Table 3.
Characteristics of the included studies.
| Authors and Year of Publication | Objective | Phenomenon of Interest | Type of Research and Design | Sample | Results | Limitations |
|---|---|---|---|---|---|---|
| Opie et al., 2016 [28] | To provide a set of practical measures based on the best available evidence to inform clinical and public health recommendations | Major depressive disorder | Qualitative recommendation for clinical practice Not reported |
Not reported | To reduce depression, it is recommended to follow traditional dietary patterns such as the Mediterranean, Norwegian or Japanese diet, increase the consumption of fruits, vegetables and legumes. Also, including foods rich in polyunsaturated acids, and eliminate the consumption of unhealthy foods | Not reported |
| Pinto- Sánchez et al., 2017 [29] | To evaluate the effects of Bifidobacterium longum NCC3001 (BL) on anxiety and depression in patients with IBS | IBS and depression-anxiety | Prospective follow-up study Double-blind, experimental group BL or placebo group, in IBS and anxious-depressive symptomatology |
44 adults with IBS and anxious-depressive symptomatology | 14/22 patients in the BL group had a reduction in depression scores vs. 7/22 patients in the placebo group. BL had no significant effect on anxiety or IBS symptoms. | Not reported |
| Von Berens et al., 2018 [30] | To analyze the effects of a physical activity program in combination with protein supplementation on health-related quality of life (HRQoL) and depressive symptoms in community-dwelling, mobility-limited older adults | Depressive disorder/depressive symptomatology | Randomized clinical trial Double-blind, G1: nutritional supplementation + physical exercise G2: no nutritional supplementation + physical exercise |
149 seniors | There was a significant improvement in both the mental component summary and the Center for Epidemiological Studies Depression Scale (CES-D) during the intervention. No differences were detected between those who received the nutritional supplement and those who received the placebo. The results did not reveal significant changes in the Physical Component Summary (PCS) or variations in the effects between the subcategories | Not reported |
| Haybar et al., 2018 [31] | To investigate the effect of Melissa officinalis (MO) capsules on depression, stress, anxiety, and sleep disorders of patients with chronic stable angina (CSA) | Depression, anxiety, stress and insomnia in patients with CSA | Randomized clinical trial Double-blind, G1: intervention with calming MO G2: placebo |
80 patients with ASC | The intervention group receiving MO capsules had a significant reduction in scores of depression, anxiety, stress, and total sleep disturbance, compared with the placebo group. Eight-week supplementation with 3 g of MO can decrease these conditions in patients with CSA | Not reported |
| Forsyth et al., 2015 [32] | To evaluate the efficacy of a diet and exercise lifestyle intervention on mental health outcomes for patients currently being treated for depression and/or anxiety in primary care | Depressive or anxious disorder | Randomized clinical trial G1: individualized care in primary care G2: control group without such care |
119 patients with depressive or anxious disorder | Significant improvement was found for both groups on Depression, Anxiety and Stress Scale (DASS) scores, measures of nutrient intake and total Australian modified Healthy Eating Index (Aust-HEI) scores. Significant differences between groups over time were found only for iron intake and body mass index. Patients participating in individual consultations with a dietitian were more likely to maintain or improve diet quality than those participating in an attention control | Not reported |
| Jacka et al., 2017 [33] | To investigate the efficacy of a dietary program for the treatment of major depressive episodes. In this trial, Supporting the Modification of lifestyle in Lowered Emotional States (SMILES) | Major depressive disorder | Randomized clinical trial Single-blind, parallel groups, G1: seven sessions of individualized nutritional counseling. G2: social support group of the same duration as G1 |
116 patients | The dietary support group demonstrated significantly greater improvement between baseline and 12 weeks on the Montgomery–Åsberg Depression Rating Scale (MADRS) than the social support control group Improved diet may provide an effective and accessible treatment strategy for the management of this highly prevalent mental disorder |
Not reported |
| Ostadmohammadi et al., 2019 [34] | To determine the effect of vitamin D and probiotic co-administration on mental health, hormonal, inflammatory and oxidative stress parameters in women with polycystic ovary syndrome (PCOS) | PCOS and MH | Randomized clinical trial Double-blind experimental group vitamin D + probiotic and placebo group |
60 subjects between 18 and 40 years of age | Vitamin D and probiotic co-supplementation, compared with the placebo, significantly improved beck depression inventory, general health questionnaire scores and depression, anxiety and stress scale scores. Compared with the placebo levels, vitamin D and probiotic co-supplementation was associated with a significant reduction in total testosterone, hirsutism, high-sensitivity C-reactive protein and malondialdehyde (MDA) and a significant increase in total antioxidant capacity (TAC) and total glutathione (GSH) levels | Not reported |
| Kazemi et al., 2019 [35] | To compare the effect of supplementation with the probiotic and prebiotic on the Beck Depression Inventory (BDI) score as a primary outcome as well as the kynurenine/tryptophan ratio and tryptophan/branch chain amino acids (BCAAs) ratio as secondary outcomes in patients with major depressive disorder (MDD) | Major depressive disorder | Randomized clinical trial Double-blind, G1: probiotic G2: prebiotic G3: placebo |
110 patients with depressive disorder 81 completed the trial |
Probiotic supplementation resulted in a significant decrease in BDI score compared to the placebo and prebiotic supplementation. Inter-group comparison indicated no significant differences among the groups in terms of serum kynurenine/tryptophan ratio and tryptophan/BCAAs ratio. However, the kynurenine/tryptophan ratio decreased significantly in the probiotic group compared to the placebo group after adjusting for serum isoleucine. | Not reported |
| Parletta et al., 2019 [36] | To investigate the impacts of a Mediterranean-style diet intervention for mental health and quality of life (QoL) in people with depression using a RCT design over 3 months with follow-up at 6 months | Depressive disorder | Randomized clinical trial G1: Mediterranean diet education + fish oil supplementation 6 months G2: bi-weekly social groups 3 months |
152 adults with self-reported depression | At 3 months, the MedDiet group had a higher MedDiet score, consumed more vegetables, fruit, nuts, legumes, wholegrains, and vegetable diversity; less unhealthy snacks and red meat/chicken. The MedDiet group had greater reduction in depression and improved mental health QoL scores at 3 months. Improved diet and mental health were sustained at 6 months. Reduced depression was correlated with an increased MedDiet score, nuts, and vegetable diversity. Other mental health improvements had similar correlations, most notably for increased vegetable diversity and legumes | Not reported |
| Uemura et al., 2019 [37] | To investigate changes in obesity and psychological health in obese Japanese women following nutritional education focusing on gut microbiota composition | Obesity and MH | Randomized clinical trial G1: experimental group (n = 22) G2: control group (n = 22) |
44 women with obesity | After the intervention, dietary fiber intake, frequency of vegetable consumption, and frequency of milk and milk product consumption increased significantly in the intervention group, compared with the control group. Body weight and body mass index, waist circumference, and the depression scale score decreased significantly, while significant improvements were found in self-rated health and microbiome diversity | Not reported |
| Dawe et al., 2020 [38] | To investigate the influence of Lactobacillus rhamnosus GG and Bifdobacterium lactis BB12 on depression, anxiety, and functional health and well-being, among a multi-ethnic sample of pregnant women with obesity residing in the Counties Manukau Health region in South Auckland, New Zealand | Obesity and consequences in MH | Randomized clinical trial Double-blind experimental group with probiotics and placebo control group |
230 pregnant women with obesity in New Zealand | Depression scores remained stable and did not differ between the probiotic and placebo groups at 36 weeks. Anxiety and physical well-being scores worsened over time irrespective of group allocation, and mental well-being scores did not differ between the two groups at 36 weeks. Probiotics did not improve mental health outcomes in this multi-ethnic cohort of pregnant women with obesity | Need for further studies to validate the findings |
| Kaviani et al., 2020 [39] | To explore the effect of high-dose vitamin D supplementation on depression, neurotransmitters, and HPA axis | Mild-to-moderate depressive disorder | Randomized clinical trial Double-blind, vitamin D experimental group and placebo control group |
56 subjects mild to moderate depression | Following intervention, significant changes were observed in the intervention group compared to the controls: 25(OH)D concentrations increased and BDI scores decreased. Oxytocin concentrations were significantly reduced in controls, but between-group differences were insignificant. Within- and between-group differences of platelet serotonin concentrations were not significant; however, the increment in controls was higher | The duration of the study may not reflect the long-term effects of vitamin D on depression |
| Hemamy et al., 2021 [40] | To determine the effect of vitamin D and magnesium supplementation on mental health in children with ADHD | Children with ADHD | Randomized clinical trial with baseline and endline questionnaire on mental health Double-blind, experimental group with magnesium + vitamin D and control group with placebo |
66 children with ADHD | After eight weeks of intervention, the serum levels of 25-hydroxy-vitamin D3 and magnesium increased significantly in the intervention group compared with the control group. Also, children receiving vitamin D plus magnesium showed a significant reduction in emotional problems, conduct problems, peer problems, prosocial score, total difficulties, externalizing score, and internalizing score compared with children treated with the placebo | Need for more studies with larger sample size |
| Noah et al., 2021 [41] | To explore whether addition of vitamin B6 to magnesium supplementation enhances any observed effects on mental health and quality of life | Low magnesemia and severe/extremely severe stress | Randomized clinical trial Blinded investigator, parallel groups; G1: vitamin b6 + magnesium G2: magnesium alone |
74% women 26% men | DASS anxiety and depression scores significantly improved from baseline to week 8 with both treatments, particularly during the first 4 weeks. Improvement in quality of life continued over 8 weeks. Participants’ perceived capacity for physical activity in daily life showed greater improvement with magnesium + vitamin B6 than magnesium alone | Not reported |
| Roponen et al., 2021 [42] | To investigate the effectiveness and cost-effectiveness of a behavioral nutrition group intervention compared to a social support intervention in the treatment of depression | Depressive disorder/depressive symptomatology | Randomized clinical trial G1: 72 patients FM nutritional intervention G2: 71 patients social support group intervention |
144 patients with mild or moderate depression and outpatient treatment | Improvement is anticipated in both groups, as the intervention would prove to be cost-effective and acceptable, can be implemented in health care to support the treatment of depression | Regarding profitability |
Note. ADHD: Attention Deficit Hyperactivity Disorder. Aus-HEI: Australian Modified Healthy Eating Index. BCAAs: tryptophan/branch chain amino acids. BDI: Beck Depression Inventory. BL: Bifidobacterium longum NCC3001. CES-D: Center for Epidemiological Studies Depression Scale. CSA: Chronic Stable Angina. DASS: Depression, Anxiety and Stress Scale. FM: Food for Mind. G1: group 1. G2: group 2. GHS: glutathione. HPA: hypothalamic-pituitary-adrenal. HRQoL: health-related quality of life. IBS: Irritable Bowel Syndrome. MADRS: Montgomery–Åsberg Depression Rating Scale. MDA: malondialdehyde. MDD: Major Depressive Disorder. MedDiet: Mediterranean diet. MH: Mental Health. MO: Melissa Officinalis. PCS: Physical Component Summary. PCOS: Polycystic Ovary Syndrome. QoS: quality of life. SMILES: Supporting the Modification of lifestyle In Lowered Emotional States. TAC: total antioxidant capacity.