Seven Resources on Treating Seasonal Affective Disorder with Integrative Medicine

Nutritional Considerations for Seasonal Affective Disorder

Of course, the therapeutic meal plan is personalized, but the Modified Mediterranean Diet (Mod/MedDiet) as studied in the SMILES trial is one option to consider. As described in Nutritional Neuroscience, the Mod/MedDiet contains plentiful vegetables, fruits, whole grain cereal, oily fish, legumes, unsalted nuts and seeds, and extra virgin olive oil. It allows for moderate consumption of natural reduced-fat dairy products and lean red meat. The results of the SMILES randomized controlled trial indicated this meal pattern, with the support of a registered dietitian, is one effective option for improving symptoms in those with major depression. 

While the Mod/MedDiet significantly reduces sugar and inflammatory fats, these are two specific areas of focus when I educate patients with depressive symptoms. In a prospective study published in Scientific Reports, increased sugar intake raised the likelihood of mood disorders like depression. One possible mechanism involves the dysregulation of glucose in the brain leading to inflammation, but sugar is also known to negatively affect the gut microbiota. As reported in Nutrients, after treatment with high glucose and high fructose diets, mice showed lower microbial diversity, increased intestinal permeability, and higher levels of inflammatory cytokines.

Inevitably, when I suggest removing sugar, my patients ask about artificial sweeteners. However, artificial sweeteners have been shown to alter the gut microbiota as well. In addition, a variety of studies have shown an increase in glucose intolerance and altered microbial metabolic pathways increasing the risk of metabolic disease. I generally have patients avoid all added sugars, refined carbohydrates, and artificial sweeteners. As occasional sweeteners, I recommend organic honey and pure maple syrup.

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