Summary:
Depression is a leading cause of disability worldwide and often occurs alongside other medical conditions. Current clinical management typically involves medication, psychotherapy, and lifestyle advice. Increasing evidence suggests that lifestyle factors, particularly diet and physical activity, are closely linked to depression in both protective and harmful ways. Chronic inflammation has been identified as a shared feature of depression and other non-communicable diseases. This inflammatory state is strongly associated with physical inactivity and dietary patterns such as a high intake of ultra-processed foods and low intake of fiber. Diets high in refined carbohydrates, added sugars, unhealthy fats, and sodium, and low in fruits, vegetables, legumes, and whole grains are consistently linked with pro-inflammatory states. This study is a mini-review that synthesised recent literature on anti-inflammatory diets and physical activity in the management of depression, and the presence of these recommendations in clinical guidelines. The review examined dietary patterns, ultra-processed food consumption, sedentarism, aerobic exercise, and resistance training. Most nutrition studies emphasised whole food, plant-based eating patterns or reduction of ultra-processed and animal-sourced foods, while most physical activity studies focused on aerobic exercise, with fewer addressing resistance training or providing specific exercise parameters. When compared with national and international depression guidelines, lifestyle recommendations were inconsistently included and often lacked specificity, particularly for nutrition and resistance exercise. Overall, this study identified a clear gap between the strength of evidence supporting anti-inflammatory dietary patterns and regular physical activity and their representation in depression management guidelines. The findings suggest that dietary improvement, reduced ultra-processed food intake, increased physical activity, and both aerobic and resistance exercise have potential to meaningfully reduce depressive symptoms and complement standard treatments. Greater alignment between research evidence and clinical guidelines may improve depression outcomes and reduce reliance on pharmacological approaches alone.
Abstract:
Background: Chronic low-grade systemic inflammation (CLGSI) is implicated in depression and its amelioration. Pro-inflammatory nutrition and inactivity are associated with CLGSI. We triangulated the degree to which recent literature on anti-inflammatory nutrition and physical activity/physical exercise (PA/PE) corroborates the extant body of knowledge related to depression management and is reflected in the guidelines of leading mental health domains (national/international mental health associations/bodies). Methods: We used mini-review methodology. The search was narrowed to recent state-of-the-art literature (2024) in PubMed, on diet and exercise specifications in depression management. Then, we compared recommendations of aforementioned domains regarding diet and PA/PE in depression management. Results: Of 73 nutrition source studies, 50 (68%) focused on anti-inflammatory whole food, plant-based (WFPB) nutrition to manage depression; 4 (5%) on reducing consumption of animal-sourced foods; 16 (23%) focused on the effect of ultra-processed food (UPF) and its role in depression and its avoidance vis-à-vis its anti-depressant effects. Of the 55 PA/PE source studies, 49 (89%) focused on the effects of aerobic exercise; 14 (29%) described specific parameters to achieve an anti-depressant effect and 35 (71%) were non-specific. Twelve (22%) studies focused on resistance muscle training; 2 (17%) that reported specific training parameters and 10 (83%) that were non-specific. Nine domains were identified with established depression management guidelines: Australia/New Zealand; Canada; Europe (Belgium, Scotland, Spain); United Kingdom; United States; WFSBP and ASLM; and World Health Organization. Regarding nutrition, 5 (55%) domains recommended WFPB nutrition; 4 (44%) reduced animal-sourced foods; and 3 (33%), avoidance of UPF. With respect to sedentarism, 3 (33%) domains recommended reduced prolonged sitting. Eight domains (89%) mentioned aerobic exercise; 3 (33%) resistance training. Three domains mentioned aerobic exercise non-specifically; 5 (56%) made specific recommendations. Three domains mentioned resistance muscle training; 2 (22%) made non-specific recommendations and 1 (11%) made specific recommendations. Conclusions: Disparities that exist in leading depression management guidelines vis-à-vis inclusion of evidence-informed nutrition and PA/PE recommendations, warrant reconciliation. Evidence supporting anti-depressant WFPB nutrition and limiting pro-inflammatory animal-sourced food and UPF and supporting anti-inflammatory aerobic exercise and resistance training warrants being translated into national/international depression management guidelines as consistently as recommendations for pharmacotherapy and psychotherapy.
Article Publication Date: 15/12/2025
DOI: 10.1186/s41043-025-01138-0
