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Review
. 2020 Jul 1;11(4):890-907.
doi: 10.1093/advances/nmaa016.

The Role of the Gut Microbiota in Dietary Interventions for Depression and Anxiety

Tracey L K Bear  1   2   3 , Julie E Dalziel  2   4 , Jane Coad  1 , Nicole C Roy  2   4   5 , Christine A Butts  3 , Pramod K Gopal  2   3
Affiliations
Review

The Role of the Gut Microbiota in Dietary Interventions for Depression and Anxiety

Tracey L K Bear et al. Adv Nutr. .

Abstract

There is emerging evidence that an unhealthy dietary pattern may increase the risk of developing depression or anxiety, whereas a healthy dietary pattern may decrease it. This nascent research suggests that dietary interventions could help prevent, or be an alternative or adjunct therapy for, depression and anxiety. The relation, however, is complex, affected by many confounding variables, and is also likely to be bidirectional, with dietary choices being affected by stress and depression. This complexity is reflected in the data, with sometimes conflicting results among studies. As the research evolves, all characteristics of the relation need to be considered to ensure that we obtain a full understanding, which can potentially be translated into clinical practice. A parallel and fast-growing body of research shows that the gut microbiota is linked with the brain in a bidirectional relation, commonly termed the microbiome-gut-brain axis. Preclinical evidence suggests that this axis plays a key role in the regulation of brain function and behavior. In this review we discuss possible reasons for the conflicting results in diet-mood research, and present examples of areas of the diet-mood relation in which the gut microbiota is likely to be involved, potentially explaining some of the conflicting results from diet and depression studies. We argue that because diet is one of the most significant factors that affects human gut microbiota structure and function, nutritional intervention studies need to consider the gut microbiota as an essential piece of the puzzle.

Keywords: anxiety; depression; diet; mental health; microbiome–gut–brain axis; microbiota; mood; nutrition; nutritional psychiatry.

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Figures

FIGURE 1
FIGURE 1
Diet has been linked with the risk of developing depression and anxiety; there are direct effects from dietary components which could mediate this relation. Emerging research suggests that the gut microbiota is also associated with depression and anxiety in a bidirectional relation. Because diet also has a large influence on gut microbiota, the gut microbiota should be considered a key variable in the diet–depression relation.
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