condition is welcome, it’s important to recognise the limitations of this research.

These include:

the poor quality of some of the studies included, especially cross-sectional studies that cannot show the direction of cause and effect

use of depression symptoms rather than clinically diagnosed depression as an outcome in most of the studies

potential inaccuracy of the food frequency questionnaires, which rely on people remembering what they’ve eaten, sometimes over previous weeks, months or even a year

potential influence of other confounding factors – even studies that accounted for things like exercise and socioeconomic factors may not have been able to fully remove their influence

Having a healthy lifestyle, which includes not smoking, plenty of physical activity and drinking alcohol only in moderation, is linked to a reduction in depression. But that doesn’t mean people get depressed because they have a less healthy lifestyle. It’s very hard to stick to a healthy lifestyle if you are struggling with symptoms of depression. It can be hard to shop, prepare and eat healthy meals while depressed, similarly you may feel less motivated to socialise and take exercise.

Clearly, it’s a good thing to eat a healthy diet, whether that’s for your physical or mental health. But it’s also important not to make people with depression feel that it’s their own fault for not eating more vegetables.

Read more advice about what you can do to help relieve feelings of low mood and depression.

Analysis by Bazian
Edited by NHS Website

Anorexia nervosa – an overview

Anorexia and autism

Anorexia and autism

Anorexia is an eating disorder and serious mental health condition.

People who have anorexia try to keep their weight as low as possible by not eating enough food or exercising too much, or both. This can make them very ill because they start to starve.

They often have a distorted image of their bodies, thinking they are fat even when they are underweight.

Men and women of any age can get anorexia, but it’s most common in young women and typically starts in the mid-teens.

Signs and symptoms of anorexia

Signs and symptoms of anorexia include:

if you’re under 18, your weight and height being lower than expected for your age

if you’re an adult, having an unusually low body mass index (BMI)

missing meals, eating very little or avoiding eating any foods you see as fattening

believing you are fat when you are a healthy weight or underweight

taking medication to reduce your hunger (appetite suppressants)

your periods stopping (in women who have not reached menopause) or not starting (in younger women and girls)

physical problems, such as feeling lightheaded or dizzyhair loss or dry skin

Some people with anorexia may also make themselves sick, do an extreme amount of exercise, or use medication to help them poo (laxatives) or to make them pee (diuretics) to try to stop themselves gaining weight from any food they do eat.

Read more about the symptoms of anorexia and warning signs in others.

Getting help for anorexia

Getting help and support as soon as possible gives you the best chance of recovering from anorexia.

If you think you may have anorexia, even if you are not sure, see your GP as soon as you can.

They will ask you questions about your eating habits and how you’re feeling, and will check your overall health and weight.

They may also refer you for some blood tests to make sure your weight loss is not caused by something else.

If they think you may have anorexia, or another eating disorder, they should refer you to an eating disorder specialist or team of specialists.

It can be very hard to admit you have a problem and to ask for help. It may make things easier if you bring a friend or loved one with you to your appointment.

You can also talk in confidence to an adviser from eating disorders charity Beat by calling its adult helpline on 0808 801 0677 or youth helpline on 0808 801 0711.

Getting help for someone else

If you’re concerned that a family member or friend may have anorexia, let them know you’re worried about them and encourage them to see their GP. You could offer to go along with them.

Read more about talking to your child about eating disorders and supporting someone with an eating disorder.

Treatment for anorexia

You can recover from anorexia, but it may take time and recovery will be different for everyone.

Your treatment plan will be tailored to you and should consider any other support you might need, such as for depression or anxiety.

If you are over 18, you should be offered a type of talking therapy to help you manage your feelings about food and eating so that you are able to eat enough to be healthy. Talking therapies that are commonly used to treat anorexia in adults include:

cognitive behavioural therapy (CBT)

Maudsley Anorexia Nervosa Treatment for Adults (MANTRA)

specialist supportive clinical management (SSCM)

If you are under 18, you should be offered family therapy. You may also be offered another type of talking therapy, such as CBT or adolescent-focused psychotherapy.

Read more about the treatments for anorexia.

Health risks of anorexia

Long-term anorexia can lead to severe health problems associated with not getting the right nutrients (malnutrition). But these will usually start to improve once your eating habits return to normal.

Possible complications include:

problems with muscles and bones – including feeling tired and weak, osteoporosis, and problems with physical development in children and young adults

fertility problems

loss of sex drive

problems with the heart and blood vessels – including poor circulation, an irregular heartbeat, low blood pressure, heart valve disease, heart failure, and swelling in the feet, hands or face (oedema)

problems with the brain and nerves – including fits (seizures), and difficulties with concentration and memory

kidney or bowel problems

having a weakened immune system or anaemia

Anorexia can also put your life at risk. It’s one of the leading causes of deaths related to mental health problems. Deaths from anorexia may be due to physical complications or suicide.

Causes of anorexia

We don’t know exactly what causes anorexia and other eating disorders. You may be more likely to get an eating disorder if:

you or a member of your family has a history of eating disorders, depression, or alcohol or drug addiction

you have been criticised for your eating habits, body shape or weight

you are overly concerned with being slim, particularly if you also feel pressure from society or your job – for example, ballet dancers, jockeys, models or athletes

you have anxiety, low self-esteem, an obsessive personality or are a perfectionist

you have been sexually abused

Combating Panic Disorder With Music

In the UK, 1 in 6 people experience a common mental health issue each week, with anxiety being one of the most common problems. When anxiety becomes chronic it can develop into an anxiety disorder such as panic disorder. This condition affects roughly 1 in 200 people in the UK and can be extremely frightening and crippling for the person going through it. Medication is the most common form of treatment for it, but something else that can have a hugely positive impact is music. Whether you listen to music or actively participate in it, the potential for music to calm your mind and lessen the frequency or severity of panic attacks is striking.

When does stress need to be addressed?

Some level of stress in our lives is important as it forms part of ‘the fight or flight’ stimulus that can force us to ‘get things done.’ However, panic disorder causes you to become consumed by anxious thoughts regularly, to the point where your daily life is being impacted detrimentally. This is when you need to address your mental health properly.

How music helps panic disorder

The emotional power of music cannot be overstated. Listening to music prompts the release of dopamine, a neurotransmitter within the brain that regulates our emotional responses, among other things. High levels of dopamine can keep us motivated and happy, helping to alleviate anxiety and replace it with positive thoughts. In the case of people with panic disorders, it can be particularly helpful to listen to a soothing or upbeat piece of music, as research shows that our moods can mimic those portrayed in songs or musical arrangements.

The power of song for panic disorder

Studies have shown the positive effect of singing on panic disorder and other anxiety-related conditions. Singing in a group is particularly effective, as it is less intimidating than singing alone, and helps create a sense of belonging, boosting your self-esteem in the process. Meanwhile, the deep breathing that comes with singing increases oxygen and blood flow around the body, releasing the ‘happy hormones’ oxytocin and endorphins.

Tackling panic disorder: the importance of reaching out to others

Living with panic disorder can be a traumatic and isolating experience. However, help is available. Seek medical advice as a starting point and consider undergoing therapy to help you address the root of your anxiety. Alongside these things, make room for music in your daily life – either by listening to it, singing or both. It really can make the world of difference.

Generalised anxiety disorder in adults – An overview

Anxiety

Anxiety

Overview

Anxiety is a feeling of unease, such as worry or fear, that can be mild or severe.

Everyone has feelings of anxiety at some point in their life – for example, you may feel worried and anxious about sitting an exam, or having a medical test or job interview. During times like these, feeling anxious can be perfectly normal.

However, some people find it hard to control their worries. Their feelings of anxiety are more constant and can often affect their daily lives.

Anxiety is the main symptom of several conditions, including:

panic disorder

phobias – such as agoraphobia or claustrophobia

post-traumatic stress disorder (PTSD)

social anxiety disorder (social phobia)

However, the information in this section is about a specific condition called generalised anxiety disorder (GAD).

GAD is a long-term condition that causes you to feel anxious about a wide range of situations and issues, rather than one specific event.

People with GAD feel anxious most days and often struggle to remember the last time they felt relaxed. As soon as one anxious thought is resolved, another may appear about a different issue.

GAD can cause both psychological (mental) and physical symptoms. These vary from person to person, but can include:

feeling restless or worried

having trouble concentrating or sleeping

dizziness or heart palpitations

Read about the symptoms of GAD.

When to get help for anxiety

Although feelings of anxiety at certain times are completely normal, see your GP if anxiety is affecting your daily life or causing you distress.

Your GP will ask about your symptoms and your worries, fears and emotions to find out if you could have GAD.

Read more about diagnosing GAD.

What causes GAD?

The exact cause of GAD isn’t fully understood, although it’s likely that a combination of several factors plays a role. Research has suggested that these may include:

overactivity in areas of the brain involved in emotions and behaviour

an imbalance of the brain chemicals serotonin and noradrenaline, which are involved in the control and regulation of mood

the genes you inherit from your parents – you’re estimated to be 5 times more likely to develop GAD if you have a close relative with the condition

having a history of stressful or traumatic experiences, such as domestic violence, child abuse or bullying

having a painful long-term health condition, such as arthritis

having a history of drug or alcohol misuse

However, many people develop GAD for no apparent reason.

Who is affected?

GAD is a common condition, estimated to affect up to 5% of the UK population.

Slightly more women are affected than men, and the condition is more common in people from the ages of 35 to 59.

How GAD is treated

GAD can have a significant effect on your daily life, but several different treatments are available that can ease your symptoms. These include:

 

There are also many things you can do yourself to help reduce your anxiety, such as:

going on a self-help course

exercising regularly

stopping smoking

cutting down on the amount of alcohol and caffeine you drink

trying one of the mental health apps and tools in the NHS apps library

Read how stopping smoking can improve your anxiety.

With treatment, many people are able to control their anxiety levels. However, some treatments may need to be continued for a long time and there may be periods when your symptoms worsen.

Read more about:

treating GAD

self-help tips for GAD