By Micah Stoner, Student Pharmacist and Karen Kier, Pharmacist 

On behalf of the ONU HealthWise team 

MEDIA RELEASE_On April 23, 1971, the Carpenters released their song Rainy Days and Mondays. The Carpenter siblings were Richard, an older brother, and sister Karen. Richard grew up learning the piano, while Karen played the drums. Both provided vocals for the group, but Karen’s voice was what made the group recognizable. Karen’s voice was described as a warm, rich, velvety contralto spanning 3 octaves. In 1971, the Carpenters won the Grammy Award for Best New Artist.  

Rainy Days and Mondays was written by Paul Williams and Roger Nichols and explored the themes of feeling unfulfilled, aging and isolation.  

Feeling persistent sadness, loss of interest in activities and low energy that disrupts activities of daily living is often used to describe depression. Signs include changes in thoughts, mood, and behavior. It is estimated that 18.3% of adult Americans currently have a diagnosis of depression and this correlates to 48 million individuals over the age of 18 years. Additional data suggests 29% of adults have experienced depression in their lifetime. 

Can diet influence and improve depression symptoms? 

Previous research and studies have noted the influence of foods and exercise on depression symptoms. However, there is minimal information focused on specific dietary choices and their impact on depression. A recent trial published in JAMA Psychiatry sought to discover whether switching patients with treatment-resistant depression to a ketogenic diet would reduce their symptoms of depression. 

The researchers evaluated 88 patients with treatment-resistant depression who had significant symptoms. The study defined treatment resistance as patients who have taken at least two different antidepressants medications at maximum tolerated doses and experienced a PHQ-9 score greater than 15 (moderately severe depression). The PHQ-9 test is a validated tool used to assess depression symptoms and is on a scale of zero to twenty-seven, with twenty-seven being the most severe. 

The patients were equally divided between two different dietary treatment groups. The first group was placed on a ketogenic diet (keto) involving less than 30 grams of carbohydrates in a day. The second group was given a phyto diet, which consists of phytonutrients featuring foods from 4 distinct colors. These colors include foods that are red, orange/yellow, dark green and purple/blue. It is often referred to as “eating the rainbow.” 

The patients were followed for a total of 12 weeks, with depression screenings in the beginning and every two weeks during the twelve-week trial. They also assessed anxiety and several other factors. Of the two groups formed, 44 patients were put on a ketogenic diet, or a diet that focuses on increasing fats and decreasing carbohydrate intake, and 44 were put on a phyto diet, or a diet with the main focus of increasing vitamins in the form of fruits and vegetables.

When compared to the phyto group, researchers found an average difference of -2.18 in the depression screenings of the ketogenic group. Both groups showed a significant improvement in depression symptoms as early as six weeks after starting the diets. However, the keto diet showed a slightly better improvement than the phyto diet. It is important to note that all patients in the study stayed on their medications for depression. The diet is considered add-on therapy or adjuvant treatment. 

There was no significant difference in any other measured variables. The researchers found with a switch to a ketogenic diet, depression severity could be slightly decreased. Both groups had significant changes to depression screening scores, which supports the theory that a healthy diet can improve symptoms of depression. 

Even though diet can affect depression, scores did not go down enough to support complete dependence on lifestyle changes over taking medications. If you have questions about depression, lifestyle changes, medications, or the guidelines for depression management, contact a healthcare professional.