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Visa fullständig version : Kostomläggning effektiv behandling för depression


King Grub
2017-02-06, 10:21
Background

The possible therapeutic impact of dietary changes on existing mental illness is largely unknown. Using a randomised controlled trial design, we aimed to investigate the efficacy of a dietary improvement program for the treatment of major depressive episodes.

Methods

‘SMILES’ was a 12-week, parallel-group, single blind, randomised controlled trial of an adjunctive dietary intervention in the treatment of moderate to severe depression. The intervention consisted of seven individual nutritional consulting sessions delivered by a clinical dietician. The control condition comprised a social support protocol to the same visit schedule and length. Depression symptomatology was the primary endpoint, assessed using the Montgomery–Åsberg Depression Rating Scale (MADRS) at 12 weeks. Secondary outcomes included remission and change of symptoms, mood and anxiety. Analyses utilised a likelihood-based mixed-effects model repeated measures (MMRM) approach. The robustness of estimates was investigated through sensitivity analyses.

Results

We assessed 166 individuals for eligibility, of whom 67 were enrolled (diet intervention, n = 33; control, n = 34). Of these, 55 were utilising some form of therapy: 21 were using psychotherapy and pharmacotherapy combined; 9 were using exclusively psychotherapy; and 25 were using only pharmacotherapy. There were 31 in the diet support group and 25 in the social support control group who had complete data at 12 weeks. The dietary support group demonstrated significantly greater improvement between baseline and 12 weeks on the MADRS than the social support control group, t(60.7) = 4.38, p < 0.001, Cohen’s d = –1.16. Remission, defined as a MADRS score <10, was achieved for 32.3% (n = 10) and 8.0% (n = 2) of the intervention and control groups, respectively (χ 2 (1) = 4.84, p = 0.028); number needed to treat (NNT) based on remission scores was 4.1 (95% CI of NNT 2.3–27.8). A sensitivity analysis, testing departures from the missing at random (MAR) assumption for dropouts, indicated that the impact of the intervention was robust to violations of MAR assumptions.

Conclusions

These results indicate that dietary improvement may provide an efficacious and accessible treatment strategy for the management of this highly prevalent mental disorder, the benefits of which could extend to the management of common co-morbidities.

A randomised controlled trial of dietary improvement for adults with major depression (the ‘SMILES’ trial). BMC Medicine, 30 January 2017.

http://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0791-y

mytimecouldbeyou
2017-02-06, 11:19
Bättre än många antidepressiva då alltså. Gissar att det här ändå stärker serotonin-hypotesen.

Shqypnia
2017-02-06, 11:25
Förbättrad kost + regelbunden träning + en joint om dagen = inga mer deppiga människor?

Konradsson
2017-02-06, 20:05
Förbättrad kost + regelbunden träning + en joint om dagen = inga mer deppiga människor?
https://www.ncbi.nlm.nih.gov/pubmed/23795762
Cannabis use, and particularly heavy cannabis use, may be associated with an increased risk for developing depressive disorders.
https://www.ncbi.nlm.nih.gov/pubmed/14616175
Heavy cannabis use and depression are associated and evidence from longitudinal studies suggests that heavy cannabis use may increase depressive symptoms among some users.

vonad
2017-02-06, 20:06
Förbättrad kost + regelbunden träning + en joint om dagen = inga mer deppiga människor?

Alkohol är nog mer effektivt i det avseendet. :D

kalis
2017-02-06, 20:16
Tror själv på att träning kan hålla depression på avstånd.

Skrollovicz
2017-02-06, 22:38
Tror själv på att träning kan hålla depression på avstånd.

Det är väl inget att tro på, det är bevisat. :D

Tree Fiddy
2017-02-06, 22:53
https://www.ncbi.nlm.nih.gov/pubmed/23795762

https://www.ncbi.nlm.nih.gov/pubmed/14616175

Fast nu jämför ju du "en joint om dagen" med "heavy cannabis use"?

Diomedea exulans
2017-02-06, 23:55
Och så här åt de.

This comprised the ‘ModiMedDiet’, developed by RO and CI, which was based on the Australian Dietary guidelines [29] and the Dietary Guidelines for Adults in Greece [30] and is concordant with our previous dietary recommendations for the prevention of depression [31]. The primary focus was on increasing diet quality by supporting the consumption of the following 12 key food groups (recommended servings in brackets): whole grains (5–8 servings per day); vegetables (6 per day); fruit (3 per day), legumes (3–4 per week); low-fat and unsweetened dairy foods (2–3 per day); raw and unsalted nuts (1 per day); fish (at least 2 per week); lean red meats (3–4 per week) [32], chicken (2–3 per week); eggs (up to 6 per week); and olive oil (3 tablespoons per day), whilst reducing intake of ‘extras’ foods, such as sweets, refined cereals, fried food, fast-food, processed meats and sugary drinks (no more than 3 per week). Red or white wine consumption beyond 2 standard drinks per day and all other alcohol (e.g. spirits, beer) were included within the ‘extras’ food group. Individuals were advised to select red wine preferably and only drink with meals. The dietary composition of the ModiMedDiet was as follows: protein 18% of total energy (E); fat 40% of E; carbohydrates 37% of E; alcohol 2% of E; fibre/other 3% of E. The diet was designed to be easy to follow, sustainable, palatable, and satiating. Individuals were advised to consume the diet ad libitum, as the intervention did not have a weight loss focus. The method for scoring the ModiMedDiet is similar to those used in PREDIMED [33] and the Framingham Offspring Cohort [34]. It is a criterion-based diet score that uses pre-defined absolute or normative goals of consumption for specific food items, independent of the individual’s characteristics. It was developed based on the recommended intakes of the 11 food group components that comprise the ModiMedDiet (as above), and of the score has a theoretical maximum value of 120.

Konradsson
2017-02-07, 00:31
Fast nu jämför ju du "en joint om dagen" med "heavy cannabis use"?

I studien stod det "Cannabis use, and particularly heavy cannabis use". Heavy cannabis use räknas som >4 joints/dag. Risken för depression är antagligen dosrelaterad. Jag hittar dock ingenting som visar att <4 joints/dag skulle motverka depression (förutom några spekulativa studier om cannabidiol, men det förutsätter ju att man använder strains med mycket CBD och lite THC, vilket är ganska ovanligt).

sumialic
2017-02-08, 11:43
För er som är införstådda i studien, vilka kostförbättringar gjordes?

King Grub
2017-02-08, 11:50
Jag har länkat till fullängdsartikeln.

sumialic
2017-02-08, 11:59
Jag har länkat till fullängdsartikeln.

Jo, jag vet det, men jag har ingen tid att sitta och läsa igenom den.

Diomedea exulans
2017-02-08, 12:15
Jo, jag vet det, men jag har ingen tid att sitta och läsa igenom den.

Jag skrev det två inlägg ovanför ditt.

sumialic
2017-02-08, 12:24
Jag skrev det två inlägg ovanför ditt.

Tack, missade det :)