Mild-moderate depression is perhaps the single most common concurrent diagnosis of the patients and people I speak with. Patients often describe "lack of energy" and "fatigue" as a top concern following the original complaint that brings them into my office. While it needs to be investigated with a good case-history, physical exam, and potentially blood work to rule out other causes (i.e. low iron, low thyroid, etc.) fortunately in my practice, most people are simply depressed and over-worked. Usually this is rooted in a poor self-care routine and too many demands on one's time and energy. Most commonly, I prescribe a combination of naturopathic fundamentals like diet, exercise, relaxation, and a healthy dose of sun and fresh air to help them lift their moods and provide a little balance to their lives. Occasionally, I will also prescribe supplements such as omega-3's, which have great research to support their use for depression. Of course, when and where I can I prefer to recommend food rather than capsules.
Which is why I am so excited to share today's research...
Since the discovery of the cardiovascular benefit of omega-3 fatty acids on human health in the late 90s, the race has been on to get more of it into our bodies. The primary source of omega-3 fatty acids in the human diet is fish, but the research was always being done on the omega-3 constituent, not the food it was found in. So, in true academic fashion, the connection between fish consumption (rather than omega-3s) and depression was a point of debate.
I'm delighted to share this research because it focusses on a whole food choice rather than chemical compound. Research like this is rarer than you would expect. I suspect it has to do with not being able to patent a whole food (like fish or a potato) and the challenge presented by tracking a variable that is inherently, well... variable. One fish is not the same as another, tomato-tomato so to speak. I digress. Back to the study...
The study is a meta-analysis, meaning it looks at the results of a bunch of similar studies and compiled them. After finding, reviewing the published literature (over 1000 articles). Out of thousands, it decided only a whopping total of 26 separate studies were of good enough quality to meet the standards of the British Medical Journal.
These 26 studies compared a total of just over 150,000 fish eating and non-fish eating participants from the general population.
The relative risk of depression for highest versus lowest fish consumption was 0.83. Translation: This means for every 100 non-fish eaters with depression, there would only by 83 fish eaters with depression. They even did some statistical magic on the results to make sure it was a stable relationship - controlling for variables like gender and heterogeneous populations. The relationship still held after all that.
Bottom Line: While the populations, types of fish, cooking methods, and quantity of fish eaten were all over the map in this compilation of studies, one thing is clear - those that ate more fish had less incidence of depression.
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The significance of this meta-analysis is that it clears up the controversy around whether there is a relationship between dietary fish and depression. It answers the question about whether the benefit of omega-3s for treating depression can be realized by simply eating fish. There is: it confirms that the more fish you eat, the less depression you have.
It may shock you that medical science has just confirmed this now, given all the hype about omega-3s for the last 15 years. As is often the case, whole food research comes much later after the "wonder cure compound" has been identified. It's backwards. I know. But it's scientific progress... and it leaves us with more questions to look into:
In clinical practice, I will encourage my patients to eat more fish. Likely at a "dosage" of about 3-4 times per week as that seems consistent with a mediterranean/paleo type dietary approach.
Did you like this post? How frequently do you eat fish? Will you eat more after reading this article?
As always, I hope this article serves you.
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