steady

Body · Recovery and fuel

Fix the food too

12 weeksEvidence: decent

Do this

Low for weeks and living on takeaways and snacks? See your doctor, and ask about a dietitian as well. Food goes alongside treatment, not instead of it.

How to do it

  • Doctor first if you've been low for weeks. In the trial the food was an add-on to care, not the care.
  • Ask about a dietitian. The trial's change was led by one, not done alone.
  • Mediterranean-style is the direction. What that means on your plate is the dietitian's job.
  • Give it weeks. The trial ran twelve.

What the trial did

  1. Poor dietthe starting point

    The trial took adults with major depression who were already eating badly. People with a decent diet weren't tested.

  2. Dietitianleads the change

    One group got dietitian-led help towards a Mediterranean-style diet. The other got social support. Most were already on medication or therapy, and kept it.

  3. Symptomsfell further

    At 12 weeks, depression scores had fallen further in the diet group than in the support group.

  4. Youadd, don't swap

    One small trial, as an add-on to treatment. A reason to fix the food as well, not instead.

Why it works

In one trial, adults with major depression who were eating badly got 12 weeks of dietitian-led help towards a Mediterranean-style diet, most on top of medication or therapy they already had. Their symptoms fell further than in a group given social support instead. Evidence: decent

It's one small trial. That's why the do-line says doctor first, and food as well. Evidence: decent

The long readEvery step of the chain, each study with its numbers, and what's still unproven. 2 min read.

What happens in your brain

I can't give you the route from plate to mood from this evidence. The chain is what the trial did.

A poor diet to start with. The 67 adults in the trial had major depression and were already eating badly. Evidence: decent

A dietitian leads the change. One group got dietitian-led help towards a Mediterranean-style diet; the other got social support. Most were already on medication or therapy, and kept it. Evidence: decent

Symptoms fall further. At three months, the diet group's depression scores had fallen further than the support group's. Evidence: decent

You add, you don't swap. The trial tested diet on top of treatment, not in place of it. Evidence: decent

The proof

  • The SMILES trial, 2017: 67 adults with major depression and a poor diet were randomly given 12 weeks of either dietitian-led diet support or social support. 55 of them were already on medication, therapy or both. Evidence: decent
  • At three months, the diet group had improved more, with a standardised effect of 1.16, a large one. Evidence: decent
  • It's a single small trial, and only the assessors were blinded: people knew which group they were in. Evidence: decent

How to do it

  • If you've been low for weeks, start with your doctor. See two questions, then a doctor.
  • Ask about a dietitian at the same visit. In the trial the change was dietitian-led. Evidence: decent
  • Mediterranean-style is the direction the trial took. Evidence: decent What that means for you is the dietitian's call.
  • Give it weeks, not days. The trial ran twelve. Evidence: decent

Watch out

One small trial of 67 people, all eating badly to begin with, who knew which group they were in. Evidence: decent If your diet is already decent, or you're having a flat week rather than depression, this wasn't tested. Evidence: decent

Food is not a replacement for treating depression. In the trial, most people were already on medication or therapy and stayed on it. Evidence: decent

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