Food and mood – the connection

While the traditional primary management of mental ill-health is commonly associated with psychotherapies and pharmacotherapies, there is a growing body of evidence to support adjunct treatment modalities. As an adjunct with exercise, health professionals are urging individuals with depression, anxiety and other mental health diagnoses to become more aware of their diet.

Studies involving diet and mental health have focussed on two primary areas of research including:

1)      Improving the physical health status in those diagnosed with mental illness

Research has identified individuals diagnosed with mental health ill-being are:

  • Subject to adverse cardio-metabolic drug reactions, such as weight gain, increased lethargy, increased appetite and poor gut health;
  • Around 40% more likely to develop cardiac disease, hypertension, stroke, metabolic syndrome, obesity 

2)      Improving the psychological wellbeing in those diagnosed with mental illness

Gut health/gut microbiome has gained increased attention with researchers identifying a strong relationship between the gut and brain.  This relationship has been termed the ‘gut-brain-axis’, with multiple neurotransmitters and other stress related signal pathways having been directly related to the bacteria residing in the intestines.  Inflammation; the dysregulation of inflammation throughout those with depression has been well established, with higher rates of pro-inflammatory biomarkers identified in individuals with major depressive disorder.

So… What is the best diet?

While many will argue “what is the ideal diet for mental health?”, it is commonly accepted that consuming a large variety of fresh fruit, vegetables and wholegrains will aid in improving one’s overall health.  Having said that, there is an ever-growing body of literature supporting the Mediterranean diet for those with mental illness.

What is the Mediterranean Diet?

A noteworthy paper known as the ‘SMILES Trial’ (published in Australia in 2017) found that participants in a controlled group who engaged in a 12-week Mediterranean diet with ongoing dietician support reported significant improvement in depression and anxiety scores.

The SMILES TRIAL focussed on the promotion of 12 key food groups including:

1.  Whole grains; 5-8 servings per day

2.  Vegetables; 6 servings per day

3.  Fruit; 3 servings per day

4.  Legumes 3-4 serving per day

5.  Low-fat and unsweetened dairy foods 1 serve per day

6.  Fish >2 servings per week

7.  Raw and unsalted nuts 1 serve per day

8.  Lean red meats 3-4 servings per week

9.  Chicken; 2-3 servings per week

10.  Egg up to 6 per week

11.  Olive oil 3 tablespoons per day

12.  Extras <3 serves

In summary, combining a well-balanced diet with physical activity in addition to primary treatment modalities for mental illness can positively contribute to your overall mental wellbeing.

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Healthy Eating written by Casuarina Forsyth, Accredited Practicing Dietitian and Accredited Nutritionist –

Sarris J, Logan AC, Akbaraly TS, Amminger GP, Balanzá-Martínez V, Freeman MP, et al. (2015) Nutritional medicine as mainstream in psychiatry. Lancet Psychiatry.;2:271

Firth, J, Siddiqi, N, et al. (2019) The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness. Lancet Psychiatry.; 6: 675-712

Jacka, FN, O’Neil, A, et al. (2017) A randomised controlled trial of dietary improvement for adults with major depression (the ‘SMILES’ trial) BMC Medicine; 15:27

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