We examined the utility of three definitions of rapid response to treatment for predicting remission in a transdiagnostic sample receiving 10-session cognitive behaviour therapy (CBT) for an eating disorder. Both efficiency (categorising the greatest number of people as rapid responders) and predictiveness (performs best in predicting outcomes) were compared. The participants (N = 176, 93 % female, 89 % white, mean age 26.65 years) completed measures at baseline and before session 4 of CBT which was used to calculate rapid response. Remission was achieved by 64 participants (36 %) at the end of therapy. A multivariable logistic regression analysis was used to examine the contribution of rapid response, as well as baseline disordered eating, impairment, general negative emotion, to remission status. Two of the rapid response definitions were associated with participants being 2.5 times more likely to achieve remission at end of treatment. In both cases, remission was also associated with a lower level of baseline eating disorder psychopathology. The preferred definition (a reduction of ≥1.13 points on the Eating Disorder Examination Questionnaire) categorised 58 % of participants as rapid responders. These findings can be used to inform clinicians of meaningful early change that predicts positive outcomes in brief CBT for eating disorders. Early change indicators can inform collaborative consideration of barriers to progress and approaches to tackle these, making CBT more effective for more people. The conclusions should be interpreted with caution given remission was only examined at end of treatment and not over longer-term follow-up.

It has been known since ancient times that the mind, body, and social connection are intertwined to promote thriving. More specifically, the basic pillars of health and wellbeing have been described across cultures, and they are codified in modern healthcare as the principles of lifestyle medicine. However, across the globe, emotional despair, loneliness, and chronic diseases have been rising despite a wealth of knowledge about the elements that promote happy, healthy individuals and communities. Depression has been identified as a significant element of the global mental health crisis. We know that depression is a multifaceted condition influenced by biological, psychological, social, environmental, and spiritual factors, but prevailing medical models prioritize medication and overshadow the importance of the other facets. In healthcare, pharmaceutical companies comprise a major portion of innovation that has led to the development of invaluable life-saving medications. However, some psychiatric drug makers use marketing methods rather than the scientific method to test and promote the sale of drugs to treat depression. For example, a confidential data ownership and transfer agreement that came to light during litigation over an antidepressant drug, stated that the purpose of the data collected by the drug company sponsored research was to market their product. The public and the medical community have been led to believe that drugs are more scientifically valid than other approaches to depression. We suggest a more holistic approach to prevention and treatment of emotional despair and depression, an approach that uses a public psychology lens to promote societal wellbeing.

Clinical evidence suggests that nutrition interventions can significantly improve symptoms of major depressive disorder; however, the effect on clinical anxiety symptoms in individuals with anxiety disorders has not been studied. The primary objective of the present study was to assess the feasibility and acceptability of a nutrition intervention. The secondary objectives included assessing changes in anxiety symptom severity, diet quality, self-efficacy, mindful eating, quality of life, and biomarkers.

This study was a randomized, wait-list controlled pilot trial delivering a 12-week, biweekly dietary counseling intervention and omega-3 supplementation to 50 adult women with generalized anxiety disorder. Questionnaires and blood work were completed at baseline, after the waiting period, and after the intervention.

443 individuals expressed interest within eight months; 50 met the criteria for enrollment. The mean number of sessions attended was 6.4. Final questionnaires were completed by 46 participants. Eighty-four percent of participants strongly agreed with the statement 'My experience during this study was positive'. The mean anxiety symptom severity score in the intervention group was 26.2 (95% CI 22.94-29.48) at baseline and 11.0 (95% CI 8.05-13.87) at week 12. The mean diet quality score was 7.2 (95% CI 6.32-8.10) and 10.5 (95% CI 9.55-11.49) at baseline and week 12, respectively. Among the waitlist participants, the mean baseline anxiety score was 29.3 (95% CI 24.73-33.91) and 26.8 (95% CI 22.09-31.56) at week 12.

This study was feasible and acceptable. Participation in the intervention was associated with a decrease in anxiety symptoms. These findings lay the foundation for large-scale studies. Trial registration: ClinicalTrials.gov NCT05573672.

Mental health problems are increasingly prevalent during adolescence. Nutritional factors, particularly antioxidants, are of interest due to their potential to reduce oxidative stress and inflammation linked to mental health issues. However, the relationship between dietary antioxidants and adolescent mental health remains unclear. This study aimed to investigate this association in Swedish adolescents and explore potential gender differences.

Cross-sectional data were gathered among Swedish boys and girls aged 13-14 years (n = 1139). Participants reported their dietary intake using a detailed web-based method and mental health outcomes, including anxiety, psychosomatic symptoms, and health-related quality of life (HRQoL) using self-report scales. Multiple linear regression analysis, adjusted for confounders, was used to investigate the associations between mental health outcomes and tertiles of dietary intake of vitamin C, E and β-carotene.

Adolescents in the highest tertile of β-carotene intake reported lower anxiety (β=-1.23, 95% CI=-2.34, -0.12), fewer psychosomatic symptoms (β=-0.91, 95% CI=-1.69, -0.13), and better HRQoL (β = 0.89, 95% CI = 0.11, 1.68). Similarly, higher vitamin C intake was associated with fewer psychosomatic problems (β=-1.00, 95% CI=-1.79, -0.21). Vitamin E intake showed no associations. Significant gender interactions were observed on the multiplicative scale analysis and limited to the middle tertiles of β-carotene and vitamin C for anxiety and psychosomatic symptoms, respectively.

Our findings underscore the potential role of dietary antioxidants, particularly β-carotene and vitamin C, in adolescent mental health. Further research including diverse populations and employing prospective designs could deepen the understanding and inform public health interventions.

Depression affects about 5 % of the global adult population and increases mortality. Physical activity (PA) and dietary quality (DQ) are both related to depression and mortality. However, there is limited research on the combined effects of PA and DQ among individuals with depression. This study will examine the separate and combined effects of PA and DQ on mortality in this population.

The data of 5443 individuals with depression were derived from the National Health and Nutrition Examination Survey from 2007 to 2018, a cross-sectional study since 1990. The outcomes of the study included all-cause, cardiovascular disease (CVD), and non-CVD mortality. PA was measured using the Global Physical Activity Questionnaire, while DQ was assessed via the Healthy Eating Index-2020. Cox proportional hazards regression models and restricted cubic splines were employed to determine how PA and DQ independently and jointly affect mortality.

Joint analyses revealed that individuals with depression who engaged in active PA and qualified DQ were associated with lower risk of all-cause (HR 0.47 [0.30, 0.71], P < 0.001) and non-CVD mortality (HR 0.43 [0.25, 0.75], P = 0.003) compared with lifestyle intervention alone. However, active PA and qualified DQ were not significantly associated with CVD mortality (HR 0.57 [0.30, 1.10], P = 0.089).

The study shows that combining active PA and qualified DQ significantly reduces all-cause and non-CVD mortality risk among individuals with depression. This suggests that integrating PA and dietary interventions could be a promising way to improve health outcomes for this population.

Dietary interventions are a potential alternative treatment of depression and anxiety.

To evaluate the effects of dietary interventions on depression and anxiety.

PubMed, Cochrane CENTRAL, EMBASE, CINAHL, and PsycINFO searched from inception until 12 December 2024. Trial registries and forward and backward citation analysis done on 3 January 2025.

Randomized controlled trials (RCTs) evaluated the effect of dietary advice with or without food provision compared with no specific dietary advice or active interventions for 3 months or longer on depression and/or anxiety.

Two authors independently screened articles, extracted data, and assessed risk of bias. Primary outcomes included depression and anxiety symptoms at 3 months or longer. Random-effects meta-analyses were done, and the certainty of evidence was assessed.

Twenty-five RCTs were included. Compared with no specific dietary advice, depressive symptoms might be improved in adults with elevated cardiometabolic risk by dietary advice on calorie restriction (standardized mean difference [SMD], -0.23 [95% CI, -0.38 to -0.09]; low certainty). Low-fat diets may also have very small effects on depressive symptoms in adults with elevated cardiometabolic risk (SMD, -0.03 [CI, -0.04 to -0.01]; low certainty). Evidence on other diets, comparing diets with active comparisons, and on anxiety was limited by study limitations and clinical or methodological heterogeneity.

Limited studies did not allow for adequate exploration of heterogeneity.

Calorie restrictions and low-fat diets might reduce depressive symptoms among adults with elevated cardiometabolic risk, but the differences were small and confidence in the findings was low. Evidence on other diets, comparisons to active interventions, and other outcomes is limited.

None. (PROSPERO: CRD42023485953).

We aim to update readers on the latest evidence regarding the role of the gut microbiome in generalized anxiety disorder (GAD), panic disorder (PD), agoraphobia, and social anxiety disorder (SAD). This review summarises the literature on microbiome composition and function in these conditions, provides insights about causality and mechanisms and evaluates current evidence for microbiome-based interventions in anxiety disorders.

Most studies exploring the microbiome in anxiety disorders are small, cross-sectional studies. Nevertheless, some consistent findings emerge. Bacterial taxa such as Eubacterium, Coprococcus and Faecalibacterium may be depleted in GAD. Studies in PD and SAD are scarce and, to our knowledge, there have been no studies conducted in agoraphobia. Probiotics may help reduce anxiety symptoms, although the majority of studies have been in non-clinical cohorts. Large, prospective studies are required to further elucidate the role of the microbiome-gut-brain axis in anxiety disorders. Microbiome-based interventions hold promise, but randomised controlled trials in clinical populations with relevant diagnoses are now warranted and urgently required.

Previous studies suggest that early-life stress (ELS) induced by early maternal separation and isolation (MS) stress during the stress hyporesponsive period (SHRP) leads to increased curiosity-like and increased risky decision-making behaviour in adolescence. Evidence suggests that dietary interventions early in adolescence could play an important role in mitigating the detrimental effects of MS stress on risky decision-making behaviour. Hence, the present study hypothesized that nutritional supplements such as saturated fat (SFA) and/or polyunsaturated fat (PUFA) would be beneficial in ameliorating the impact of MS stress on risky decision-making behaviour when incorporated into the diet during early adolescence. NC and MS rats were subjected to the Risky Decision-Taking Task (RDTT) to assess the rats' ability to make decisions under risky conditions. The results showed that MS rats took less time to cross the risky zone to collect a large reward. However, when an SFA-rich and PUFA-rich diet was provided, the latency of the MS rats increased. Similarly, MS stress-induced reduction in risk assessment was restored to normal with the SFA and PUFA-rich diet. Risk-index (RI) values also showed a similar trend with reduced RI values in MS, but nutritional supplementation increased the RI values making it comparable to that NC. Correlation analysis has further revealed a direct correlation between the anxiety-like behaviour and the risk-taking tendency in MS rats and not in the NC group. SFA-rich diet led to a positive correlation between anxiety-like and risk-taking behaviour. These findings thus support the hypothesis that PUFA- and SFA-rich diet may be introduced at adolescence to mitigate MS-stress induced increased risky decision-making behaviour due to a deficit in risk assessment.

This article explores food allergy and the nascent field of nutritional psychiatry. Individuals with food allergy experience lower levels of "food freedom" than their nonallergic counterparts, which can create cognitive, emotional, social, nutritional, and financial burdens. Patterns of food avoidance may influence neuroinflammatory states and the gut microbiome; these changes may be associated with neuropsychiatric symptoms. Food restriction may promote disruption of the microbiome neuroimmune axis, which has been linked to various allergic diseases. Targeted psychological counseling strategies can provide benefit. Food allergy and restricted diets may impact dietary health benefits.

The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) collects and calculates risk-outcome data for modifiable lifestyle exposures (eg, dietary intake) and physical health outcomes (eg, cancers). These estimates form a critical digital resource tool, the GBD VizHub data visualization tool, for governments and policy makers to guide local, regional, and global health decisions. Despite evidence showing the contributions of lifestyle exposures to common mental disorders (CMDs), such as depression and anxiety, GBD does not currently generate these lifestyle exposure-mental disorder outcome pairings. This gap is due to a lack of uniformly collected and analyzed data about these exposures as they relate to CMDs. Such data are required to quantify whether, and to what degree, the global burden of CMDs could be reduced by targeting lifestyle factors at regional and global levels. We have established the Global burden of disease Lifestyle And mental Disorder (GLAD) Taskforce to address this gap.

This study aims to generate the necessary estimates to afford the inclusion of lifestyle exposures as risk factors for CMDs in the GBD study and the GBD digital visualization tools, initially focusing on the relationship between dietary intake and CMDs.

The GLAD project is a multicenter, collaborative effort to integrate lifestyle exposures as risk factors for CMDs in the GBD study. To achieve this aim, global epidemiological studies will be recruited to conduct harmonized data analyses estimating the risk, odds, or hazards of lifestyle exposures with CMD outcomes. Initially, these models will focus on the relationship between dietary intake, as defined by the GBD, and anxiety and depression.

As of August 2024, 18 longitudinal cohort studies from 9 countries (Australia: n=4; Brazil: n=1; France: n=1; Italy: n=3; The Netherlands: n=3; New Zealand: n=1; South Africa: n=1; Spain: n=1; and United Kingdom: n=3) have agreed to participate in the GLAD project.

Our comprehensive, collaborative approach allows for the concurrent execution of a harmonized statistical analysis protocol across multiple, internationally renowned epidemiological cohorts. These results will be used to inform the GBD study and incorporate lifestyle risk factors for CMD in the GBD digital platform. Consequently, given the worldwide influence of the GBD study, findings from the GLAD project can offer valuable insights to policy makers worldwide around lifestyle-based mental health care.

DERR1-10.2196/65576.

Mental health issues, particularly anxiety and depression, are on the rise among university students globally, including in Bangladesh. However, comprehensive data on the factors influencing mental health outcomes in this group remain limited, hindering the development of effective programmes and interventions.

This study aims to assess the mental health status of university students in Bangladesh and examine the key factors influencing mental health outcomes.

A cross-sectional online survey was conducted in Bangladesh from December 2022 to March 2023.

Universities in Bangladesh.

University students aged 18 and older.

Data were collected through a structured survey that assessed depression and anxiety using the Patient Health Questionnaire and the Generalized Anxiety Disorder scale, as well as dietary diversity through the Individual Dietary Diversity Score.

The results showed that while female students exhibited greater dietary diversity, they also had higher obesity rates, whereas male students reported more physical activity. Mental health assessments revealed that 36.1% of participants experienced mild anxiety, 11.5% severe anxiety, 39.8% mild depression and 8.3% severe depression. Binary logistic regression analysis identified significant predictors of anxiety and depression, including gender, personal income, body mass index and screen time. Females were less likely to experience anxiety (crude odds ratios (COR): 0.531, p =0.034) and depression (COR: 0.591, p =0.023) compared with males. Furthermore, low intake of wheat, rice (COR: 2.123, p=0.050) and pulses (COR: 1.519, p=0.050), as well as high consumption of fats, oils (COR: 2.231, p=0.024) and sugary foods (COR: 2.277, p=0.001), were associated with anxiety, while inadequate intake of vitamin A- and C-rich fruits (COR: 1.435, p =0.018) was linked to depression. Overweight students were found to be more susceptible to depression.

The findings of the study emphasise the necessity for targeted interventions that promote healthier lifestyles to enhance mental health outcomes among university students in Bangladesh.

Depressive symptoms are experienced by >350 million people globally. Research suggests that a diet rich in plant foods could be protective against depressive symptoms, but vegans and vegetarians who eat a predominant plant-based diet are known to have higher depressive symptoms than omnivores.

This study aims to explore a secondary analysis of the association between diet quality and depressive symptoms in women born between 1973 and 1978 who follow vegan, vegetarian, and omnivore diets from the Australian Longitudinal Study of Women's Health at baseline (1996) and at three time points (2000, 2003 and 2009).

After controlling for covarying factors, there was a significant association between diet quality and depressive symptoms in both the plant-based and omnivore groups at both time points F(9, 4851) = 106.90, p < .001. There was no significant difference between diet quality and depressive symptoms between diet type.

Despite diet type (plant-based or omnivore), adhering to a high-quality diet may decrease depressive symptoms and a low-quality diet may increase depressive symptoms in Australian women.

Caution should be exercised when interpreting these results due to the small sample sizes and small resulting coefficients, there is uncertainty that coefficients this small can be associated with any meaningful change in an individual being treated for depressive symptoms in a clinical setting.

While low dietary quality has been linked to poor mental health, evidence on more direct relations of specific dietary quality indicators, namely degrees of food processing, with mental health disorders remains limited. This study aims to investigate the association between food groups' intakes, defined based on their degree of food processing, with depression and anxiety symptoms in a sample of Lebanese adults. We hypothesized that higher intakes of ultra-processed foods (UPF) will be related to higher risk of depression and anxiety while an opposite association will be observed for unprocessed or minimally processed foods (MPF). Data come from a Lebanese cross-sectional study (n = 188 adults). The NOVA classification was adopted for evaluating the intakes of the 4 food groups: unprocessed or minimally processed foods (MPF); processed culinary ingredients (PCI); processed foods (PF) and ultra-processed foods (UPF). Associations between food group intakes in quartiles with depression and anxiety symptoms were analyzed using multivariable regression analyses adjusted for several confounders. Median energy intake was 2481.65 (2617.2) kcal/d, with 36.12% of Total Energy Intakes coming from MPF, 29.71% from PF, 25.25% from UPF, and 5.75% from PCI. Among participants, 33% and 27.7% had elevated depression and anxiety symptoms, respectively. Higher PF intake was associated with significantly lower odds of both depression and anxiety symptoms while a higher UPF intake was associated with higher odds of depression. Results confirm the hypothesized links between UPF and adverse mental health outcomes and highlight the need for further studies on PF intakes and mental health given the culture-specific nature of foods constituting this group.

A healthy diet has been proposed to support good mental health, but the addition of either red meat or meat alternatives is nuanced.

We aimed to determine if psychological and physiological well-being is differentially affected by consuming recommended weekly amounts of either lean red meat or plant-based meat alternatives (PBMAs) supplemented with a plant-rich diet.

The trial was a parallel 2-arm randomized intervention of 10 wk duration. Eighty healthy omnivorous young adults were clustered as 40 cohabitating household pairs. Each pair was randomly assigned to consume 3 weekly servings of either fresh New Zealand beef and lamb or the equivalent PBMA. They maintained an otherwise ovo-lacto vegetarian diet, aided by a weekly meal kit and supported by engaged advice from research dietitians. Psychological measures were well-being (World Health Organization-Five Well-Being Index); depression, anxiety, and stress (depression anxiety stress scales-short form-21); and fatigue (multidimensional fatigue symptom inventory-short form) assessed weekly throughout the trial. Blood biomarkers included neurotransmitter-related compounds, iron status and vitamins B12 and D. Physical activity and sleep were estimated by a fitness wristband. Mixed effect modeling evaluated changes in each outcome over time relative to its baseline and compared the 2 interventions accounting for randomization unit clustering.

Thirty-nine household pairs completed the trial. Participants measured as psychologically healthy at baseline. There were no significant differences between groups in the degree of change from baseline for the psychological outcomes, nor for the majority of the circulatory markers. Differences in changes to vitamin B12 status and 3 neurotransmitter-related compounds (adenosine, agmatine, and tyrosine) from baseline to week 10 were observed between groups. Results were similar in all sensitivity analyses when adjusting for physical activity, sleep, and diet quality covariates.

There was no effect on the psychological measures and limited change to physiological status when comparing a balanced diet containing either red meat or PBMAs in healthy young adults.

We investigated the effects of complex textural attributes of food i.e. lubricity and oral coating, on appetite ratings, food intake, salivary and gut peptides for the first time. Milk protein-rich beverages (whey and casein) were instrumentally analyzed (tribology, viscosity and adsorption, latter representing oral coating) using in vitro measurements. Then these protein beverage preloads differing in their coating properties (low coating, medium coating and high coating) were assessed in two cross-over satiety trials (Study 1, n=37; Study 2, n=15; Total n= 52). Fullness ratings increased in the high coating beverage condition (p < .05) only after 20 min with limited effects on other time points, suggesting a sporadic effect of oral coating on appetite ratings (n=37). There was a correlation between concentration of protein in saliva and appetite ratings; the higher the concentration of protein in saliva the lower the desire to eat (r = - 0.963; p < 0.05) and prospective food consumption ratings (r =- 0.980; p < 0.05). Human saliva was more lubricating after ingesting preload with high coating properties, thus explaining the results on appetite ratings. There was no effect of oral coating on energy intake and gut peptides (n=15), suggesting that complex textural attributes having influence on oral processing might not have any effect on the later parts of the satiety cascade. Oral coating/ lubricity appears to have a subtle and sporadic effect on appetite suppression, which needs further investigation with changing macronutrients/energy load and degree of coating/ lubricity.

This review explores the understudied topic of nutritional inequality among individuals with schizophrenia, highlighting the complex interplay between diet, genetics, and mental health. Unhealthy dietary patterns, socioeconomic factors, and disordered eating behaviors contribute to malnutrition, increasing the risk of physical health issues and premature mortality. Socioeconomic factors exacerbate nutritional disparities, necessitating targeted interventions. Genetic influences on nutrient metabolism remain under-researched, although nutritional genomics shows potential for personalized interventions. Current research reveals methodological gaps, urging larger sample sizes and standardized approaches. The integration of nutrigenomics, encompassing various omics disciplines, emerges as a transformative tool. The holistic life-cycle approach to schizophrenia management underscores the vital role of nutrition, calling for personalized interventions to enhance mental health outcomes.

Mental health is an increasing topic of focus since more than 500 million people in the world suffer from depression and anxiety. In this multifactorial disorder, parameters such as inflammation, the state of the microbiota and, therefore, the patient's nutrition are receiving more attention. In addition, food products are the source of many essential ingredients involved in the regulation of mental processes, including amino acids, neurotransmitters, vitamins, and others. For this reason, this narrative review was carried out with the aim of analyzing the role of nutrition in depression and anxiety disorders. To reach the review aim, a critical review was conducted utilizing both primary sources, such as scientific publications and secondary sources, such as bibliographic indexes, web pages, and databases. The search was conducted in PsychINFO, MedLine (Pubmed), Cochrane (Wiley), Embase, and CinAhl. The results show a direct relationship between what we eat and the state of our nervous system. The gut-brain axis is a complex system in which the intestinal microbiota communicates directly with our nervous system and provides it with neurotransmitters for its proper functioning. An imbalance in our microbiota due to poor nutrition will cause an inflammatory response that, if sustained over time and together with other factors, can lead to disorders such as anxiety and depression. Changes in the functions of the microbiota-gut-brain axis have been linked to several mental disorders. It is believed that the modulation of the microbiome composition may be an effective strategy for a new treatment of these disorders. Modifications in nutritional behaviors and the use of ergogenic components are presented as important non-pharmacological interventions in anxiety and depression prevention and treatment. It is desirable that the choice of nutritional and probiotic treatment in individual patients be based on the results of appropriate biochemical and microbiological tests.

Nostalgia-the bittersweet reliving of the past-has been linked to social connection and psychological wellbeing. Although food consumption is often an intrinsically social experience, relatively little research has examined how individuals experience and understand how food consumption relates to feelings of nostalgia, food and mood.

In the current study, semi-structured interviews were conducted with eight Australians from varying cultural backgrounds to explore their experiences with nostalgia, food and mood.

Reflexive thematic analysis identified three key themes from the data: (i) The bittersweet experiences of food-evoked nostalgia-individuals' descriptions of food-evoked nostalgia and how it impacted their mood both positively and negatively (ii) social connection and identity continuity-participants' description of food-evoked nostalgia and how this provides an opportunity for social connection and identity continuity throughout life, which positively influences mood, and (iii) the role and relationship of food-evoked nostalgia and mood-individual descriptions of the important role that nostalgic food plays in their life, in addition to their relationship with food, and how this impacts mood.

Understanding the positive component of nostalgic foods allowed individuals to bolster positive mood states with food-evoked nostalgia, increasing their quality of life. SO WHAT?: Understanding the link between food-evoked nostalgia and mood has significant implications, suggesting that negative mood states altered by nostalgic foods may result in positive mood states. Appropriate use of food-evoked nostalgia may increase the quality of life for individuals experiencing low mood states.

Perinatal depression and anxiety (PDA) is prevalent in new and expectant mothers, affecting millions of women worldwide. Those with a history of mood and anxiety disorders are at the greatest risk of experiencing PDA in a subsequent pregnancy. Current safety concerns with pharmacological treatments have led to a greater need for adjunctive treatment options for PDA. Changes in the composition of the microbiome have been associated with various diseases during pregnancy, and these changes are thought to play some role in perinatal mood disorders. While the relationship between PDA and the microbiome has not been explored, evidence suggests that nutritional interventions with fiber, fish oils, and probiotics may play a favorable role in neuropsychiatric outcomes during and after pregnancy. The primary objective of the present study is to assess the feasibility and acceptability of a combination of nonpharmacological interventions to maintain stability in pregnant women who have a history of depression and/or anxiety. This study will also aim to understand ease of recruitment and protocol adherence in this cohort.

This is a single-centered, partially randomized, placebo-controlled, double-blind feasibility trial. One hundred pregnant women with a history of depression and/or anxiety/PDA will be recruited and randomized into one of four arms, which could include the following: receiving a daily dose of both investigational products and dietary counseling on increasing dietary fiber, receiving a daily dose of both investigational drugs only, receiving fish oil investigational product and placebo, and a control arm with no intervention. The study involves six study visits, all of which can be conducted virtually every 3 months from the time of enrollment. At all study visits, information on diet, mental health, physical activity, and sleep quality will be collected. Additionally, all participants will provide a stool sample at each visit.

It is anticipated that pregnant women with a history of depression and anxiety will be particularly interested in partaking in this trial, resulting in favorable recruitment rates. Given the positive findings of omega-3 fatty acids (O3FAs) and probiotic supplements on mental health symptoms in nonpregnant adults, we expect a similar trend in PDA symptoms, with a low likelihood of adverse events. This study will build the foundation for larger powered studies to further contribute evidence for the efficacy of this potential preventative treatment option.

This trial was registered at ClinicalTrials/gov on October 6, 2023; NCT06074250. Trial Sponsor: The Canadian College of Naturopathic Medicine, 1255 Sheppard Ave E, Toronto, ON M2K 1E2, 416-498-1255.

This commentary discusses the New Zealand Labour Party's announcement to remove tax on fresh and frozen fruits and vegetables. It aims to explore its potential impact on the psychological well-being of New Zealanders in the context of the growing global burden of mental illnesses in the current food environment.

The proposed tax exemption on fruits and vegetables demonstrates the government's commitment to improving the food environment. While the precise mental health effects of this potential tax change remain unstudied, existing evidence suggests a positive impact on New Zealanders' well-being, marking a pivotal step in addressing broader health issues and fostering a healthier, more equitable food landscape.

In recent years, the relationship between nutrition and mental health has gained considerable interest. We identified, synthesized, and appraised all meta--analyses of randomized controlled trials (RCTs) and observational studies reporting on the efficacy of dietary patterns and nutrient supplements in the prevention and treatment of mental disorders in children and adolescents.

Systematic research in MEDLINE, PsycINFO, Scopus, and Cochrane Database of Systematic Reviews was completed on 8 January 2024.

Our research found 24 meta-analyses: 14 on RCTs, 8 on observational studies, and 2 combining both. Emerging evidence suggests that omega-3, in particular eicosapentaenoic acid, and Vitamin D may have adjunctive benefits in the treatment of attention deficit hyperactivity disorder (ADHD), while no evidence was found for autism spectrum disorder (ASD). Observational data also indicated that prenatal folic acid supplementation (>400 μg daily) was associated with a reduced risk of ASD in offspring. In terms of dietary habits, several meta-analyses of observational data revealed that healthy dietary patterns (rich in fruits, vegetables, and fibre, low in saturated fats) during the prenatal period, childhood, and adolescence were linked to a significantly reduced risk of internalizing disorders and externalizing disorders. Conversely, unhealthy dietary habits (high in sugars, saturated animal fats, and industrial foods, low in fruits, vegetables, and fibre) are associated with an elevated risk of these mental health issues. However, the number of available studies on dietary interventions for the treatment of depression, ASD, and ADHD was limited, and the results obtained were either nonsignificant or contradictory.

Our findings emphasize the need to establish clear causal relationships between dietary habits and the risk of mental illness in children and adolescents. Moreover, further investigation of the benefits observed with some nutrient supplements (such as omega-3 and vitamin D for ADHD) through larger-scale RCTs is imperative to establish more robust conclusions.

The burden of disease attributable to mental health is expected to rise in the coming decades. Poor nutritional status is considered a modifiable risk factor for general mental health. In fact, nutrition interventions are now accepted as a core strategy in mental healthcare to combat physical health inequalities and life-expectancy gap in people with certain psychiatric disorders. However, most psychiatrists are not familiar with evidence for the potential therapeutic benefits of diet in psychiatric illness, and this may be related to sparse nutrition education for physicians. Thus, there is a need to integrate nutritional management in psychiatric practice, but there is a gap in medical education that would support this practice. Here, we discuss evidence for and challenges in 1) assessing diet quality in psychiatric illness, 2) recommending improvements in diet quality and specific dietary patterns in psychiatric illness, and 3) recommending dietary supplements in psychiatric illness. This discussion serves as a call to develop nutrition curricula within psychiatry residency programs.

Depression represents a widespread and devastating psychiatric public health challenge globally. It is particularly prevalent among young adults in Korea. Certain foods may have medicinal properties that alleviate depressive symptoms. This study aimed to examine the association between specific foods and depressive symptoms among young adults, exploring their bioactive effects and possible mechanisms. We conducted a cross-sectional study involving 1000 Korean young adults aged 18-39 years. Food frequency questionnaires were used to assess diets and their associations with depressive symptoms. Results from multivariable logistic regression analysis indicated associations between several specific foods and their effects: milk (odds ratio = 0.58, 95% confidence interval: 0.36-0.94), eggs (0.55, 0.35-0.87), bananas (0.58, 0.36-0.94), oranges (0.62, 0.40-0.96), sweet potatoes (0.60, 0.37-0.97), mushrooms (0.53, 0.31-0.92, females only), and kimchi (0.40, 0.17-0.95, males only). Furthermore, molecular docking indicated that hesperidin had the highest docking score of 5.86 in oranges. Several bioactive compounds identified as potentially beneficial in combatting depression include calcium, casein, alpha-lactalbumin, tryptophan (TRP), vitamin B6 and B12, magnesium, flavonoids (especially hesperidin), carotenoids, ergothioneine, fiber, and probiotics. To recommend these foods in the management of depression among young adults, further clinical intervention studies are necessary.

Hypertensive disorders of pregnancy, including pre-eclampsia, are a leading cause of serious and debilitating complications that affect both the mother and the fetus. Despite the occurrence and the health implications of these disorders there is still relatively limited evidence on the molecular underpinnings of the pathophysiology. An area that has come to the fore with regard to its influence on health and disease is the microbiome. While there are several microbiome niches on and within the body, the distal end of the gut harbors the largest of these impacting on many different systems of the body including the central nervous system, the immune system, and the reproductive system. While the role of the microbiome in hypertensive disorders, including pre-eclampsia, has not been fully elucidated some studies have indicated that several of the symptoms of these disorders are linked to an altered gut microbiome. In this review, we examine both pre-eclampsia and microbiome literature to summarize the current knowledge on whether the microbiome drives the symptoms of pre-eclampsia or if the aberrant microbiome is a consequence of this condition. Despite the paucity of studies, obvious gut microbiome changes have been noted in women with pre-eclampsia and the individual symptoms associated with the condition. Yet further research is required to fully elucidate the role of the microbiome and the significance it plays in the development of the symptoms. Regardless of this, the literature highlights the potential for a microbiome targeted intervention such as dietary changes or prebiotic and probiotics to reduce the impact of some aspects of these disorders.

Previous studies have explored the relationship between bipolar disorder and gut microbiota. However, there has been no bibliometric analysis to summarize and analyze these publications. Our objective was to perform a bibliometric analysis to investigate the current status and frontiers of the publications in the field of the association between bipolar disorder and the gut microbiota.

We retrieved publications concerning the interplay between the gut microbiota and bipolar disorder from the Web of Science Core Collection (WoSCC). The analysis was executed using WoSCC's literature analysis tool and VOSviewer 1.6.16.

In total, we identified 177 publications originating from 362 institutions across 39 countries/regions, and these articles were disseminated in 104 different journals. The most productive institutions, authors, countries/regions, and journals were Zhejiang University contributing 18 publications, Shaohua Hu authoring 12 publications, China with 53 publications, and Frontiers in Psychiatry with 11 publications. The first high-cited document was published in the Journal of Psychiatric Research in 2017, and authored by Evans. In this article, they found gut microbiome composition was associated with BD and its illness severity, and they concluded that targeting the gut microbiota may be helpful to develop the effective treatment for bipolar disorder. The top 5 keywords with the highest frequency except for bipolar disorder and gut microbiota were as follows: depression, inflammation, probiotic, gut-brain axis, and anxiety.

In conclusion, this is the first bibliometric analysis to explore the publications in the field of the association between bipolar disorder and the gut microbiota. The main research hotspots regarding this field were the characteristics, abundance, and diversity of gut microbiome in bipolar disorder, the role of treatment and gut microbiome in bipolar disorder, microbiome-brain connections in bipolar disorder, and interventions for bipolar disorder based on microbiota composition modification. The number of studies about the association between gut microbiota and bipolar disorder is relatively small, and more studies are needed to expand our understanding the association between gut microbiota and bipolar disorder.

Depression is considered a multifaceted and intricate mental disorder of growing concern due to its significant impact on global health issues. The human gut microbiota, also known as the "second brain," has an important role in the CNS by regulating it through chemical, immunological, hormonal, and neurological processes. Various studies have found a significant bidirectional link between the brain and the gut, emphasizing the onset of depression therapies. The biological and molecular processes underlying depression and microbiota are required, as the bidirectional association may represent a novel study. However, profound insights into the stratification and diversity of the gut microbiota are still uncommon. This article investigates the emerging evidence of a bacterial relationship between the gut and the brain's neurological system and its potential pathogenicity and relevance. The interplay of microbiota, immune system, nervous system neurotransmitter synthesis, and neuroplasticity transitions is also widely studied. The consequences of stress, dietary fibers, probiotics, prebiotics, and antibiotics on the GB axis are being studied. Multiple studies revealed the processes underlying this axis and led to the development of effective microbiota-based drugs for both prevention and treatment. Therefore, the results support the hypothesis that gut microbiota influences depression and provide a promising area of research for an improved knowledge of the etiology of the disease and future therapies.

Neuropsychiatric disorders (NPDs) are considered a potential threat to mental health. Inflammation predominantly plays a role in the pathophysiology of NPDs. Dietary patterns are widely postulated to be involved in the physiological response to inflammation. This review aims to discuss the literature on how dietary inflammatory index (DII) is related to inflammation and, consequently, NPDs. After comprehensive scrutiny in different databases, the articles that investigated the relation of DII score and various NPDs and psychological circumstances were included. The association between dietary patterns and mental disorders comprising depression, anxiety, and stress proved the role of a proinflammatory diet in these conditions' exacerbation. Aging is another condition closely associated with DII. The impact of proinflammatory and anti-inflammatory diet on sleep quality indicated related disorders like sleep latency and day dysfunctions among the different populations are in relation with the high DII score. The potential effects of genetic backgrounds, dietary patterns, and the gut microbiome on DII are discussed as well. To plan preventive or therapeutic interventions considering the DII, these factors, especially genetic variations, should be considered as there is a growing body of literature indicating the role of personalized medicine in different NPDs. To the best of our knowledge, there is a limited number of RCTs on this subject, so future research should evaluate the causality via RCTs and look for therapeutic interventions with an eye on personalized medicine using information about DII in NPDs.

Emerging evidence suggests that diet therapy (nutrients, foods and dietary patterns) could be effective as a potential adjunctive treatment option for major depressive disorder. Numerous mechanisms have been proposed, including the role inflammation, oxidative stress, brain-derived neurotrophic factor, the gastrointestinal tract microbiome and tryptophan/serotonin metabolism. Despite known differences in depression characteristics and treatment responses between males and females, there are limited sex-specific studies examining the role of diet in young men specifically. This is important as young men are often reluctant to seek mental health support, so finding treatment strategies which appeal to this demographic is crucial. This brief report provides an overview of the most recent advances in the use of diet for preventing and treating depression in young men, highlighting existing challenges and opportunities for future research. We recommend that clinicians discuss the role of diet with depressed young men, so that diet may be used alongside current treatment options.

Beneficial changes in microbiota observed in individuals with a major depressive disorder (MDD) may be initiated with a low fermentable oligosaccharide, disaccharide, monosaccharide, and polyol (FODMAP) elimination diet. Academic Search Ultimate, APA PsychINFO, Cochrane Library, MEDLINE, Scopus and Web of Science were searched for original research documenting differences in microbiota in MDD or changes with a low FODMAP diet in adults (age 18 years +). Studies with fecal microbiota, 16 s RNA sequencing and QIIME pipelines were included. Studies using antibiotics, probiotics, and medications such as antidepressants were excluded. Additionally, studies based on a single gender were excluded as gender impacts microbiota changes in MDD. Four studies addressed differences in microbiota with MDD and another four assessed shifts occurring with a low FODMAP diet. The abundance of Bacteroidetes, Bacteroidaceae and Bacteroides were lower in individuals with MDD but increased with a low FODMAP diet. Abundance of Ruminoccaceae was lower and Bilophila was higher with both a low FODMAP diet and MDD. These results provide preliminary evidence that a low FODMAP diet might drive changes in microbiota that also benefit people with MDD. Further research to assess whether a low FODMAP diet can treat MDD through modification of targeted microbiota is warranted.

Suboptimal health status (SHS) is a non-clinical or pre-disease state between optimal/ideal health and disease. While its etiology remains unclear, lifestyle is considered one of the most important risk factors. We aimed to examine the effects of lifestyles on SHS through a nationwide survey in China.

We conducted a cross-sectional survey in 148 cities across China between 20 June and 31 August 2022, on 30 505 participants from rural and urban communities gathered through stratified quota sampling. We measured SHS with the Short-Form Suboptimal Health Status Questionnaire (SHSQ-SF). We gathered information on participants' lifestyles (ie, smoking, alcohol consumption, breakfast habits, weekly food delivery frequency, intermittent fasting, sleep duration and physical activities) through face-to-face interview. We determined the relationship between lifestyle and SHS logistic regression analysis by based on odds ratios (ORs) and 95% confidence intervals (CIs).

We included 22 897 participants (female: 13 056, male: 9841), 12 108 (52.88%) of whom reported exposure to SHS. After adjusting for demographic characteristics, individuals who currently smoked (OR = 1.165; 95% CI = 1.058-1.283) and those who drank alcohol (OR = 1.483; 95% CI = 1.377.1.596) were at a higher risk of SHS than those who have never done either. In a dose-response way, takeaway food consumption was associated with a higher risk of SHS, while increased frequency of breakfast and mild-intensity exercise conversely reduced said risk. Individuals with shorter sleep duration had a higher risk of SHS when compared to those who slept for more than seven hours per day.

We observed a relatively high prevalence of SHS across China, highlighting the importance of lifestyle in health promotion. Specifically, adopting healthy dietary habits, engaging in regular physical activity, and ensuring high-quality sleep are key in preventing SHS.

Chinese Clinical Trial Registry (ChiCTR2200061046).

The exploration of diet and nutrition as they relate to mental health and psychiatric disorders is a developing field. Anxiety, depression, and pharmacological treatments used to treat these disorders are likely to have side effects that induce decreases in activity and irregular eating habits, resulting in persistent nutritional imbalance. Unhealthy dietary patterns are associated with an increased risk of developing physical and mental health conditions. Despite this, nutritional support to patients in psychiatric care is not adequate.

This study aimed to determine the factors underlying the need for nutritional counseling among patients with a mental disorder in psychiatry. The factors explored are eating-related symptoms, eating behavior, interest in food, seeking nutritional counseling, and impact on quality of life (QOL).

We utilized a cross-sectional study design. Eligible patients were asked to complete a questionnaire regarding physical measurements and nutritional counseling. In addition, patients' diagnoses and blood test data were referenced from their medical records. The analysis focused on two groups: those who desired to consult a nutritionist and those who did not.

Ninety-three patients completed the study. The nutritional status and need for nutritional counseling in psychiatry patients indicates that patients with dietary problems requested nutritional counseling (p < .001). Patients who were more likely to need nutritional counseling had lower QOL in daily life (p = .011), pain/discomfort (p = .024), and anxiety/depression (p = .010) on the EuroQol 5-Dimension 5-level (EQ-5D-5L).

Patients with mental disorders who need nutritional counseling tend to have food-related problems and low QOL. It is necessary to establish an interdisciplinary system for nutritional counseling.

Objectives: The aim of this study was to investigate whether a combination of nutrients designed to promote gut and brain health also lowers psychological distress. The hypothesis is that a probiotic with fish oil, and glutamine supplement will reduce psychological distress. Design: A multiple baseline design was used to collect data from seven naturopathic patients in private naturopathic clinics in Australia. Patients were between 18 and 65 years of age, and had a Kessler-10 (K10) score between 16 and 30 and symptoms associated with mild gastrointestinal discomfort experienced several times most weeks for 3 months. They were randomized into one of three pathways to stagger the introduction of the intervention. Interventions: Participants received either a supplement incorporating a probiotic formulation (including Lactobacillus rhamnosus), a glutamine powder formulation, and fish oil, or matched placebos. The primary outcome measure was psychological distress as measured by the K10 scale of psychological distress. Results: The data showed a general trend toward lower K10 scores during the active phase compared with the baseline phase, with a marked reduction in the variances between phases. After controlling for time and baseline values, no significant difference between the phases for the K10 and the Perceived Stress Scale was found, but there was still a significant reduction in symptoms on the Gastrointestinal Symptom Rating Scale. Conclusions: A combination of a probiotic formulation, a glutamine powder formulation, and fish oil did not affect psychological distress and perceived stress, but had a significant beneficial effect on gastrointestinal symptoms in patients with high distress and concurrent gut symptomology. Clinical trial registration number: ACTRN12620000928910.

Amidst the global rise in complementary medicine (CM) use for mental health, a substantial number of clients consulting a psychologist also utilise at least one form of CM. Yet, how psychologists should engage with CM in their clinical practice (e.g., how to respond to a client disclosing CM use or enquiries regarding CM products or services for mental health) remains contested and unclear. In response, a systematic integrative review was conducted to examine empirical literature reporting on one or more aspects of the relationship between psychology (incorporating clinical practice, professional associations and academia) and CM, and how that relationship may relate to or inform psychologists' engagement with CM in their clinical practice. Twenty-seven peer-reviewed articles met the specific inclusion criteria and quality appraisal was employed. Analysis shows a substantial number of psychologists are engaging with, or are interested in engaging with, CM in their clinical practice. Analysis identified a dissonance between psychologists' engagement with CM in clinical practice and the limited engagement of the broader discipline of psychology with CM. Further research is required to understand these differing types of engagement with a view to helping inform relevant policy and practice guidelines, and ultimately assist psychologists in navigating CM in their clinical practice.

Mental health is a public health concern among professional organizations, clinicians, and consumers alike, especially in light of the COVID-19 pandemic. Indeed, the World Health Organization has identified mental health as an epidemic of the 21st century contributing to the global health burden, which highlights the urgency to develop economical, accessible, minimally invasive interventions to effectively manage depression, anxiety, and stress. Nutritional approaches, including the use of probiotics and psychobiotics to manage depression and anxiety, have elicited interest in recent years. This review aimed to summarize evidence from studies including animal models, cell cultures, and human subjects. Overall, the current evidence suggests that 1) Specific strains of probiotics can reduce depressive symptoms and anxiety; 2) Symptoms may be reduced through one or more possible mechanisms of action, including impact on the synthesis of neurotransmitters such as serotonin and GABA, modulation of inflammatory cytokines, or enhancing stress responses through effects on stress hormones and the HPA axis; and 3) While psychobiotics may offer therapeutic benefits to manage depression and anxiety, further research, particularly human studies, is needed to better characterize their mode of action and understand optimal dosing in the context of nutritional interventions.

In Australia, women report higher rates of depressive symptoms than men. Research suggests that dietary patterns rich in fresh fruit and vegetables could protect against depressive symptoms. The Australian Dietary Guidelines suggest that consuming two servings of fruit and five serves of vegetables per day is optimal for overall health. However, this consumption level is often difficult for those experiencing depressive symptoms to achieve.

This study aims to compare diet quality and depressive symptoms in Australian women over time using (I) two serves of fruit and five serves of vegetables per day (FV7), and (ii) two serves of fruit and three serves of vegetables per day (FV5).

A secondary analysis was conducted using data from the Australian Longitudinal Study on Women's Health over 12 years at three time points 2006 (n = 9145, Mean age = 30.6, SD = 1.5), 2015 (n = 7186, Mean age = 39.7, SD = 1.5), and 2018 (n = 7121, Mean age = 42.4, SD = 1.5).

A linear mixed effects model found, after adjusting for covarying factors, a small significant inverse association between both FV7 (b = -.54, 95% CI = -.78, -.29) and FV5 (b = -.38, 95% CI = -.50, -.26) in depressive symptoms.

These findings suggest an association between fruit and vegetable consumption and decreased depressive symptoms. The small effect sizes indicate caution should be taken in interpreting these results. The findings also suggest that current Australian Dietary Guideline recommendations need not be prescriptive to two fruit and five vegetables for impact on depressive symptoms.

Future research could evaluate reduced vegetable consumption (three serves per day) in identifying the protective threshold for depressive symptoms.

Depression is classified as one of the most common mental disorders. Its prevalence has recently increased, becoming a growing public health threat. This review focuses on clarifying the role and importance of individual nutrients in the diet and the impact of nutrient deficiencies on the risk of depression. Deficiencies in nutrients such as protein, B vitamins, vitamin D, magnesium, zinc, selenium, iron, calcium, and omega-3 fatty acids have a significant impact on brain and nervous system function, which can affect the appearance of depressive symptoms. However, it is important to remember that diet in itself is not the only factor influencing the risk of or helping to treat depression. There are many other aspects, such as physical activity, sleep, stress management, and social support, that also play an important role in maintaining mental health. The data review observed that most of the available analyses are based on cross-sectional studies. Further studies, including prospective cohort, case-control studies, are recommended to draw more reliable conclusions.

(1) Background: Depression is a serious health problem with a high cost for public administration. Epidemiological studies report that one in five children have a mental disorder and about 50% of mental health problems exacerbate in childhood and adolescence. Moreover, the antidepressant efficacy in children and adolescents is poorly demonstrated and can cause severe behavioral adverse events such as suicidal ideation. (2) Methods: This systematic literature review examined oral supplementations (Omega-3, fish oil, Vitamin D3) to treat depressed children, preadolescents, and adolescents. MEDLINE, Scopus, Embase, and PsycInfo were searched for articles published in the last five years. Six studies met the eligibility criteria. The inclusion criteria encompassed children, preadolescents, and adolescents, a diagnosis of depression, and an intervention of oral supplementations such as Omega-3, fish oil, and Vitamin D3. (3) Results: Most of the studies demonstrated that dietary intervention provides positive outcomes in terms of depression symptoms. (4) Conclusions: Overall, the results demonstrate a positive effect for oral supplementation suggesting an increase intake of Omega-3, fish oil, and Vitamin D3. However, only a few studies assess the effectiveness of diet recommendations, as a monotherapy or combined treatment, for the management of depression at developmental ages. Thus, there is still a need to further investigate these aspects and to look more specifically at adolescents and preadolescents.

The gut microbiota is critical for maintaining human health and the immunological system. Several neuroscientific studies have shown the significance of microbiota in developing brain systems. The gut microbiota and the brain are interconnected in a bidirectional relationship, as research on the microbiome-gut-brain axis shows. Significant evidence links anxiety and depression disorders to the community of microbes that live in the gastrointestinal system. Modified diet, fish and omega-3 fatty acid intake, macro- and micro-nutrient intake, prebiotics, probiotics, synbiotics, postbiotics, fecal microbiota transplantation, and 5-HTP regulation may all be utilized to alter the gut microbiota as a treatment approach. There are few preclinical and clinical research studies on the effectiveness and reliability of various therapeutic approaches for depression and anxiety. This article highlights relevant research on the association of gut microbiota with depression and anxiety and the different therapeutic possibilities of gut microbiota modification.

Dietary patterns and depressive symptoms are associated in cross-sectional and prospective-designed research. However, limited research has considered depression risk related to meat-based and plant-based dietary patterns. This study explores the association between diet quality and depressive symptoms across omnivore, vegan, and vegetarian dietary patterns. A cross-sectional online survey utilised the Dietary Screening Tool (DST) and the Centre for Epidemiological Studies of Depression Scale (CESD-20) to measure diet quality and depressive symptoms, respectively. A total of 496 participants identified as either omnivores (n = 129), vegetarians (n = 151), or vegans (n = 216). ANOVA with Bonferroni post hoc corrections indicates that dietary quality was significantly different between groups F(2, 493) = 23.61, p < 0.001 for omnivores and vegetarians and omnivores and vegans. Diet quality was highest in the vegan sample, followed by vegetarian and omnivore patterns. The results show a significant, moderately negative relationship between higher diet quality and lower depressive symptoms (r = -0.385, p < 0.001) across groups. Hierarchical regression showed that diet quality accounted for 13% of the variability in depressive symptoms for the omnivore sample, 6% for vegetarians, and 8% for vegans. This study suggests that diet quality in a meat-based or plant-based diet could be a modifiable lifestyle factor with the potential to reduce the risk of depressive symptoms. The study indicates a greater protective role of a high-quality plant-based diet and lower depressive symptoms. Further intervention research is needed to understand the bi-directional relationship between diet quality and depressive symptoms across dietary patterns.