A Mediterranean-style dietary intervention supplemented with fish oil improves diet quality and mental health in people with depression: A randomized controlled trial (HELFIMED)

Parletta, Natalie; Zarnowiecki, Dorota; Cho, Ji-Hyun; Wilson, Andrew; Bogomolova, Svetlana; Villani, Anthony; Itsiopoulos, Catherine; Niyonsenga, Théophile; Blunden, Sarah; Meyer, Barbara J.; Segal, Leonie; Baune, Bernhard T.; O’Dea, Kerin

doi:10.1080/1028415x.2017.1411320

Cited by 412 publications

(358 citation statements)

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“…Of those randomized to the therapy groups, 71% attended 8 or more of the 21 sessions. A median of 14 of 15 individual sessions were attended (interquartile range [IQR], [6][7][8][9][10][11][12][13][14][15], and a median of 0 of 6 group sessions (IQR, 0-4) were attended, indicating that adherence to individual sessions was highest.…”

Section: Adherence To Interventionsmentioning

confidence: 99%

“…4 Food-related behaviors, like unhealthful eating styles, 5 have been cross-sectionally related to increased depressive symptoms. Recent randomized clinical trials (RCTs) found that dietary improvement strategies reduced depressive symptoms in depressed adults relative to control conditions, 6,7 but there remains a clear lack of RCTs testing dietary strategies to prevent depression. 8 Similarly, observational studies have suggested that lower levels of specific nutrients (eg, omega-3 polyunsaturated fatty acids, folic acid, vitamin D, selenium) are related to higher levels of depressive symptoms.…”

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confidence: 99%

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Effect of Multinutrient Supplementation and Food-Related Behavioral Activation Therapy on Prevention of Major Depressive Disorder Among Overweight or Obese Adults With Subsyndromal Depressive Symptoms

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Brouwer

Roca

et al. 2019

JAMA

127

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IMPORTANCE Effects of nutritional interventions on the prevention of major depressive disorder (MDD) in overweight adults are unknown.OBJECTIVE To examine the effect of 2 nutritional strategies (multinutrient supplementation, food-related behavioral activation therapy) and their combination for prevention of a new MDD episode in overweight adults with subsyndromal depressive symptoms. DESIGN, SETTING, AND PARTICIPANTSThis multicenter 2 × 2 factorial randomized clinical trial included overweight adults (body mass index, 25-40) with elevated depressive symptoms (Patient Health Questionnaire-9 [PHQ-9] scores Ն5) and no MDD episode in the past 6 months from 4 European countries. A total of 1025 adults were randomized (July 30, 2015-October 12, 2016) and followed up for 1 year (October 13, 2017).INTERVENTIONS Daily multinutrient supplements (1412-mg omega-3 fatty acids, 30-μg selenium, 400-μg folic acid, and 20-μg vitamin D 3 plus 100-mg calcium) vs placebo and 21 individual or group therapy sessions vs none (blinded to researchers) for 1 year. Participants were allocated to placebo without therapy (n = 257), placebo with therapy (n = 256), supplements without therapy (n = 256), and supplements with therapy (n = 256). MAIN OUTCOME AND MEASURESCumulative 1-year onset of MDD via the Mini International Neuropsychiatric Interview at 3, 6, and 12 months. Logistic regression using effect-coded variables (−1 indicating control, 1 indicating intervention) evaluated intervention effects both individually and in combination (interaction) on MDD onset. RESULTS Among 1025 participants (mean age, 46.5 years; 772 women [75%]; mean BMI, 31.4), 779 (76%) completed the trial. During the 12-month follow-up, 105 (10%) developed MDD: 25 (9.7%) patients in the placebo without therapy, 26 (10.2%) in the placebo with therapy, 32 (12.5%) in the supplement without therapy, and 22 (8.6%) in the supplement with therapy group. None of the treatment strategies affected MDD onset. The odds ratio (OR) for supplements was 1.06 (95% CI, 0.87-1.29); for therapy, 0.93 (95% CI, 0.76-1.13); and for their combination, 0.93 (95% CI, 0.76-1.14; P for interaction, .48). One person in the supplementation with therapy group, died. Twenty-four patients in each of the placebo groups and 24 patients in the supplementation with therapy group were hospitalized, and 26 patients in the supplementation-only group were hospitalized.CONCLUSIONS AND RELEVANCE Among overweight or obese adults with subsyndromal depressive symptoms, multinutrient supplementation compared with placebo and food-related behavioral activation therapy compared with no therapy did not reduce episodes of major depressive disorder during 1 year. These findings do not support the use of these interventions for prevention of major depressive disorder.

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Section: Adherence To Interventionsmentioning

confidence: 99%

mentioning

confidence: 99%

Effect of Multinutrient Supplementation and Food-Related Behavioral Activation Therapy on Prevention of Major Depressive Disorder Among Overweight or Obese Adults With Subsyndromal Depressive Symptoms

Bot

Brouwer

Roca

et al. 2019

JAMA

127

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“…There are numerous health benefits associated with n-3 LCPUFA, including cardiovascular disease [4][5][6], inflammatory disease [7,8] and mental health [9][10][11][12]. Harris and von Schacky postulated that the Omega-3 Index (sum of EPA and DHA expressed as a percentage of total erythrocyte fatty acids) could be a biomarker for cardiovascular disease risk and that an omega-3 index of greater than 8% is optimal [13].…”

Section: Introductionmentioning

confidence: 99%

“…Harris and von Schacky postulated that the Omega-3 Index (sum of EPA and DHA expressed as a percentage of total erythrocyte fatty acids) could be a biomarker for cardiovascular disease risk and that an omega-3 index of greater than 8% is optimal [13]. There is evidence that this omega-3 index biomarker may also be useful in terms of mental health [9][10][11]14].…”

Section: Introductionmentioning

confidence: 99%

High Variability in Erythrocyte, Plasma and Whole Blood EPA and DHA Levels in Response to Supplementation

et al. 2020

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1) Aim: the aim of this secondary analysis was to report the variability in response to n-3 long chain polyunsaturated fatty acids (LCPUFA) supplementation in erythrocytes, plasma and whole blood of a previously published dose response study. (2) Methods: a randomized, double-blind, placebo-controlled trial of parallel design was conducted, whereby pre-menopausal women were randomly assigned to consume 0, 0.35, 0.7 or 1 g/day of supplemental eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA). Fasted blood samples were taken at baseline and after eight weeks intervention. Erythrocyte, plasma and whole blood fatty acids were extracted using the method of Lepage and Roy and analysed using gas chromatography. (3) Results: There were significant increases in EPA plus DHA levels in the 0.7 g and 1 g dose groups, with the highest increase with the 1 g dose notably: in erythrocytes (from 5.69% to 7.59%), plasma (from 2.94% to 5.48%) and in whole blood (from 3.81% to 6.03%). There was high variability in response to the supplement in erythrocytes, plasma and whole blood across the different doses. (4) Conclusion: there is high individual variability in n-3 LCPUFA levels in response to n-3 LCPUFA supplementation, which should be taken into account in clinical trials using n-3 LCPUFA supplements.

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“…Intervention studies specifically designed to investigate dietary patterns and depression have begun to emerge only in the last few years. In a study of 85 Australian adults, all aged 18-65 years and with selfreported depression, adherence to a MedDiet was associated with a significantly greater reduction in depressive symptoms (P = 0.03) and improved quality of life (P = 0.04) after 3 months of follow-up, in comparison to the control group, who only attended social group sessions (Parletta et al 2017). These effects were found to be maintained at the 6-month follow-up.…”

Section: Mediterranean Diet Intervention Trials and Depressionmentioning

confidence: 98%

The Mediterranean diet and depression – can a healthier dietary pattern reduce the risk of depression?

Steenson

2019

Nutrition Bulletin

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A Mediterranean-style dietary intervention supplemented with fish oil improves diet quality and mental health in people with depression: A randomized controlled trial (HELFIMED)

Abstract: This is one of the first randomized controlled trials to show that healthy dietary changes are achievable and, supplemented with fish oil, can improve mental health in people with depression.

Cited by 412 publications

References 56 publications

Effect of Multinutrient Supplementation and Food-Related Behavioral Activation Therapy on Prevention of Major Depressive Disorder Among Overweight or Obese Adults With Subsyndromal Depressive Symptoms

Effect of Multinutrient Supplementation and Food-Related Behavioral Activation Therapy on Prevention of Major Depressive Disorder Among Overweight or Obese Adults With Subsyndromal Depressive Symptoms

High Variability in Erythrocyte, Plasma and Whole Blood EPA and DHA Levels in Response to Supplementation

The Mediterranean diet and depression – can a healthier dietary pattern reduce the risk of depression?

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