Are There Diets to Fight Depression In Women

Written by Dr. Steve Chaney on . Posted in Diets to Fight Depression, Health Current Events

A Story of 6 Blind Men And An Elephant

Author: Dr. Stephen Chaney

 

 

6 blind men and a elephantAre there diets to fight depression in women?  This week’s health tip reminds me of the story of 6 blind men and an elephant. You probably remember the story. One blind man grabbed a leg and declared that an elephant is like a tree trunk. Another blind man grabbed the tail and declared that an elephant was like a rope – and so it went. Each blind man had a different version of reality, but none of them really knew what an elephant was like.

Sometimes science is like that. Every scientific study is designed to test a specific hypothesis, and sometimes we scientists can become limited by the hypothesis we are testing. We only see what we are looking for. We become like the blind men trying to figure out what an elephant really is.

That thought came to mind recently when one study claimed that an anti-inflammatory diet decreased the risk of depression by 26% in women, and another claimed that increased flavonoid intake was the secret to decreasing depression in women. Of course, both of those reports came on the heels of another study a few months ago claiming that a Mediterranean diet was the secret to decreasing depression.

If all of this sounds confusing, keep that image of the blind men and the elephant in your mind for a while. I’m going to come back to the elephant later, but let me start by evaluating the merits of the two most recent studies which claim there are diets to fight depression in women.

How Were These Studies Designed?

diets to fight depressionThe first study (Shivappa et al, British Journal of Nutrition, doi:10.1017/S0007114516002853, 2016)  was designed to test the association between the anti-inflammatory potential of their diets and the risk of depression in middle-aged Australian women. The study followed 6,438 women with an average age of 52 for 12 years.

Self-administered surveys were sent to the participants every 2-3 years (most participants completed 5 surveys during the study). A Dietary Inflammation Index (DII) was calculated based on the food frequency portion of the surveys. Depression scores were calculated based on their answers to 10 questions from a well established depression rating system.

This was a well designed study and the results were fairly straight forward. Those women consuming the most anti-inflammatory diets were 26% less likely to develop depression than the women consuming the most pro-inflammatory diets.

The second study (Chang et al, American Journal of Clinical Nutrition, doi: 10.3945/ajcn.115.124545, 2016) was designed to test the association between flavonoid intake and depression in middle aged and older American women. This study followed 82,643 women ages 36-80 for an average of 10 years.

Flavonoid intake was calculated based on food frequency questionnaires administered every 4 years. Depression was assessed based on several well established ratings systems.

Again, this was a very well designed study, and the results were quite impressive:

  • Women who consumed the largest amounts of flavonoids were 7-10% less likely to develop depression than women consuming the least flavonoids.
  • When the study was broken down into flavonoid-containing foods, citrus fruits appeared to be particularly beneficial. Women consuming >2 servings per week were 18% less likely to develop depression than women consuming <1 serving per week.
  • Tea also scored high in their analysis. Women consuming >4 cups per day were 12% less likely to develop depression than women who rarely or never consumed tea.
  • While those flavonoid-rich foods stood out, the authors emphasized that there were no “magic” foods. It was a composite of all flavonoid containing foods that was related to lower depression risk.
  • The effect of a flavonoid-rich diet was particularly beneficial for older women. For women aged 65 or older at the beginning of the study, high flavonoid intake was associated with a 17% lower risk of developing depression.

 

Diets to Fight Depression:  The Secret

diets to fight depression secretsI have just described two very well designed studies on diets to fight depression in women. One concluded that an anti-inflammatory diet reduced the risk of depression while the other concluded that diets rich in flavonoids decreased the risk of depression. I have previously described studies suggesting that omega-3 fatty acids decrease depression risk in women and that consuming junk food increases depression risk . Other studies have suggested that a Mediterranean diet may significantly reduce depression.

If you are looking for a natural solution to recurring depression, these individual reports are probably confusing and overwhelming. I call it the “study du jour” syndrome. It can lead to paralysis. You just don’t know what you should try first.

What if these individual studies were like the blind men trying to describe an elephant?  Perhaps we need to step back and see if we can find the commonality in all of these studies. We need to look for the elephant.

For example, we might start by asking what is an anti-inflammatory diet? It turns out that diets rich in fruits, vegetables, fatty fish, olive oil and legumes are anti-inflammatory, while diets rich in saturated fats, cholesterol, and refined carbohydrates are pro-inflammatory. In short, the anti-inflammatory diet is very similar to the Mediterranean diet, and fully consistent with the reported benefits of omega-3 fatty acids. The pro-inflammatory diet, on the other hand, perfectly describes a junk food diet loaded with fat, cholesterol, and simple sugars and are not diets to fight depression.

What about diets rich in flavonoids? What are those flavonoid-rich foods? It turns out that flavonoids are found primarily in plant foods, and fruits, vegetables, and whole grains.  Beverages such as tea and coffee are particularly good sources.

So the secret is that there is no secret. Your mom was right all along. Eat your fruits, vegetables and whole grains. Take your fish oil. Take a vitamin supplement to make sure you didn’t miss anything. Avoid the junk foods. You’ll be healthier, and you’ll be happier. Include these in your diets to fight depression.

What Do These Studies Mean For You?

When considered individually these studies may seem confusing. However, when you consider them altogether the evidence is overwhelming. A good diet can significantly reduce your risk of depression, and a bad diet can make your depression even worse.

Of course, diet alone will not be enough to prevent depression in everyone. A more holistic approach would be to include exercise, socialization, and some stress reduction practices. Whether stress reduction occurs through yoga, meditation, counseling or other practices will vary from individual to individual.

Of course, if your depression is severe, professional help may be needed. I regard anti-depressant medications as a very last resort, but they can be life savers for some people.

So, with the inclusion of the right foods, the above studies seem to show there are diets to fight depression in women.

 

The Bottom Line

 

  • Two very good studies have recently been published concerning diet and depression in women:
  • One study concluded that an anti-inflammatory diet reduced the risk of depression in women.
  • Another study concluded that a diet rich in flavonoids reduced the risk of depression in women.
  • Other recent studies have concluded that diets rich in omega-3s and Mediterranean diets decrease depression risk in women. Another study concluded that consuming junk foods significantly increased depression risk.
  • When considered individually these studies may seem confusing. However, when you consider them altogether the evidence is overwhelming. A good diet can significantly reduce your risk of depression, and a bad diet can make your depression even worse.
  • Your mom was right all along. Eat your fruits, vegetables and whole grains. Take your fish oil. Take a vitamin supplement to make sure you didn’t miss anything. Avoid the junk foods. You’ll be healthier, and you’ll be happier
  • Of course, diet alone will not be enough to prevent depression in everyone. A more holistic approach would be to include exercise, socialization, and some stress reduction practices. If your depression is severe, professional help may be needed. I regard anti-depressant medications as a very last resort, but they can be life savers for some people.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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Can Plant-based Diets Be Unhealthy?

Posted September 10, 2019 by Dr. Steve Chaney

Do Plant-Based Diets Reduce Heart Disease Deaths?

Author: Dr. Stephen Chaney

 

plant-based diets vegetablesPlant-based diets have become the “Golden Boys” of the diet world. They are the diets most often recommended by knowledgeable health and nutrition professionals. I’m not talking about all the “Dr. Strangeloves” who pitch weird diets in books and the internet. I am talking legitimate experts who have spent their life studying the impact of nutrition on our health.

Certainly, there is an overwhelming body of evidence supporting the claim that plant-based diets are healthy. Going on a plant-based diet can help you lower blood pressure, inflammation, cholesterol and triglycerides. People who consume a plant-based diet for a lifetime weigh less and have decreased risk of heart disease, diabetes, and cancer.

But, can a plant-based diet be unhealthy? Some people consider a plant-based diet to simply be the absence of meat and other animal foods. Is just replacing animal foods with plant-based foods enough to make a diet healthy?

Maybe not. After all, sugar and white flour are plant-based food ingredients. Fake meats of all kinds abound in our grocery stores. Some are very wholesome, but others are little more than vegetarian junk food. If you replace animal foods with plant-based sweets, desserts, and junk food, is your diet really healthier?

While the answer to that question seems obvious, very few studies have asked that question. Most studies on the benefits of plant-based diets have compared population groups that eat a strictly plant-based diet (Seventh-Day Adventists, vegans, or vegetarians) with the general public. They have not looked at variations in plant food consumption within the general public. Nor have they compared people who consume healthy and unhealthy plant foods.

This study (H Kim et al, Journal of the American Heart Association, 8:e012865, 2019) was designed to fill that void.

 

How Was The Study Done?

plant-based diets studyThis study used data collected from 12,168 middle aged adults in the ARIC (Atherosclerosis Risk in Communities) study between 1987 and 2016.

The participant’s usual intake of foods and beverages was assessed by trained interviewers using a food frequency questionnaire at the time of entry into the study and again 6 years later.

Participants were asked to indicate the frequency with which they consumed 66 foods and beverages of a defined serving size in the previous year. Visual guides were provided to help participants estimate portion sizes.

The participant’s adherence to a plant-based diet was assessed using four different well-established plant-based diet scores. For the sake of simplicity, I will include 3 of them in this review.

  • The PDI (Plant-Based Diet Index) categorizes foods as either plant foods or animal foods. A high PDI score means that the participant’s diet contains more plant foods than animal foods. A low PDI score means the participant’s diet contains more animal foods than plant foods.
  • The hPDI (healthy plant-based diet index) is based on the PDI but emphasizes “healthy” plant foods. A high hPDI score means that the participant’s diet is high in healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, coffee and tea) and low in animal foods.
  • The uPDI (unhealthy plant-based diet index) is based on the PDI but emphasizes “unhealthy” plant foods. A high uPDI score means that the participant’s diet is high in unhealthy plant foods (refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts) and low in animal foods.

For statistical analysis the scores from the various plant-based diet indices were divided into 5 equal groups. In each case, the group with the highest score consumed the most plant foods and least animal foods. The group with the lowest score consumed the least plant foods and the most animal foods.

The health outcomes measured in this study were heart disease events, heart disease deaths, and all-cause deaths. Again, for the sake of simplicity, I will only include 2 of these outcomes (heart disease deaths and all-cause deaths) in this review. The data on deaths were obtained from state death records and the National Death Index. (Yes, your personal information is available on the web even after you die.)

 

Do Plant-Based Diets Reduce Heart Disease Deaths?

plant-based diets reduce heart deathsThe participants in this study were followed for an average of 25 years.

The investigators looked at heart disease deaths over the 25 years and compared people with the highest intake of plant foods to people with the highest intake of red meat and other animal foods. The results were:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, coffee and tea) had a 19-32% lower risk of dying from heart disease than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods (refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts) had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

When the investigators looked at all-cause deaths over the 25 years:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods had an 11-25% lower risk of dying from any cause than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

What Else Did The Study Show?

The investigators made a couple of other interesting observations:

  • The association of the overall diet with heart disease and all-cause deaths was stronger than the association of individual food components. This underscores the importance of looking at the effect of the whole diet on health outcomes rather than the “magic” foods you hear about on Dr. Strangelove’s Health Blog.
  • Diets with the highest amount of healthy plant foods were associated with higher intake of carbohydrates, plant protein, fiber, and micronutrients, including potassium, magnesium, iron, vitamin A, vitamin C, folate, and lower intake of saturated fat and cholesterol.
  • Diets with the highest amount of unhealthy plant foods were associated with higher intake of calories and carbohydrates and lower intake of fiber and micronutrients.

The last two observations may help explain some of the health benefits of plant-based diets.

 

Can Plant-Based Diets Be Unhealthy?

plant-based diets unhealthy cookiesNow, let’s return to the question I asked at the beginning of this article: “Can plant-based diets be unhealthy?” Although some previous studies have suggested that unhealthy plant-based diets might increase the risk of heart disease, this study did not show that.

What this study did show was that an unhealthy plant-based diet was no better for you than a diet containing lots of red meat and other animal foods.

If this were the only conclusion from this study, it might be considered a neutral result. However, this result clearly contrasts with the data from this study and many others showing that both plant-based diets in general and healthy plant-based diets reduce the risk of heart disease deaths and all-cause deaths compared to animal-based diets.

The main message from this study is clear.

  • Replacing red meat and other animal foods with plant foods can be a healthier choice, but only if they are whole, minimally processed plant foods like whole grains, fruits, vegetables, nuts, legumes, coffee and tea.
  • If the plant foods are refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts, all bets are off. You may be just as unhealthy as if you kept eating a diet high in red meat and other animal foods.

There is one other subtle message from this study. This study did not compare vegans with the general public. Everyone in the study was the general public. Nobody in the study was consuming a 100% plant-based diet.

For example:

  • The group with the highest intake of plant foods consumed 9 servings per day of plant foods and 3.6 servings per day of animal foods.
  • The group with the lowest intake of plant foods consumed 5.4 servings per day of plant foods and 5.6 servings per day of animal foods.

In other words, you don’t need to be a vegan purist to experience health benefits from adding more whole, minimally processed plant foods to your diet.

 

The Bottom Line

A recent study analyzed the effect of consuming plant foods on heart disease deaths and all-cause deaths over a 25-year period.

When the investigators looked at heart disease deaths over the 25 years:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods had a 19-32% lower risk of dying from heart disease than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

When the investigators looked at all-cause deaths over the 25 years:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods had an 11-25% lower risk of dying from any cause than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

The main message from this study is clear.

  • Replacing red meat and other animal foods with plant foods can be a healthier choice, but only if they are whole, minimally processed plant foods like whole grains, fruits, vegetables, nuts, legumes, coffee and tea.
  • If the plant foods are refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts, all bets are off. You may be just as unhealthy as if you kept eating a diet high in red meat and other animal foods.

A more subtle message from the study is that you don’t need to be a vegan purist to experience health benefits from adding more whole, minimally processed plant foods to your diet. The people in this study were not following some special diet. The only difference was that some of the people in this study ate more plant foods and others more animal foods.

For more details on the study, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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