Plain language summary
Seasonal affective disorder (SAD) is a mood disorder characterised by annual depression or bipolar disorder in a seasonal pattern. Recent evidence suggests dietary intervention and nutrition status can affect the symptoms in depressed patients, but none have specifically considered depression among SAD patients. The aim of this review was to assess the associations between diet, eating behaviour and nutrition intervention in SAD patients. Eleven studies were included and found vegetarian diet patterns and alcoholism to be associated with higher SAD prevalence. Additionally, SAD patients tend to consume larger dinners, more snacks, and show more cravings for starch-rich foods. Despite these patterns, dietary supplementation or nutrition intervention did not show benefit for SAD symptoms. Overall, the authors conclude there is a lack of evidence to draw conclusions on dietary pattern and nutritional interventions for preventing and managing SAD. The authors suggest further evidence is needed from larger controlled trials and encourage investigation of the role of the B vitamin group, rather than an isolated B12 supplementation.
Abstract
Background: Seasonal affective disorder (SAD) is a biological and mood disorder with a seasonal pattern. Dietary intervention and nutritional status have been reported to affect SAD severity. The objective of this study was to systematically review the evidence of associations between SAD and diet, eating behavior, and nutrition intervention. Methods: We performed a comprehensive search of MEDLINE, EMBASE, Web of Science, and Google Scholar from inception up to July 1, 2019. Studies that examined diet and eating behaviors in SAD patients and tests of nutrition interventions for SAD were included. Two independent investigators extracted data based on study designs, participants, outcomes, exposures, and association measures. Results: Eleven studies were included: six studies examined distinctive dietary patterns and eating behaviors in SAD patients and five studies explored the efficacy of nutrition interventions for SAD. Vegetarianism and alcoholism were associated with higher SAD prevalence, but normal alcohol intake was not correlated with SAD severity. Compared with non-clinical subjects, SAD patients tended to consume significantly larger dinners and more evening snacks during weekdays and weekends and exhibit a higher frequency of binge eating, external eating, and emotional eating. Additionally, compared to healthy controls, SAD patients presented more cravings for starch-rich food and food with high fiber. However, neither the ingestion of carbohydrate-loaded meals nor Vitamin D/B12 supplementation showed benefit for SAD. Conclusion: Studies suggest that SAD patients may exhibit distinctive diet preferences and eating behaviors, but no current nutrition intervention has demonstrated efficacy for ameliorating SAD symptoms. Further evidence is needed from randomized controlled trials with larger sample sizes and longer durations.
Methodological quality
Jadad score
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Not applicable
Allocation concealment
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