Elsevier

EBioMedicine

Volume 17, March 2017, Pages 24-29
EBioMedicine

Review
Nutritional Psychiatry: Where to Next?

https://doi.org/10.1016/j.ebiom.2017.02.020Get rights and content
Under a Creative Commons license
open access

Highlights

  • Extensive observational evidence supports an inverse association between diet quality and common mental disorders

  • Preliminary RCT evidence now suggests that dietary improvement can both prevent and treat depression

  • Some nutraceutical agents are efficacious as adjunctive and monotherapies in some mental and neurodevelopmental disorders

  • Mechanisms relate to the immune and oxidative stress systems, brain plasticity, and the gut and its resident microbiota

Abstract

The nascent field of ‘Nutritional Psychiatry’ offers much promise for addressing the large disease burden associated with mental disorders. A consistent evidence base from the observational literature confirms that the quality of individuals' diets is related to their risk for common mental disorders, such as depression. This is the case across countries and age groups. Moreover, new intervention studies implementing dietary changes suggest promise for the prevention and treatment of depression. Concurrently, data point to the utility of selected nutraceuticals as adjunctive treatments for mental disorders and as monotherapies for conditions such as ADHD. Finally, new studies focused on understanding the biological pathways that mediate the observed relationships between diet, nutrition and mental health are pointing to the immune system, oxidative biology, brain plasticity and the microbiome-gut-brain axis as key targets for nutritional interventions. On the other hand, the field is currently limited by a lack of data and methodological issues such as heterogeneity, residual confounding, measurement error, and challenges in measuring and ensuring dietary adherence in intervention studies. Key challenges for the field are to now: replicate, refine and scale up promising clinical and population level dietary strategies; identify a clear set of biological pathways and targets that mediate the identified associations; conduct scientifically rigorous nutraceutical and ‘psychobiotic’ interventions that also examine predictors of treatment response; conduct observational and experimental studies in psychosis focused on dietary and related risk factors and treatments; and continue to advocate for policy change to improve the food environment at the population level.

Keywords

Diet
Nutrition
Depression
Psychosis
Mental disorder
Neurodevelopment
Neurodegenerative
Nutraceutical
Prevention
Treatment

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