Obesity, metabolic syndrome and Mediterranean diet: Impact on depression outcome

Both obesity and MetS predict worse depression outcome.Low adherence to the Mediterranean diet is not associated with a poor depression prognosis at one year follow-up.Patients with obesity and comorbid MetS at baseline are the most clearly associated to a poorer depression prognosis after one year.If these findings are confirmed, clinicians should consider MetS and facilitate their diagnosis and treatment in overweight depressed patients, especially if the outcome is not satisfactory enough.

ObjectiveObesity, metabolic syndrome (MetS) and low adherence to Mediterranean diet are frequent in major depression patients and have been separately related with prognosis. The aim of this study is to analyse their predictive power on major depression outcome, at 6 and 12 months.Methods273 Major depressive patients completed the Beck Depression Inventory for depressive symptoms and the 14-item Mediterranean diet adherence score. MetS was diagnosed according to the International Diabetes Federation (IDF).ResultsAt the baseline Mediterranean diet adherence was inversely associated with depressive symptoms (p=0.007). Depression response was more likely in those patients with normal weight (p=0.006) and not MetS (p=0.013) but it was not associated with Mediterranean diet adherence (p=0.625). Those patients with MetS and obesity were less likely to improve symptoms of depression than patients with obesity but not MetS.ConclusionsObesity and MetS, but not low adherence to the Mediterranean diet at baseline, predicted a poor outcome of depression at 12 months. Our study suggests that MetS is the key factor that impacts negatively in depression prognosis, rather than obesity or diet. If this finding is confirmed, clinicians should be aware about MetS diagnosis and treatment in overweight depressed patients, especially if outcome is not being satisfactory enough.