Adequate nutrition is needed for countless aspects of brain functioning. Poor diet
quality, ubiquitous in the United States, may be a modifiable risk factor for depression.
The objective was to review and synthesize the current knowledge of the role of nutrition
in depression, and address implications for childbearing-aged women. Poor omega-3
fatty acid status increases the risk of depression. Fish oil and folic acid supplements
each have been used to treat depression successfully. Folate deficiency reduces the
response to antidepressants. Deficiencies of folate, vitamin B12, iron, zinc, and
selenium tend to be more common among depressed than nondepressed persons. Dietary
antioxidants have not been studied rigorously in relation to depression. Childbearing-aged
women are particularly vulnerable to the adverse effects of poor nutrition on mood
because pregnancy and lactation are major nutritional stressors to the body. The depletion
of nutrient reserves throughout pregnancy and a lack of recovery postpartum may increase
a woman’s risk of depression. Prospective research studies are needed to clarify the
role of nutrition in the pathophysiology of depression among childbearing-aged women.
Greater attention to nutritional factors in mental health is warranted given that
nutrition interventions can be inexpensive, safe, easy to administer, and generally
acceptable to patients.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Biological PsychiatryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Arachidonic acid to eicosapentaenoic acid ratio in blood correlates positively with clinical symptoms of depression.Lipids. 1996; 31: S157-S161
- Long-chain polyunsaturated fatty acids, pregnancy, and pregnancy outcome.Am J Clin Nutr. 2000; 71: 285S-291S
- “Vascular depression” hypothesis.Arch Gen Psychiatry. 1997; 54: 915-922
- Nutrition and depression.Nutrition. 2000; 16: 544-546
- Folinic acid (Leucovorin) as an adjunctive treatment for SSRI-refractory depression.Ann Clin Psychiatry. 2002; 14: 33-38
- Prediction of treatment response in geriatric depression from baseline folate level.J Clin Psychopharmacol. 2003; 23: 309-313
- American Psychiatry Association, Washington, DC1994 Diagnostic and Statistical Manual of Mental Disorders. 4th ed.
- Methylenetetrahydrofolate reductase variant and schizophrenia/depression.Am J Med Genet. 1997; 74: 526-528
- Cobalamin level is related to self-reported and clinically rated mood and to syndromal depression in bereaved HIV-1(+) and HIV-1(−) homosexual men.J Psychosom Res. 2000; 48: 177-185
- Iron state in female adolescents.Am J Dis Child. 1992; 146: 803-805
- One person’s view of iron deficiency, development, and cognitive function.Am J Clin Nutr. 1995; 62: 709-710
- Iron status and neural functioning.Annu Rev Nutr. 2003; 23: 41-58
- Maternal iron deficiency anemia affects postpartum emotions and cognition.J Nutr. 2005; 135: 267-272
- The effects of postpartum depression on child development.Arch Psychiatr Nurs. 1998; 12: 12-20
- The impact of selenium supplementation on mood.Biol Psychiatry. 1991; 29: 1092-1098
- Folate, vitamin B12, homocysteine, and the MTHFR 677C->T polymorphism in anxiety and depression.Arch Gen Psychiatry. 2003; 60: 618-626
- Who should be screened for postpartum anemia? An evaluation of current recommendations.Am J Epidemiol. 2002; 156: 903-912
- Folate, vitamin B12, and neuropsychiatric disorders.Nutr Rev. 1996; 54: 382-390
- High-dose ascorbic acid increases intercourse frequency and improves mood.Biol Psychiatry. 2002; 52: 371-374
- Dieting, essential fatty acid intake, and depression.Nutr Rev. 2000; 58: 98-108
- Randomised study of cognitive effects of iron supplementation in non-anaemic iron-deficient adolescent girls.Lancet. 1996; 348: 992-996
- Tolerability issues during long-term treatment with antidepressants.Ann Clin Psychiatry. 2004; 16: 15-25
- Folate, vitamin B12, and serum total homocysteine levels in confirmed Alzheimer disease.Arch Neurol. 1998; 55: 1449-1455
- Antidepressant effect of vitamin C.Pediatrics. 1980; 65: 862-863
- Enhancement of the antidepressant action of fluoxetine by folic acid.J Affect Disord. 2000; 60: 121-130
- Low hemoglobin level is a risk factor for postpartum depression.J Nutr. 2003; 133: 4139-4142
- Effect of the methylenetetrahydrofolate reductase 677C–>T mutation on the relations among folate intake and plasma folate and homocysteine concentrations in a general population sample.Am J Clin Nutr. 2003; 77: 687-693
- Lowered serum n-3 polyunsaturated fatty acid (PUFA) levels predict the occurrence of postpartum depression.Life Sci. 2003; 73: 3181-3187
- Omega-3 polyunsaturated fatty acid levels in the diet and in red blood cell membranes of depressed patients.J Affect Disord. 1998; 48: 149-155
- Iron supplementation in pregnancy: Is less enough? A randomized, placebo controlled trial of low dose iron supplementation with and without heme iron.Acta Obstet Gynecol Scand. 1997; 76: 822-828
- Folate, vitamin B12, and homocysteine in major depressive disorder.Am J Psychiatry. 1997; 154: 426-428
- Definition and epidemiology of treatment-resistant depression.Psychiatr Clin North Am. 1996; 19: 179-200
- Adequacy or deprivation of dietary selenium in healthy men.J Trace Elements Exp Med. 1998; 11: 11-27
- Overweight and obesity in the United States.Int J Obes Relat Metab Disord. 1998; 22: 39-47
- Neurobiology of zinc and zinc-containing neurons.Int Rev Neurobiol. 1989; 31: 145-238
- Omega-3 fatty acids in psychiatry.Ann Clin Psychiatry. 2000; 12: 159-165
- Vitamin E and Alzheimer disease.Am J Clin Nutr. 2000; 71: 630S-636S
- The effect of tetrahydrofolate on tetrahydrobiopterin metabolism.J Ment Defic Res. 1986; 30: 179-183
- Copper and zinc deficiencies in association with depression and neurological findings.Biol Psychiatry. 1983; 18: 395-401
- Effects of dietary selenium on mood in healthy men living in a metabolic research unit.Biol Psychiatry. 1996; 39: 121-128
- Thyroid hormones and the treatment of depression.Synapse. 1997; 27: 36-44
- Fish consumption and major depression.Lancet. 1998; 351: 1213
- Seafood consumption, the DHA content of mothers’ milk and prevalence rates of postpartum depression.J Affect Disord. 2002; 69: 15-29
- Dietary polyunsaturated fatty acids and depression.Am J Clin Nutr. 1995; 62: 1-9
- The National Depressive and Manic-Depressive Association consensus statement on the undertreatment of depression.JAMA. 1997; 277: 333-340
- Metal ions and synaptic transmission.Proc Natl Acad Sci U S A. 1997; 94: 13386-13387
- Dietary reference intakes for thiamin, riboflavin, niacin, vitamin B-6, folate, vitamin B-12, pantothenic acid, biotin, and choline. National Academy Press, Washington, DC1998
- Dietary reference intakes for vitamin C, vitamin E, selenium, and carotenoids. National Academy Press, Washington, DC2000
- Epidemiology of women and depression.J Affect Disord. 2003; 74: 5-13
- Arteriosclerotic depression.Med Hypotheses. 1995; 44: 111-115
- A new era for science in nutrition.Am J Clin Nutr. 1987; 45: 1048-1153
- Effect of maternal docosahexaenoic acid supplementation on postpartum depression and information processing.Am J Obstet Gynecol. 2003; 188: 1348-1353
- Neurobehavioral aspects of omega-3 fatty acids.Altern Med Rev. 2003; 8: 410-425
- Major depression and activation of the inflammatory response system.in: Dantzer R. Wollman E.E. Yirmiya R. Cytokines, Stress, and Depression. Kluwer Academic/Plenum, New York, NY1999: 24-46
- Depression-related disturbances in mitogen-induced lymphocyte responses and interleukin-1 beta and soluble interleukin-2 receptor production.Acta Psychiatr Scand. 1991; 84: 379-386
- Hypozincemia in depression.J Affect Disord. 1994; 31: 135-140
- Lower serum vitamin E concentrations in major depression. Another marker of lowered antioxidant defenses in that illness.J Affect Disord. 2000; 58: 241-246
- Fatty acid composition in major depression: decreased omega 3 fractions in cholesteryl esters and increased C20: 4 omega 6/C20:5 omega 3 ratio in cholesteryl esters and phospholipids.J Affect Disord. 1996; 38: 35-46
- Free radical pathology and antioxidant defense in schizophrenia.Schizophr Res. 1996; 19: 1-17
- Zinc in depressive disorder.Acta Psychiatr Scand. 1990; 82: 451-453
- Depression and folate status in the US Population.Psychother Psychosom. 2003; 72: 80-87
- Depression and anxiety in relation to social status. A prospective epidemiologic study.Arch Gen Psychiatry. 1991; 48: 223-229
- Vanadium.Psychol Med. 1981; 11: 249-256
- Addition of omega-3 fatty acid to maintenance medication treatment for recurrent unipolar depressive disorder.Am J Psychiatry. 2002; 159: 477-479
- Patterns and trends in food portion sizes, 1977–1998.JAMA. 2003; 289: 450-453
- Trends in food locations and sources among adolescents and young adults.Prev Med. 2002; 35: 107-113
- Rates and risk of postpartum depression—A meta-analysis.Int Rev Psychiatry. 1996; 8: 37-54
- Maternal depressive symptoms and the risk of poor pregnancy outcome. Review of the literature and preliminary findings.Epidemiol Rev. 1995; 17: 165-171
- The nonhematologic manifestations of iron deficiency.Am J Dis Child. 1979; 133: 315-322
- Increased risk of postpartum depressive symptoms is associated with slower normalization after pregnancy of the functional docosahexaenoic acid status.Prostaglandins Leukot Essent Fatty Acids. 2003; 69: 237-243
- Serum folate, vitamin B12, and homocysteine in major depressive disorder, Part 1.J Clin Psychiatry. 2004; 65: 1090-1095
- Serum folate, vitamin B12, and homocysteine in major depressive disorder, Part 2.J Clin Psychiatry. 2004; 65: 1096-1098
- A dose-ranging study of the effects of ethyl-eicosapentaenoate in patients with ongoing depression despite apparently adequate treatment with standard drugs.Arch Gen Psychiatry. 2002; 59: 913-919
- Vitamin B(12) deficiency and depression in physically disabled older women.Am J Psychiatry. 2000; 157: 715-721
- Peroxidation induced changes in synaptosomal transport of dopamine and gamma-aminobutyric acid.Free Radic Biol Med. 1989; 6: 485-492
- Iron status and non-specific symptoms of female students.J Am Coll Nutr. 1998; 17: 351-355
- The importance of selenium to human health.Lancet. 2000; 356: 233-241
- Methylation and mood.Lancet. 1984; 2: 196-198
- Low serum folate levels as a risk factor for depressive mood in patients with chronic epilepsy.J Neuropsychiatry Clin Neurosci. 2003; 15: 64-66
- Mechanisms of action of docosahexaenoic acid in the nervous system.Lipids. 2001; 36: 945-959
- The Effect of Selenium Supplementation on the Mood of Chronic Fatigue Syndrome and Healthy Control Subjects. University of Canterbury, New Zealand1993
- Selenium and human health.Lancet. 2000; 356: 943
- Relationship of serum cholesterols and vitamin E to depressive status in the elderly.J Epidemiol. 1999; 9: 261-267
- Psychological burden in the era of HAART.Int J Psychiatry Med. 2003; 33: 55-69
- Dietary trends among low socioeconomic status women of childbearing age in the United States from 1977 to 1996.J Am Med Womens Assoc. 2001; (72): 5644-5648
- Prevalence and predictors of depression treatment in an international primary care study.Am J Psychiatry. 2004; 161: 1626-1634
- Serum fatty acids and the risk of coronary heart disease.Am J Epidemiol. 1995; 142: 469-476
- Zinc and copper.in: Shils M.E. Young V.R. Modern Nutrition in Health and Disease. Lea & Febiger, Philadelphia1988: 238-262
- Omega 3 fatty acids in bipolar disorder.Arch Gen Psychiatry. 1999; 56: 407-412
- Omega-3 fatty acids in major depressive disorder.European Neuropsychopharmacology. 2003; 13: 267-271
- Fish consumption, depression, and suicidality in a general population.Arch Gen Psychiatry. 2001; 58: 512-513
- Vitamin E and depressive symptoms are not related. The Rotterdam Study.J Affect Disord. 2002; 72: 79-83
- Plasma fatty acid composition and depression are associated in the elderly.Am J Clin Nutr. 2003; 78: 40-46
- Vitamin B12, folate, and homocysteine in depression.Am J Psychiatry. 2002; 159: 2099-2101
- Dietary folate and depressive symptoms are associated in middle-aged Finnish men.J Nutr. 2003; 133: 3233-3236
- Healthy People 2010. National Health Promotion and Disease Prevention Objectives. Author, Washington, DC2003
- Change in folate status with antidepressant treatment.Psychiatry Res. 1994; 53: 313-322
- Selenium and the brain.Nutr Neurosci. 2001; 4: 81-97
- Pharmacologic treatment of depression during pregnancy.JAMA. 1999; 282: 1264-1269
- Risk–benefit decision making for treatment of depression during pregnancy.Am J Psychiatry. 2000; 157: 1933-1940
- The impact of iron and selenium deficiencies on iodine and thyroid metabolism.Thyroid. 2002; 12: 867-878
Article info
Publication history
Published online: July 27, 2005
Accepted:
May 4,
2005
Received in revised form:
April 28,
2005
Received:
March 17,
2005
Identification
Copyright
© 2005 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.