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

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...

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Main Authors: Wendy Lou, Shakila Meshkat, Venkat Bhat, Qiaowei Lin, Gabriella Menniti, Amy Reichelt
Format: Article
Language:English
Published: BMJ Publishing Group
Series:BMJ Nutrition, Prevention & Health
Online Access:https://nutrition.bmj.com/content/early/2025/05/28/bmjnph-2025-001167.full
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author Wendy Lou
Shakila Meshkat
Venkat Bhat
Qiaowei Lin
Gabriella Menniti
Amy Reichelt
author_facet Wendy Lou
Shakila Meshkat
Venkat Bhat
Qiaowei Lin
Gabriella Menniti
Amy Reichelt
author_sort Wendy Lou
collection DOAJ
description 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.
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spelling doaj-art-cc9373e9cb064cc0880c8e9f4a4f0e042025-08-20T02:32:22ZengBMJ Publishing GroupBMJ Nutrition, Prevention & Health2516-554210.1136/bmjnph-2025-001167Mental health consequences of dietary restriction: increased depressive symptoms in biological men and populations with elevated BMIWendy Lou0Shakila Meshkat1Venkat Bhat2Qiaowei Lin3Gabriella Menniti4Amy Reichelt53 Department of Biostatistics, University of Toronto, Toronto, Ontario, Canada1 Interventional Psychiatry Program, St Michael`s Hospital, Toronto, Ontario, Canada2 Department of Psychiatry, University of Toronto, Toronto, Ontario, CanadaInterventional Psychiatry Program, St Michael’s Hospital, Unity Health Toronto, Toronto, Ontario, Canada1 Interventional Psychiatry Program, Unity Health Toronto, Toronto, Ontario, Canada4 Department of Physiology and Pharmacology, Western University, London, Ontario, CanadaIntroduction 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.https://nutrition.bmj.com/content/early/2025/05/28/bmjnph-2025-001167.full
spellingShingle Wendy Lou
Shakila Meshkat
Venkat Bhat
Qiaowei Lin
Gabriella Menniti
Amy Reichelt
Mental health consequences of dietary restriction: increased depressive symptoms in biological men and populations with elevated BMI
BMJ Nutrition, Prevention & Health
title Mental health consequences of dietary restriction: increased depressive symptoms in biological men and populations with elevated BMI
title_full Mental health consequences of dietary restriction: increased depressive symptoms in biological men and populations with elevated BMI
title_fullStr Mental health consequences of dietary restriction: increased depressive symptoms in biological men and populations with elevated BMI
title_full_unstemmed Mental health consequences of dietary restriction: increased depressive symptoms in biological men and populations with elevated BMI
title_short Mental health consequences of dietary restriction: increased depressive symptoms in biological men and populations with elevated BMI
title_sort mental health consequences of dietary restriction increased depressive symptoms in biological men and populations with elevated bmi
url https://nutrition.bmj.com/content/early/2025/05/28/bmjnph-2025-001167.full
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