This week's research review focuses on The Modern Hygienic Diet.
A recent article published in the journal BMC Psychiatry recommended the following hygienic-dietary measures for the treatment of major depression. During the sixth month evaluation, a smaller number of patients from the group receiving hygienic-dietary recommendations met MetS criteria comparing with the control group. (Garcia-Toro et al., 2012a) (Garcia-Toro et al., 2014) (Garcia-Toro et al., 2012b)
Go to bed only when you feel sleepy and never before 11 p.m. Use your bedroom only for sleeping and sexual relations. Do not read, watch TV or stay inside the bedroom with any other purpose during the day. If you are unable to fall asleep within 15–20 minutes after going into bed, get up and get involved in an activity until you feel sleepy enough to go to bed again. Get up early, even if you have not slept properly. Do not get up later than 9 a.m. in any case. Do not lie down during the day and avoid taking a nap if you have not slept well the previous night.
Walk for a minimum of one hour every day, with a pace with which you do not feel breathless or are unable to speak. If you think you suffer any medical condition that would advise against this recommendation, please ask your doctor. Use comfortable trainers and wash after exercising by having a shower or a bath.
Expose yourself to environmental sun light, taking appropriated cautions to avoid sunburn or sunstroke (sunscreen, hat, etc.) Try to follow a healthy and well-balanced diet. Eat at regular times, avoiding snacks between meals, especially sweets and sweetened drinks. Consume legumes and fish at least three times per week. Also, eat fruits, cereals, nuts and dried food, and other vegetables daily.
Four hygienic-dietary recommendations as add-on treatment in depression: a randomized-controlled trial.
(Garcia-Toro et al., 2012b) Download
BACKGROUND: Modifying diet, exercise, sunlight exposure and sleep patterns may be useful in the treatment of depression. METHOD: Eighty nonseasonal depressive outpatients on anti-depressant treatment were randomly assigned either to the active or control group. Four hygienic-dietary recommendations were prescribed together. Outcome measures were blinded assessed before and after the six month intervention period. RESULTS: A better evolution of depressive symptoms, a higher rate of responder and remitters and a lesser psychopharmacological prescription was found in the active group. LIMITATIONS: Small sample size. Lacked homogeneity concerning affective disorders (major depression, dysthimia, bipolar depression). CONCLUSIONS: This study suggests lifestyle recommendations can be used as an effective antidepressant complementary strategy in daily practice.
Hygienic-dietary recommendations for major depression treatment: study protocol of a randomized controlled trial.
(Garcia-Toro et al., 2012a) Download
BACKGROUND: Depression is a highly prevalent and disabling mental disorder with an incidence rate which appears to be increasing in the developed world. This fact seems to be at least partially related to lifestyle factors. Some hygienic-dietary measures have shown their efficacy as a coadjuvant of standard treatment. However, their effectiveness has not yet been proved enough in usual clinical practice. METHODS: Multicenter, randomized, controlled, two arm-parallel, clinical trial involving 300 patients over 18 years old with a diagnosis of Major Depression. Major depression will be diagnosed by means of the Mini-International Neuropsychiatric Interview. The Beck Depression Inventory total score at the end of the study will constitute the main efficacy outcome. Quality of Life and Social and Health Care Services Consumption Scales will be also administered. Patients will be assessed at three different occasions: baseline, 6-month follow-up and 12-month follow-up. DISCUSSION: We expect the patients in the active lifestyle recommendations group to experience a greater improvement in their depressive symptoms and quality of life with lower socio-sanitary costs. TRIAL REGISTRATION: ISRCTN73931675.
Metabolic syndrome improvement in depression six months after prescribing simple hygienic-dietary recommendations.
(Garcia-Toro et al., 2014) Download
BACKGROUND: Changes in diet and exercise have been separately demonstrated to improve Depression, although scientific evidence available is scarce. In a previously published controlled study, just recommending these and other lifestyle measures (sleep restriction and sunlight exposure) in combination once, patients experienced improvements in their depressive symptoms six months later. In this sample, one in three depressive patients had metabolic syndrome (MetS) at baseline. First line treatment of MetS condition is hygienic-dietetic, being Mediterranean diet and exercise especially important. Therefore we analyzed if lifestyle recommendations also improved their metabolic profile. FINDINGS: During the sixth month evaluation, a smaller number of patients from the group receiving hygienic-dietary recommendations met MetS criteria comparing with the control group. CONCLUSIONS: This study suggests that costless lifestyle recommendations, such as exercise and Mediterranean diet, have the capacity to promote both mental and physical health in a significant proportion of depressive patients. Further research is needed to confirm or discard these preliminary findings.
Garcia-Toro, M, et al. (2012a), 'Hygienic-dietary recommendations for major depression treatment: study protocol of a randomized controlled trial.', BMC Psychiatry, 12 201. PubMedID: 23158080
Garcia-Toro, M, et al. (2012b), 'Four hygienic-dietary recommendations as add-on treatment in depression: a randomized-controlled trial.', J Affect Disord, 140 (2), 200-3. PubMedID: 22516309
Garcia-Toro, M, et al. (2014), 'Metabolic syndrome improvement in depression six months after prescribing simple hygienic-dietary recommendations.', BMC Res Notes, 7 339. PubMedID: 24899528