Study Spotlight Take-Away with Chef Dr. Mike: Aging, Depression, and Diet

by Michael S. Fenster, MD

“I am not young enough to know everything.”

― Oscar Wilde

Several years ago, the World Health Organization introduced the concept of intrinsic capacity (IC). IC is defined as the composite of all physical and mental capacities that an individual can draw upon during life. IC is often used in conjunction with frailty in the discussion regarding healthy aging. Frailty is defined as an age-related medical syndrome caused by multiple causes and contributors negatively affecting the individual’s homeostatic reserves. The resulting accentuated vulnerability predisposes a person to a high risk of negative outcomes as they age. Increased frailty translates as increased risk.

Although we are generally living longer, we are not always living better. Despite an aging population, the increase in longevity does not automatically translate into healthy aging. Non-communicable diseases and multiple co-morbidities are major contributors to years lived with disability. The effect of diet is among the factors impacting these chronic disabilities and diseases.

The Study:

  • The study examined 294 Australian participants aged 60 or older.
  • The mean age was 70.4 years
  • The study looked at adherence to a Mediterranean diet (MedDiet) and the severity of symptoms related to depression, anxiety, and stress.
  • MedDiet adherence was assessed using the Mediterranean Diet Adherence Screener (MEDAS)
  • The Depression, Anxiety, and Stress Scale (DASS−21) was used to assess the severity of negative emotional symptoms.
  • The study was performed as an online survey.

The Take-Away:

  • Adherence to a MedDiet was inversely associated with the severity of anxiety symptoms.
  • MedDiet adherence was inversely associated with symptoms of stress.
  • No relationship between MedDiet adherence and depressive symptoms was observed.

The Caveat:

Healthy aging is not regarded merely as the absence of disease but as the process of fostering and maintaining the individual’s functional ability. The World Health Organization has set healthy aging as a priority and, to help accomplish this introduced the concept of intrinsic capacity in 2015. Its purpose was to create a multidimensional indicator related to an individual’s functional status. This marker could then be used in an individual’s later years as a measure of healthy aging. It was proposed as a holistic way to capture and record an individual’s functions and capacities over the course of their life; in other words, “[b]y interacting with the surrounding environment, IC largely defines the individual’s functional ability.[1]” Frailty marks the other end of the spectrum and is not limited to physical vulnerabilities. Mental health disorders are a major influence on disability and disease burden. These disorders include depressive and anxiety disorders, which are commonly reported in older adults.

One of the interesting observations of this study is that it portrays the Mediterranean diet as less of the simply “eat this, not that” program and more of a lifestyle choice. I have always held that particular perspective and choose to refer to the practice as the Mediterranean Approach, with food selection being one of several practices. This study notes that such a Mediterranean practice emphasizes a sense of balance in both the kitchen and life. There is an appreciation for the natural world and real, authentic foods consumed in moderation. Generally speaking, there is a preference to use local, seasonal, and traditional comestibles. This is also coupled with an inclination to not just prepare the food at home but to share the food experience with others.

This study showed that adherence to a MedDiet is inversely associated with the severity of symptoms related to anxiety and stress but not depression. However, many other studies have shown an inverse relationship between MedDiet and depression. What is the important takeaway, I believe, is the general finding that a Mediterranean approach to food and diet is fundamentally a positive approach to our food-health relationship. Such a positive food-health relationship increases our intrinsic capacity and thus can act as a buffer against frailty in our later years, and this includes not just physical ailments but potentially devastating mental health conditions such as anxiety, stress, and depression.

[1] (Belloni, 2019)


Allcock L, Mantzioris E, Villani A. Adherence to a Mediterranean Diet Is Inversely Associated with Anxiety and Stress but Not Depression: A Cross-Sectional Analysis of Community-Dwelling Older Australians. Nutrients. 2024 Jan 26;16(3):366. doi:10.3390/nu16030366.

Additional resources:

Beard J.R., Officer A., De Carvalho I.A., Sadana R., Pot A.M., Michel J.P., Lloyd-Sherlock P., Epping-Jordan J.E., Peeters G.M.E.E.G., Mahanani W.R., et al. The World report on ageing and health: A policy framework for healthy ageing. Lancet. 2016;387:2145–2154. doi:10.1016/S0140-6736(15)00516-4.

Belloni G., Cesari M. Frailty and intrinsic capacity: Two distinct but related constructs. Front. Med. 2019;6:133. doi:10.3389/fmed.2019.00133.

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