Nutritional Plans Show No Benefit for Depression in Overweight Patients

MARCH 12, 2019
Patrick Campbell
Multi-nutrient supplementation and food-related behavioral activation therapy may have no effect on the prevention of major depressive disorder (MDD) among overweight adults. 
Clinical obesity
In a recent randomized clinical trial investigators examined the impact of 2 unique nutritional plans—multi-nutrient supplementation and food-related behavioral activation therapy—might have on obese or overweight adults in Europe. Previous trials have shown that keeping a high-quality diet correlates with reduced future onset of depressive symptoms, yet the authors noted there was still an apparent lack of studies exploring the impact of dietary strategies in terms of preventing MDD. 

In an editorial accompanying the published study, Michael Berk, MD, and Felice N. Jacka, PhD, of the Food and Mood Center, Deacon University in Australia, noted that MDD prevention is already difficult to study.

 “There are issues with statistical power because only a small subset of participants with subsyndromal depressive symptoms will develop depression in the follow-up period,” they wrote. “The diverse and multiple nature of risk factors for depression, each with a small effect, also complicates prevention endeavors.” 

Investigators took results from a group of 1025 adults with a body mass index (BMI)  between 25 and 40 who exhibited elevated depressive symptoms and no MDD episodes in the past 6 months. The group, comprised of individuals from Germany, Spain, the United Kingdom, and the Netherlands, was 75% female, had a mean age of 46.5 years, and an average BMI of 31.4.  

The group was divided into 4 categories to determine the efficacy of multi-nutrient supplementation and food-related behavioral activation therapy as a means to reduce MDD in overweight or obese individuals. Patients were given supplements or placebo in the form of 2 pills per day for the course of the year. Food-related behavioral activation therapy consisted of 21 sessions, 15 of which were individual and the remaining 6 were group sessions. Just placebo was given to 257 participants, 256 were given placebos with therapy, 256 were given only supplements, and 256 received supplements and therapy. 

At the conclusion of the 12-month period, 105 (10%) of the participants had experienced an MDD. More than half of that group, had been receiving the supplement. There were 32 (12.5%) individuals that received the supplement and no therapy that experienced an MDD, while 22 (8.6%) participants who received therapy and the supplement experienced an MDD. 

Of the 51 individuals in the placebo group that experienced an MDD, 25 (9.7%) were receiving only the placebo, while 26 (10.2%) were receiving the placebo and attending therapy. 
Despite previous observations that linked low nutrient levels to elevated depressive symptoms, the trial concluded that multi-nutrient supplementation and food-related behavioral activation did not reduce episodes of MDD among participants during the one-year period. 

Berk and Jacka noted the multi-nutrient supplementation group did worse on some metrics than their placebo counterparts.  

“Concordant with the results of this study, a recent study of a multi-nutrient formulation for the treatment of depression not only failed to benefit participants but also performed significantly worse than placebo,” they concluded. “These results offer a note of caution about the liberal and mostly non–evidence-based use of nutrient supplement combinations for psychiatric disorders.”

The study, “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,” was published online in the Journal of the American Medical Association. 

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