Coaching in Healthy Dietary Practices in At-Risk Older Adults: A Case of Indicated Depression Prevention

Abstract

Prevention of major depressive disorder is important because current treatments are only partially adequate in reducing symptom burden and promoting health-related quality of life. Lifestyle interventions may be a desirable prevention strategy for reasons of patient preference, particularly among older patients from minority groups. Using evidence from a randomized depression prevention trial for older adults, the authors found that coaching in healthy dietary practices was potentially effective in protecting at-risk older adults from developing incident episodes of major depression. The authors describe the dietary coaching program (highlighted in a case example) as well as the feasibility and potential efficacy of the program within the context of evidence-based interventions for preventing episodes of major depression and mitigating symptoms of depression. Older adults receiving dietary coaching experienced a low incidence of major depressive episodes and exhibited a 40%–50% decrease in depressive symptoms, as well as enhanced well-being, during the initial 6-week intervention; these gains were sustained over 2 years. The authors also describe why lifestyle interventions like coaching in healthy dietary practices may hold promise as effective, practical, nonstigmatizing interventions for preventing episodes of major depressive disorder in older adults with sub-syndromal depressive symptoms.

Nutritional Aspects of Depression

“…Although Creatine Clearance similarly decreased in both groups, depression score and cognitive outcome improved significantly more in the seven days a week group than in the 6 days a week [103]. Using evidence from a randomized depression prevention trial for older adults, it has been confirmed that coaching in healthy dietary practices are effective in the protection of episodes of major depression and in the reduction of depressive symptoms to an extent from 40% to 50% [100].…”

“…Higher consumption of lactose, fiber, nonjuice fruit, and vegetables was significantly associated with lower odds of incident depression [99]. In elderly subjects a dietary coaching might be effectfull and result in a decrease in depressive symptoms and an enhanced well-being over 2 years and even less hospital admissions [100,101]. In a further randomized controlled trial, the mediterranean diet combined with nuts reduced the risk for depression [92].…”

Measuring Participant Effort in a Depression Prevention Trial: Who Engages in Problem-Solving Therapy?

“…3 Emerging research suggests that PST is also an effective prevention strategy to reduce the incidence of major and subsyndromal depression among older adults at high risk for converting to the full clinical disorder. [8][9][10][11][12][13] The goal of PST is to help participants identify and solve problems that are contributing to stress and reduced quality of life. Components of PST include psychoeducation, active problem solving in sessions, and homework assignments where patients can apply problemsolving skills.…”

Mindfulness-Based Cognitive Therapy in Major depressive disorder - systematic review and metanalysis

“…Because of these limitations, some nonpharmacological alternatives have been implemented, including interventions in lifestyle, behavior modification, counseling and psychological therapies (13,14). One of these therapies is meditation, which is currently being integrated into the clinical practice for some medical conditions, such as hypertension, cancer, chronic pain, diabetes, etc.…”