Low-calorie diets 'could increase risk of depressive symptoms', study says
Calorie restriction also affected mood more in men and overweight people, researchers added.
Findings from the study contrast with those which have come before, with previous studies claiming that low-calorie diets improve depressive symptoms.
Academics have, however, argued that prior trials included tailored and balanced diet programmes that may not be the same as what people realistically follow in everyday life.
For the study, published by BMJ on Wednesday, researchers in Canada used data from the 28,525 people who took part in the US National Health and Nutrition Examination Survey (NHANES) and had completed a health questionnaire relating to depressive symptoms, which gave them a score based on severity.
The majority of the group (87%) said they were not on a specific diet, while 2,206 were restricting calories.
Some 859 were on a 'nutrient-restrictive' diet, low in fat, sugar, salt, fibre or carbohydrate, and 631 were on diets tailored for the likes of diabetes.
Questionnaire scores for depressive symptoms, such as a low mood, low energy and sleep disturbances, were higher among those restricting calories compared to those who reported not being on a diet at all.
The scores were also higher among overweight people following low-calorie diets.
Researchers said: 'Numerous studies have consistently focused on 'healthy' versus 'unhealthy' diets."
Restricting calories can lead to deficiencies in protein, vitamins and minerals, researchers suggest, which puts the body under stress.
The findings also contradict previous studies showing low-calorie diets improve depressive symptoms.
The team said a focus on 'idealised diets' can 'overlook the diversity of dietary patterns', adding: 'In contrast, real-life calorie-restricted diets and obesity often result in nutritional deficiencies, particularly in protein, essential vitamins and minerals, and induce physiological stress, which can exacerbate depressive symptomatology including cognitive-affective symptoms.'
Researchers stressed the study has several limitations, but gives an insight into how diets recommended by healthcare professionals should be considered for risk factors for depression, especially in men and obese patients.
Professor Sumantra Ray, chief scientist and executive director of the NNEdPro Global Institute for Food, Nutrition and Health, which co-owns BMJ Nutrition Prevention & Health with BMJ Group, added: 'This study adds to the emerging evidence linking dietary patterns and mental health, raising important questions about whether restrictive diets which are low in nutrients considered beneficial for cognitive health, such as omega-3 fatty acids and vitamin B12, may precipitate depressive symptoms.
'But the effect sizes are small, with further statistical limitations limiting the generalisability of the findings. Further well-designed studies that accurately capture dietary intake and minimise the impact of chance and confounding are needed to continue this important line of inquiry.'
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The Independent
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In recent decades, the term ' diet ' has become synonymous with weight loss. However, an ever-expanding bank of research tells us that what we eat has impacts extending far more than the number on our bathroom scales. The food we consume can affect our mood, energy levels and immune system, among other things; its impact on our gut is central to many of these processes. For this reason, gut health has become a topic of increasing interest for many. 'Our research found that over 40 per cent of adults experience tummy troubles,' explains Holland and Barrett's Emily Foster, a certified nutritionist with a masters degree in applied sport and exercise nutrition. 'This indicates there's a need, now more than ever, to understand how to support gut health. Gut health isn't just about the gut either. It's linked to many more elements of health and it can influence other aspects of the body.' 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Aim to consume fermented probiotic fibres such as kimchi, kombucha, kefir, tempeh, miso and sauerkraut at least two or three times per week, varying the ones you eat. If you are new to fermented foods, introduce them into your diet slowly to minimise any possible digestive discomfort – 'your gut microbiome isn't used to such a rapid influx of these new microbes... it's a sign of the beneficial bacteria getting to work'. Swap refined grains in your diet like white flour and white rice for whole grains. Read on for a more detailed list of the ingredients you should be adding to your weekly shopping basket, and why they are worthy of your time. What is a healthy gut? A healthy gut is one with a balanced and diverse microbiome, Foster tells me. 'Within our gut microbiome, we have trillions of different microorganisms – you can think of them like a bustling, microscopic city,' she says. 'There are beneficial bacteria, but also some viruses and fungi in there as well. The aim is to keep that balance in the bacteria, and also diversity within the types of bacteria that we have in our gut. 'There was a really interesting study called the American Gut Project [later renamed the Microsetta Initiative] which highlighted that a more diverse diet can lead to a more diverse gut microbiome, and this is linked to a healthier gut microbiome. '[To achieve this] we want to be consuming plenty of plant fibres to support our gut health. We also want to be consuming lots of different types [of plant fibres] throughout the week as well.' The foods Foster recommends for improving gut health can be split into two camps: foods rich in dietary fibre, particularly prebiotic fibres, and fermented foods with live cultures – many items in this latter camp fall under the probiotic banner. Group one: Foods rich in dietary fibre, particularly prebiotic fibres Fruits (especially those with prebiotic fibres, such as apples, berries, and bananas – bonus points if they are slightly green) Vegetables (particularly those with prebiotic fibres like Jerusalem artichokes, asparagus, leeks, onions and garlic) Legumes Whole grains Nuts and seeds The American Gut Health (or Microsetta Initiative) study mentioned above showed that consuming 30 or more different plant foods per week can increase gut microbiome diversity, and thus gut health. 'These are foods like fruits and vegetables, whole grains, beans and lentils, and nuts and seeds – even things like herbs and spices count towards it as well,' says Foster. However, gorging on your favourite fruit will soon see you hit a point of diminishing returns – diversity in your diet should be prioritised. 'If you were to eat a banana today, then you had a banana tomorrow, you wouldn't then be able to count that as a second plant food,' Foster continues. 'You need to consume different types of plant foods to reach that recommended 30 different plant foods per week.' For this reason, she says look out for 'plant points' on food packaging, so you know how much closer a food is taking you to that elusive weekly target. Of the plant-based foods listed above, Foster gives special mention to prebiotic fibres. These fibres feed and fuel the beneficial bacteria within our gut, promoting a diverse and balanced gut microbiome. 'Some of the big prebiotic fibres I always encourage people to eat are things like asparagus, onions, garlic, leeks and Jerusalem artichokes – these are all prebiotic vegetables,' Foster says. 'Berries and apples contain pectin, which is a type of prebiotic fibre. And bananas, especially slightly green ones, have resistant starch in them, which is again a prebiotic fibre to help feed that beneficial bacteria. 'Things like legumes, lentils, chickpeas and beans also have soluble fibre as well as resistant starch, feeding that good bacteria.' Another of Foster's recommendations is to swap refined grains in your diet, like white flour and white rice, for whole grains. 'Go for oats, barley, quinoa, brown rice, buckwheat and spelt,' she advises. 'Unlike refined grains, they retain their germ, their endosperm and their bran [the nutrient-rich embryo of the grain, the nutritious tissue that surrounds it, and the hard outer layer of the grain, respectively]. 'This makes whole grains rich in various types of fibres that are fermentable by the gut bacteria, again feeding that good bacteria within the gut. 'All fruit, vegetables and fibrous foods are great, but while all prebiotics are types of fibre, not all dietary fibre is prebiotic. Those prebiotic ones I've mentioned are especially beneficial for supporting the gut microbiome.' Group two: Fermented foods with live cultures Kimchi Kefir Kombucha Sauerkraut Tempeh Miso Live yoghurt If you've ever found yourself involved in a discussion about gut health, then someone has probably prescribed you a diet containing kimchi, kefir and kombucha. These are examples of probiotic fermented foods, and they can play a role to play in keeping your midsection content. 'Fermented foods, especially those that contain live cultures, are particularly good for the gut microbiome because they contain the beneficial bacteria strains within them,' says Foster. 'Instead of just feeding what you've already got within the gut, you're actually putting new strains in there as well, which is going to help to support diversity within the gut microbiome. 'Most, not all, fermented foods are probiotics, because not all of them actually contain live cultures. So things like beer, for example, are technically a fermented food, but it's not one we would encourage people to consume more of.' But, Foster adds, there are 'no official guidelines on how many types of fermented foods we should eat per week'. 'I always recommend aiming to eat them two to three times per week to start off with,' she continues. 'More is even better, and ideally, you are consuming different types of fermented foods on those two to three days, because the different fermented foods will contain different strains of beneficial bacteria. 'One important thing to note is that, if we do incorporate fermented foods into our diet, incorporating them slowly is better because it's quite common to experience a little bit of digestive discomfort when introducing fermented foods for the first time. 'This is because our gut microbiome isn't used to such a rapid influx of these new microbes. And it's a sign of the beneficial bacteria getting to work. It can be beneficial to start small and then gradually increase [the amount of fermented foods you eat] to allow time for your microbiome to adapt.' Below, you can find Foster's top recommendations for fermented foods to include in your weekly plans. Kimchi 'Kimchi is a traditional Korean side dish made from fermented cabbage,' Foster says. 'There are usually other vegetables in there, and things like chilli, garlic and ginger as well. 'It contains beneficial strains of bacteria to increase diversity and balance out the gut microbiome, improving overall digestion and potentially enhancing immunity. It's also rich in things like vitamin K and C for general health, and antioxidants from the vegetables that are in it.' Kefir 'Kefir is a fermented milk drink with a texture similar to a thin yoghurt. It's made with kefir grains, but these aren't actual grains – they're what's called a symbiotic culture of bacteria and yeast, which is known as a SCOBY in a lot of scientific research. 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