Mediterranean diet, interoception and mental health: Is it time to look beyond the 'Gut-brain axis'?

Physiol Behav. 2022 Dec 1:257:113964. doi: 10.1016/j.physbeh.2022.113964. Epub 2022 Sep 18.


Objective: A Mediterranean style diet (i.e., high in fruit, vegetables, fish, pulses, and wholegrains) is said to benefit psychological health. Many low-level interoceptive processes, such as those involved in the 'gut-brain' axis, are suggested to play a mechanistic role in in this relationship. However, interoceptive sensations in other domains, and at higher hierarchical levels of abstraction, have hitherto been overlooked. One domain often studied in relation to psychological health is cardioception. Therefore, we examined whether the Mediterranean diet was associated with first-order perceptual and second-order metacognitive cardioception.

Methods: Participants completed the Heartbeat Detection Task, the Heartbeat Counting Task, and the EPIC-Norfolk Food Frequency Questionnaire from which diet was quantified.

Results: Adherence to a Mediterranean style diet was associated with higher cardioceptive accuracy (i.e., perceptual performance) across both tasks. In addition, those consuming a Mediterranean diet had a better ability to detect errors in first order perceptual performance, and a lower prediction error (the magnitude of the difference between accuracy and confidence).

Discussion: These findings indicated that deepening our understanding of how interoceptive processes beyond the 'gut-brain' axis are shaped by diet could deepen our understanding of the link between diet and mental health and wellbeing.

Keywords: Cardioception; Heartbeat perception; Interoception; Mediterranean diet; Metacognition.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Awareness
  • Brain
  • Diet, Mediterranean*
  • Heart Rate
  • Interoception*
  • Mental Health