Healthy Diet vs Nutraceuticals in Depression by Prof Michael Berk
Prof Michael Berk is the Alfred Deakin Chair of Psychiatry at Deakin University. He is a past President of the International Society of Bipolar Disorders and the Australasian Society of Bipolar and Depressive Disorders. In addition, he holds several honorary professorial research fellowships. Prof Berk has published over 800 papers and has received several national and international awards, including the Brain and Behaviour Foundation Colvin prize.
The first really good evidence from randomised controlled trials that diet influences mental health came from the Predimed study; this is a fabulous study.
1Referring to Estruch et al., 2013.
I was asked to review a much larger study looking at exactly the same thing, in one of the very fanciest journals, and guess what? Combination nutraceuticals, iatrogenic, made people worse, worse than placebo.
4Referring to Sarris et al., 2016.
Summary and slides
Professor Berk begins this segment by describing the first good randomised controlled trial which linked diet to mental health, in which a prescribed Mediterranean diet reduced the risk of developing depression by 30-40%.
He then discusses a study which investigated the effects on depression of dietary intervention compared with psychosocial support intervention, which showed a marked reduction in depressive symptoms with diet. The effects of the diet far surpassed reductions seen in the psychosocial support group, and these findings were reproducible.
He notes there is a direct reduction in health care costs of using dietary interventions to treat depression and goes on to summarize the benefits of dietary interventions.
He moves on to talk about the use of supplements in treating depression, and that a recent meta-analysis found some evidence of improvements with certain nutraceuticals.
He describes a large study in which adults with major depressive disorder were treated with a cocktail of ‘useful’ supplements or placebo for 8 weeks. The results of the study were negative. Placebo performed better than the supplements in reducing depressive symptoms, hence the supplements had made patients worse.
Professor Berk concludes with 5 key recommendations for the prevention and treatment of depression.
Take Home Points
- Mediterranean diet is better than psychosocial intervention at reducing depressive symptoms.
- There are economic advantages to prescribing a healthy diet to patients with depression.
- Combination nutraceuticals perform worse than placebo when prescribed to patients with depression.