The mediterranean diet and mental health

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The Mediterranean Diet (MD) is known to be one of the best dietary models. It is associated with a large number of health benefits and with the prevention of many chronic diseases (1). There is evidence that it can help in the fight against a number of cancers (2), is beneficial for cardiovascular disease (3) (4), prevention of obesity (5), management of type 2 diabetes (6) and cognitive decline (7) (8).

Research is also emerging for the benefits of the MD on mental health, particularly anxiety and depression. These conditions have been bought to the forefront of peoples’ minds with the recent COVID-19 pandemic.

The COVID-19 pandemic has affected health and wellbeing globally. In addition to the physical health, economic and social implications, the psychological impacts are increasingly being reported in the scientific literature.

The current research suggests that people affected by COVID-19 may have a high burden of mental health problems, including depression, anxiety disorders, stress, panic attack, sleep disorders, emotional disturbance, post traumatic stress symptoms, and suicidal behaviour. This suggests that a psychiatric epidemic is occurring alongside the COVID-19 pandemic (9). An important large scale international study published in June 2021 (10) highlighted the effects of home confinement on mental health and lifestyle behaviours during the COVID-19 outbreak.

What is the evidence that the MD diet can help with mental health?

Below is a summary of a few of the most recent studies linking the MD with mental health

  • A review published in 2020 (11) suggests that the MD has a possible positive impact on general health and the outcome of psychiatric disorders (e.g., major depression and anxiety). It encourages further studies to look at the benefits of healthy food choices on the health of the general population.

  • A study published in 2018 (12) concluded that following a MD is associated with a reduced presence of depressive symptoms in female adolescents. Another recent study (13) looked at 3172 Iranian adults and found an inverse association between adopting a Mediterranean dietary pattern and the odds of psychological disorders including depression, anxiety and psychological distress.

What is the Mediterranean Diet?

The Mediterranean Diet is characterized by a daily intake of fresh fruit and vegetables. Legumes, pulses, non-refined cereals, nuts, seeds, and olive oil are regularly included. Dairy products, poultry and fish are consumed in moderation and there is a low intake of red meat. A small amount of alcohol (usually red wine) is consumed with the main meal. Sweet foods and processed foods are consumed infrequently.

Importantly, an integral part of the MD are the lifestyle habits: Regular physical activity, adequate rest, spending time with family and friends, taking time to prepare and cook food and consuming seasonal, traditional and local products (2).

How can we incorporate aspects of the MD into our own lives?

To make any dietary changes it is better to start with small, simple tweaks rather than attempt a compete overhaul. This is where working with a Registered Nutritional Therapist can help identify where to begin and what to prioritise for your goals and needs. Here are a few ideas:

  • Add chopped fruit to morning cereal/porridge/muesli.
  • Include a large interesting salad alongside your lunch time sandwich.
  • Add in an extra portion of vegetables at dinner.
  • Use olive oil on salads and on cooked vegetables.
  • Include beans and lentils in stews and casseroles.
  • Include oily fish.

This is a very interesting area in Nutritional Science and we hope that more studies will be published to back up the existing research into the benefits of the MD for mental health.

Lucy Kelly BSc (Hons), DIP ION, MBANT, CNHC Registered

Research references

  1. Romagnolo, D. F. and Selmin, O. I. (2017) ‘Mediterranean Diet and Prevention of ChronicDiseases’, Nutr Today, 52(5), pp 208-222. Available at:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5625964/?report=reader (Accessed July2021)
  2. Mentella, M. C., Scaldaferri, F. and Miggiano, G. A. D. (2019) ‘Cancer and MediterraneanDiet: A Review’, Nutrients, 11(9), pp 2059. Available at:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6770822/#!po=19.8276(Accessed July 2021)
  3. Widmer, R. J., Flammer, A. J. and Lerman, A. (2015) ‘The Mediterranean Diet, itsComponents, and Cardiovascular Disease’, Am J Med, 128(3), pp 229-238. Available at:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4339461/ (Accessed July 2021)
  4. Martinez-Gonzaliez, M. A., Gea, A. and Ruiz-Canela, M. (2019) ‘ The Mediterranean Dietand Cardiovascular Health’, Circulation Research, 124(5), pp 779-798. Available at:https://www.ahajournals.org/doi/10.1161/CIRCRESAHA.118.313348?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed (Accessed July 2021)
  5. D’Innocenze, S., Biagi, C. and Lanari, M. (2019) ‘Obesity and the Mediterranean Diet: AReview of Evidence of the Role and Sustainability of the Mediterranean Diet’, Nutrients,11(6), pp 1306. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6627690/(Accessed July 2021)
  6. Esposito, K., Maiorino, M. I. and Giugliano, D. (2015) ‘A journey into a Mediterranean dietand type 2 diabetes: a systematic review with meta-analyses’, BMJ Open, 5(8), e008222.Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4538272/ (Accessed July2021)
  7. Roman, G. C. et al. (2019) ‘Mediterranean diet: The role of long-chain ω-3 fatty acids infish; polyphenols in fruits, vegetables, cereals, coffee, tea, cacao and wine; probiotics andvitamins in prevention of stroke, age-related cognitive decline, and Alzheimer disease’, RevNeurol (Paris), 175(10), pp 724-741. Available at:https://pubmed.ncbi.nlm.nih.gov/31521398/ (Accessed July 2021)
  8. Sofi, F., Cesari, f. and Casini, A. (2008) ‘Adherence to Mediterranean diet and healthstatus: meta-analysis’, BMJ, 337: a1344. Available at:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2533524/ (Accessed July 2021)
  9. Hossain, M. M. et al, (2020) ‘Epidemiology of mental health problems in Covid-19: areview’, F1000Res, 9, pp 638. Available at:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7549174/ (Accessed July 2021).
  10. Ammar, A. et al. (2021) ‘Effects of home confinement on mental health and lifestylebehaviours during the COVID-19 outbreak: insights from the ECLB-COVID19 multicentre study’, Biol Sport, 38(1), pp 9-21 Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7996377/ (Accessed July 2021)
  11. Ventriglio, A., Sancassiani, F. and Bhugra, D. (2020) ‘Mediterranean Diet and its Benefitson Health and Mental Health: A Literature Review’, Clin Pract Epidemiol Ment Health,16(Suppl-1), pp 156-164. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7536728/ (Accessed July 2021)
  12. Tehrani, A. N. et al. (2018) ‘Adherence to Mediterranean dietary pattern and depression,anxiety and stress among high-school female adolescents’, Mediterranean Journal ofNutrition and Metabolism 11(1). Available at: https://www.researchgate.net/publication/324220081_Adherence_to_Mediterranean_dietary_pattern_and_depression_anxiety_and_stress_among_high-school_female_adolescents(Accessed July 2021)
  13. Sadeghi, O. et al. (2019) ‘Adherence to Mediterranean dietary pattern is inverselyassociated with depression, anxiety and psychological distress’, Nutritional Neuroscience,24(4), pp 248-259. Available at: https://www.tandfonline.com/doi/abs/10.1080/1028415X.2019.1620425?journalCode=ynns20 (Accessed July 2021)

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