The role of diet in depression is becoming increasingly acknowledged. This umbrella review aimed to summarize comprehensively the current evidence reporting the effects of dietary factors on the prevention and treatment of depression. PubMed, Embase, and the Cochrane Library were searched up to June 2021 to identify relevant meta-analyses of prospective studies. Twenty-eight meta-analyses, with 40 summary estimates on dietary patterns (n = 8), food and beverages (n = 19), and nutrients (n = 13) were eligible. The methodological quality of most meta-analyses was low (50.0%) or very low (25.0%). Quality of evidence was moderate for inverse associations for depression incidence with healthy diet [risk ratio (RR): 0.74, 95% confidential interval (CI), 0.48–0.99, I² = 89.8%], fish (RR: 0.88, 95% CI, 0.79–0.97, I²= 0.0%), coffee (RR: 0.89, 95% CI, 0.84–0.94, I²= 32.9%), dietary zinc (RR: 0.66, 95% CI 0.50–0.82, I²= 13.9%), light to moderate alcohol (<40 g/day, RR: 0.77, 95% CI, 0.74–0.83, I²= 20.5%), as well as for positive association with sugar-sweetened beverages (RR: 1.05, 95% CI, 1.01–1.09, I²= 0.0%). For depression treatment, moderate-quality evidence was identified for the effects of probiotic [standardized mean difference (SMD): −0.31, 95% CI, −0.56 to −0.07, I²= 48.2%], omega-3 polyunsaturated fatty acid (SMD: −0.28, 95% CI, −0.47 to −0.09, I² = 75.0%) and acetyl-l-carnitine (SMD: −1.10, 95% CI, −1.65 to −0.56, I² = 86.0%) supplementations. Overall, the associations between dietary factors and depression had been extensively evaluated, but none of them were rated as high quality of evidence, suggesting further studies are likely to change the summary estimates. Thus, more well-designed research investigating more detailed dietary factors in association with depression is warranted.

饮食在抑郁症中的作用越来越得到认可。本综述旨在全面总结目前报告饮食因素对抑郁症预防和治疗影响的证据。检索了截至 2021 年 6 月的 PubMed、Embase 和 Cochrane 图书馆，以确定前瞻性研究的相关荟萃分析。28 项荟萃分析，40 项对饮食模式 ( n  = 8)、食物和饮料 ( n  = 19) 和营养素 ( n  = 13) 的总结估计符合条件。大多数荟萃分析的方法学质量低（50.0%）或非常低（25.0%）。抑郁症发病率与健康饮食呈负相关的证据质量中等 [风险比 (RR): 0.74, 95% 置信区间 (CI), 0.48–0.99,I ²  = 89.8%]、鱼 (RR: 0.88, 95% CI, 0.79–0.97, I ² = 0.0%), 咖啡 (RR: 0.89, 95% CI, 0.84–0.94, I ² = 32.9%), 饮食锌 (RR: 0.66, 95% CI 0.50–0.82, I ² = 13.9%), 轻度至中度酒精 (<40 g/day, RR: 0.77, 95% CI, 0.74–0.83, I ² = 20.5%),以及与含糖饮料的正相关（RR：1.05，95% CI，1.01–1.09，I ² = 0.0%）。对于抑郁症治疗，确定了益生菌作用的中等质量证据 [标准化平均差 (SMD)：-0.31, 95% CI, -0.56 至 -0.07, I ²= 48.2%]、omega-3 多不饱和脂肪酸（SMD：-0.28，95% CI，-0.47 至 -0.09，I ²  = 75.0%）和乙酰左旋肉碱（SMD：-1.10，95% CI，- 1.65 至 -0.56，I ²  = 86.0%) 补充剂。总体而言，饮食因素与抑郁症之间的关联已被广泛评估，但没有一个被评为高质量证据，这表明进一步的研究可能会改变总结估计。因此，有必要进行更精心设计的研究，调查与抑郁症相关的更详细的饮食因素。