Dietary Pattern and Depressive Outcomes in Children and Adolescents: Systematic Review and Meta-analysis of Observational Studies

Nutr Rev. 2025 Apr 15:nuae182. doi: 10.1093/nutrit/nuae182. Online ahead of print.

ABSTRACT

CONTEXT: Research suggests that dietary pattern plays an important role in mental health and constitutes a modifiable risk factor for depression.

OBJECTIVE: The aim of this systematic review and meta-analysis was to evaluate the association between dietary patterns and depressive outcomes in adolescents.

DATA SOURCES: Medline/PubMed, Lilacs, EMBASE, PsycINFO, and PsycARTICLES, gray literature up to March 2024 were searched; the reference lists were also verified. Observational studies in participants with a mean age ⩽19 years reporting associations between dietary patterns and clinical depression or depressive symptoms were searched. Overall, 21 studies were included in this systematic review.

DATA EXTRACTION: Data from eligible articles were extracted by 2 reviewers.

DATA ANALYSIS: Odds ratios (ORs) and confidence intervals (CIs) were determined under a random-effects model. The risk of bias assessment was conducted by 2 independent researchers using the Joanna Briggs Institute Critical Appraisal Checklist tool.

RESULTS: The qualitative results revealed that a higher unhealthy diet score was positively associated with depressive symptoms, while a healthy diet was negatively associated with depressive symptoms. In the study that included adolescents with a clinical diagnosis of depression, the relationship between inflammatory dietary pattern tertiles and depression was attenuated after all covariates were adjusted for. The meta-analysis to evaluate the association between depressive symptoms and a posteriori dietary patterns found that the “healthy” dietary pattern decreased depressive symptoms in adolescents (OR: 0.69; 95% CI: 0.44, 0.95). There was no statistically significant association between depressive symptoms and “unhealthy” and “snacks” patterns (OR: 1.20 [95% CI: 0.95, 1.46]; OR: 1.20 [95% CI: 0.70, 1.48]) dietary patterns.

CONCLUSION: The results identified that a healthy dietary pattern decreased depressive symptoms in adolescents. However, considering the high heterogeneity and the low level of certainty of the evidence, these results should be interpreted with caution.

SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42020159921.

PMID:40233215 | DOI:10.1093/nutrit/nuae182