The DOI matches its Crossref record; 43 of the 46 references it cites were found in a registry or an index.
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: The MooDFOOD Randomized Clinical Trial
Open accessAbstract
Importance: Effects of nutritional interventions on the prevention of major depressive disorder (MDD) in overweight adults are unknown. Objective: To examine the effect of 2 nutritional strategies (multinutrient supplementation, food-related behavioral activation therapy) and their combination for prevention of a new MDD episode in overweight adults with subsyndromal depressive symptoms. Design, Setting, and Participants: This multicenter 2 × 2 factorial randomized clinical trial included overweight adults (body mass index, 25-40) with elevated depressive symptoms (Patient Health Questionnaire-9 [PHQ-9] scores ≥5) and no MDD episode in the past 6 months from 4 European countries. A total of 1025 adults were randomized (July 30, 2015-October 12, 2016) and followed up for 1 year (October 13, 2017). Interventions: Daily multinutrient supplements (1412-mg omega-3 fatty acids, 30-μg selenium, 400-μg folic acid, and 20-μg vitamin D3 plus 100-mg calcium) vs placebo and 21 individual or group therapy sessions vs none (blinded to researchers) for 1 year. Participants were allocated to placebo without therapy (n = 257), placebo with therapy (n = 256), supplements without therapy (n = 256), and supplements with therapy (n = 256). Main Outcome and Measures: Cumulative 1-year onset of MDD via the Mini International Neuropsychiatric Interview at 3, 6, and 12 months. Logistic regression using effect-coded variables (-1 indicating control, 1 indicating intervention) evaluated intervention effects both individually and in combination (interaction) on MDD onset. Results: Among 1025 participants (mean age, 46.5 years; 772 women [75%]; mean BMI, 31.4), 779 (76%) completed the trial. During the 12-month follow-up, 105 (10%) developed MDD: 25 (9.7%) patients in the placebo without therapy, 26 (10.2%) in the placebo with therapy, 32 (12.5%) in the supplement without therapy, and 22 (8.6%) in the supplement with therapy group. None of the treatment strategies affected MDD onset. The odds ratio (OR) for supplements was 1.06 (95% CI, 0.87-1.29); for therapy, 0.93 (95% CI, 0.76-1.13); and for their combination, 0.93 (95% CI, 0.76-1.14; P for interaction, .48). One person in the supplementation with therapy group, died. Twenty-four patients in each of the placebo groups and 24 patients in the supplementation with therapy group were hospitalized, and 26 patients in the supplementation-only group were hospitalized. Conclusions and Relevance: Among overweight or obese adults with subsyndromal depressive symptoms, multinutrient supplementation compared with placebo and food-related behavioral activation therapy compared with no therapy did not reduce episodes of major depressive disorder during 1 year. These findings do not support the use of these interventions for prevention of major depressive disorder. Trial registration: ClinicalTrials.gov Identifier: NCT02529423.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The cited source says what the claim attributes to it.
In the citing paper
“a recent four-arm RCT examined nutrition-based interventions for the prevention of depressive episodes in 1,025 participants with subclinical depressive symptoms, and found no significant benefits from the behavioral activation intervention promoting healthy eating 101 .”
From A meta-review of "lifestyle psychiatry": the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders (2020) · cites this paper as [101]
The cited source says what the claim attributes to it.
In the citing paper
“Interestingly, the other 'active' arm of this RCT provided daily multinutrient supplementation, observing significantly worsened outcomes for depressive symptoms compared to placebo 101 .”
From A meta-review of "lifestyle psychiatry": the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders (2020) · cites this paper as [101]
In the citing paper
“a diet supplemented with omega-3 fatty acids, selenium, vitamin D, and calcium in the MooDFOOD randomized controlled trial did not reduce major depression episodes in overweight or obese adults with subsyndromal depressive symptoms [73, 74].”
From Role of diet and its effects on the gut microbiome in the pathophysiology of mental disorders (2022) · cites this paper as [73]
In the citing paper
“However, accounting for only subjects who complied over 12 months, a supplemented diet may be preventive in depression onset.”
From Role of diet and its effects on the gut microbiome in the pathophysiology of mental disorders (2022) · cites this paper as [73]
In the citing paper
“Of note, a recent large clinical trial found no significant benefits of a behavioural intervention promoting a Mediterranean diet for adults with subclinical depressive symptoms.34”
From Food and mood: How do diet and nutrition affect mental wellbeing? (2020) · cites this paper as [34]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
The PHQ-9: Validity of a brief depression severity measure
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.2001.016009606.x · Cited by 44,910
A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.10.1092 · Cited by 31,765
Multiple Imputation for Nonresponse in Surveys
Rubin, D. B. (1987) · Wiley Series in Probability and Statistics · doi:10.1002/9780470316696 · Cited by 20,701
(1998) · The Journal of Clinical Psychiatry · Cited by 19,139
EuroQol: a new facility for the measurement of health-related quality of life
(1990) · Health Policy · doi:10.1016/0168-8510(90)90421-9 · Cited by 15,736
(1998) · PubMed · Cited by 10,216
Vos, T., Flaxman, A. D., Naghavi, M., Lozano, R., Michaud, C., Ezzati, M., Shibuya, K., Salomon, J. A., Abdalla, S., Aboyans, V., et al. (2012) · The Lancet · doi:10.1016/s0140-6736(12)61729-2 · Cited by 8,291
Identification of Causal Effects Using Instrumental Variables
Angrist, J. D., Imbens, G. W., & Rubin, D. B. (1996) · Journal of the American Statistical Association · doi:10.1080/01621459.1996.10476902 · Cited by 4,230
Multiple Imputation for Nonresponse in Surveys.
Lynn, P. J., & Rubin, D. B. (1988) · Journal of the Royal Statistical Society Series D (The Statistician) · doi:10.2307/2348774 · Cited by 2,330
The Inventory of Depressive Symptomatology (IDS): Psychometric properties
Rush, A. J., Gullion, C. M., Basco, M. R., Jarrett, R. B., & Trivedi, M. H. (1996) · Psychological Medicine · doi:10.1017/s0033291700035558 · Cited by 2,177
Estimating effect sizes from pretest-posttest-control group designs
Morris, S. B. (2008) · Organizational Research Methods · doi:10.1177/1094428106291059 · Cited by 2,133
Use of the Danish Adoption Register for the study of obesity and thinness.
Stunkard, A. J., Sørensen, T. I. A., & D, F. S. M. (1983) · PubMed · Cited by 1,773
Wendel‐Vos, W. (2003) · Journal of Clinical Epidemiology · doi:10.1016/s0895-4356(03)00220-8 · Cited by 1,417
Valuing health-related quality of life: an EQ-5D-5L value set for England
Devlin, N. J., Shah, K. K., Feng, Y., Mulhern, B., & van Hout, B. (2018) · Health Economics · doi:10.1002/hec.3564 · Cited by 1,356
Jacka, F. N., O’Neil, A., Opie, R., Itsiopoulos, C., Cotton, S., Mohebbi, M., Castle, D., Dash, S., Mihalopoulos, C., Chatterton, M. L., et al. (2017) · BMC Medicine · doi:10.1186/s12916-017-0791-y · Cited by 1,093
Depression and obesity: evidence of shared biological mechanisms
Milaneschi, Y., Simmons, W. K., van Rossum, E. F. C., & Penninx, B. W. (2019) · Molecular Psychiatry · doi:10.1038/s41380-018-0017-5 · Cited by 1,073 · cited 1×
“Median (IQR) 20 (14-27) 21 (13-29) 21 (15-30) 20 (14-28) Anxiety severitye”
Self-citationThe Descriptive Epidemiology of Commonly Occurring Mental Disorders in the United States
Kessler, R. C., & Wang, P. S. (2008) · Annual Review of Public Health · doi:10.1146/annurev.publhealth.29.020907.090847 · Cited by 888
de Lauzon‐Guillain, B., Romon, M., Deschamps, V., Lafay, L., Borys, J.-M., Karlsson, J., Ducimetière, P., & Charles, M.-A. A. (2004) · Journal of Nutrition · doi:10.1093/jn/134.9.2372 · Cited by 738
Parletta, N., Zarnowiecki, D., Cho, J., Wilson, A., Bogomolova, S., Villani, A., Itsiopoulos, C., Niyonsenga, T., Blunden, S., Meyer, B., et al. (2019) · Nutritional Neuroscience · doi:10.1080/1028415x.2017.1411320 · Cited by 629
Ekers, D., Webster, L., Van Straten, A., Cuijpers, P., Richards, D., & Gilbody, S. (2014) · PLoS ONE · doi:10.1371/journal.pone.0100100 · Cited by 565
Molendijk, M., Molero, P., Ortuño Sánchez-Pedreño, F., Van der Does, W., & Angel Martínez-González, M. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2017.09.022 · Cited by 550
Different ways to estimate treatment effects in randomised controlled trials
J, T., L, B., T, H., J, R., M, W., & M, H. (2018) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2018.03.008 · Cited by 532
Preventing the Onset of Depressive Disorders: A Meta-Analytic Review of Psychological Interventions
Cuijpers, P., van Straten, A., Smit, F., Mihalopoulos, C., & Beekman, A. (2008) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2008.07091422 · Cited by 456 · cited 1×
“Median (IQR) 20 (14-27) 21 (13-29) 21 (15-30) 20 (14-28) Anxiety severitye”
Adjunctive Nutraceuticals for Depression: A Systematic Review and Meta-Analyses
Sarris, J., Murphy, J., Mischoulon, D., Papakostas, G. I., Fava, M., Berk, M., & Ng, C. H. (2016) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2016.15091228 · Cited by 436
van Zoonen, K., Buntrock, C., Ebert, D. D., Smit, F., Reynolds, C. F., Beekman, A. T., & Cuijpers, P. (2014) · International Journal of Epidemiology · doi:10.1093/ije/dyt175 · Cited by 425 · cited 1×
“comparable to that reported in (meta-analytic) studies of psychological interventions for depression.(35,28,40) In a post hoc analysis, a more beneficial effect of F-BA on depressive symptoms for those with higher baseline depression scores was observed.”
ResultPreventing Depression: A Global Priority
Cuijpers, P., Beekman, A. T. F., & Reynolds, C. F. (2012) · JAMA · doi:10.1001/jama.2012.271 · Cited by 368
Emsley, R., Dunn, G., & White, I. R. (2010) · Statistical Methods in Medical Research · doi:10.1177/0962280209105014 · Cited by 356
Collins, L. M., Dziak, J. J., Kugler, K. C., & Trail, J. B. (2014) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2014.06.021 · Cited by 335
Stepped-Care Prevention of Anxiety and Depression in Late Life
Veer-Tazelaar, P. J. V., van Marwijk, H., van Oppen, P., van Hout, H. P. J., van der Horst, H. E., Cuijpers, P. J., Smit, F., & Beekman, A. T. F. (2009) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2008.555 · Cited by 320
Mocking, R. J. T., Harmsen, I. M., Assies, J., Koeter, M. W. J., Ruhé, H. G., & Schene, A. H. (2016) · Translational Psychiatry · doi:10.1038/tp.2016.29 · Cited by 284
Behavioural activation for depression
Veale, D. (2008) · Advances in Psychiatric Treatment · doi:10.1192/apt.bp.107.004051 · Cited by 282
The association between low vitamin D and depressive disorders
Milaneschi, Y., Hoogendijk, W. J. G., Lips, P. T. A. M., Heijboer, A. C., Schoevers, R. A., van Hemert, A. M., Beekman, A. T. F., Smit, J. H., & Penninx, B. W. J. H. (2013) · Molecular Psychiatry · doi:10.1038/mp.2013.36 · Cited by 265
Self-citationRogers, P. J., Appleton, K. M., Kessler, D., Peters, T. J., Gunnell, D., Hayward, R. C., Heatherley, S. V., Christian, L. M., McNaughton, S. A., & Ness, A. R. (2008) · British Journal of Nutrition · doi:10.1017/s0007114507801097 · Cited by 243
Opie, R. S., O’Neil, A., Itsiopoulos, C., & Jacka, F. N. (2015) · Public Health Nutrition · doi:10.1017/s1368980014002614 · Cited by 243
Buntrock, C., Ebert, D. D., Lehr, D., Smit, F., Riper, H., Berking, M., & Cuijpers, P. (2016) · JAMA · doi:10.1001/jama.2016.4326 · Cited by 232
The role of vitamin D in the prevention of late-life depression
Okereke, O. I., & Singh, A. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.03.022 · Cited by 115
Impact of Selenium on Mood and Quality of Life: A Randomized, Controlled Trial
Rayman, M. P., Thompson, A., Warren-Perry, M., Galassini, R., Catterick, J., Hall, E., Lawrence, D., & Bliss, J. M. (2005) · Biological Psychiatry · doi:10.1016/j.biopsych.2005.06.019 · Cited by 101
Eating styles in major depressive disorder: Results from a large-scale study
Paans, N. P. G., Bot, M., van Strien, T., Brouwer, I. A., Visser, M., & Penninx, B. W. J. H. (2017) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2017.11.003 · Cited by 95
Self-citationVitamins B12, B6, and Folic Acid for Onset of Depressive Symptoms in Older Men
Ford, A. H., Flicker, L. A., Thomas, J., Norman, P. E., Jamrozik, K. D., & Almeida, O. P. (2008) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v69n0801 · Cited by 76
on behalf of the MooDFOOD Prevention Trial Investigators, Roca, M., Kohls, E., Gili, M., Watkins, E. R., Owens, M., Hegerl, U., van Grootheest, G., Bot, M., Cabout, M., et al. (2016) · BMC Psychiatry · doi:10.1186/s12888-016-0900-z · Cited by 65
Self-citationGarcia-Larsen, V., Luczyńska, M., Kowalski, M., Voutilainen, H., Ahlström, M., Haahtela, T., Toskala, E., Bockelbrink, A., Lee, H. H., Vassilopoulou, E., et al. (2011) · European Journal of Clinical Nutrition · doi:10.1038/ejcn.2011.15 · Cited by 63
Okereke, O. I., Cook, N. R., Albert, C. M., Denburgh, M. V., Buring, J. E., & Manson, J. E. (2015) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.114.148361 · Cited by 62
Bellón, J. Á., Moreno-Peral, P., Motrico, E., Morejón, A. R., Fernández, A., Serrano‐Blanco, A., Zabaleta‐del‐Olmo, E., & Cerón, S. C. (2014) · Preventive Medicine · doi:10.1016/j.ypmed.2014.11.003 · Cited by 59
Cited by
Sorted by citations
Firth, J., Solmi, M., Wootton, R. E., Vancampfort, D., Schuch, F. B., Hoare, E., Gilbody, S., Torous, J., Teasdale, S. B., Jackson, S. E., et al. (2020) · World Psychiatry · doi:10.1002/wps.20773 · Cited by 1,242
Marx, W., Penninx, B. W. J. H., Solmi, M., Furukawa, T. A., Firth, J., Carvalho, A. F., & Berk, M. (2023) · Nature Reviews Disease Primers · doi:10.1038/s41572-023-00454-1 · Cited by 910
Self-citationDiet and depression: Exploring the biological mechanisms of action
Marx, W., Lane, M., Hockey, M., Aslam, H., Berk, M., Walder, K., Borsini, A., Firth, J., Pariante, C. M., Berding, K., et al. (2021) · Molecular Psychiatry · doi:10.1038/s41380-020-00925-x · Cited by 685
Comorbid depression in medical diseases
Gold, S. M., Köhler‐Forsberg, O., Moss-Morris, R. E., Mehnert-Theuerkauf, A., Miranda, J. J., Bullinger, M., Steptoe, A., Whooley, M. A., & Otte, C. (2020) · Nature Reviews Disease Primers · doi:10.1038/s41572-020-0200-2 · Cited by 583
Food and mood: How do diet and nutrition affect mental wellbeing?
Firth, J., Gangwisch, J. E., Borsini, A., Wootton, R. E., & Mayer, E. A. (2020) · BMJ · doi:10.1136/bmj.m2382 · Cited by 475
Metadata
- Authors
- Bot, M., Brouwer, I. A., Roca, M., Kohls, E., Penninx, B. W. J. H., Watkins, E., van Grootheest, G., Cabout, M., Hegerl, U., Gili, M., Owens, M., Visser, M., & for the MooDFOOD Prevention Trial Investigators
- Affiliations
- Amsterdam Public Health (NL)
- Health Research Institute of the Balearic Islands (ES)
- Leipzig University (DE)
- Department of Psychology, University of Exeter, Exeter, United Kingdom
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health research institute, GGZ inGeest Specialized Mental Health Care, Amsterdam, the Netherlands
- University of Exeter (GB)
- Corresponding author
- Visser, Marjolein
- ORCID
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2019-03-05
- Volume
- 321
- Issue
- 9
- Pages
- 858
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- PMC
- PMC6439597
- OpenAlex
- W2919675892
- Cited by
- 128
- References
- 46
- Citations by year
- 2026: 13 · 2025: 11 · 2024: 14 · 2023: 17 · 2022: 21 · 2021: 16 · 2020: 21 · 2019: 15
- FWCI
- 11.31
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- JAMA (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion, other-oa)
- VU Research Portal (publishedVersion, other-oa)
- Open Research Exeter (University of Exeter) (acceptedVersion)
- Figshare (submittedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- National Institute for Health and Care Research (613598)
- University of Exeter
- European Commission (613598)
- GGZ inGeest
- NIHR Exeter Clinical Research Facility
- Topics
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Keywords
- subsyndromal depressive symptoms, overweight adults, obesity, omega-3 fatty acids, selenium, folic acid, vitamin D3, calcium, depression onset, dietary intervention, psychotherapy, factorial design, depression recurrence prevention, physical activity
- MeSH terms
- Adult, Analysis of Variance, Behavior Therapy, Combined Modality Therapy, Major Depressive Disorder, Depressive Disorder, Major, Female, Follow-Up Studies, Humans, Male, Middle Aged, Obesity, Psychotherapy, Group, Treatment Failure, Dietary Supplements, Overweight
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
