The role of diet and physical activity in managing anxiety and depression: A scoping review.

Forty-five studies met the inclusion criteria for this scoping review on diet, supplementation, and physical activity interventions related to anxiety and depression.

• Searches were performed in PubMed, Web of Science, CrossRef, and Google Scholar.
• The review was conducted in accordance with PRISMA-ScR guidelines.
• Eligible studies examined dietary patterns, nutritional supplements, physical activity, or combined lifestyle interventions.
• Studies were charted and categorized by intervention type and outcome focus.

Most studies primarily assessed depressive symptoms, while anxiety was less frequently examined and rarely defined as a primary outcome.

• Dietary interventions predominantly focused on depression-related outcomes.
• Physical activity and supplementation studies more often included anxiety, stress, and broader psychological measures.
• Anxiety was rarely defined as a primary outcome across the included studies.
• This imbalance represents a key evidence gap identified by the review.

Substantial heterogeneity was observed across intervention formats, populations, follow-up durations, and outcome measures.

• Heterogeneity was noted across all study characteristics including intervention type and format.
• Variability in studied populations contributed to the dispersed nature of the evidence.
• Differences in follow-up durations and outcome measures were observed across studies.
• This heterogeneity limited the ability to draw unified conclusions across lifestyle intervention types.

Some studies reported secondary outcomes beyond anxiety and depression, including sleep, cognitive performance, biological markers, and neuroimaging findings.

• Secondary outcomes included sleep quality, cognitive performance, biological markers, and neuroimaging findings.
• These additional outcomes were not the primary focus of most included studies.
• The presence of diverse secondary outcomes further reflects the heterogeneity of the literature.

Key evidence gaps identified include anxiety-specific interventions, standardized outcomes, long-term follow-up, and integrated multimodal approaches.

• Anxiety-specific lifestyle interventions were underrepresented in the existing literature.
• Lack of standardized outcome measures was identified as a major gap.
• Long-term follow-up studies were notably absent or insufficient.
• Integrated multimodal approaches combining diet, supplementation, and physical activity were identified as an area needing further research.
• These gaps were identified to inform future primary research and the development of targeted systematic reviews.