The association between gut-health promoting diet and depression: a mediation analysis

Background: Recent research has highlighted the relevance of a gut-health promoting diet as a possible treatment and prevention for depression. A dietary pattern with consumption of fermented food and high consumption of dietary fiber can promote gut health, physical health, and might even improve mental health. This study aimed to investigate the interrelationship among diet, physical health, and depression. Methods: This study used a nationally representative sample (N = 16,572) from the National Health and Nutrition Examination Survey (2011–2018). Dietary information was collected by dietary recall interviews. Depression was assessed by the 9-item Patient Health Questionnaire. Subjective physical health was indicated by self-reported Body Mass Index (BMI). Objective physical health was indicated by BMI measured by trained health technicians. Path analysis was used to test the association between diet and depression, and the mediating roles of self-reported BMI and BMI measured by technicians. Results: Consumption of probiotic foods and higher intake of fiber were significantly associated with lower levels of depressive symptoms. Both subjective and objective physical health significantly mediated the relationship between variables of diet and mild depressive symptoms. Subjective physical health also significantly mediated the relationship between high intake of dietary fiber and lower likelihood of reporting severe depressive symptoms. Conclusion: Despite being cross-sectional in nature, this study presented evidence that gut-health promoting diets may reduce depressive symptoms through improving physical health. These findings provide preliminary support to diet programs for preventing depression and diet programs as an alternative or supplementary treatment of depression.