Depression is a prevalent psychiatric disorder that affect more than 350 million people globally. It is mostly associated with unhealthy eating habits and lifestyle patterns. This paper addresses how the Mediterranean diet can help reduce depression, including other health issues. Appropriate qualitative research designs, including interviews, are presented with their benefits, limitations, and challenges on the overall process. Relevant literature is presented on the challenges of the methods and any existence of validity threats. Ethical issues that may arise during the study are also highlighted. The main topic of discussion is the usefulness of the Mediterranean diet in reducing depression and the qualitative methods that are most efficient in obtaining the information.
Key Words : Depression, Mediterranean diet, Qualitative research, Food
Background
The problems associated with mental health, particularly depression, are becoming a great challenge to public health. According to Opie et al. (2018), unipolar depressive disorders are among the top on the list of illness contributing to the burden of disease control in the world with the high income and middle countries being affected most. Depression is related to less productivity at work, reduced social interactions, and early retirement (Lassale et al., 2018). The results of these factors are economic loss and a decrease in lifespan for the affected individuals. It is, therefore important to consider effective prevention strategies like the use of Mediterranean Seafood to reduce, fight, and prevent depression.
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There is growing evidence that eating habits and lifestyle patterns could be one of the major causes of depression. The psychological processes may be influenced by diet in different ways to cause the development of depression, for example, hormonal factors, oxidative stress, and inflammation (Rahe, Unrath & Berger, 2014). However, depression can be prevented if the emphasis is put on the dietary patterns, unlike other infectious diseases which cannot be prevented. People tend to consume diets which contain combinations of several nutrients which possibly interact with each other. The nutrients may have possible synergetic effects that may cause an impact in the development of health problems which are associated with depression.
Several epidemiological studies over the past years have examined the role played by nutrients, food groups, and food in the prevention of unipolar depression. Higher quality diets are likely to have lower risks in the development of depression, unlike low-quality foods (Gibson-Smith et al., 2018). Mediterranean Dietary Pattern is one of the universally dietary patterns that is known to prevent and reduce depression. Different studies have analyzed the role of dietary patterns in preventing depression. This paper examines how the Mediterranean diet is beneficial in decreasing the levels of depression and improving the symptoms of this condition.
Problem of Interest
The problem of interest in this particular research is how the Mediterranean diet is useful in lowering the levels of depression. Studies indicate that the diet is not only the best choice for longevity but it also good for physical health, most importantly, the brain. Mediterranean diet is also known to reduce the risks of depression considerably through its richness in antioxidant and anti-inflammatory components, which usually protects the brain from inflammation and stress (Pagliai, 2018). A significant connection exists between depression and diets with high inflammatory. The Mediterranean diet, however, reduces the risks since it fosters an assortment of beneficial bacteria that mostly affects people’s moods and brains.
The dietary pattern of Mediterranean food is characterized by plenty of vegetables, legumes, fruits, cereals, nuts poultry, a moderate amount of low fish amounts of wine and red meat and dairy products. Apart from being beneficial in controlling the effects of chronic degenerative diseases such as neoplastic, cardiovascular and nonnegative diseases, the Mediterranean diet also reduces the chances of any incoming symptoms of depression among older adults (Sánchez-Villegas et al., 2019) . Individuals following the Mediterranean dietary pattern have a 33% chance of developing depression, unlike those whose diets least resemble the Mediterranean diet (Quirk et al., 2013). This is because the diet regulates psychological and molecular mechanisms, including insulin resistance, gut microbes, inflammation, oxidative stress, and the flow of blood in the brain.
Research Methods
Selection of an appropriate research method is instrumental to the collection of the data which the researcher uses to answer the research question. It is of utmost importance to choose a research method that will encompass all the data variables and offer meaningful results and conclusions. To aid this research’s data collection, the researcher can use the following methods; interviews, observation, and secondary analysis of documents and other literature. Upon the identification of the target group in the research, the researcher will use a random sampling method to recruit a group of participants. The use of random sampling technique will help avoid instances of data skewness
Interviews
The use of interviews as a research method will be instrumental to the researcher’s investigation of dietary patterns among the participants. The author can interview those who use Mediterranean diet, those who do not follow the diet and the recovered victims of depression on how the diet has been advantageous to them. Where interviews will not be applicable, the researcher will conduct observation on willing participants in the chosen sample group. Finally, the researcher can strive to conduct case studies on the recovered victims of depression after following the Mediterranean diet to understand more on the role the diet played in there in helping those affected by depression. Case studies will also be a rich source of information on how the Mediterranean diet reduces depression. Data collected through interviews with the respondents will enable attainment of highly personalized data and create opportunity probing to get the underlying factors. The face-to-face interviews will help in getting accurate information since the respondents cannot give false information during the screening of questions. The interviews can be recorded and transcribed for further analysis.
Secondary analysis
Firstly, the researcher intends to use secondary analysis to collect views and discoveries of other researchers regarding the same topic of study or related topics. Knowledge of previous research will empower the author to develop a unique approach to the study. To this end, the researcher will try to reduce as much redundancy in literature as possible by identifying the existing research gaps and furthering the knowledge base on the subject. In addition, knowledge of previous research will furnish the researcher with enough statistics to support the findings of the research.
Literature Analysis
Selected Software Program
The most suitable software analysis program to be use in this research is the QDA miner qualitative software program. QDA miner will be most essential especially when coding textual data obtained from participants. It is also vital in data analysis especially during the processes of managing, coding and analyzing information gathered concerning how Mediterranean diet helps in reducing depression. The program will be advantageous in coding large number of documents and analysis of the effects of depression including other outcomes from the research without any challenges. It is necessary for this research to Excel spreadsheets and PowerPoint presentations based on the data obtained which can be developed through the use of QDA. This software program will lead to collection of volume and breadth data because it will increase pressure on researchers to focus on what is important.
Limitations, Benefits, and Challenges of the Chosen Qualitative methods
According to Lassale et al. (2018), Interviews are worthwhile since they will offer an opportunity to uncover inaccessible information through the use of techniques like observation and questionnaires. Additionally, interviews are merely tools of data collection but rather natural ways of interactions between the interviewers and the respondents, and they can also take place in various situations. Quirk et al. (2013) argue that interviews create a mutual understanding since questions can be rephrased by the interview to make the participants comprehend what is presented to them. This ensures that appropriate answers are obtained and eventually, accurate data. The researcher can also record the interviewed information, and also it can be reviewed several times during analysis to produce accurate and reliable reports. Above all the other benefits, interviewing is the most economical method of qualitative data collection.
Orb, Eisenhauer & Wynaden (2001), allude that secondary data analysis is one of the best data collection methods that save time. This process has been simplified through the internet, and all relevant information concerning depression and the Mediterranean diet can be easily obtained through the search engines. It is also easily accessible, and information can be obtained using phones, laptops, and computers at any time. This will make it easier for this research since a lot of prior literature on how the Mediterranean diet help reduces depression in the past. Additionally, secondary analysis generates insights from the continuous surveys from the government and other official registers. It is, therefore, the most reliable source for data for this research,
Despite the advantages of interviewing as a qualitative research design for this research, they can be fraught by drawbacks like any other research tool. Pigliai et al. (2018) remark that despite interviewing being the most enjoyable and revealing method in research, it can be deceptively difficult since most interviewees are always prepared to give what they only want to reveal about their opinions and perceptions. The perceptions can be subjective and eventually change over time. Relying on interviews alone cannot be enough to study the social life of people as both the interviewer and the respondent may have an incomplete memory of the vents.
Secondary data analysis also has some limitations that may bring about challenges during data collection. According to research conducted by Gibson-Smith et al. (2018), secondary data analysis usually present information that addresses only certain objectives; hence, it can cause inappropriateness of information. It may provide vast information, but its quantitate is not always appropriate. Secondary data analysis also does not have control over quality data. For example, the government and other institutions always guarantee quality information, which is not often the case. As such, this method is also disadvantageous in this research, but the limitations can be controlled.
Validity Threats of Interviews and Secondary Data Analysis
Several validity threats may arise during interviews. Lassale et al. (2018) assert that interviews can generate misunderstanding due to age, gender, or cultural differences. Some concepts and terms may significantly differ according to generations and culture hence causing invalid and inaccurate data. Similarly, the readiness to discuss sensitive issues and disclose inner feelings may cause biases and invalidity. Research also indicates that secondary data analysis can present exaggerated information, and it still produces some skepticism in behavioral treatment. Further, there is a higher likelihood of bias from the secondary sources due to different information from different publications. It is also inconsistent because of development and changing trends.
Ethical issues
Ethical considerations are important during interviews for protection of respondents from any possible harm. Specific ethical considerations can take into account before, during, and after the interviews. Participants will be given the best terms for a constructive relationship after the end of the interviews. The conversations are always completely confidential, and the participants are assured that their names would not be linked with their responses in the final report (Orb, Eisenhauer & Wynaden, 2001). They will also be required to sign an ethical clearance form which outlined that the interviewers would treat their data and particulars confidential and that the information would not be used to recognize them in conference discussions or publications personally. The simple language will be used to enable effective communication with the respondents as well as their well-being.
Conclusion
Dietary habits affect the physical and mental health of an individual. The Mediterranean diet is associated with decreasing the susceptibility and levels of depression among individuals because its nutrients are rich in anti-oxidation, anti-inflammatory, and blood regulation elements that help keep the brain from stress or any other problem. Concerning the qualitative research design used, some methodological limitations can be controlled. Research also shows that data collection methods may generate some validity threats that are likely to cause challenges during the research. Therefore, effective measures should be taken when conducting interviews and obtaining secondary data. Further research from prospective studies should be conducted to clarify how the Mediterranean diet helps in reducing depression.
References
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Lassale, C., Batty, G. D., Baghdadli, A., Jacka, F., Sánchez-Villegas, A., Kivimäki, M., & Akbaraly, T. (2018). Healthy dietary indices and risk of depressive outcomes: a systematic review and meta-analysis of observational studies. Molecular Psychiatry , 1.
Opie, R. S., O'Neil, A., Jacka, F. N., Pizzinga, J., & Itsiopoulos, C. (2018). A modified Mediterranean dietary intervention for adults with major depression: Dietary protocol and feasibility data from the SMILES trial. Nutritional Neuroscience , 21 (7), 487-501.
Orb, A., Eisenhauer, L., & Wynaden, D. (2001). Ethics in qualitative research. Journal of nursing scholarship , 33 (1), 93-96.
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Quirk, S. E., Williams, L. J., O’Neil, A., Pasco, J. A., Jacka, F. N., Housden, S., ... & Brennan, S. L. (2013). The association between diet quality, dietary patterns, and depression in adults: a systematic review. BMC Psychiatry , 13 (1), 175.
Rahe, C., Unrath, M., & Berger, K. (2014). Dietary patterns and the risk of depression in adults: a systematic review of observational studies. European journal of nutrition , 53 (4), 997-1013.
Sánchez-Villegas, A., Cabrera-Suárez, B., Molero, P., González-Pinto, A., Chiclana-Actis, C., Cabrera, C., ... & Pla, J. (2019). Preventing the recurrence of depression with a Mediterranean diet supplemented with extra-virgin olive oil. The PREDI-DEP trial: study protocol. BMC Psychiatry , 19 (1), 63.
