Dataset Information

Effects of dietary interventions on depressive symptom profiles: results from the MooDFOOD depression prevention study.

ABSTRACT:

Background

Dietary interventions did not prevent depression onset nor reduced depressive symptoms in a large multi-center randomized controlled depression prevention study (MooDFOOD) involving overweight adults with subsyndromal depressive symptoms. We conducted follow-up analyses to investigate whether dietary interventions differ in their effects on depressive symptom profiles (mood/cognition; somatic; atypical, energy-related).

Methods

Baseline, 3-, 6-, and 12-month follow-up data from MooDFOOD were used (n = 933). Participants received (1) placebo supplements, (2) food-related behavioral activation (F-BA) therapy with placebo supplements, (3) multi-nutrient supplements (omega-3 fatty acids and a multi-vitamin), or (4) F-BA therapy with multi-nutrient supplements. Depressive symptom profiles were based on the Inventory of Depressive Symptomatology.

Results

F-BA therapy was significantly associated with decreased severity of the somatic (B = -0.03, p = 0.014, d = -0.10) and energy-related (B = -0.08, p = 0.001, d = -0.13), but not with the mood/cognition symptom profile, whereas multi-nutrient supplementation was significantly associated with increased severity of the mood/cognition (B = 0.05, p = 0.022, d = 0.09) and the energy-related (B = 0.07, p = 0.002, d = 0.12) but not with the somatic symptom profile.

Conclusions

Differentiating depressive symptom profiles indicated that food-related behavioral interventions are most beneficial to alleviate somatic symptoms and symptoms of the atypical, energy-related profile linked to an immuno-metabolic form of depression, although effect sizes were small. Multi-nutrient supplements are not indicated to reduce depressive symptom profiles. These findings show that attention to clinical heterogeneity in depression is of importance when studying dietary interventions.

SUBMITTER: Vreijling SR

PROVIDER: S-EPMC9772915 | biostudies-literature | 2021 Apr

REPOSITORIES: biostudies-literature

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Effects of dietary interventions on depressive symptom profiles: results from the MooDFOOD depression prevention study.

Vreijling Sarah R SR Penninx Brenda W J H BWJH Bot Mariska M Watkins Ed E Owens Matthew M Kohls Elisabeth E Hegerl Ulrich U Roca Miquel M Gili Margalida M Brouwer Ingeborg A IA Visser Marjolein M Beekman Aartjan T F ATF Jansen Rick R Lamers Femke F

Psychological medicine 20210407

<h4>Background</h4>Dietary interventions did not prevent depression onset nor reduced depressive symptoms in a large multi-center randomized controlled depression prevention study (MooDFOOD) involving overweight adults with subsyndromal depressive symptoms. We conducted follow-up analyses to investigate whether dietary interventions differ in their effects on depressive symptom profiles (mood/cognition; somatic; atypical, energy-related).<h4>Methods</h4>Baseline, 3-, 6-, and 12-month follow-up d ...[more]

PMID: 33823960

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Project description:ObjectivesWe report on the acceptability, feasibility, dose-response relationship and adherence of two nutritional strategies to improve mood (multinutrient supplements; food-related behavioural activation (F-BA)) studied in a randomised controlled depression prevention trial (the Multi-country cOllaborative project on the rOle of Diet, Food-related behaviour, and Obesity in the prevention of Depression (MooDFOOD) Trial). We also assessed baseline determinants of adherence and assessed whether better adherence resulted in lower depressive symptoms.DesignRandomised controlled trial with a 2×2 factorial design conducted between 2015 and 2017.SettingGermany, the Netherlands, UK and Spain.ParticipantsCommunity sample of 1025 overweight adults with elevated depressive symptoms without a current episode of major depressive disorder. Main eligibility criteria included age (18-75 years), being overweight or obese, and having at least mild depressive symptoms, shown by a Patient Health Questionnaire Score of ≥5. A total of 76% of the sample was retained at the 12-month follow-up.InterventionsDaily nutritional supplements versus pill placebo or an F-BA therapy, delivered in individual and group sessions versus no behavioural intervention over a 1-year period.Primary and secondary outcome measuresPrimary outcome: self-reported acceptability of the interventions.Secondary outcomesadherence and self-reported depressive symptoms.ResultsMost participants reported that the F-BA was acceptable (83.61%), feasible to do (65.91%) and would recommend it to a friend (84.57%). Individual F-BA sessions (88.10%) were significantly more often rated as positive than group F-BA sessions (70.17%) and supplements (28.59%). There were statistically significant reductions in depressive symptoms for those who both adhered to the F-BA intervention and had a history of depression (B=-0.08, SE=0.03, p=0.012) versus those who had no history of depression. Supplement intake had no effect on depressive symptoms irrespective of adherence.ConclusionsF-BA may have scope for development as a depression prevention intervention and public health strategy but further refinement and testing are needed.Trial registration numberNCT02529423.

Project description:BackgroundThis study aimed to (1) provide a comprehensive characterization of depressive symptoms profiles, and (2) examine the cross-sectional association between depressive symptom profiles and cardio-metabolic outcomes, including metabolic syndrome and obesity, while controlling for sociodemographic variables, health behaviors and inflammation.MethodsOur sample was comprised of 1085 participants (55.80% female) enrolled in the MIDUS-II biomarker study. Latent profile analysis (LPA) was used to derive depressive symptom profiles using subscales of the Mood and Anxiety Symptom Questionnaire (MASQ) and the Center for Epidemiologic Studies Depression Scale (CES-D) subscales as well as Pittsburgh Sleep Quality Index (PSQI) global score. Metabolic syndrome was defined according to the Interim Joint Statement definition. CRP was used as a marker of inflammation.ResultsFour depressive symptom profiles were identified. The "No Symptoms" subgroup (60.65% of the sample) had the lowest overall scores across subscales. The "Mild Symptoms" subgroup (26.73%) was characterized by lower scores across indicators, with subscales measuring somatic symptoms being the highest within group. The "Moderate Symptoms" subgroup (10.32%) had higher scores across subscales (1 SD above the mean), with subscales measuring negative affect/loss of interest being the highest within group. Finally, the "Acute symptoms" subgroup (2.30%) was characterized by the highest overall scores (1.5-3 SD above the mean) on all indicators. After controlling for sociodemographic characteristics and health behaviors, the "Moderate Symptoms" subgroup was significantly associated with metabolic syndrome (OR=1.595, p=0.035) and obesity (OR=1.555, p=0.046). Further, there was a trend between the "Mild Symptoms" subgroup and the presence of obesity (OR=1.345, p=0.050). Inflammation attenuated these associations.ConclusionsFour depressive symptom profiles were identified among healthy mid-life individuals in the US. These profiles are differentially associated with cardio-metabolic outcomes. Future work should examine whether distinct symptom profiles may reflect differential pathways to increased risk, and whether tailored management of symptoms is needed.

Project description:BackgroundObesity and depression are two prevalent conditions that are costly to individuals and society. The bidirectional association of obesity with depression, in which unhealthy dietary patterns may play an important role, has been well established. Few experimental studies have been conducted to investigate whether supplementing specific nutrients or improving diet and food-related behaviors can prevent depression in overweight persons.Method/designThe MooDFOOD prevention trial examines the feasibility and effectiveness of two different nutritional strategies [multi-nutrient supplementation and food-related behavioral change therapy (FBC)] to prevent depression in individuals who are overweight and have elevated depressive symptoms but who are not currently or in the last 6 months meeting criteria for an episode of major depressive disorder (MDD). The randomized controlled prevention trial has a two-by-two factorial design: participants are randomized to daily multi-nutrient supplement (omega-3 fatty acids, calcium, selenium, B-11 vitamin and D-3 vitamin) versus placebo, and/or FBC therapy sessions versus usual care. Interventions last 12 months. In total 1000 participants aged 18-75 years with body mass index between 25-40 kg/m(2) and with a Patient Health Questionnaire-9 score ≥ 5 will be recruited at four study sites in four European countries. Baseline and follow-up assessments take place at 0, 3, 6, and 12 months. Primary endpoint is the onset of an episode of MDD, assessed according to DSM-IV based criteria using the MINI 5.0 interview. Depressive symptoms, anxiety, food and eating behavior, physical activity and health related quality of life are secondary outcomes. During the intervention, compliance, adverse events and potentially mediating variables are carefully monitored.DiscussionThe trial aims to provide a better understanding of the causal role of specific nutrients, overall diet, and food-related behavior change with respect to the incidence of MDD episodes. This knowledge will be used to develop and disseminate innovative evidence-based, feasible, and effective nutritional public health strategies for the prevention of clinical depression.Trial registrationClinicalTrials.gov. Number of identification: NCT02529423 . August 2015.

Project description:Depression shows a metabolomic signature overlapping with that of cardiometabolic conditions. Whether this signature is linked to specific depression profiles remains undetermined. Previous research suggested that metabolic alterations cluster more consistently with depressive symptoms of the atypical spectrum related to energy alterations, such as hyperphagia, weight gain, hypersomnia, fatigue and leaden paralysis. We characterized the metabolomic signature of an "atypical/energy-related" symptom (AES) profile and evaluated its specificity and consistency. Fifty-one metabolites measured using the Nightingale platform in 2876 participants from the Netherlands Study of Depression and Anxiety were analyzed. An 'AES profile' score was based on five items of the Inventory of Depressive Symptomatology (IDS) questionnaire. The AES profile was significantly associated with 31 metabolites including higher glycoprotein acetyls (β = 0.13, p = 1.35*10-12), isoleucine (β = 0.13, p = 1.45*10-10), very-low-density lipoproteins cholesterol (β = 0.11, p = 6.19*10-9) and saturated fatty acid levels (β = 0.09, p = 3.68*10-10), and lower high-density lipoproteins cholesterol (β = -0.07, p = 1.14*10-4). The metabolites were not significantly associated with a summary score of all other IDS items not included in the AES profile. Twenty-five AES-metabolites associations were internally replicated using data from the same subjects (N = 2015) collected at 6-year follow-up. We identified a specific metabolomic signature-commonly linked to cardiometabolic disorders-associated with a depression profile characterized by atypical, energy-related symptoms. The specific clustering of a metabolomic signature with a clinical profile identifies a more homogenous subgroup of depressed patients at higher cardiometabolic risk, and may represent a valuable target for interventions aiming at reducing depression's detrimental impact on health.

Project description:Background: Depression and anxiety are the most common comorbid psychiatric disorders in the elderly. Psychiatrists have been reporting worsened depression symptoms and prognosis by comorbid anxiety symptoms. However, it is still unclear how anxiety affects the course of depression in the elderly. The aims of this study are (1) to identify the symptom network in late-life depression (LLD), and (2) to examine the role of anxiety in LLD with a network perspective. Methods: The study analyzed 776 community-based participants who were clinically diagnosed with depression and enrolled in Suwon Geriatric Mental Health Center. Network analysis was used to investigate the relationships between the symptoms of the Montgomery-Åsberg Depression Rating Scale (MADRS). The depression sample was divided into groups of low and high anxiety according to the Beck Anxiety Index. Propensity score matching (PSM) was used to minimize the effects of depression severity on the network. Network comparison test (NCT) were carried out to compare the global connectivity, global strength, and specific edge strength between the two subgroups. Results: Reported sadness, pessimistic thinking, and suicidal ideation are the core symptoms of LLD in terms of node strength. The MADRS sum score [mean (SD) 28.10 (9.19) vs 20.08 (7.11); P < .01] was much higher in the high anxiety group. The NCT before PSM showed the high anxiety group had significantly higher global strength (P < .01). However, the NCT after PSM did not reveal any statistical significance both in global structure (P = .46) and global strength (P = .26). A comparison between centrality indices showed a higher node strength of vegetative symptoms in the high anxiety group and this also remained after PSM. Conclusion: Based on the statistical analysis, anxiety worsens the severity of depression in the elderly. However, NCT after PSM revealed comorbid anxiety does not change the global structure and strength of the depression symptom network. Therefore, anxiety may affect LLD in a way of worsening the severity, rather than changing psychopathology. Additionally, the study revealed the centrality of vegetative symptoms was low in LLD but increased substantially in patients with comorbid anxiety.

Dataset Information

Effects of dietary interventions on depressive symptom profiles: results from the MooDFOOD depression prevention study.

Background

Methods

Results

Conclusions

Publications

Effects of dietary interventions on depressive symptom profiles: results from the MooDFOOD depression prevention study.

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