The EAT-Lancet Diet Helps Lower Depression and Anxiety Risk?

 

  • An analysis of UK Biobank data published in Nature Communications showed that individuals adhering to the EAT-Lancet diet have a lower risk of depression and anxiety.
  • The group with the highest adherence to this diet had around 20% lower risk of depression and anxiety compared to the lowest adherence group.
  • The EAT-Lancet diet emphasizes plant-based foods, moderate animal product consumption, and limited processed and red meat intake.

We can often read that eating certain foods might be good for our health. Studies frequently report that heightened or decreased intake of a certain type of food is associated with increased or reduced risk of certain diseases. For example,  regular consumption of refined sugars, particularly sugary drinks, has been linked to a host of adverse health outcomes (Hedrih, 2023; Huang et al., 2023). On the other hand, snacking on whole almonds has been found to reduce LDL cholesterol and improve endothelial function (Dikariyanto et al., 2020) and was, therefore, beneficial for overall health.

These findings refer to individual foods or food components. However, scientists also study the effects of broad dietary patterns on health and overall well-being.

Regular consumption of refined sugars has been linked to a host of adverse health outcomes.

Dietary patterns

A dietary pattern is the overall composition and combination of foods and beverages one consumes over time. It’s not just about individual nutrients but the synergistic effects of various foods in a person’s diet. Examples of dietary patterns include the Mediterranean diet, which emphasizes whole grains, vegetables, and healthy fats, and the MIND diet, which focuses on brain health.  These patterns define an individual’s long-term eating habits. Scientists have defined certain broad dietary patterns that individuals’ diets can be compared to for research purposes. These diets reflect the general dietary habits of certain groups and cultures or are created by scientists to improve health or research a certain topic.

For example, many studies explore the associations between the Western diet and health, finding that adherence to this diet is linked to various adverse health outcomes. The Western diet is characterized by a high intake of processed foods, red and processed meats, refined grains, sugars, and unhealthy fats (Hayes et al., 2024). On the other hand, studies link adherence to the Mediterranean diet and the Nordic diet with beneficial health outcomes (Adamsson et al., 2012; Araste et al., 2024; Camprodon-Boadas et al., 2024; Poulsen et al., 2014; The InterAct Consortium, 2011).

A dietary pattern is the overall combination and frequency of foods and beverages a person consumes regularly.

The EAT-Lancet diet

In January 2019, the EAT-Lancet Commission, a group of scientists and experts, developed recommendations for a sustainable and healthy diet that can support human health and environmental stability. The Commission based its diet on the best available evidence for what constitutes a healthy diet and considered food production sustainability. Their recommendations were published in the Lancet, one of the leading scientific journals in the world (Willett et al., 2019).

The EAT-Lancet diet is largely plant-based. It consists of whole grains, fruits, vegetables, nuts, legumes, unsaturated oils, low to moderate amounts of seafood and poultry, and no or low red meat, processed meat, added sugar, refined grains, and starchy vegetables. Adherence to this diet would represent a substantial dietary shift for most people. Adopting worldwide would require the global consumption of healthy foods to double, halving the consumption of less nutritious foods (Dalile et al., 2022).

The current study

Study author Xujia Lu and her colleagues wanted to explore how adherence to the EAT-Lancet diet might be associated with anxiety and depression among UK adults (Lu et al., 2024). They analyzed data from the UK Biobank, a large-scale biomedical database and research resource containing health and genetic information from half a million U.K. participants. This database is available for scientific purposes to researchers worldwide.

This study used data from 180,466 participants. At the start of the study, their average age was 56 years, and 46% were male.

These participants completed a dietary questionnaire called Oxford WebQ. This questionnaire asks participants to recall their food and drink intake in the previous 24 hours. Some participants completed it when they were included in the UK Biobank group, and all participants received invitations to complete it on multiple occasions.

Study authors used these data to calculate how much participants’ diets resembled the EAT-Lancet diet (i.e., how much participants adhered to it). There is currently no consensus about the right way to calculate adherence to the EAT-Lancet diet, so the study authors created several different scores to express this adherence. Data about depression and anxiety came from participants’ reports, hospital data, and the death registry records.

Individuals adhering to the EAT-Lancet diet were less likely to suffer from depression and anxiety

During the follow-up of around 11-12 years on average, 4548 cases of depression, 6026 cases of anxiety, and 1262 individuals with both depression and anxiety were identified.

Depending on the way adherence to the EAT-Lancet diet was calculated, participants with the strongest adherence to the EAT-Lancet diet had between 16% and 26% lower risk of developing depression or anxiety disorders compared to those with the lowest adherence to the EAT-Lancet diet. The risk reduction was the strongest for the co-occurrence of depression and anxiety, i.e., for suffering from both depression and anxiety at the same time (see Figure 1).

 

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

Figure 1. Study procedure and findings (Lu et al., 2024)

 

Participants with the strongest adherence to the EAT-Lancet diet had between 16% and 26% lower risk of developing depression or anxiety disorders.

 

Participants with higher adherence to the EAT-Lancet diet were more likely to be women, slightly older, nonsmokers, more physically active, and have lower body mass index and total energy intake.

Conclusion

Overall, the study suggests that higher adherence to the EAT-Lancet diet is associated with lower risks of depression, anxiety, and co-occurrence. Individuals adhering to this diet also tended to have healthier lifestyle habits.

The design of this study does not allow any cause-and-effect conclusions to be derived from the results. Because of this, we do not know whether this dietary pattern itself reduces the risk of anxiety and depression. It is also possible that factors producing the lowered risk of depression and anxiety make individuals more likely to adhere to a healthy diet. Still, it is possible that promoting the dietary pattern described by the EAT-Lancet diet might help prevent depression and anxiety.

The paper “Adherence to the EAT-Lancet diet and incident depression and anxiety” was authored by Xujia Lu, Luying Wu, Liping Shao, Yulong Fan, Yalong Pei, Xinmei Lu, Yan Borné, and Chaofu Ke.

 

References

Adamsson, V., Reumark, A., Cederholm, T., Vessby, B., Risérus, U., & Johansson, G. (2012). What is a healthy Nordic diet? Foods and nutrients in the NORDIET study. Food & Nutrition Research, 56(1), 18189. https://doi.org/10.3402/fnr.v56i0.18189 

Araste, A., Moghadam, M. R. S. F., Mohammadhasani, K., Fard, M. V., Khorasanchi, Z., Latifi, M., Hasanzadeh, E., Talkhi, N., Sharifan, P., Asadiyan-Sohan, P., Bidokhti, M. K., Ghassemi, A., Darban, R. A., Ferns, G., & Ghayour-Mobarhan, M. (2024). Adherence to the Nordic diet is associated with anxiety, stress, and depression in recovered COVID-19 patients, a case-control study. BMC Nutrition, 10(1), 38. https://doi.org/10.1186/s40795-024-00845-x 

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 

Dalile, B., Kim, C., Challinor, A., Geurts, L., Gibney, E. R., Galdos, M. V., Fata, G. L., Layé, S., Mathers, J. C., Vauzour, D., Verkuyl, J. M., & Thuret, S. (2022). The EAT–Lancet references diet and cognitive function across the life course. The Lancet Planetary Health, 6(9), e749–e759. https://doi.org/10.1016/S2542-5196(22)00123-1 

Dikariyanto, V., Smith, L., Francis, L., Robertson, M., Kusaslan, E., O’Callaghan-Latham, M., Palanche, C., D’Annibale, M., Christodoulou, D., Basty, N., Whitcher, B., Shuaib, H., Charles-Edwards, G., Chowienczyk, P. J., Ellis, P. R., Berry, S. E. E., & Hall, W. L. (2020). Snacking on whole almonds for 6 weeks improves endothelial function and lowers LDL cholesterol but does not affect liver fat and other cardiometabolic risk factors in healthy adults: The ATTIS study, a randomized controlled trial. The American Journal of Clinical Nutrition, 111(6), 1178–1189. https://doi.org/10.1093/AJCN/NQAA100 

Hayes, A. M. R., Lauer, L. T., Kao, A. E., Sun, S., Klug, M. E., Tsan, L., Rea, J. J., Subramanian, K. S., Gu, C., Tanios, N., Ahuja, A., Donohue, K. N., Décarie-Spain, L., Fodor, A. A., & Kanoski, S. E. (2024). Western diet consumption impairs memory function via dysregulated hippocampus acetylcholine signaling. Brain, Behavior, and Immunity, 118, 408–422. https://doi.org/10.1016/j.bbi.2024.03.015 

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

Lu, X., Wu, L., Shao, L., Fan, Y., Pei, Y., Lu, X., Borné, Y., & Ke, C. (2024). Adherence to the EAT-Lancet diet and incident depression and anxiety. Nature Communications, 15(1), 5599. https://doi.org/10.1038/s41467-024-49653-8 

Poulsen, S. K., Due, A., Jordy, A. B., Kiens, B., Stark, K. D., Stender, S., Holst, C., Astrup, A., & Larsen, T. M. (2014). Health effect of the New Nordic Diet in adults with increased waist circumference: A 6-mo randomized controlled trial1234. The American Journal of Clinical Nutrition, 99(1), 35–45. https://doi.org/10.3945/ajcn.113.069393

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 

Willett, W., Rockström, J., Loken, B., Springmann, M., Lang, T., Vermeulen, S., Garnett, T., Tilman, D., DeClerck, F., Wood, A., Jonell, M., Clark, M., Gordon, L. J., Fanzo, J., Hawkes, C., Zurayk, R., Rivera, J. A., Vries, W. D., Sibanda, L. M., … Murray, C. J. L. (2019). Food in the Anthropocene: The EAT–Lancet Commission on healthy diets from sustainable food systems. The Lancet, 393(10170), 447–492. https://doi.org/10.1016/S0140-6736(18)31788-4

 

 

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

  • 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

 

 

 

 

 

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