IMPACT (The Institute for Mental and Physical Health and Clinical Translation), Food and Mood Centre, Deakin University, Geelong, Victoria, Australia.
Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
Mod Trends Psychiatry. 2021;32:100-112. doi: 10.1159/000510422. Epub 2021 May 6.
There is accumulating evidence from observational and intervention studies in nutritional psychiatry regarding the importance of diet for mental health outcomes across the lifespan. Here, we synthesise this evidence, including findings from large meta-analyses showing cross-sectional and prospective associations between diet quality and mental health, even following adjustment for relevant confounding factors. Potential mechanistic pathways underpinning these associations include those of the gut-brain axis, demonstrated mostly in animal models. Dietary fibre is an important component of healthy diet and may be relevant for common mental disorders, with some studies showing a dose-dependent relationship between fibre intake and risk of depression. The potential contribution of nutraceuticals is also discussed, such as omega-3 fatty acids, vitamins, minerals, and psychobiotics. We consider the relevance of special diets such as the ketogenic diet and food sensitivities in the management of severe mental illness (e.g., anorexia nervosa) and brain disease (e.g., Alzheimer's disease). Given the relatively early nature of research in nutritional psychiatry, there remain a number of challenges to its translation into clinical practice. These span individual, clinical, and societal domains. We conclude with a discussion of micro- and macroeconomic factors which may be considered in the successful application of nutritional psychiatry research to improve public health.
越来越多的观察性和干预性研究在营养精神病学领域表明，饮食对于全生命周期的心理健康结果至关重要。在这里，我们综合了这些证据，包括大型荟萃分析的研究结果，这些研究结果表明，即使在调整了相关混杂因素后，饮食质量与心理健康之间也存在横断面和前瞻性关联。这些关联的潜在机制途径包括肠道-大脑轴，这主要在动物模型中得到证实。膳食纤维是健康饮食的重要组成部分，可能与常见精神障碍有关，一些研究表明，纤维摄入量与抑郁风险之间存在剂量依赖性关系。我们还讨论了营养保健品的潜在作用，如欧米伽 3 脂肪酸、维生素、矿物质和益生菌。我们考虑了特殊饮食（如生酮饮食）和食物敏感性在严重精神疾病（如神经性厌食症）和脑部疾病（如阿尔茨海默病）管理中的相关性。鉴于营养精神病学研究相对较早，要将其转化为临床实践仍存在许多挑战。这些挑战涉及个体、临床和社会等多个领域。最后，我们讨论了微观和宏观经济因素，这些因素可能会影响营养精神病学研究在改善公众健康方面的成功应用。
