Food and exercise can treat depression as well as a psychologist, our study found. And it’s cheaper

Food and Exercise Can Treat Depression as Well as a Psychologist, Our Study Found. And It’s Cheaper.

What’s the Problem?

Around 3.2 million Australians live with depression. At the same time, few Australians meet recommended dietary or physical activity guidelines. What has one got to do with the other? Our world-first trial, published this week, shows improving diet and doing more physical activity can be as effective as therapy with a psychologist for treating low-grade depression.

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What Did Our Study Measure?

During the prolonged COVID lockdowns, Victorians’ distress levels were high and widespread. Face-to-face mental health services were limited. Our trial targeted people living in Victoria with elevated distress, meaning at least mild depression but not necessarily a diagnosed mental disorder. Typical symptoms included feeling down, hopeless, irritable or tearful.

The Study

We partnered with our local mental health service to recruit 182 adults and provided group-based sessions on Zoom. All participants took part in up to six sessions over eight weeks, facilitated by health professionals. Half were randomly assigned to participate in a program co-facilitated by an accredited practising dietitian and an exercise physiologist. That group – called the lifestyle program – developed nutrition and movement goals:

• Eating a wide variety of foods
• Choosing high-fibre plant foods
• Including high-quality fats
• Limiting discretionary foods, such as those high in saturated fats and added sugars
• Doing enjoyable physical activity

The second group took part in psychotherapy sessions convened by two psychologists. The psychotherapy program used cognitive behavioural therapy (CBT), the gold standard for treating depression in groups and when delivered remotely.

Lifestyle Therapies Just as Effective

We found similar results in each program. At the trial’s beginning, we gave each participant a score based on their self-reported mental health. We measured them again at the end of the program. Over eight weeks, those scores showed symptoms of depression reduced for participants in the lifestyle program (42%) and the psychotherapy program (37%). That difference was not statistically or clinically meaningful, so we could conclude both treatments were as good as each other.

What Does This Mean for Mental Health Workforce Shortages?

Demand for mental health services is increasing in Australia, while at the same time the workforce faces worsening nation-wide shortages. Psychologists, who provide about half of all mental health services, can have long wait times. Our results suggest that, with the appropriate training and guidelines, allied health professionals who specialise in diet and exercise could help address this gap.

Potential Barriers

Australians with chronic conditions (such as diabetes) can access subsidised dietitian and exercise physiologist appointments under various Medicare treatment plans. Those with eating disorders can also access subsidised dietitian appointments. But mental health care plans for people with depression do not support subsidised sessions with dietitians or exercise physiologists, despite peak bodies urging them to do so.

Future Directions

Our trial took place during COVID lockdowns and examined people with at least mild symptoms of depression who did not necessarily have a mental disorder. We are seeking to replicate these findings and are now running a study open to Australians with mental health conditions such as major depression or bipolar disorder.

Conclusion

Our study found that lifestyle therapies, such as diet and exercise, can be as effective as therapy with a psychologist for treating low-grade depression. This is a significant finding, as it suggests that dietitians and exercise physiologists may one day play a role in managing depression. With the appropriate training and guidelines, these professionals could help address the nation-wide shortages of mental health services.

FAQs

Q: What did the study find?
A: The study found that lifestyle therapies, such as diet and exercise, can be as effective as therapy with a psychologist for treating low-grade depression.

Q: Who were the participants in the study?
A: The participants were 182 adults living in Victoria with elevated distress, meaning at least mild depression but not necessarily a diagnosed mental disorder.

Q: What were the goals of the lifestyle program?
A: The goals of the lifestyle program were to develop nutrition and movement goals, including eating a wide variety of foods, choosing high-fibre plant foods, including high-quality fats, limiting discretionary foods, and doing enjoyable physical activity.

Q: What were the results of the study?
A: The results showed that symptoms of depression reduced for participants in both the lifestyle program (42%) and the psychotherapy program (37%). The difference between the two groups was not statistically or clinically meaningful, so we could conclude both treatments were as good as each other.

Q: What are the implications of the study?
A: The study suggests that dietitians and exercise physiologists may one day play a role in managing depression, and that lifestyle therapies could help address the nation-wide shortages of mental health services.