A review of dietary and microbial connections to depression, anxiety, and stress

Nutr Neurosci. 2020 Mar;23(3):237-250. doi: 10.1080/1028415X.2018.1493808. Epub 2018 Jul 9.


Objective: Pre-clinical evidence suggests that the gastrointestinal microbiota contributes to mood and behavior disorders. Among humans, diet quality and patterns, which also impact the gastrointestinal microbiota, have been linked to depression, anxiety, and stress. This review summarizes findings from clinical studies using dietary intervention to improve depression, anxiety, or stress and the role the gastrointestinal microbiota may have in these disorders.Methods: A literature search was conducted using the keywords microbiome, microbiota, depression, anxiety, stress, diet, dietary pattern, diet quality, fiber, prebiotics, probiotics, and mood.Results: Mood was improved by enhancing diet quality. Fructooligosaccharide and galactooligosaccharide improved anxiety and depression in participants consuming ≥ 5 g/day. Additionally, bifidobacteria were enriched in subjects consuming ≥ 5 g/day. Probiotic consumption improved psychological or biological measures of depression, anxiety, or stress in individuals predisposed to a mood disorder. Probiotics suppressed biological markers of stress in healthy individuals in a strain-dependent manner.Discussion: High-quality diets, prebiotics, and probiotics may beneficially affect mood. Habitual diets rich in dietary fiber and omega-3-polyunsaturated fatty acids may be linked to reduced risk of developing symptoms of depression, anxiety, and stress; however, additional studies are necessary. Certain probiotics may enhance mood, but their influence on the gastrointestinal microbiota requires further investigation.

Keywords: Diet quality; Fiber; Microbiome; Microbiota; Mood; Prebiotics; Probiotics.

Publication types

  • Review

MeSH terms

  • Affect / physiology
  • Anxiety / epidemiology*
  • Anxiety / microbiology
  • Anxiety / prevention & control
  • Depression / epidemiology*
  • Depression / microbiology
  • Depression / prevention & control
  • Diet*
  • Diet, Healthy
  • Diet, Mediterranean
  • Dietary Fiber / administration & dosage
  • Fatty Acids, Omega-3 / administration & dosage
  • Gastrointestinal Microbiome / physiology*
  • Humans
  • Prebiotics / administration & dosage
  • Probiotics / administration & dosage
  • Stress, Psychological / epidemiology*
  • Stress, Psychological / microbiology
  • Stress, Psychological / prevention & control


  • Dietary Fiber
  • Fatty Acids, Omega-3
  • Prebiotics