Mediterranean diet linked to lower anxiety and stress levels, but no effect on depression, study shows

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In a recently published study, Dr nutrientsResearchers investigated the relationship between adherence to a Mediterranean diet (MedDiet) and the severity of symptoms of depression, anxiety and stress in independently living adults ≥60 years of age in Australia.

Study: Adherence to a Mediterranean diet is inversely associated with anxiety and stress but not depression: a cross-sectional analysis of community-dwelling older Australians.  Image credit: Uriya Ganor/
Study: Adherence to a Mediterranean diet is inversely associated with anxiety and stress but not depression: a cross-sectional analysis of community-dwelling older Australians.. Image credit: Uriya Ganor/


The literature on the benefits associated with maintaining physical and mental activity with age is compelling. Mental health disorders, particularly depression and anxiety, show marked heterogeneity in clinical presentation, multiple etiologies, and complex pathophysiology.

Diet is a modifiable risk factor for mental health problems. Research has supported the MedDiet to reduce risk of chronic disease(s) and support healthy aging.

Studies have shown that adherence to an anti-inflammatory diet is inversely associated with depression in young and middle-aged adults; However, these results remain inconsistent. This may be due to differences in study designs used (eg, longitudinal, cross-sectional), differences in outcome (anxiety vs. depression) assessments, methods used to identify depression or depressive symptoms, or subgroups of the population studied (young, middle-aged, elderly).

Overall, there is a lack of evidence regarding the etiology of mental health and its relationship to lifestyle habits, such as diet, particularly among older adults.

Study Methodology

Researchers conducted a 75-item online survey among older adults in Australia to understand possible associations between adherence to the MedDiet, its dietary components, and severity of symptoms of depression, anxiety, and stress.

In addition, they used the DASS-21, a screening tool with seven items each, to measure the severity of depression, anxiety, and stress symptoms. In previous work, it has demonstrated good psychometric properties in older adults with good internal consistency and high convergent validity.

Next, the team assessed MedDiet adherence using the 14-item MEDAS, where they scored each question as either zero or one, with higher scores indicating greater adherence.

Statistical analysis involved the use of linear regression to examine associations between meddiet adherence and covariates (eg, cognitive status) with depression, anxiety, and stress symptoms. They adjusted for cognitive status (a potential confounder) using validated tools such as Lawton’s iADLs scale and the AD8 dementia screening intervention.

Furthermore, the group presented continuous variables as means/means performed t-test To compare demographic characteristics between genders and performed regression diagnostics.


Of the 303, 294 older Australians completed the questionnaire items used in the final analysis, including 201 women, 91 men and two unspecified.

A significant number of participants reported mild symptoms of depression (n=99), anxiety (n=80), and stress (n=47) according to the DASS-21. However, there were no significant differences in these symptoms across gender in the study sample.

Adherence to the MedDiet was moderate in the entire sample, with women showing greater adherence than men.

Although adherence to the MedDiet was inversely associated with severity of anxiety and stress symptoms among community-dwelling older Australians, it was not associated with any depressive symptoms among them.

Depression is multidimensional, involving biological, psychological, and social risk factors. Therefore, it is unlikely that simply following a healthy diet can reduce its symptoms.

Further, the results revealed the effect(s) of specific dietary components of a MedDiet as defined by MEDAS.

Higher vegetable intake was inversely associated with depressive symptoms, while fruit intake was inversely associated with stress-related symptoms. Additionally, nut consumption was inversely associated with anxiety and stress symptoms, nut consumption was inversely associated with anxiety symptom severity, and low consumption of sugar-sweetened beverages (less than 250mL per day) was associated with less severe anxiety symptoms.


Overall, the study findings contribute to the literature supporting adherence to a healthy dietary pattern to combat mental health disorders, particularly in older adults.

Prospective studies with adequate samples and robust clinical trials, particularly in older adults with established mental health disorders, should further investigate these findings. Studies should also explore inconsistencies in results between participants of different ages.

In the future, this will help position the MedDiet intervention as an adjunctive treatment in psychiatric practice for the management of mental health symptoms, allowing practitioners to adopt evidence-based nutritional medicine for the treatment of mental health disorders in older adults.

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