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In line with our previous responses to Dr Molendijk’s correspondences (eg, ref.[1]), we reassert that, although there are limitations in the current literature that require further investigation (as highlighted in our review and in previous work in the field), both observational and randomized controlled trial (RCT) data, supported by extensive preclinical data, are supportive of a role for diet in the aetiology and adjunctive treatment of depression. Indeed, Dr Molendijk and colleagues’ own metaanalysis of prospective studies shows a 0.64–0.78 odds ratio reduced risk of depressive symptoms with improved diet quality. Although their subgroup analysis of 3 (of 17) effect sizes reported no significant effect when controlling for baseline depressive symptoms, this is in contrast to a more recent meta-analysis that used a rigorous harmonized analysis to address between-study heterogeneity [2].

Regarding the emerging RCT data …