Supplementation with B vitamins or n−3 fatty acids and depressive symptoms in cardiovascular disease survivors: ancillary findings from the SUpplementation with FOLate, vitamins B-6 and B-12 and/or OMega-3 fatty acids (SU.FOL.OM3) randomized trial

Andreeva, Valentina A.; Galán, Pilar; Torrès, Martine; Julia, Chantal; Herçberg, Serge; Kesse‐Guyot, Emmanuelle

doi:10.3945/ajcn.112.035253

Cited by 50 publications

(47 citation statements)

References 33 publications

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“…Hence, this latter has been translated in a correlation of efficacy to more severe symptoms whereas, according to our results, we hypothesized that this efficacy may be more related to the specific pathophysiological processes of the MDD rather than to its severity. Compared with previous meta-analyses, the differences of findings may depend on the additional number of RCTs published since the publication of the last study [37], [40], [53], [60], [61], [66], [68], [69], [84], [89], [92], [94]–[97], [100]–[102], the increasing number of participants which vary the overall weight of previous studies, the requirement for public registration of trials resulting in an increase of general studies’ quality and may be responsible for the decreased evidence of publication bias.…”

Section: Discussionmentioning

confidence: 83%

Role of Omega-3 Fatty Acids in the Treatment of Depressive Disorders: A Comprehensive Meta-Analysis of Randomized Clinical Trials

et al. 2014

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BackgroundDespite omega-3 polyunsaturated fatty acids (PUFA) supplementation in depressed patients have been suggested to improve depressive symptomatology, previous findings are not univocal.ObjectivesTo conduct an updated meta-analysis of randomized controlled trials (RCTs) of omega-3 PUFA treatment of depressive disorders, taking into account the clinical differences among patients included in the studies.MethodsA search on MEDLINE, EMBASE, PsycInfo, and the Cochrane Database of RCTs using omega-3 PUFA on patients with depressive symptoms published up to August 2013 was performed. Standardized mean difference in clinical measure of depression severity was primary outcome. Type of omega-3 used (particularly eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) and omega-3 as mono- or adjuvant therapy was also examined. Meta-regression analyses assessed the effects of study size, baseline depression severity, trial duration, dose of omega-3, and age of patients.ResultsMeta-analysis of 11 and 8 trials conducted respectively on patients with a DSM-defined diagnosis of major depressive disorder (MDD) and patients with depressive symptomatology but no diagnosis of MDD demonstrated significant clinical benefit of omega-3 PUFA treatment compared to placebo (standardized difference in random-effects model 0.56 SD [95% CI: 0.20, 0.92] and 0.22 SD [95% CI: 0.01, 0.43], respectively; pooled analysis was 0.38 SD [95% CI: 0.18, 0.59]). Use of mainly EPA within the preparation, rather than DHA, influenced final clinical efficacy. Significant clinical efficacy had the use of omega-3 PUFA as adjuvant rather than mono-therapy. No relation between efficacy and study size, baseline depression severity, trial duration, age of patients, and study quality was found. Omega-3 PUFA resulted effective in RCTs on patients with bipolar disorder, whereas no evidence was found for those exploring their efficacy on depressive symptoms in young populations, perinatal depression, primary disease other than depression and healthy subjects.ConclusionsThe use of omega-3 PUFA is effective in patients with diagnosis of MDD and on depressive patients without diagnosis of MDD.

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Section: Discussionmentioning

confidence: 83%

Role of Omega-3 Fatty Acids in the Treatment of Depressive Disorders: A Comprehensive Meta-Analysis of Randomized Clinical Trials

et al. 2014

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“…289 Conversely, COX and LOX metabolites of ω-6 FFA such as arachidonic acid (e.g., prostaglandin E 2 and thromboxane) are often pro-inflammatory 282, 290, 291 Notably, ω-3 FFA supplementation could specifically be for ICAD, as it does not prevent post-partum depression 292 nor perinatal depression, 293 nor vascular depression. 294 Thus, both sleep and ω-3 FFA may be good clinical targets for preventing ICAD.…”

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confidence: 99%

Inflammatory cytokine-associated depression

Lotrich

2015

Brain Research

153

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Inflammatory cytokines can sometimes trigger depression in humans, are often associated with depression, and can elicit some behaviors in animals that are homologous to major depression. Moreover, these cytokines can affect monoaminergic and glutamatergic systems, supporting an overlapping pathoetiology with major depression. This suggests that there could be a specific major depression subtype, inflammatory cytokine-associated depression (ICAD), which may require different therapeutic approaches. However, most people do not develop depression, even when exposed to sustained elevations in inflammatory cytokines. Thus several vulnerabilities and sources of resilience to inflammation-associated depression have been identified. These range from genetic differences in neurotrophic and serotonergic systems to sleep quality and omega-3 fatty acid levels. Replicating these sources of resilience as treatments could be one approach for preventing “ICAD”.

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“…In the VITATOPS study, treatment with B vitamins ranging from one to 10.5 years (mean 7.2 years) reduced the risk of a major depressive episode [32]. Conversely, the SU.FOL.OM3 trial found no effects of B vitamin supplementation on depressive symptoms in those with a cardiovascular disease history [65]. Interestingly, supplementation with omega 3s in men resulted in a 28% higher risk of presenting with depressive symptoms than those receiving a placebo, with no such increased risk observed in women.…”

Section: Subjective Outcomesmentioning

confidence: 99%

Dietary Intake and Intervention in Chronic Stroke: Review of the Evidence

Serra¹

2017

J Neurol Neurophysiol

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Despite evidence for a role of nutrition in the development of metabolic dysfunction, physical deconditioning, and psychological dysfunction common post-stroke, very little is known about the dietary habits and nutritional needs of chronic (>6 months) stroke survivors. This review summarizes the available evidence regarding dietary intake adequacy in chronic stroke survivors. It appears that a combination of screening methods, including food record, laboratory and malnutrition screening tools assessments may be beneficial to assess the dietary intake adequacy of stroke survivors. We also review the evidence suggesting the need for dietary modification by summarizing the strongest evidence (i.e., randomized controlled trial data) supporting and refuting the impact of nutritional interventions on clinical outcomes post-stroke. Data suggest that the B vitamins, omega 3s and vitamin D have promising effects on recovery post-stroke; however, to date, study limitations make drawing definitive conclusions regarding the impact of nutritional supplementation difficult. Further research is needed to provide insight on the ideal supplement dose and duration and about how different rehabilitation therapies (i.e., nutritional supplements, medications, exercise and caloric restriction) may interact to affect recovery. A better understanding of the role of nutrition during chronic stroke is needed as this information may one day help to individualize rehabilitation approaches to optimize patient outcomes.

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Supplementation with B vitamins or n−3 fatty acids and depressive symptoms in cardiovascular disease survivors: ancillary findings from the SUpplementation with FOLate, vitamins B-6 and B-12 and/or OMega-3 fatty acids (SU.FOL.OM3) randomized trial

Abstract: We showed no beneficial effects of a long-term, low-dose supplementation with B vitamins or n-3 fatty acids on depressive symptoms in cardiovascular disease survivors. The adverse effects of n-3 fatty acids in men merit confirmation.

Cited by 50 publications

References 33 publications

Role of Omega-3 Fatty Acids in the Treatment of Depressive Disorders: A Comprehensive Meta-Analysis of Randomized Clinical Trials

Role of Omega-3 Fatty Acids in the Treatment of Depressive Disorders: A Comprehensive Meta-Analysis of Randomized Clinical Trials

Inflammatory cytokine-associated depression

Dietary Intake and Intervention in Chronic Stroke: Review of the Evidence

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