Department of Nutrition and Dietetics, School of Life Course and Population Sciences, King's College London, London, UK.
Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus.
Nutr Bull. 2022 Mar;47(1):27-49. doi: 10.1111/nbu.12540. Epub 2022 Jan 19.
Recent evidence suggests that vegetarian and vegan diets may increase the risk and symptoms of depression, a mental health condition affecting 350 million people globally. We aimed to systematically review the literature on the associations between vegetarian and/or vegan diets and the risk or symptoms of depression using evidence from both observational and intervention studies. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, with pre-specification of all methods. A systematic search for relevant papers was performed on Medline and Embase, Web of Science and the Cochrane Library for cohort, case-control, cross-sectional studies or randomised controlled trials examining associations between a vegetarian or vegan diet and depression in adults. Three independent reviewers extracted data and assessed risk of bias using the National Heart, Lung, and Blood Institute of the National Institutes of Health for Quality Assessment of Observational Cohort and Cross-Sectional Studies and Controlled Studies. Evidence was tabulated according to the type of diet analysed as vegetarian, vegan or both and narratively synthesised. A total of 23 studies (18 cross-sectional, three prospective cohort and two randomised controlled trials) with 25 study outcomes were eligible for inclusion in this review. Conflicting evidence was found on the association between vegetarian or vegan diets and depression. Eleven (44%) of the outcomes indicated that vegetarian and vegan diets were associated with higher rates of depression, while seven (28%) outcomes revealed beneficial effects of the diets on depression. Seven (28%) outcomes found no association between vegetarian and vegan diets and depression, although two of these studies found a higher risk of depression in some groups. The quality of evidence was rated as good for four of the studies with the remaining 19 studies rated as fair. The evidence on the effect of vegetarian and vegan diets on depression is contradictory, possibly due to the heterogeneity of the studies analysed. Further research, including longitudinal and intervention studies, is required to resolve this observation.
最近的证据表明，素食和纯素饮食可能会增加患抑郁症的风险和症状，抑郁症是一种影响全球 3.5 亿人的心理健康疾病。我们旨在系统地综述观察性和干预性研究中关于素食和/或纯素饮食与抑郁症风险或症状之间关联的文献。我们遵循系统评价和荟萃分析的首选报告项目（PRISMA）指南，所有方法均预先指定。在 Medline、Embase、Web of Science 和 Cochrane 图书馆中进行了系统搜索，以查找关于成年人素食或纯素饮食与抑郁症之间关联的队列研究、病例对照研究、横断面研究或随机对照试验的相关论文。三位独立评审员使用美国国立卫生研究院国家心肺血液研究所的方法提取数据并评估偏倚风险，用于评估观察性队列和横断面研究和对照研究的质量。根据分析的饮食类型（素食、纯素或两者兼而有之）将证据制成表格，并进行叙述性综合。共有 23 项研究（18 项横断面研究、3 项前瞻性队列研究和 2 项随机对照试验）和 25 项研究结果符合本综述的纳入标准。素食和纯素饮食与抑郁症之间的关联存在相互矛盾的证据。11 项（44%）结果表明素食和纯素饮食与更高的抑郁症发生率相关，而 7 项（28%）结果表明这些饮食对抑郁症有有益影响。7 项（28%）结果发现素食和纯素饮食与抑郁症之间没有关联，尽管其中两项研究发现某些群体的抑郁症风险更高。四项研究的证据质量评为良好，其余 19 项研究评为一般。关于素食和纯素饮食对抑郁症影响的证据相互矛盾，这可能是由于分析的研究存在异质性。需要进一步的研究，包括纵向研究和干预研究，以解决这一观察结果。
