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Mental health consequences of dietary restriction: increased depressive symptoms in biological men and populations with elevated BMI

Abstract

Introduction The literature primarily examines the mental health effects of dietary patterns, with ‘healthy’ diets linked to fewer depressive symptoms, although no standardised definition of a ‘healthy’ diet exists. Many individuals adopt restrictive diets such as caloric or nutrient restriction or medically prescribed patterns (eg, diabetic diets) to improve health, yet their impact on depressive symptoms remains understudied. This study aims to evaluate the association between restrictive dietary patterns and depressive symptoms stratified by sex and body mass index (BMI).
Methods A cross-sectional study was performed using the National Health and Nutrition Examination Survey (NHANES) 2007–2018. Adults who completed dietary assessments and the Patient Health Questionnaire-9 (PHQ-9) for depressive symptom severity were included. Statistical analyses were performed using R. Multivariable linear regression was used to examine associations, and interaction effects were explored by including BMI or sex, with subgroup analysis performed when appropriate.
Results The study included 28 525 adults, of whom 7.79% reported depressive symptoms. Compared with individuals not following a specific diet, those adhering to calorie-restrictive diets had a 0.29 point increase in PHQ-9 scores (95% CI 0.06 to 0.52). Among overweight individuals, calorie-restricted diets were associated with a 0.46 point increase (95% CI 0.02 to 0.89) and nutrient-restricted diet was associated with a 0.61 point increase (95% CI 0.13 to 1.10) in PHQ-9 scores. Men who followed any diet showed higher somatic symptom scores than those not on a diet. Additionally, men on a nutrient-restrictive diet had a 0.40 point increase in cognitive-affective symptom scores (95% CI 0.10 to 0.70) compared with women not following a diet.
Conclusions There are potential implications of widely followed diets on depressive symptoms, and a need for tailored dietary recommendations based on BMI and sex.
Check out the book Change Your Diet, Change Your Mind by Dr Georgia Ede (https://www.amazon.com/dp/1399709127).
It's an outstanding book on how a low-carb, keto, or carnivore diet can heal (yes, actually HEAL) severe mental illness, including depression.
Here's a segment from the introduction. Also if you want some more quick info on the book, check out some of her interviews online.
A NEW WAY FORWARD This book is divided into four parts.
In part 1, I’ll show you how sloppy, unscientific research methods have led to flip-flopping headlines, illogical guidelines, and public confusion about what we’re supposed to eat. The problem is that most brain food researchers study nutrition from the outside in, by questioning people about their eating habits and then trying to guess how their food choices might be affecting their mental health. This flawed approach is why some of us dutifully top our morning oatmeal with blueberries, choose plant-based patties over hamburgers, or wash handfuls of supplements down with kale smoothies. We’re told that these habits will protect our brains, but not only are these strategies very unlikely to help, they can even work against us. In this book, we will look at nutrition from the inside out by discovering what the brain needs to function at its best and then using that list of ingredients to redefine what a brain-healthy diet should look like.
In part 2, we’ll explore the dietary roots of our global mental health crisis. You’ll see exactly how our modern ultraprocessed diet contributes to brain inflammation, hormonal imbalances, neurotransmitter imbalances, emotional instability, depression, and dementia—and how focusing on the right whole foods and customizing your carbohydrate intake can restore internal harmony and reveal your best self. For those of you who need more relief, there is an entire chapter dedicated to the promise of ketogenic diets for psychiatric disorders.
In part 3, I take you on a guided tour of the fascinating world of food. We’ll weigh the risks and benefits of different foods groups, learn how they affect the brain, and sort out which ones are essential and which ones are optional so you can make informed choices about what to eat. I’ll introduce you to some of the devilishly clever natural chemicals lurking within grains, legumes, nightshades, and certain other plant foods that can work against optimal brain nutrition and function, but I will also help you identify kinder, gentler plant foods so you can find the mix that works best for you.
In part 4, I boil down all of the information laid out in previous sections into three dietary strategies—all of which can be customized to your food preferences, health circumstances, and personal goals. Since changing how we eat is hard, you’ll find meal plans and recipes for each one, along with plenty of tips and tools to support your success. I am nutritionally pro-choice and want everyone to have a seat at the table, so regardless of your dietary preferences, you will find the information you need to optimize your diet for better mental health.
My hope is that this book will ignite your curiosity about food and the brain, empower you and your family to live happier, healthier lives, and bring you peace of mind.
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Trying to ‘restrict’ your way to health sounds like trying to hodl yourself out of poverty — some balance and strategy are needed. Just like with stacking, consistency beats extremes.
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So is it recommended or not to go carnivore or to do fasting?
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I'm not really the right one to answer that. But my general take is a varied diet is probably your best bet. Just keep in mind that everyone's unique, so what clicks for some might not for others.
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A cross-sectional design is totally inappropriate for this type of question. The results are almost certainly driven by selection bias: i.e. depressed people behave differently.
Without seeing changes from before and after the dietary change, you basically can’t learn anything.
TLDR; nutrition research is almost always done poorly.
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