Tag: Mediterranean Diet

Mediterranean Diet Might Be a Protective Factor for Mental Health in Children

Posted on by CNP Staff
  • A systematic review published in Nutrition Reviews found that adherence to a Mediterranean diet could be a protective factor for mental health in children
  • The review included 13 studies, 2 of which were randomized controlled trials, and seven were found to be of high quality
  • Analyzed studies included 3058 children between 8 and 16 years of age

“You are what you eat,” the old saying goes. It means one must eat good food to stay healthy and fit. This link between eating well and staying healthy is obvious – our body needs specific nutrients to function. If we do not obtain them through food, serious health consequences will follow.

Diet and health


Science has known for centuries that a lack of specific nutrients can lead to serious health conditions. Nutrient deficiency diseases such as anemia (caused by a lack of iron, leading to fatigue, weakness, and pale skin), scurvy (caused by a deficiency of vitamin C, leading to bleeding gums, joint pain, and anemia), pellagra (caused by a deficiency of niacin (vitamin B3), leading to dermatitis, diarrhea, and dementia) or hypothyroidism (caused by a deficiency of iodine, leading to fatigue, weight gain, and depression) have been described and well understood for over 100 years.

However, studies in the past several decades revealed much more nuanced links between diet and health. Unlike nutrient deficiency diseases, these new studies link adverse health outcomes to more complex dietary patterns (i.e., patterns involving different foods containing many different nutrients and micronutrients in specific ratios or entire food consumption patterns referred to as diets).

For example, studies report that excessive intake of refined sugars is associated with increased risks of cardiovascular diseases, depression, type 2 diabetes, and even cancer (Hedrih, 2023; Huang et al., 2023; Zhang et al., 2024). Consumption of ultra-processed foods, i.e., food items created through extensive industrial processing, has also been linked to a wide range of adverse health outcomes ranging from cardiovascular and gastrointestinal diseases, depression, and anxiety to cancer (Lane et al., 2024) (see Figure 1).

 

%learn about nutrition mental health %The Center for Nutritional Psychology

Figure 1. Link of ultra-processed food to disease

 

These studies effectively tell us which foods or dietary patterns to avoid. But all living organisms need to eat if they want to live. So, are there dietary patterns that may protect our health? One such pattern might be the Mediterranean diet.

The Mediterranean diet


The Mediterranean diet is a pattern inspired by the traditional eating habits of people in countries bordering the Mediterranean Sea. It emphasizes the consumption of fruits, vegetables, whole grains, legumes, nuts, and olive oil, with a moderate intake of fish and poultry and limited consumption of red meat and sweets. This diet also includes moderate wine consumption, usually with meals.

Studies have shown that this diet is associated with numerous health benefits, including reduced risks of heart disease and diabetes (Salas-Salvadó et al., 2018; The InterAct Consortium, 2011). Adherence to the Mediterranean diet is even associated with a slightly lower risk of several types of cancer and a lower overall risk of dying from cancer (Schwingshackl & Hoffmann, 2016).

The current study


Study author Patricia Camprodon-Boadas and her colleagues wanted to investigate the association between adherence to the Mediterranean diet and mental health outcomes in children and adolescents (Camprodon-Boadas et al., 2024).

These authors note that childhood and adolescence are critical periods in the development of mental illness. Anxiety disorders are the most common mental health issue among children, followed by behavior disorders, mood disorders, and substance use disorders. Girls generally tend to have higher rates of mood and anxiety disorders, while boys are more susceptible to behavior disorders. Drug use disorders are equally common among girls and boys (Camprodon-Boadas et al., 2024). But could this diet be a protective factor against these disorders?

 

Childhood and adolescence are critical periods in the development of mental illness

 

These authors conducted a systematic review and meta-analysis of research articles in English and Spanish that investigated the links between adherence to the Mediterranean diet and mental health symptoms in children and adolescents.

Their search of several scientific article databases initially yielded 450 articles. However, after the authors removed duplicates and read these articles in detail to examine whether they contained the data they needed, the number of articles fell to 13.

Eight of the studies described in these articles were conducted in Spain, while the remaining five articles came from Iran, Turkey, and the United Kingdom. One study included participants from five different countries. Two of the studies were randomized controlled trials (researchers had participants eat different diets to test their effects), and one study was longitudinal.

The 13 studies included 3058 children between 8 and 16 years of age. The studies used different ways to assess adherence to the Mediterranean diet, but most of them used the Mediterranean Diet Quality Index, a 16-item questionnaire. Study authors found 7 of these studies to be of high quality (see Figure 2).

 

%learn about nutrition mental health %The Center for Nutritional Psychology

Figure 2. Study Procedure (Camprodon-Boadas et al., 2024)

 

High adherence to Mediterranean diet was linked to lower odds of ADHD
4 of the 13 studies examined the links between adherence to the Mediterranean diet and attention-deficit/hyperactivity disorder (ADHD). Their results indicated that children and adolescents with high adherence to the Mediterranean diet had 30% lower odds of suffering from ADHD.

Two studies examined the links between adherence to the Mediterranean diet and impulsivity. 1 of them reported that participants with higher impulsivity tended to have low adherence to a Mediterranean diet, while the other did not find this link. 1 study found no relationship between adherence to the Mediterranean diet and attention capacity

 

Children and adolescents with high adherence to the Mediterranean diet were less likely to suffer from depression or anxiety

 

Five studies examined the links between the Mediterranean diet and depressive symptoms. Of these, four found that participants with depressive symptoms showed much lower adherence to the Mediterranean diet. Conversely, participants with high adherence to the Mediterranean diet were less likely to suffer from depression and had fewer depressive symptoms.

Four studies examined the association between the Mediterranean diet and anxiety. 2 of these studies found participants highly adhering to the Mediterranean diet to have fewer anxiety symptoms. In contrast, the other 2 found no such association (see Figure X).

 

%learn about nutrition mental health %The Center for Nutritional Psychology

Figure 3. Findings (Camprodon-Boadas et al., 2024)

 

Conclusion


Overall, the results reported by examined studies were not uniform, but the majority found higher adherence to the Mediterranean diet associated with fewer mental health issues.

 

The majority found higher adherence to the Mediterranean diet associated with fewer mental health issues

 

At the moment, it remains insufficiently clear whether it is the Mediterranean diet that reduces the risks of developing mental health issues or the absence of mental health issues that leads to higher adherence to the Mediterranean diet. A possibility exists that adherence to the Mediterranean diet might indeed be a protective factor for the mental health of children and adolescents.

The paper “Mediterranean Diet and Mental Health in Children and Adolescents: A Systematic Review” was authored by Patricia Camprodon-Boadas, Aitana Gil-Dominguez, Elena De la Serna, Gisela Sugranyes, Iolanda Lazaro, and Immaculada Baeza.


Camprodon-Boadas, P., Gil-Dominguez, A., De La Serna, E., Sugranyes, G., Lázaro, I., & Baeza, I. (2024). Mediterranean Diet and Mental Health in Children and Adolescents: A Systematic Review. Nutrition Reviews, nuae053. https://doi.org/10.1093/nutrit/nuae053

Hedrih, V. (2023, June 6). Health Consequences of High Sugar Consumption. CNP Articles in Nutritional Psychology. https://www.nutritional-psychology.org/health-consequences-of-high-sugar-consumption/

Huang, Y., Chen, Z., Chen, B., Li, J., Yuan, X., Li, J., Wang, W., Dai, T., Chen, H., Wang, Y., Wang, R., Wang, P., Guo, J., Dong, Q., Liu, C., Wei, Q., Cao, D., & Liu, L. (2023). Dietary sugar consumption and health: Umbrella review. BMJ (Clinical Research Ed.), 381, e071609. https://doi.org/10.1136/bmj-2022-071609

Lane, M. M., Gamage, E., Du, S., Ashtree, D. N., McGuinness, A. J., Gauci, S., Baker, P., Lawrence, M., Rebholz, C. M., Srour, B., Touvier, M., Jacka, F. N., O’Neil, A., Segasby, T., & Marx, W. (2024). Ultra-processed food exposure and adverse health outcomes: Umbrella review of epidemiological meta-analyses. BMJ, e077310. https://doi.org/10.1136/bmj-2023-077310

Salas-Salvadó, J., Becerra-Tomás, N., García-Gavilán, J. F., Bulló, M., & Barrubés, L. (2018). Mediterranean Diet and Cardiovascular Disease Prevention: What Do We Know? Progress in Cardiovascular Diseases, 61(1), 62–67. https://doi.org/10.1016/j.pcad.2018.04.006

Schwingshackl, L., & Hoffmann, G. (2016). Does a Mediterranean-Type Diet Reduce Cancer Risk? Current Nutrition Reports, 5(1), 9–17. https://doi.org/10.1007/s13668-015-0141-7

The InterAct Consortium. (2011). Mediterranean Diet and Type 2 Diabetes Risk in the European Prospective Investigation Into Cancer and Nutrition (EPIC) Study. Diabetes Care, 34(9), 1913–1918. https://doi.org/10.2337/dc11-0891

Zhang, L., Sun, H., Liu, Z., Yang, J., & Liu, Y. (2024). Association between dietary sugar intake and depression in US adults: A cross-sectional study using data from the National Health and Nutrition Examination Survey 2011–2018. BMC Psychiatry, 24(110), 1–10. https://doi.org/10.1186/s12888-024-05531-7

 

 

 

 

 

The “Diet-Sleep” Relationship: Is there A Connection?

Posted on by CNP Staff

With growing recognition of the link between mental health and sleep, many of us want to know if making lifestyle changes, including what we eat, can impact our sleep habits and potentially improve our overall psychological well-being.  

Recent research by Rostami et al. (2022) examines the link between sleep quality and sleep-related outcomes and a newly proposed hybrid diet, referred to as the Mediterranean-DASH Diet Intervention for Neurodegenerative Delay, or MIND diet. The MIND diet combines the Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diets, which have both been previously studied for their impact on various aspects of psychological health (Bayes et al., 2022; Salari-Moghaddam et al., 2019) respectively). 

 

Rostami and colleagues set out to explore the relationship between the MIND diet and psychological function, including depression, anxiety/stress, and sleep.

 

The MIND diet includes 10 “brain-healthy food groups” (green leafy vegetables, other vegetables, nuts, berries, beans, whole grains, fish, poultry, olive oil, and wine) and identifies 5 “brain-unhealthy food groups” (red meats and processed red meat products, butter and stick margarine, cheese, pastries, fast fried foods, and sweets). 

In this study, Rostami and colleagues set out to explore the relationship between the MIND diet and psychological function, including depression, anxiety/stress, and sleep.

 

This is the first study to explore the relationship between adherence to the MIND diet and sleep.

 

400 Iranian adult males with a mean age of 38.67 years working in healthcare centers were randomly selected to participate. They had no history of chronic disease. Using a food frequency questionnaire (FFQ) consisting of 168 foods and their standard serving sizes, participants reported how often they consumed each food. The research team then calculated an overall MIND diet score of 0-14 for participants based on intake of both the “brain-healthy food groups” of the MIND diet and the specified “brain-unhealthy food groups” (Note: wine was not included in the calculated MIND diet score since it was not on the FFQ). A higher MIND diet score indicated greater adherence to the MIND diet. 

Additional information obtained from participants consisted of demographics (i.e., age, smoking status, marital status, education), height and weight measurements for calculation of Body Mass Index (BMI), and frequency of physical activity. The researchers used the Depression Anxiety and Stress Scale (DASS-21) to look for depression, anxiety, and stress and included questionnaires to examine sleep quality (Pittsburgh Sleep Quality Index), daytime sleepiness (Epworth Sleepiness Scale), and insomnia (Insomnia Severity Index). 

 

Greater adherence to the MIND diet was linked to better sleep quality and fewer reports of daytime sleepiness and insomnia. 

 

According to Rostami et al., this is the first study to explore the relationship between adherence to the MIND diet and sleep. They found that greater adherence to the MIND diet was linked to better sleep quality and fewer reports of daytime sleepiness and insomnia. The authors suggest that the anti-inflammatory and antioxidant properties of the MIND diet likely contribute to the observed positive impact on sleep. 

 

The anti-inflammatory and antioxidant properties of the MIND diet likely contribute to the observed positive impact on sleep. 

 

No significant effect between MIND-diet adherence and depression, anxiety, or stress was observed in this study. 

Limitations of these findings include lack of generalizability of results to other populations and possible misreporting from participants on self-report measures. The nature of the study design (cross-sectional) prevents findings related to causality. The authors recommend further investigation to address these factors and verify their results.

References:

Bayes, J., Schloss, J., & Sibbritt, D. (2022). The effect of a Mediterranean diet on the symptoms of depression in young males (the “AMMEND” study): A Randomized Control Trial. The American journal of clinical nutrition, nqac106. Advance online publication. https://doi.org/10.1093/ajcn/nqac106

Rostami, H., Parastouei, K., Samadi, M., Taghdir, M., & Eskandari, E. (2022). Adherence to the MIND dietary pattern and sleep quality, sleep related outcomes and mental health in male adults: A cross-sectional study. BMC Psychiatry, 22(167). https://doi.org/10.1186/s12888-022-03816-3

Salari-Moghaddam, A., Keshteli, A. H., Mousavi, S. M., Afshar, H., Esmaillzadeh, A., & Adibi,(2019). Adherence to the MIND diet and prevalence of psychological disorders in adults. Journal of affective disorders, 256, 96–102. https://doi.org/10.1016/j.jad.2019.05.056

 

Is Diet Affecting Children’s Mood, Happiness, and Well-being?

Posted on by CNP Staff

Adolescence is a developmental period commonly associated with increasing independence. With regards to eating behavior, teens and young adults take on more responsibility for exactly when they eat, along with what types of foods they choose to consume. This age group is therefore at greater risk for developing unhealthy lifestyle habits (Quehl et al., 2017). 

 

Adolescence is a developmental period commonly associated with increasing independence.

 

One lifestyle habit that tends to develop during the adolescent years is skipping meals. Hayhoe et al. (2021) explored the relationship between dietary choices and mental well-being and discovered that secondary school-age students who skipped breakfast or lunch scored lower on well-being. Well-being scores were also lower for those who chose an energy drink over eating a more traditional breakfast. Similar findings have been reported for older adolescents (Lesani et al., 2016). More specifically, college students who ate breakfast and did not skip meals reported being happier.   

So, once teens decide to eat, WHAT they eat definitely matters. Higher fruit and vegetable intake has been repeatedly linked to better mental health and well-being (Glabska et al., 2020; Guzek et al., 2020; Hayhoe et al.). Self-reported creativity, curiosity, and “eudaemonic” well-being (whether people feel engaged and experience life as meaningful and purposeful) are also greater with higher fruit and vegetable consumption (Conner et al., 2015). 

 

Higher fruit and vegetable intake has been linked to better mental health and mental well-being.

 

You may have heard of the Mediterranean diet — it has garnered much attention for its potential mental health benefits. It includes fish, fruits, vegetables, whole grains, legumes/nuts, and monounsaturated fats from olive oil. This diet prioritizes whole foods over highly processed convenience foods. Adherence to a Mediterranean diet among adolescents has been associated with higher levels of subjective happiness, mental well-being, and positive emotional states (Esteban-Gonzalo et al., 2019; Ferrer-Cascales et al., 2019; Lopez-Olivares et al., 2020). Unfortunately, teens more commonly adopt Westernized diets. These consist of high-inflammatory foods, such as refined starches, sugar, saturated fats, and trans-fats that are nutritionally deficient. Think of processed meats, chips, sugary desserts, and other “junk” foods. 

Increased symptoms of depression have been associated with diets poorer in nutritional quality among female college students (Quehl et al.). McMartin et al. (2013) noted similar findings in preadolescents; diet quality was inversely associated with feelings of worry, sadness, or unhappiness. In other words, as diet quality dropped, these negative feelings grew. Also worth noting is that inflammatory dietary components can lead to a higher risk of being in the worst mental well-being category on outcome measures of psychosocial health, quality of life, and life satisfaction in this preadolescent age group (Lycett et al., 2021). Observing the diet trends in this slightly younger age group can help us predict what food choices they will make in adolescence.  

 

Westernized diets more commonly adopted by teens consist of high-inflammatory foods.

 

On a positive note, it doesn’t take long to notice the mental health benefits of a nutrient-rich diet. According to White et al. (2013), eating fruits and vegetables predicted improvements in positive affect the following day for young adults. These meaningful changes in positive affect were noted with 7-8 servings of fruits and vegetables per day. Smith and Rogers (2014) reported that eating fruit as a mid-afternoon snack for just 10 consecutive days (versus a chocolate/crisp) was associated with lower anxiety, depression, and emotional distress.  

Researchers are just beginning to investigate dietary change as an intervention for the treatment of mental health problems. To date, Francis et al.’s 2019 study represents the only randomized controlled trial demonstrating how a brief, three-week diet intervention in young adults decreases symptoms of depression. By increasing their intake of vegetables, fruits, whole-grain cereals, protein, unsweetened dairy, fish, nuts and seeds, olive oil, and spices, and decreasing refined carbohydrates, sugar, fatty or processed meats, and soft drinks, participants saw a significant reduction in depressive symptoms. Intervention effects were even maintained at a three-month follow-up.

 

Researchers are just beginning to investigate dietary change as an intervention for the treatment of mental health problems.

 

The teen years are often characterized by greater freedom, increased opportunity, and new challenges. What adolescents eat and when they eat can impact their outlook on these experiences and affect their overall well-being. So, when addressing the question, “Is diet affecting our children’s mood, happiness, and well-being?” the answer is proving to be “Yes.” To find out more about the child diet-mental health relationship, view CNP’s Parent Research Libraries.

 

References

Conner, T. S., Brookie, K. L., Richardson, A. C., & Polak, M. A. (2015). On carrots and curiosity: Eating fruit and vegetables is associated with greater flourishing in daily life. British Journal of Health Psychology, 20(2), 413-427. https://doi.org/10.1111/bjhp.12113

Esteban-Gonzalo, L., Turner, A. I., Torres, S. J., Esteban-Cornejo, I., Castro-Piñero, J., Delgado-Alfonso, Á., Marcos, A., Gómez-Martínez, S., & Veiga, Ó. L. (2019). Diet quality and well-being in children and adolescents: The UP&DOWN longitudinal study. The British Journal of Nutrition, 121(2), 221–231.  https://doi.org/10.1017/S0007114518003070

Ferrer-Cascales, R., Albaladejo-Blazquez, N., Ruiz-Robledillo, N., Clement-Carbonell, V., Sánchez-SanSegundo, M., & Zaragoza-Marti, A. (2019). Higher adherence to the Mediterranean diet is related to more subjective happiness in adolescents: The role of health-related quality of life. Nutrients, 11(3), 698. https://doi.org/10.3390/nu11030698

Francis, H. M., Stevenson, R. J., Chambers, J. R., Gupta, D., Newey, B., & Lim, C. K. (2019). A brief diet intervention can reduce symptoms of depression in young adults – A randomised controlled trial. PLoS ONE, 14(10), e0222768. https://doi.org/10.1371/journal.pone.0222768

Glabska, D., Guzek, D., Groele, B., & Gutkowska, K. (2020). Fruit and vegetables intake in adolescents and mental health: A systematic review. Roczniki Państwowego Zakładu Higieny, 71(1), 15-25. https://doi.org/10.32394/rpzh.2019.0097

Guzek, D., Głąbska, D., Groele, B., & Gutkowska, K. (2020). Role of fruit and vegetables for the mental health of children: A systematic review. National Institute of Hygiene, 71(1), 5–13. https://doi.org/10.32394/rpzh.2019.0096

Hayhoe, R., Rechel, B., Clark, A. B., Gummerson, C., Smith, S. J. L., & Welch A. A. (2021). Cross-sectional associations of schoolchildren’s fruit and vegetable consumption, and meal choices, with their mental well-being: A cross-sectional study. BMJ Nutrition, Prevention & Health 2021; 0. http://dx.doi.org/10.1136/bmjnph-2020-000205

Lesani, A., Mohammadpoorasl, A., Javadi, M., Esfeh, J. M., & Fakhari, A. (2016). Eating breakfast, fruit and vegetable intake and their relation with happiness in college students. Eating and weight disorders: EWD, 21(4), 645–651. https://doi.org/10.1007/s40519-016-0261-0

López-Olivares, M., Mohatar-Barba, M., Fernández-Gómez, E., & Enrique-Mirón, C. (2020). Mediterranean diet and the emotional well-being of students of the campus of Melilla (University of Granada). Nutrients, 12(6), 1826. https://doi.org/10.3390/nu12061826

Lycett, K. M., Wijayawickrama, D. J., Liu, M., Grobler, A., Burgner, D. P., Baur, L. A., Liu, R., Lange, K., Wake, M, & Kerr, J. A. (2021). Does an inflammatory diet affect mental well-being in late childhood and mid-life? A cross-sectional study. British Journal of Nutrition, 17, 1-9. https://doi.org/10.1017/S0007114521001616

McMartin, S. E., Willows, N. D., Colman, I., Ohinmaa, A., Storey, K., & Veugelers, P. J. (2013). Diet quality and feelings of worry, sadness or unhappiness in Canadian children. Canadian Journal of Public Health, 104(4), e322-326. https://doi.org/10.17269/cjph.104.3845

Quehl, R., Haines, J., Lewis, S. P., & Buchholz, A. C. (2017). Food and mood: Diet quality is inversely associated with depressive symptoms in female university students. Canadian Journal of Dietetic Practice and Research : A Publication of Dietitians of Canada = Revue canadienne de la pratique et de la recherche en diététique : une publication des Diététistes du Canada, 78(3), 124–128. https://doi.org/10.3148/cjdpr-2017-007

Smith, A. P., & Rogers, R. (2014). Positive effects of a healthy snack (fruit) versus an unhealthy snack (chocolate/crisps) on subjective reports of mental and physical health: a preliminary intervention study. Frontiers in Nutrition, 1, 10. https://doi.org/10.3389/fnut.2014.00010

White, B. A., Horwath, C. C., & Conner, T. S. (2013). Many apples a day keep the blues away–daily experiences of negative and positive affect and food consumption in young adults. British Journal of Health Psychology, 18(4), 782-798. https://doi.org/10.1111/bjhp.12021

 

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