Most of us readily accept that the food we eat can impact our moods. And now, while working with La Trobe’s School of Allied Health, dietitian Dr Rachelle Opie has developed a modified Mediterranean diet that has been shown to help people with depression.
The diet is a modified version of the classic Mediterranean diet – often dubbed the world’s healthiest. The Mediterranean diet typically includes lots of fruits, vegies, legumes and whole grains, is high in lean protein like fish and poultry, and features olive oil as the main fat.
The link between food and mood
Opie was part of a major La Trobe study which trialled her ModiMed diet on more than 30 adults with depression. They found over a third of their participants experienced remission of depression (compared to eight per cent of the control group). These results could be linked to the diet.
Opie first completed a Bachelor of Science, followed by a Bachelor of Nutrition and Dietetics degree. She has worked as a dietitian ever since, alongside her PhD studies and research activities.
‘Working in community rehab as a dietician, you do notice a clear link between food and mood,’ she says. ‘Lowered mood is a common side effect of stroke, and typically also results from any long stay in the hospital system.’
People with lowered mood commonly crave unhealthy foods that are high in fat, sugar and salt, Opie says.
‘Anecdotally, they would tell us that they felt better when they started to eat healthier. But without doing research, you don’t know – are people eating badly because they’re experiencing lowered mood, or is that because of the poor quality diet their mood gets worse?’
‘The Smiles Trial’ was born
Keen to study further, Opie returned to university to do an honours year, where her thesis involved finding out how dietary changes might help elderly people at risk of cognitive decline.
‘I used the Mediterranean diet score to see whether a good adherence to a Mediterranean-style diet delayed the progression of cognitive changes and decline, such as that seen in Alzheimer’s,’ she says.
She wanted to expand on her interest in the effectiveness of the Mediterranean diet and planned to do a PhD on the impacts the diet could have on brain health.
When Opie heard that Professor Catherine Itsiopoulos, who heads La Trobe’s School of Allied Health, was looking for a dietician to work on a grant-funded project investigating links between mental health and the Mediterranean diet, Opie jumped at the opportunity and linked the project with her PhD.
‘Mental health is such a huge issue in health and is such an area of interest for me, and I strongly believed that we could make a difference with the project,’ Opie says.
The La Trobe team worked for three years in a community based setting with 67 people who had depression. The project was dubbed ‘The Smiles Trial.’
‘We delivered a dietary intervention that was very much individually tailored,’ Opie says. People came in for seven sessions, and they were encouraged to comply as much as possible with a modified version of the Mediterranean-type diet.’
The team then used a standard depression scale, the MADRS, to check symptoms over time, and compared the patients to a control group who had seven ‘social support’ sessions.
‘We found a third of the group in the dietary intervention, went into remission of depression, so they had no symptoms, compared to just six percent of the control group.’
The dietary intervention group had significant improvements in their consumption of whole grain cereals, fruit, dairy, olive oil, pulses and fish, which make up a Mediterranean diet, while the control group didn’t show much change in their diet.
The implications for people with depression are great, Opie says.
An overall positive impact
Patients were encouraged to swap unhealthy snacks with healthy foods high in nutrients, using healthy fats like olive oil and nuts, natural sugars like honey and fresh fruit, and salty foods like olives and feta cheese, to help them tackle common cravings.
‘The effect size was similar to what you’d see if people took medications and had psychotherapy. Improving your diet quality can certainly have very significant impacts.’
She adds that the team does not make any suggestion that patients should stop taking medication or seeing psychologists.
Plans for the future
It’s early days for the modified diet, but Opie has already been in discussions about how the diet could be rolled out to a bigger audience.
‘We believe that the diet works best when it’s individualised, rather than done in group education or in a public health campaigns. We’re yet to test it out in other forms, such as public health and group settings,’ she says.
Doing this on a larger scale would be a challenge, she says. ‘We’ve discussed the possibility of running it online, so people could get all the information through perhaps Skype or webinars.’
The team has also recommended dieticians be part of the GP mental health treatment plan, so that individuals with depression could receive Medicare rebates for up to six dietitian consultations. ‘That would make an enormous difference.’
Opie loves the work she does and says she feels there’s huge scope to make a big difference in peoples’ lives.
‘We know that people are becoming more and more unhealthy and our diet quality is seemingly becoming worse. Australians have such an amazing variety of foods available, so it should be very easy for people to follow something like a modified Mediterranean diet.’
Allied health professionals at La Trobe are doing research that can change people’s lives.
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