Combined Effects of Diet and Physical Activity Interventions on Depression and Anxiety. A Systematic Review and Meta-Analysis.

The aim of this systematic review and meta-analysis (registration: CRD420251179983) was to examine the combined effects of diet and physical activity interventions on depression and anxiety in adult populations of any health status. Eligibility criteria included adults >18 years old, healthy and patients of any disease and any comorbidity and potential medicine intake, who undertook combined interventions of any type and intensity of exercise/physical activity and any diet, of >2 weeks. We searched PubMed, Ovid and Sport Discus databases from their inception to October 2025. Using the GRADE analysis and the Cochrane handbook for interpretation, we found moderate quality of evidence that the combinations of "exercise + low fat diet," "exercise/physical activity + calorie restriction," "exercise/physical activity and balanced diets in specific amounts of carbohydrates, fats and proteins" and "exercise + high protein diet" likely reduce depression. Also, we found low quality of evidence that the combination of exercise/physical activity and diet interventions may reduce anxiety. To determine implications of these findings future randomized controlled trials should examine the effects of specific exercise interventions, along with low fat diets or calorie restriction or high protein diets with potential dose-response effects of these interventions.