Maternal Fiber Intake and Perinatal Depression & Anxiety

Background: Dietary fiber can significantly alter gut microbiota composition. The role of gut microbiome in the Gut-Brain Axis and modulation of neuropsychiatric disease is increasingly recognized. The role of antenatal diet, particularly fiber intake, in mitigating maternal mental health disorders remains unexplored. The objective of this review is to investigate the association between maternal fiber intake and perinatal depression and anxiety (PDA). Methods: A literature review of PubMed and Google Scholar was conducted using appropriate keyword/MeSH terms for pregnancy, diet, fiber, and mental health. Observational and clinical trials published between 2015-2021 were included and data pertaining to dietary patterns (DP), food intake, mental health, and demographic data were extracted. The top three fiber-containing food groups (FG) per study were identified using a sum rank scoring system of fiber per 100 grams and fiber per serving size. The consumption of these top three fiber FGs was then ranked for each dietary pattern/group. Mental health outcomes for each study were simplified into three categories of improved, no change, and worsened. The relationship between top three fiber FGs consumed within each DP and mental health outcomes was analyzed using Spearman's correlation. Results: Thirteen of 52 studies met inclusion criteria. Ten (76.9%) studies assessed DPs (7 examined depression only, 2 examined depression and anxiety, and 1 examined anxiety only). Seven (53.9%) studies reported at least one significant positive relationship between mental health outcomes and DPs while 3 reported at least one negative outcome. Three (23.1%) studies compared intake of different food groups between depressed and non-depressed groups. In studies of DPs, the average consumption ranking of the top 3 fiber FGs, bore a significant inverse association with mental health outcomes [r=-0.419(95%CI: -0.672-0.078)] p=0.015. In studies comparing intake of different FGs between depressed and non-depressed groups, consumption of top-ranking fiber foods was higher in the non-depressed groups, but significantly higher in 4 of the 10 high fiber FGs. Conclusion: This study reframes findings from previously published studies of maternal diet and mental health outcomes to focus on fiber intake specifically, using a fiber ranking system. A significant correlation between lower intake of fiber and poorer mental health outcomes warrants further investigation in future studies.