The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine and Barwon Health, Deakin University, Geelong, Victoria, Australia.
IMPACT, School of Medicine and Barwon Health, Deakin University, Geelong, Victoria, Australia.
Nutr Rev. 2024 Dec 1;82(12):1678-1695. doi: 10.1093/nutrit/nuad143.
Dietary fibers hold potential to influence depressive and anxiety outcomes by modulating the microbiota-gut-brain axis, which is increasingly recognized as an underlying factor in mental health maintenance.
Evidence for the effects of fibers on depressive and anxiety outcomes remains unclear. To this end, a systematic literature review and a meta-analysis were conducted that included observational studies and randomized controlled trials (RCTs).
The PubMed, Embase, CENTRAL, CINAHL, and PsychINFO databases were searched for eligible studies.
Study screening and risk-of-bias assessment were conducted by 2 independent reviewers.
Meta-analyses via random effects models were performed to examine the (1) association between fiber intake and depressive and anxiety outcomes in observational studies, and (2) effect of fiber intervention on depressive and anxiety outcomes compared with placebo in RCTs. A total of 181 405 participants were included in 23 observational studies. In cross-sectional studies, an inverse association was observed between fiber intake and depressive (Cohen's d effect size [d]: -0.11; 95% confidence interval [CI]: -0.16, -0.05) and anxiety (d = -0.25; 95%CI, -0.38, -0.12) outcomes. In longitudinal studies, there was an inverse association between fiber intake and depressive outcomes (d = -0.07; 95%CI, -0.11, -0.04). In total, 740 participants were included in 10 RCTs, all of whom used fiber supplements. Of note, only 1 RCT included individuals with a clinical diagnosis of depression. No difference was found between fiber supplementation and placebo for depressive (d = -0.47; 95%CI, -1.26, 0.31) or anxiety (d = -0.30; 95%CI, -0.67, 0.07) outcomes.
Although observational data suggest a potential benefit for higher fiber intake for depressive and anxiety outcomes, evidence from current RCTs does not support fiber supplementation for improving depressive or anxiety outcomes. More research, including RCTs in clinical populations and using a broad range of fibers, is needed.
PROSPERO registration no. CRD42021274898.
膳食纤维通过调节微生物群-肠道-大脑轴，具有影响抑郁和焦虑结果的潜力，而微生物群-肠道-大脑轴正日益被视为维持心理健康的一个潜在因素。
膳食纤维对抑郁和焦虑结果的影响证据仍不清楚。为此，进行了系统文献综述和荟萃分析，包括观察性研究和随机对照试验（RCT）。
在 PubMed、Embase、CENTRAL、CINAHL 和 PsychINFO 数据库中搜索了合格的研究。
两名独立评审员对研究筛选和偏倚风险评估进行了评估。
通过随机效应模型进行荟萃分析，以检验（1）观察性研究中膳食纤维摄入与抑郁和焦虑结果之间的关系，以及（2）与安慰剂相比，纤维干预对 RCT 中抑郁和焦虑结果的影响。共有 23 项观察性研究纳入了 181405 名参与者。在横断面研究中，膳食纤维摄入与抑郁（Cohen 的 d 效应大小[d]：-0.11；95%置信区间[CI]：-0.16，-0.05）和焦虑（d = -0.25；95%CI：-0.38，-0.12）结果呈负相关。在纵向研究中，膳食纤维摄入与抑郁结果呈负相关（d = -0.07；95%CI：-0.11，-0.04）。共有 10 项 RCT 纳入了 740 名参与者，他们都使用了纤维补充剂。值得注意的是，只有 1 项 RCT 纳入了有临床诊断为抑郁症的个体。纤维补充剂与安慰剂相比，对抑郁（d = -0.47；95%CI：-1.26，0.31）或焦虑（d = -0.30；95%CI：-0.67，0.07）结果均无差异。
尽管观察性数据表明较高的膳食纤维摄入量可能对抑郁和焦虑结果有益，但目前 RCT 的证据并不支持纤维补充剂改善抑郁或焦虑结果。需要开展更多研究，包括针对临床人群的 RCT 以及使用广泛的纤维。
PROSPERO 注册号 CRD42021274898。
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