Nutrition and mental health

22 important questions on Nutrition and mental health

Of which 9 symptom do you have to have at least 5 symptoms for >2 weeks to be diagnosed with major depressive disorder?

1. Depressed mood
2. Lack of interest

3. Sleep problems
4. Appetite/weight changes
5. Low energy
6. Concentration problems
7. Psychomotor retardation or agitation
8. Guilt or worthlessness
9. Suicidal ideation       

The first 2: at least one of these 2 has to be present

What is the % prevalence of major depressive disorder in lifetime?

18.7%

Name 5 types of factors/mechanisms that can contribute to developing major depressive disorder

Genetic factors
psychosocial factors (personality, life events)
behavioral factors (smoking, alcohol, nutrition (?))
somatic health factors (CVD, diabetes, pain)
Biological factors (inflammation, cortisol)
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Name 4 different nutrients that has been studied to have a link with depression

- omega-3 fatty acids
- zinc
- folate
- vitamin D

Name 2 examples of foods that have been studied in relationship with depression

- fish
- vegetables

Name 3 limitations from an ecological study that is done between 7 countries, fish intake and prevalence of depression.

- you select the countries.
- you dont know if the people with lower fish intake have higher prevalence of depression
- you cannot say anything about causation.

What 4 things are said about omega-3 fatty acids in relation to depression?

- EPA: no surplus effect over placebo in DM2 with comorbid depression treated with antidepressant medication
- there is a small to moderate positive effect of omega-3 PUFAs on depression compared to placebo
-  Lower fish intake and omega-3 intake is related to depression
- lower blood levels of omega-3 PUFAs is related to depsreeion

What is said about folate and depression?

Treatment with folate supplements was found significant to reduce symptoms of major depression disorder and negative simproms in schizophrenia, however, low review qualirt score.

What is said about zinc and magnesium in relation to depression?

Zinc and magnesium: there is a lack of compelling evidence that zinc and magnesium are efficient for any mental disorders

What is said about vitamin D supplementation and depression?

No significant effect on depression for vitamin D supplementation in MDD

What does the approach 'a priori' mean with dietary data?

You know which data you are searching for. So you look at adherence to dietary guidelines, etc.

What does the approach 'a posteriori' mean with dietary data?

That you let the data tell you which patterns there are. You dont know which patterns are there.

What is said about the quality of the diet in relation to depression?

when you have a high quality diet (vegetables, nuts, fish, low processed foods), you have lower risk of depression
when you have low quality diet (lots of sugar, fats) some study found that it did not result in higher depression risk, some found there might be an effect of low quality diet on depression risk.

What is the research question of MooDFOOD?

What is the effect of 2 nutritional strategies (multinutrient supplementation, food-related behavioral activation therapy) and their combination on prevention of a new MDD episode in overweight adults with subsyndromal depressive symptoms?

What where the 3 inclusion criteria of the MooDFOOD study?

- age 18-75 yr
- BMI 25-40
- depressive symptoms

What where the 3 exclusion cirteria of the MooDFOOD study?

- current depressive disorder
- other psychiatric disorders
- already taking supplements

What where the 2 nutritional interventions int he MooDFOOD study?

- multinutrient supplement (omega-3, selenium, folic acid, vit D, calcium) vs placebo
- food-related behavioral activation (21 sessions (15 individual, 6 group), focus on healthy dietary habits, emphasizing mediterranean diet) vs no therapy

What was the primary finding of the MooDFOOD study?

They did not find an effect of the supplement or the FBA, or a combination on a depressive episode.

What where the 3 secondary findings of the MooDFOOD study?

- F-BA (food behavioral activation) increased vegetables, fruit, legumes and whole grain intake and decreased intake of sweets
- F-BA improved two unhealthy eating styles (emotional eating and uncontrolled eating)
- Both interventions had no effect on bodyweight

What is the conclusion in general about nutritional strategies and the prevention of MDD?

Nutritional strategies are not effective for prevention of MDD onset

What is the difference in the results between observational studies and intervention studies for omega-3 PUFAs and depression?

- observational studies: found lower fish intake and omega-3 levels in persons with depression.
- intervention studies: small-to-moderate positive effect of omega-3 PUFAs on treatment of depression compared to placebo, especially for clinical depression and EPA

What was the study design the MooDFOOD study used?

A 2x2 factorial randomized controlled prevention trial

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