Depression & nutrition


We can all feel sad, irritable or experience low mood from time to time. Having multiple sclerosis may increase your susceptibility to depression and or anxiety.

If you feel you are depressed it is important to seek help. There are many support services to help you. This may be directly via your doctors such as GP or neurologist, from a psychologist or through a phone-based support service such as those listed below:
Beyond Blue: 1300 22 4636
Lifeline: 13 11 14
MS Connect 1800 042 138

Medication, exercise, counselling, support groups and dietary changes are some of the supportive options available to you.

When our mood is low we often reach for cakes, chips and lollies as they may make us feel good for a short time but sluggish and tired longer term. Nutritional support may help with low mood and mild depression. 

There is no specific diet that is known to help manage diagnosed depression; however, healthy eating is associated with improved general wellbeing.1, 2 A nutritious diet that limits processed, high-sugar and high-fat foods may help to prevent depression.2-4 You may reduce your risk of low mood and depressive symptoms if you:
  • Eat more plant foods: vegetables, fresh fruits, legumes, wholegrain cereals, nuts and seeds. These foods provide dietary fibre and many useful vitamins and minerals 

  • Choose fish, lean meats, eggs, tofu and healthy oils, such as olive oil, rather than fatty or processed meats and saturated fats

  • Include reduced-fat dairy foods such as milk, yoghurt and cheese, or their alternatives

  • Look after your gut health with fermentable fibers such as vegetables, fruit, sauerkraut, kimchi, tempeh and kefir.

  • Eat less processed food, ‘fast food’ and confectionary (this will help to limit your intake of unhealthy (saturated) fats, sugars and refined carbohydrates) 

  • Drink plenty of water and limit sugar-sweetened drinks and alcohol

As there are many factors that influence mental health, it is often difficult to isolate the effect of specific nutrients. There is mixed or inconclusive evidence for some nutrients that are commonly recommended for the relief of depressive symptoms. Some nutrients that may help some people include omega-3 fats, 5, 6 zinc,7, 8 and vitamins B6, B9 (folate) and B12.9, 10;

There is also emerging evidence of the effect of the gut microbiome on mood and depressive symptoms.11-13 Regular intake of probiotics (live cultures found in fermented foods) and prebiotics (dietary fibre, which feeds the helpful microorganisms that contribute to a healthy gut microbiome) may lead to improvements in mood.11-13


The following list provides examples of sources of these nutrients:

  • Nutrient: Omega-3 fats
    Sources: Fish. Fortified foods (some breads, milk, eggs and margarine spreads). Supplements

  • Nutrient: Probiotics
    SourcesFermented foods that contain live cultures (e.g. some yoghurts, some vinegars, probiotic milk drinks, sauerkraut, kimchi, kombucha and tempeh)

  • Nutrient: Prebiotics
    SourcesHigh-fibre foods such as vegetables, fruits, legumes, wholegrain cereals, nuts and seeds

  • Nutrient: Vitamin B6
    SourcesMeat, breakfast cereals, vegetables and fruits. Supplements

  • Nutrient: Vitamin B9 (folate)
    SourcesVegetables, (especially dark green leafy vegetables), legumes, eggs, fruit, nuts, seafood, meat and dairy foods. Fortified foods (most breads, some breakfast cereals and juices). Supplements

  • Nutrient: Vitamin B12
    SourcesMeat, fish, seafood, eggs, dairy foods, nutritional yeast and yeast spreads. Fortified foods (some milks and breakfast cereals). Supplements

  • Nutrient: Zinc
    SourcesMeat, seafood, cereals, dairy foods. Supplements (consult your GP prior to taking a zinc supplement)

 

Check

  • Ask your GP to check for nutritional deficiencies that may affect energy levels and mood.

Acknowledgements

MSL would like to acknowledge the contribution of Ms Eleanor Dunlop (MSc Dietetics, PhD student), School of Public Health, Curtin University.

Resources

https://www.eatforhealth.gov.au 
Beyond Blue: Beyondblue.org.au
https://foodandmoodcentre.com.au/diet-and-mental-health/

 

[1] National Health and Medical Research Council. About the Australian Dietary Guidelines. 2015 [cited 23 May]. Available from: https://www.eatforhealth.gov.au/guidelines/about-australian-dietary-guidelines.

[2] Food and Mood Centre. Diet and mental health. Burwood, VIC: Deakin University; 2016 [cited 26]. Available from: https://foodandmoodcentre.com.au/diet-and-mental-health/

[3] Opie RS, Itsiopoulos C, Parletta N, Sanchez-Villegas A, Akbaraly TN, Ruusunen A, et al. Dietary recommendations for the prevention of depression. Nutritional Neuroscience. 2017; 20(3):161-171. DOI:10.1179/1476830515Y.0000000043.

[4] Li Y, Lv M-R, Wei Y-J, Sun L, Zhang J-X, Zhang H-G, et al. Dietary patterns and depression risk: A meta-analysis. Psychiatry Research. 2017; 253:373-382. DOI:10.1016/j.psychres.2017.04.020.

[5] Beydoun MA, Fanelli Kuczmarski MT, Beydoun HA, Rostant OS, Evans MK, Zonderman AB. Associations of the ratios of n-3 to n-6 dietary fatty acids with longitudinal changes in depressive symptoms among US women. American Journal of Epidemiology. 2015; 181(9):691-705. DOI:10.1093/aje/kwu334.

[6] Appleton KM, Sallis HM, Perry R, Ness AR, Churchill R. Omega‐3 fatty acids for depression in adults. Cochrane Database of Systematic Reviews 2015; 11:Art. No.: CD004692. DOI:10.1002/14651858.CD004692.pub4.

[7] Schefft C, Kilarski LL, Bschor T, Köhler S. Efficacy of adding nutritional supplements in unipolar depression: A systematic review and meta-analysis. European Neuropsychopharmacology. 2017; 27(11):1090-1109. DOI:10.1016/j.euroneuro.2017.07.004.

[8] Petrilli MA, Kranz TM, Kleinhaus K, Joe P, Getz M, Johnson P, et al. The Emerging Role for Zinc in Depression and Psychosis. Frontiers in pharmacology. 2017; 8:414-414. DOI:10.3389/fphar.2017.00414.

[9] Almeida OP, Ford AH, Flicker L. Systematic review and meta-analysis of randomized placebo-controlled trials of folate and vitamin B12 for depression. International Psychogeriatrics. 2015; 27(5):727-737. DOI:10.1017/S1041610215000046.

[10] Taylor MJ, Carney SM, Geddes J, Goodwin G. Folate for depressive disorders. Cochrane Database of Systematic Reviews. 2003; 2:Art. No.: CD003390. DOI:10.1002/14651858.CD003390

[11] Mohajeri MH, La Fata G, Steinert RE, Weber P. Relationship between the gut microbiome and brain function. Nutrition Reviews. 2018; 76(7):481-496. DOI:10.1093/nutrit/nuy009.

[12] Wallace CJK, Milev R. The effects of probiotics on depressive symptoms in humans: a systematic review. Annals of General Psychiatry. 2017; 16(1):14-14. DOI:10.1186/s12991-017-0138-2.

[13] Mörkl S, Wagner-Skacel J, Lahousen T, Lackner S, Holasek SJ, Bengesser SA, et al. The role of nutrition and the gut-brain axis in psychiatry: A review of the literature. Neuropsychobiology. 2018:1-9. DOI:10.1159/000492834.

 

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