ReviewJournal of health, population, and nutrition2025
Priority of nutrition and exercise in depression management: triangulating mini-review of past and recent evidence with clinical practice guidelines.
Review in Journal of health, population, and nutrition, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundChronic low-grade systemic inflammation (CLGSI) is implicated in depression and its amelioration. Pro-inflammatory nutrition and inactivity are associated with CLGSI. We triangulated the degree to which recent literature on anti-inflammatory nutrition and physical activity/physical exercise (PA/PE) corroborates the extant body of knowledge related to depression management and is reflected in the guidelines of leading mental health domains (national/international mental health associations/bodies).
methodsWe used mini-review methodology. The search was narrowed to recent state-of-the-art literature (2024) in PubMed, on diet and exercise specifications in depression management. Then, we compared recommendations of aforementioned domains regarding diet and PA/PE in depression management.
resultsOf 73 nutrition source studies, 50 (68%) focused on anti-inflammatory whole food, plant-based (WFPB) nutrition to manage depression; 4 (5%) on reducing consumption of animal-sourced foods; 16 (23%) focused on the effect of ultra-processed food (UPF) and its role in depression and its avoidance vis-à-vis its anti-depressant effects. Of the 55 PA/PE source studies, 49 (89%) focused on the effects of aerobic exercise; 14 (29%) described specific parameters to achieve an anti-depressant effect and 35 (71%) were non-specific. Twelve (22%) studies focused on resistance muscle training; 2 (17%) that reported specific training parameters and 10 (83%) that were non-specific. Nine domains were identified with established depression management guidelines: Australia/New Zealand; Canada; Europe (Belgium, Scotland, Spain); United Kingdom; United States; WFSBP and ASLM; and World Health Organization. Regarding nutrition, 5 (55%) domains recommended WFPB nutrition; 4 (44%) reduced animal-sourced foods; and 3 (33%), avoidance of UPF. With respect to sedentarism, 3 (33%) domains recommended reduced prolonged sitting. Eight domains (89%) mentioned aerobic exercise; 3 (33%) resistance training. Three domains mentioned aerobic exercise non-specifically; 5 (56%) made specific recommendations. Three domains mentioned resistance muscle training; 2 (22%) made non-specific recommendations and 1 (11%) made specific recommendations.
conclusionsDisparities that exist in leading depression management guidelines vis-à-vis inclusion of evidence-informed nutrition and PA/PE recommendations, warrant reconciliation. Evidence supporting anti-depressant WFPB nutrition and limiting pro-inflammatory animal-sourced food and UPF and supporting anti-inflammatory aerobic exercise and resistance training warrants being translated into national/international depression management guidelines as consistently as recommendations for pharmacotherapy and psychotherapy.
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