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Q) I understand there has been some kind of study released about the effects of diet on depression. Can you tell me what you know about it?
A) The first-ever randomized and controlled clinical trial designed to test the effects of a specific diet on depression has just been published.
For the millions of Canadians who have not adequately responded to traditional pharmaceutical and/or psychotherapy or perhaps are looking for a way to lessen their need for such, there are natural solutions such as choosing better food options available.
This study was conducted in much the same way many drug studies so that hopefully the researchers could use the data to help health care practitioners better guide their patients. It was conducted in Australia and held over a 12 week trial. There were 67 patients in total all of whom had been diagnosed with depression ranging from moderate to severe in nature. They were entered into one of two treatment groups.
The first received seven 60-minutes sessions of dietary counseling while the parallel group received a matching social support protocol. All but nine of the 67 were already receiving another active treatment- either medications, psychotherapy or both. These were continued throughout the 12 weeks.
In the dietary counseling sessions, the participants were strongly encouraged to increase their consumption in 12 food categories. My guess is that the vast majority of you could already guess what most if not all of these food groups are without reading any further.
Like many things in life, we all know better, but still continue to make undisciplined choices far too often. Anyway, the groups included such foods as whole grains, fruits, vegetables, nuts, legumes, lean meats, chicken, seafood as well as incorporating foods high in omega-3 fats, zinc, B12, magnesium and iron.
Just as importantly, the counseling emphasized the need to decrease the consumption of foods that have previously been linked to depression such as refined starches (white flour, bread, rice, pasta...), highly processed foods and the whole host of empty carbohydrate food options one can find at your neighbourhood variety store.
Both before and at the end of the 12 weeks, both groups were given surveys designed to help them rate the level of their depression according to the Montgomery-Asberg Depression Rating Scale (MADRS).
This scale has been in use since 1979 and is essentially a ten-item diagnostic questionnaire in which each item yields an answer from 0-6. As such, the overall score ranges from 0 (normal, symptoms absent) all the way up to 60 (yikes). Scores ranging from 7-19 are categorized as mild depression, 20-34 as moderate and any score above 34 as being a sign of severe depression.
When the researchers compared the results of the two groups, it was found that there was a whopping 7.1 point difference in favour of the treatment group. Furthermore it was found that the more the treatment group adhered to their diet, the better their scores came in. In other words, when the patients ate better, they felt better.
Other numbers from this study further cemented just how effective dietary interventions proved to be. For instance, 32% of patients in the treatment group achieved remission versus only 8% in the social protocol group.
The number needed to treat (a key indicator in pharmaceutical research which tells us the how many people have to take a particular treatment in order for one to achieve the desired results) was only 4 which compares extremely favourably to our current antidepressants as well as most other pharmaceutical classes (which is a kind of a depressing reality when you think about it, no pun intended).
One issue raised was about the potential cost of eating this way as seafood and organic foods tend to be more expensive options at the local grocery store. Yet, when the researchers compared the food bills of the people in the study to average Australian weekly expenditure on food, the food group came in at a substantially lower amount.
Overall, the results of the study should not be a major surprise to anyone, although the robustness of the improvement does cause one to take a second look.
We have long known that nutrients such as magnesium, vitamin B12, iron, omega-3 fatty acids and others are intimately involved in the way our brain functions. Keep in mind, this should not be interpreted as a cry for patients to quit their drugs and stop consulting with their psychiatrists. These are still important and effective options for many.
However, at the end of the day, we need to reinforce that the individual can do more to help themselves get better than their entire health care team can put together.
It’s not easy when you have zero energy, negative self-esteem and wouldn’t know a good night’s sleep if it kicked you in the head to prep a good meal, drag yourself around the block and get to bed at a decent hour. But the effort is more than worthwhile and the very quality of your life may well be depending upon it.
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Tuesday, February 21, 2017