Schizophrenia and depression affected by diet

Embargoed until Friday, April 30, 2004

  • Higher intake of refined sugar and dairy products predict worse 2-year outcome of schizophrenia
  • High national rates of depression predicted by low intake of fish and seafood
 
A new study has found that a higher national dietary intake of refined sugar and dairy products predicted a worse two-year outcome of schizophrenia. A high national prevalence of depression was predicted by a low dietary intake of fish and seafood.
 
It is known that dietary variations predict the prevalence of physical illnesses, such as diabetes and heart disease. However, the possible influence of diet on mental health has so far been neglected.
 
Published in the May issue of the British Journal of Psychiatry, this study was an ecological analysis of international variations in food supply in relation to epidemiological data on the outcome of schizophrenia and on the prevalence of depression.
 
The countries included in the analysis were Denmark, Columbia, India, Nigeria, UK, USSR, USA and Czechoslovakia for the International Pilot Study of Schizophrenia (IPSS; World Health Organisation, 1979); Denmark, India, Colombia, Ireland, USA, Nigeria, USSR, Japan, UK and Czechoslovakia for the Determinants of Outcome of Severe Mental Disorders study (DOSMED, 1992); and New Zealand, Canada, Germany, France, USA, USSR, Taiwan and Japan for the depression study (Weissman at al, 1996; Hibbeln, 1998).
 
Data on food usage were taken from the Food and Agriculture Organisation (FAOSTAT) database (FAO, 2002). Food groups included were meat; fish and seafood; eggs; dairy products; vegetable oil, vegetables; cereals; fruits; starchy roots; refined sugar; pulses; nuts; coffee; and alcoholic beverages.
 
The most consistent finding was that a greater consumption of refined sugar was associated with a worse outcome of schizophrenia and a greater prevalence of depression. Other correlations for outcome of schizophrenia include consumption of meat and eggs (adverse relationship) and consumption of pulses (beneficial relationship). Dairy products and alcohol consumption were associated with a poor outcome in the IPSS study, but not in the DOSMED database.
 
For depression, the strongest association was between a high intake of dietary fish and seafood and reduced prevalence of depression. A high intake of dairy products and sugar was associated with an increased prevalence of depression, whereas a high intake of starchy roots was linked to a lower prevalence.
 
Its author, Malcolm Peet, comments that these findings allow the hypothesis that nutrition is important in the genesis and maintenance of mental ill-health.
 
It is of note that diabetes, coronary heart disease and other related conditions that cluster together have been described as ‘metabolic syndrome’ diseases. Because these disorders also cluster with schizophrenia and depression, it has been proposed that they may share some causal factors with physical diseases that constitute the metabolic syndrome.
 
The dietary predictors of outcome of schizophrenia and prevalence of depression in this study reflect dietary patterns that influence insulin resistance, in particular, consumption of large quantities of sugar and saturated fats, and lead to metabolic syndrome diseases.
 
It may therefore be that altering diet could have a positive effect on mental as well as physical health.
 
There is anecdotal evidence that diets that do not lead to insulin resistance may be useful in the treatment of schizophrenia (Meiers, 1973). Omega-3 fatty acids, found in fish and seafood, have recently been shown to have strong positive antidepressant benefits (Nemets et al, 2002; Peet and Horrobin, 2002).
 
Whether the relationship between nutritional factors and mental health is causal can only be determined by intervention studies
 

For further information, please contact Liz Fox or Deborah Hart in the Communications Department.
Telephone: 020 7235 2351 Extensions. 6298 or 6127

 

© 2005 Royal College of Psychiatrists