{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T05:46:02Z","timestamp":1790747162561,"version":"4.1.0"},"reference-count":101,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,10,20]],"date-time":"2021-10-20T00:00:00Z","timestamp":1634688000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antioxidants"],"abstract":"<jats:p>Recent evidence suggests that diet modifies key biological factors associated with the development of depression. It has been suggested that this could be due to the high flavonoid content commonly found in many plant foods, beverages and dietary supplements. Our aim was to conduct a systematic review to evaluate the effects of dietary flavonoids on the symptoms of depression. A total of 46 studies met the eligibility criteria. Of these, 36 were intervention trials and 10 were observational studies. A meta-analysis of 36 clinical trials involving a total of 2788 participants was performed. The results showed a statistically significant effect of flavonoids on depressive symptoms (mean difference = \u22121.65; 95% C.I., \u22122.54, \u22120.77; p &lt; 0.01). Five of the 10 observational studies included in the systematic review reported significant results, suggesting that a higher flavonoid intake may improve symptoms of depression. Further studies are urgently required to elucidate whether causal and mechanistic links exist, along with substantiation of functional brain changes associated with flavonoid consumption.<\/jats:p>","DOI":"10.3390\/antiox10111644","type":"journal-article","created":{"date-parts":[[2021,10,20]],"date-time":"2021-10-20T07:05:57Z","timestamp":1634713557000},"page":"1644","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["Exploring the Impact of Flavonoids on Symptoms of Depression: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"10","author":[{"given":"Sawan","family":"Ali","sequence":"first","affiliation":[{"name":"Department of Medicine and Health Sciences \u201cV. Tiberio\u201d, University of Molise, 86100 Campobasso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3441-889X","authenticated-orcid":false,"given":"Graziamaria","family":"Corbi","sequence":"additional","affiliation":[{"name":"Department of Medicine and Health Sciences \u201cV. Tiberio\u201d, University of Molise, 86100 Campobasso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Maes","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1592-5586","authenticated-orcid":false,"given":"Giovanni","family":"Scapagnini","sequence":"additional","affiliation":[{"name":"Department of Medicine and Health Sciences \u201cV. Tiberio\u201d, University of Molise, 86100 Campobasso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2578-7199","authenticated-orcid":false,"given":"Sergio","family":"Davinelli","sequence":"additional","affiliation":[{"name":"Department of Medicine and Health Sciences \u201cV. Tiberio\u201d, University of Molise, 86100 Campobasso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,20]]},"reference":[{"key":"ref_1","first-page":"1517","article-title":"Depression Is the Leading Cause of Disability Around the World","volume":"317","author":"Friedrich","year":"2017","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1002\/jclp.10174","article-title":"Dysthymia and chronic depression: Introduction, classification, risk factors, and course","volume":"59","author":"Klein","year":"2003","journal-title":"J. Clin. Psychol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2214","DOI":"10.1001\/jama.2016.17324","article-title":"Prevalence of Depression, Depressive Symptoms, and Suicidal Ideation Among Medical Students: A Systematic Review and Meta-Analysis","volume":"316","author":"Rotenstein","year":"2016","journal-title":"JAMA"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1146\/annurev-publhealth-040218-044106","article-title":"Environmental Exposures and Depression: Biological Mechanisms and Epidemiological Evidence","volume":"40","year":"2019","journal-title":"Annu. Rev. Public Health"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1270","DOI":"10.1016\/j.drudis.2020.05.001","article-title":"Role of oxidative stress in depression","volume":"25","author":"Bhatt","year":"2020","journal-title":"Drug Discov. Today"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Liu, T., Zhong, S., Liao, X., Chen, J., He, T., Lai, S., and Jia, Y. (2015). A Meta-Analysis of Oxidative Stress Markers in Depression. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0138904"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1357","DOI":"10.1016\/S0140-6736(17)32802-7","article-title":"Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: A systematic review and network meta-analysis","volume":"391","author":"Cipriani","year":"2018","journal-title":"Lancet"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1017\/S0029665117002026","article-title":"Nutritional psychiatry: The present state of the evidence","volume":"76","author":"Marx","year":"2017","journal-title":"Proc. Nutr. Soc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1038\/s41380-020-00925-x","article-title":"Diet and depression: Exploring the biological mechanisms of action","volume":"26","author":"Marx","year":"2021","journal-title":"Mol. Psychiatry"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Jacka, F.N., O\u2019Neil, A., Opie, R., Itsiopoulos, C., Cotton, S., Mohebbi, M., Castle, D., Dash, S., Mihalopoulos, C., and Chatterton, M.L. (2017). A randomised controlled trial of dietary improvement for adults with major depression (the \u201cSMILES\u201d trial). BMC Med., 15.","DOI":"10.1186\/s12916-017-0791-y"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Molendijk, M.L., Fried, E.I., and Van Der Does, W. (2018). The SMILES trial: Do undisclosed recruitment practices explain the remarkably large effect?. BMC Med., 16.","DOI":"10.1186\/s12916-018-1221-5"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1080\/1028415X.2017.1411320","article-title":"A Mediterranean-style dietary intervention supplemented with fish oil improves diet quality and mental health in people with depression: A randomized controlled trial (HELFIMED)","volume":"22","author":"Parletta","year":"2019","journal-title":"Nutr. Neurosci."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"S\u00e1nchez-Villegas, A., Mart\u00ednez-Gonz\u00e1lez, M.A., Estruch, R., Salas-Salvad\u00f3, J., Corella, D., Covas, M.I., Ar\u00f3s, F., Romaguera, D., G\u00f3mez-Gracia, E., and Lapetra, J. (2013). Mediterranean dietary pattern and depression: The PREDIMED randomized trial. BMC Med., 11.","DOI":"10.1186\/1741-7015-11-208"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1097\/PSY.0000000000000673","article-title":"The Effects of Dietary Improvement on Symptoms of Depression and Anxiety: A Meta-Analysis of Randomized Controlled Trials","volume":"81","author":"Firth","year":"2019","journal-title":"Psychosom. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/j.psychres.2017.04.020","article-title":"Dietary patterns and depression risk: A meta-analysis","volume":"253","author":"Li","year":"2017","journal-title":"Psychiatry Res."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Davinelli, S., Ali, S., Solfrizzi, V., Scapagnini, G., and Corbi, G. (2021). Carotenoids and cognitive outcomes: A meta-analysis of randomized intervention trials. Antioxidants, 10.","DOI":"10.3390\/antiox10020223"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e47","DOI":"10.1017\/jns.2016.41","article-title":"Flavonoids: An overview","volume":"5","author":"Panche","year":"2016","journal-title":"J. Nutr. Sci."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"6076","DOI":"10.1007\/s12035-017-0798-6","article-title":"Natural Dietary Supplementation of Anthocyanins via PI3K\/Akt\/Nrf2\/HO-1 Pathways Mitigate Oxidative Stress, Neurodegeneration, and Memory Impairment in a Mouse Model of Alzheimer\u2019s Disease","volume":"55","author":"Ali","year":"2018","journal-title":"Mol. Neurobiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2908","DOI":"10.1080\/10408398.2017.1345853","article-title":"Intracellular signaling pathways of inflammation modulated by dietary flavonoids: The most recent evidence","volume":"58","author":"Chen","year":"2018","journal-title":"Crit. Rev. Food Sci. Nutr."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.pnpbp.2013.10.002","article-title":"BDNF signaling is necessary for the antidepressant-like effect of naringenin","volume":"48","author":"Yi","year":"2014","journal-title":"Prog. Neuropsychopharmacol. Biol. Psychiatry"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1016\/j.pnpbp.2010.06.024","article-title":"Involvement of monoaminergic system in the antidepressant-like effect of the flavonoid naringenin in mice","volume":"34","author":"Yi","year":"2010","journal-title":"Prog. Neuropsychopharmacol. Biol. Psychiatry"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1016\/j.fct.2018.04.052","article-title":"Current standing of plant derived flavonoids as an antidepressant","volume":"119","author":"Khan","year":"2018","journal-title":"Food Chem. Toxicol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/2046-4053-4-1","article-title":"Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement","volume":"4","author":"Moher","year":"2015","journal-title":"Syst. Rev."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"d5928","DOI":"10.1136\/bmj.d5928","article-title":"The Cochrane Collaboration\u2019s tool for assessing risk of bias in randomised trials","volume":"343","author":"Higgins","year":"2011","journal-title":"BMJ"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1007\/s10654-010-9491-z","article-title":"Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses","volume":"25","author":"Stang","year":"2010","journal-title":"Eur. J. Epidemiol."},{"key":"ref_26","first-page":"126","article-title":"Cochrane Handbook for Systematic Reviews of Interventions","volume":"2","author":"Higgins","year":"2011","journal-title":"Res. Syn. Meth."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.2307\/2533446","article-title":"Operating Characteristics of a Rank Correlation Test for Publication Bias","volume":"50","author":"Begg","year":"1994","journal-title":"Biometrics"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1136\/bmj.315.7109.629","article-title":"Bias in meta-analysis detected by a simple, graphical test","volume":"315","author":"Egger","year":"1997","journal-title":"Br. Med. J."},{"key":"ref_29","first-page":"108","article-title":"Serum serotonin response to aerobic exercise verus phoenix","volume":"9","author":"Abdelhamid","year":"2016","journal-title":"Int. J. PharmTech Res."},{"key":"ref_30","first-page":"44","article-title":"Chamomile (Matricaria recutita) may provide antidepressant activity in anxious, depressed humans: An exploratory study","volume":"18","author":"Amsterdam","year":"2012","journal-title":"Altern. Ther. Health Med."},{"key":"ref_31","first-page":"323","article-title":"Effects of antidepressants and soybean association in depressive menopausal women","volume":"71","author":"Estrella","year":"2014","journal-title":"Acta Pol. Pharm."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.3233\/JAD-142958","article-title":"Cognitive Effects of Soy Isoflavones in Patients with Alzheimer\u2019s Disease","volume":"47","author":"Gleason","year":"2015","journal-title":"J. Alzheimer\u2019s Dis. JAD"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1007\/s00404-015-3849-0","article-title":"Low-dose isoflavone aglycone alleviates psychological symptoms of menopause in Japanese women: A randomized, double-blind, placebo-controlled study","volume":"293","author":"Hirose","year":"2016","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_34","first-page":"897S","article-title":"An Increase in Plasma Homovanillic Acid with Cocoa Extract Consumption Is Associated with the Alleviation of Depressive Symptoms in Overweight or Obese Adults on an Energy Restricted Diet in a Randomized Controlled Trial","volume":"146","author":"Ramirez","year":"2015","journal-title":"J. Nutr."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1097\/gme.0b013e31818379fa","article-title":"New equol supplement for relieving menopausal symptoms: Randomized, placebo-controlled trial of Japanese women","volume":"16","author":"Ishiwata","year":"2009","journal-title":"Menopause"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.ijgo.2005.03.011","article-title":"Comparison of 70 mg and 35 mg isoflavone soya supplement for menopause symptoms","volume":"90","author":"Jou","year":"2005","journal-title":"Int. J. Gynecol. Obstet."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1097\/00042192-200512010-00011","article-title":"A randomized, placebo-controlled trial on the effects of soy protein containing isoflavones on quality of life in postmenopausal women","volume":"12","author":"Kok","year":"2005","journal-title":"Menopause"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"3996","DOI":"10.1021\/jf9029332","article-title":"Blueberry supplementation improves memory in older adults","volume":"58","author":"Krikorian","year":"2010","journal-title":"J. Agric. Food Chem."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Lau, H., Shahar, S., Mohamad, M., Rajab, N.F., Yahya, H.M., Din, N.C., and Hamid, H.A. (2020). The effects of six months Persicaria minor extract supplement among older adults with mild cognitive impairment: A double-blinded, randomized, and placebo-controlled trial. BMC Complement. Med. Ther., 20.","DOI":"10.1186\/s12906-020-03092-2"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1111\/j.1600-0447.1999.tb10915.x","article-title":"Can winter depression be prevented by Ginkgo biloba extract? A placebo-controlled trial","volume":"100","author":"Lingaerde","year":"1999","journal-title":"Acta Psychiatr. Scand."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1089\/acm.2019.0252","article-title":"Putative Antidepressant Effect of Chamomile (Matricaria chamomilla L.) Oral Extract in Subjects with Comorbid Generalized Anxiety Disorder and Depression","volume":"26","author":"Amsterdam","year":"2020","journal-title":"J. Altern. Complement. Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/j.maturitas.2009.10.014","article-title":"Improvement of postmenopausal depressive and anxiety symptoms after treatment with isoflavones derived from red clover extracts","volume":"65","author":"Lipovac","year":"2010","journal-title":"Maturitas"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1177\/2045125312464103","article-title":"Effect of epigallocatechin gallate supplementation in schizophrenia and bipolar disorder: An 8-week, randomized, double-blind, placebo-controlled study","volume":"3","author":"Loftis","year":"2013","journal-title":"Ther. Adv. Psychopharmacol."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Malaguarnera, G., Bertino, G., Chisari, G., Motta, M., Vecchio, M., Vacante, M., Caraci, F., Greco, C., Drago, F., and Nunnari, G. (2016). Silybin supplementation during HCV therapy with pegylated interferon-\u03b1 plus ribavirin reduces depression and anxiety and increases work ability. BMC Psychiatry, 16.","DOI":"10.1186\/s12888-016-1115-z"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1143","DOI":"10.1089\/jmf.2008.0244","article-title":"The safety of flavocoxid, a medical food, in the dietary management of knee osteoarthritis","volume":"12","author":"Morgan","year":"2009","journal-title":"J. Med. Food"},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Park, M., Choi, J., and Lee, H.J. (2020). Flavonoid-rich orange juice intake and altered gut microbiome in young adults with depressive symptom: A randomized controlled study. Nutrients, 12.","DOI":"10.3390\/nu12061815"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Platero, J.L., Cuerda-Ballester, M., Sancho-Cantus, D., Benlloch, M., Ceron, J.J., Rubio, C.P., Garc\u00eda-Pardo, M.P., L\u00f3pez-Rodr\u00edguez, M.M., and de la Rubia Ort\u00ed, J.E. (2021). The impact of epigallocatechin gallate and coconut oil treatment on cortisol activity and depression in multiple sclerosis patients. Life, 11.","DOI":"10.3390\/life11040353"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1111\/jog.12659","article-title":"Effects of a phyto complex on well-being of climacteric women","volume":"41","author":"Quattrocchi","year":"2015","journal-title":"J. Obstet. Gynaecol. Res."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1017\/S0007114508024008","article-title":"Administration of a dietary supplement (N-oleyl-phosphatidylethanolamine and epigallocatechin-3-gallate formula) enhances compliance with diet in healthy overweight subjects: A randomized controlled trial","volume":"101","author":"Rondanelli","year":"2009","journal-title":"Br. J. Nutr."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1590\/S0100-879X2010007500104","article-title":"Effects of isoflavone on the learning and memory of women in menopause: A double-blind placebo-controlled study","volume":"43","author":"Facco","year":"2010","journal-title":"Braz. J. Med. Biol. Res."},{"key":"ref_51","first-page":"132","article-title":"Comparative study of gabapentin and isoflavone in menopausal vasomotor symptoms","volume":"7","author":"Singhal","year":"2016","journal-title":"J. MidLife Health"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1007\/s00198-013-2512-5","article-title":"Genistein effects on quality of life and depression symptoms in osteopenic postmenopausal women: A 2-year randomized, double-blind, controlled study","volume":"25","author":"Atteritano","year":"2014","journal-title":"Osteoporos. Int. J. Establ. Result Coop. Eur. Found. Osteoporos. Natl. Osteoporos. Found. USA"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"990","DOI":"10.1097\/GME.0000000000000200","article-title":"Effects of grape seed proanthocyanidin extract on menopausal symptoms, body composition, and cardiovascular parameters in middle-aged women: A randomized, double-blind, placebo-controlled pilot study","volume":"21","author":"Terauchi","year":"2014","journal-title":"Menopause"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1183","DOI":"10.1111\/j.1532-5415.2000.tb02589.x","article-title":"The efficacy of ginkgo for elderly people with dementia and age-associated memory impairment: New results of a randomized clinical trial","volume":"48","author":"Kessels","year":"2000","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"350697","DOI":"10.1093\/ecam\/nen069","article-title":"Dietary soy supplement on fibromyalgia symptoms: A randomized, double-blind, placebo-controlled, early phase trial","volume":"2011","author":"Thompson","year":"2011","journal-title":"Evid. Based Complement. Altern. Med."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"162","DOI":"10.3109\/00952990.2015.1114118","article-title":"An open-label pilot study of icariin for co-morbid bipolar and alcohol use disorder","volume":"42","author":"Xiao","year":"2016","journal-title":"Am. J. Drug Alcohol Abuse"},{"key":"ref_57","first-page":"15","article-title":"Antidepressant Effect of Asperugo procumbens L. in Comparison with Fluoxetine: A Randomized Double Blind Clinical Trial","volume":"5","author":"Zarghami","year":"2018","journal-title":"Res. J. Pharmacogn."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1186\/1475-2891-12-84","article-title":"Effect of green tea on reward learning in healthy individuals: A randomized, double-blind, placebo-controlled pilot study","volume":"12","author":"Zhang","year":"2013","journal-title":"Nutr. J."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1002\/ptr.5044","article-title":"American Skullcap (Scutellaria lateriflora): A randomised, double-blind placebo-controlled crossover study of its effects on mood in healthy volunteers","volume":"28","author":"Brock","year":"2014","journal-title":"Phyther. Res. PTR"},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Brown, E.S., Bice, C., Putnam, W.C., Leff, R., Kulikova, A., Nakamura, A., Ivleva, E.I., Van Enkevort, E., Holmes, T., and Miingi, N. (2019). Human safety and pharmacokinetics study of orally administered icariin: Randomized, double-blind, placebo-controlled trial. Nat. Prod. Commun., 14.","DOI":"10.1177\/1934578X19856789"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"972","DOI":"10.1016\/j.fertnstert.2005.09.048","article-title":"Psychological assessment of the effects of treatment with phytoestrogens on postmenopausal women: A randomized, double-blind, crossover, placebo-controlled study","volume":"85","author":"Casini","year":"2006","journal-title":"Fertil. Steril."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"307","DOI":"10.3109\/09513590.2010.490614","article-title":"The effect of soy-derived isoflavones over hot flushes, menopausal symptoms and mood in climacteric women with increased body mass index","volume":"27","author":"Chedraui","year":"2011","journal-title":"Gynecol. Endocrinol. Off. J. Int. Soc. Gynecol. Endocrinol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1136\/jnnp-2018-319496","article-title":"A randomised double-blind placebo-controlled feasibility trial of flavonoid-rich cocoa for fatigue in people with relapsing and remitting multiple sclerosis","volume":"90","author":"Coe","year":"2019","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.maturitas.2009.02.008","article-title":"Efficacy of soy isoflavones for depressive symptoms of the climacteric syndrome","volume":"63","author":"Filizola","year":"2009","journal-title":"Maturitas"},{"key":"ref_65","first-page":"29","article-title":"Association between isoflavones consumption and cognitive function and comorbidities among older adults residing in the State of Johor, Malaysia","volume":"22","author":"Hakim","year":"2016","journal-title":"Malays. J. Nutr."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"704","DOI":"10.3945\/ajcn.115.124545","article-title":"Dietary flavonoid intake and risk of incident depression in midlife and older women","volume":"104","author":"Chang","year":"2016","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Godos, J., Castellano, S., Ray, S., Grosso, G., and Galvano, F. (2018). Dietary polyphenol intake and depression: Results from the mediterranean healthy eating, lifestyle and aging (MEAL) study. Molecules, 23.","DOI":"10.3390\/molecules23050999"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1007\/s00394-016-1327-5","article-title":"Soy isoflavone intake and prevalence of depressive symptoms during pregnancy in Japan: Baseline data from the Kyushu Okinawa Maternal and Child Health Study","volume":"57","author":"Miyake","year":"2018","journal-title":"Eur. J. Nutr."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1016\/j.jad.2017.08.073","article-title":"Dietary patterns and depressive symptoms during pregnancy in Japan: Baseline data from the Kyushu Okinawa Maternal and Child Health Study","volume":"225","author":"Miyake","year":"2018","journal-title":"J. Affect. Disord."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"6","DOI":"10.3109\/13697139909025557","article-title":"Hot flushes and other menopausal symptoms in relation to soy product intake in Japanese women","volume":"2","author":"Nagata","year":"1999","journal-title":"Climacteric J. Int. Menopause Soc."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/j.jad.2013.12.029","article-title":"Urinary phytoestrogens and depression in perimenopausal US women: NHANES 2005\u20132008","volume":"156","author":"Richard","year":"2014","journal-title":"J. Affect. Disord."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"72","DOI":"10.21315\/mjms2019.26.3.6","article-title":"Prevalence of Poor Mental Health and Cognitive Status among Middle-Aged Adults and Its Predictors in Relation to Polyphenols Intake","volume":"26","author":"Rosli","year":"2019","journal-title":"Malays. J. Med. Sci. MJMS"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1002\/gps.1603","article-title":"Nutrient intake and psychological health in an elderly Chinese population","volume":"21","author":"Woo","year":"2006","journal-title":"Int. J. Geriatr. Psychiatry"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.jad.2019.10.001","article-title":"Daily dietary isoflavone intake in relation to lowered risk of depressive symptoms among men","volume":"261","author":"Cui","year":"2020","journal-title":"J. Affect. Disord."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"104002","DOI":"10.1016\/j.archger.2019.104002","article-title":"Diagnostic accuracy of various forms of geriatric depression scale for screening of depression among older adults: Systematic review and meta-analysis","volume":"87","author":"Krishnamoorthy","year":"2020","journal-title":"Arch. Gerontol. Geriatr."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1037\/0882-7974.12.2.277","article-title":"Center for epidemiologic studies depression scale (CES-D) as a screening instrument for depression among community-residing older adults","volume":"12","author":"Lewinsohn","year":"1997","journal-title":"Psychol. Aging"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1159\/000066239","article-title":"On the validity of the Beck Depression Inventory. A review","volume":"31","author":"Richter","year":"1998","journal-title":"Psychopathology"},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Dunlop, B.W., Parikh, S.V., Rothschild, A.J., Thase, M.E., Debattista, C., Conway, C.R., Forester, B.P., Mondimore, F.M., Shelton, R.C., and Macaluso, M. (2019). Comparing sensitivity to change using the 6-item versus the 17-item Hamilton depression rating scale in the GUIDED randomized controlled trial. BMC Psychiatry, 19.","DOI":"10.1186\/s12888-019-2410-2"},{"key":"ref_79","doi-asserted-by":"crossref","unstructured":"Thomas-Odenthal, F., Molero, P., van der Does, W., and Molendijk, M. (2020). Impact of review method on the conclusions of clinical reviews: A systematic review on dietary interventions in depression as a case in point. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0238131"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1016\/j.jad.2017.09.022","article-title":"Diet quality and depression risk: A systematic review and dose-response meta-analysis of prospective studies","volume":"226","author":"Molendijk","year":"2018","journal-title":"J. Affect. Disord."},{"key":"ref_81","doi-asserted-by":"crossref","unstructured":"Kimball, S.M., Mirhosseini, N., and Rucklidge, J. (2018). Database analysis of depression and anxiety in a community sample\u2014response to a micronutrient intervention. Nutrients, 10.","DOI":"10.3390\/nu10020152"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1111\/j.1532-5415.1991.tb01646.x","article-title":"B Complex Vitamin Patterns in Geriatric and Young Adult Inpatients with Major Depression","volume":"39","author":"Edman","year":"1991","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1016\/j.mehy.2006.01.047","article-title":"Rapid recovery from major depression using magnesium treatment","volume":"67","author":"Eby","year":"2006","journal-title":"Med. Hypotheses"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1080\/10408398.2013.876959","article-title":"Omega 3 polyunsaturated fatty acids and the treatment of depression","volume":"57","author":"Deacon","year":"2017","journal-title":"Crit. Rev. Food Sci. Nutr."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"1501","DOI":"10.3390\/nu6041501","article-title":"Vitamin D and depression: A systematic review and meta-analysis comparing studies with and without biological flaws","volume":"6","author":"Spedding","year":"2014","journal-title":"Nutrients"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.jad.2017.12.004","article-title":"Association of total zinc, iron, copper and selenium intakes with depression in the US adults","volume":"228","author":"Li","year":"2018","journal-title":"J. Affect. Disord."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.ejmech.2016.05.026","article-title":"Antidepressant-like effects and mechanisms of flavonoids and related analogues","volume":"121","author":"Guan","year":"2016","journal-title":"Eur. J. Med. Chem."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"1541","DOI":"10.1016\/j.jada.2006.07.020","article-title":"Do Food Frequency Questionnaires Have Too Many Limitations?","volume":"106","author":"Brown","year":"2006","journal-title":"J. Am. Diet. Assoc."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.neuint.2015.08.002","article-title":"The mechanisms of action of flavonoids in the brain: Direct versus indirect effects","volume":"89","author":"Rendeiro","year":"2015","journal-title":"Neurochem. Int."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1007\/s10787-011-0111-7","article-title":"New drug targets in depression: Inflammatory, cell-mediated immune, oxidative and nitrosative stress, mitochondrial, antioxidant, and neuroprogressive pathways. And new drug candidates\u2014Nrf2 activators and GSK-3 inhibitors","volume":"20","author":"Maes","year":"2012","journal-title":"Inflammopharmacology"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/j.neuroscience.2013.04.060","article-title":"Inflammatory cytokines in depression: Neurobiological mechanisms and therapeutic implications","volume":"246","author":"Felger","year":"2013","journal-title":"Neuroscience"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"477","DOI":"10.2165\/11633190-000000000-00000","article-title":"Antioxidants as antidepressants: Fact or fiction?","volume":"26","author":"Scapagnini","year":"2012","journal-title":"CNS Drugs"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1186\/s12979-016-0070-3","article-title":"Dietary phytochemicals and neuro-inflammaging: From mechanistic insights to translational challenges","volume":"13","author":"Davinelli","year":"2016","journal-title":"Immun. Ageing"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.freeradbiomed.2008.04.008","article-title":"Blueberry-induced changes in spatial working memory correlate with changes in hippocampal CREB phosphorylation and brain-derived neurotrophic factor (BDNF) levels","volume":"45","author":"Williams","year":"2008","journal-title":"Free Radic. Biol. Med."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"34783","DOI":"10.1074\/jbc.M305063200","article-title":"Modulation of pro-survival Akt\/protein kinase B and ERK1\/2 signaling cascades by quercetin and its in vivo metabolites underlie their action on neuronal viability","volume":"278","author":"Spencer","year":"2003","journal-title":"J. Biol. Chem."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1007\/s12263-009-0136-3","article-title":"Flavonoids and brain health: Multiple effects underpinned by common mechanisms","volume":"4","author":"Spencer","year":"2009","journal-title":"Genes Nutr."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.copbio.2019.12.018","article-title":"Flavonoids and gut health","volume":"61","author":"Pei","year":"2020","journal-title":"Curr. Opin. Biotechnol."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"230S","DOI":"10.1093\/ajcn\/81.1.230S","article-title":"Bioavailability and bioefficacy of polyphenols in humans. I. Review of 97 bioavailability studies","volume":"81","author":"Manach","year":"2005","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"243S","DOI":"10.1093\/ajcn\/81.1.243S","article-title":"Bioavailability and bioefficacy of polyphenols in humans. II. Review of 93 intervention studies","volume":"81","author":"Williamson","year":"2005","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"1348","DOI":"10.1097\/GME.0000000000000709","article-title":"Evaluation of the potential antidepressant effects of soybean isoflavones","volume":"23","author":"Messina","year":"2016","journal-title":"Menopause"},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.maturitas.2016.11.016","article-title":"Influence of equol and resveratrol supplementation on health-related quality of life in menopausal women: A randomized, placebo-controlled study","volume":"96","author":"Davinelli","year":"2017","journal-title":"Maturitas"}],"container-title":["Antioxidants"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3921\/10\/11\/1644\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:18:42Z","timestamp":1760167122000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3921\/10\/11\/1644"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,20]]},"references-count":101,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,11]]}},"alternative-id":["antiox10111644"],"URL":"https:\/\/doi.org\/10.3390\/antiox10111644","relation":{},"ISSN":["2076-3921"],"issn-type":[{"value":"2076-3921","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,20]]}}}