- Our standard Western diets are highly inflammatory.
- Low or anti-inflammatory foods are linked to a lower risk of depression.
- The Mediterranean diet is an excellent source of anti-inflammatory foods.
Let food be thy medicine.
I frequently discuss with patients how to boost their mental health through the pillars of exercise and sleep, but I've become increasingly convinced that there is a third pillar: food—specifically, an anti-inflammatory diet.
We all know that food is a huge determinant of our physical health, but its direct connection to our mental health has been less well-defined—until recently. Now a growing volume of research points to the specific mental health benefits of the anti-inflammatory diet, the best example of which is the Mediterranean diet. This includes foods like whole grains, vegetables, and fish. The worst example is, unfortunately, the Western diet, which often features such foods as cheeseburgers, sugary drinks, and processed junk foods.
What does the research tell us about anti-inflammatory food and mood?
A 2023 study in the Journal of Affective Disorders looked at 30,627 research participants in the National Health and Nutrition Examination Survey. They were interviewed about their diets, were given a dietary inflammation score, and were also rated for depression. The key discovery was that, at a set point, the amount of inflammatory intake appeared to exceed the body's capacity, and then it began to correlate with a significantly higher risk for depression. The researchers concluded that their findings have "major implications for clinical practice as well as public health."
Results from a study of 1,701 offspring of participants from the famed Framingham Heart Study were published in a 2022 Journal of Gerontology article. The participants were defined as non-frail at the start of the study, and frailty was defined as including such features as weak grip strength, slow gait, and exhaustion. The researchers followed their subjects over 13 years and found that an association between depression and a high dietary inflammation score was linked to increased odds of frailty by the end of the study period.
Outcomes from a study published in Brain, Behavior, and Immunity described 43,685 adult women followed over 12 years. At the start of the study, they were all depression-free and their diet patterns were rated based on how inflammatory they were. At the end of the study, researchers found that subjects with proinflammatory diets were more likely to develop depression. These types of prospective studies are especially compelling since they look at a naturalistic, longitudinal development of symptoms, which may more closely parallel what happens to us in real life, over time.
Conversely, other researchers have found correlations between the Mediterranean diet and decreased risk and rates of depression.
The mechanism connecting inflammatory foods to our brain health continues to be elucidated, but we know that inflammatory biomarkers can enter the brain and affect the neurotransmitters and neural pathways involved in depression. Depressed patients have also been found to have elevated levels of inflammatory biomarkers in both blood and spinal fluid samples. And studies have shown that patients being treated with anti-inflammatory drugs for diseases like psoriasis demonstrate a significant improvement in depressive symptoms, whether or not the psoriasis responds to the drugs.
The bonus: In addition to being good for mental health, a Mediterranean diet can help prevent chronic medical conditions like hypertension, cardiovascular disease, and diabetes.
How does this help us decide what's for dinner tonight?
As a recap: The Mediterranean diet embodies an anti-inflammatory food "gold standard" that researchers have linked to so many health benefits. This diet is not actually a specific set of rules but instead an overall eating lifestyle. Here then are some key anti-inflammatory food "Do's and Don'ts," based on the Mediterranean dietary approach:
- fruit, nuts, and seeds
- legumes and beans
- leafy green and yellow vegetables
- whole grains
- generous amounts of olive oil
- fish, plant-based proteins, eggs, skinless chicken breast
- anti-inflammatory spices (e.g., garlic, turmeric, ginger, cinnamon)
- green tea
- water as your main daily beverage
- junk or fast foods
- red meat and butter (use minimally)
- refined carbohydrates (white bread, sugary desserts)
- added sugars such as those in soft drinks, sweetened juices
- processed meats (e.g., deli meats, hot dogs, bacon)
Both physically and mentally, you really are what you eat. Let delicious anti-inflammatory foods be thy medicine.