The benefits of vitamin D, omega-3 fatty acids, and exercise in disease prevention remain unclear.OBJECTIVE To test whether vitamin D, omega-3s, and a strength-training exercise program, alone or in combination, improved 6 health outcomes among older adults. DESIGN, SETTING, AND PARTICIPANTS Double-blind, placebo-controlled, 2 × 2 × 2 factorial randomized clinical trial among 2157 adults aged 70 years or older who had no major health events in the 5 years prior to enrollment and had sufficient mobility and good cognitive status. Patients were recruited between December 2012 and November 2014, and final follow-up was in November 2017. INTERVENTIONS Participants were randomized to 3 years of intervention in 1 of the following 8 groups: 2000 IU/d of vitamin D 3 , 1 g/d of omega-3s, and a strength-training exercise program (n = 264); vitamin D 3 and omega-3s (n = 265); vitamin D 3 and exercise (n = 275); vitamin D 3 alone (n = 272); omega-3s and exercise (n = 275); omega-3s alone (n = 269); exercise alone (n = 267); or placebo (n = 270). MAIN OUTCOMES AND MEASURESThe 6 primary outcomes were change in systolic and diastolic blood pressure (BP), Short Physical Performance Battery (SPPB), Montreal Cognitive Assessment (MoCA), and incidence rates (IRs) of nonvertebral fractures and infections over 3 years. Based on multiple comparisons of 6 primary end points, 99% confidence intervals are presented and P < .01 was required for statistical significance. Infections, IR ratio 0.95 (0.84-1.08) .33 0.89 (0.78-1.01) .02 1.04 (0.92-1.18) .38CONCLUSIONS AND RELEVANCE Among adults without major comorbidities aged 70 years or older, treatment with vitamin D 3 , omega-3s, or a strength-training exercise program did not result in statistically significant differences in improvement in systolic or diastolic blood pressure, nonvertebral fractures, physical performance, infection rates, or cognitive function. These findings do not support the effectiveness of these 3 interventions for these clinical outcomes.

Backround Inflammation is considered as a mechanism leading to depression, but the association between inflammatory dietary pattern and depression risk is unknown. Methods Using reduced-rank regression, we identified a dietary pattern that was related to plasma levels of inflammatory markers (C-reactive protein, interleukin-6, tumor necrosis factor α receptor 2), and we conducted a prospective analysis of the relationship of this pattern and depression risk among participants in the Nurses’ Health Study. A total of 43,685 women (aged 50–77) without depression at baseline (1996) were included and followed up until 2008. Diet information was obtained from food frequency questionnaires completed between 1984 through 2002 and computed as cumulative average of dietary intakes with a 2-year latency applied. We used a strict definition of depression that required both self-reported physician-diagnosed depression and use of antidepressants, and a broader definition that included women who reported either clinical diagnosis or antidepressant use. Results During the 12-year follow-up, we documented 2,594 incident cases of depression using the stricter definition and 6,446 using the broader definition. After adjustment for body mass index and other potential confounders, relative risks comparing extreme quintiles of the inflammatory dietary pattern were 1.41 (95% confidence interval [CI], 1.22, 1.63; P-trend <.001) for the strict definition and 1.29 (95% CI, 1.18, 1.41; P-trend <.001) for the broader definition of depression. Conclusions The inflammatory dietary pattern is associated with a higher depression risk. This finding suggests that chronic inflammation may underlie the association between diet and depression.

Background: Although individual nutrients have been investigated in relation to depression risk, little is known about the overall role of diet in depression. Objective: We examined whether long-term dietary patterns derived from a food-frequency questionnaire (FFQ) predict the development of depression in middle-aged and older women. Design: We conducted a prospective study in 50,605 participants (age range: 50-77 y) without depression in the Nurses' Health Study at baseline (1996) who were followed until 2008. Long-term diet was assessed by using FFQs every 4 y since 1986. Prudent (high in vegetables) and Western (high in meats) patterns were identified by using a principal component analysis. We used 2 definitions for clinical depression as follows: a strict definition that required both a reported clinical diagnosis and use of antidepressants (3002 incident cases) and a broad definition that further included women who reported either a clinical diagnosis or antidepressant use (7413 incident cases). Results: After adjustment for age, body mass index, and other potential confounders, no significant association was shown between the diet patterns and depression risk under the strict definition. Under the broad definition, women with the highest scores for the Western pattern had 15% higher risk of depression (95% CI: 1.04, 1.27; Ptrend = 0.01) than did women with the lowest scores, but after additional adjustment for psychological scores at baseline, results were no longer significant (RR: 1.09; 95% CI: 0.99, 1.21; P-trend = 0.08). Conclusion: Overall, results of this large prospective study do not support a clear association between dietary patterns from factor analysis and depression risk.Am J Clin Nutr 2013;98:813-20.Supplemental Material can be found at: 814 CHOCANO-BEDOYA ET AL at KAINAN UNIVERSITY on March 23, 2015 ajcn.nutrition.org Downloaded from with correlation coefficients .0.30 are presented.

We observed a significantly lower risk of PMS in women with high intakes of thiamine and riboflavin from food sources only. Further research is needed to evaluate the effects of B vitamins in the development of premenstrual syndrome.