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On this episode of the CMAJ Podcast, Dr. Mojola Omole and Dr. Blair Bigham discuss the growing evidence around the impact of diet on mental health, particularly depression. The conversation is inspired by the CMAJ practice article, “Diet and depression,” co-authored by Dr. Nicholas Fabiano.

Dr. Fabiano explains how the mechanistic connection between diet and depression is not well understood, but it is theorized that diets known to promote inflammation may play a part in exacerbating symptoms. He highlights findings from the SMILES trial, which demonstrated how dietary interventions like the Mediterranean diet—rich in leafy greens, fish, fruits, and whole grains—reduced depression symptoms in trial participants.

Dr. Rachelle Opie, an accredited practicing dietitian and credentialed eating disorder clinician, offers practical advice on how physicians can coach patients toward dietary changes in a way that is inclusive, sustainable, and sensitive to individual needs. Drawing from her work on the SMILES trial, Dr. Opie highlights the importance of a whole-of-diet approach that prioritizes small, achievable changes, such as incorporating legumes, beans, or frozen and canned foods. She emphasizes trauma-informed, weight-neutral approaches to avoid triggering or alienating patients and encourages focusing on what patients can add to their diet rather than restricting foods.

Together, the hosts and guests explore how subtle, realistic changes in dietary habits can provide meaningful improvements in mental health without placing undue pressure on patients.

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