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Masot O, Ochoa Herrera JJ, Paraíso Pueyo E, Roca J, Miranda J, Lavedán A. The impact of docosahexaenoic acid on maternal mental health: scoping review. NUTR HOSP 2023; 40:848-857. [PMID: 37334807 DOI: 10.20960/nh.04523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023] Open
Abstract
Introduction Docosahexaenoic acid (DHA) is a polyunsaturated essential fatty acid from the omega-3 series that appears to be key to perinatal mental health. For this, the aim of this review is to evaluate the effect of DHA on maternal mental health during pregnancy and lactation with respect to depression and anxiety. The present scoping review was carried out following the methodology of Arksey and O'Malley (2005). The selection of studies was carried out in accordance with PRISMA by means of systematic searches in the PubMed, Scopus, PsycINFO and Medline databases. The results classified according to the effectiveness of DHA. In most (n = 9) of the 14 studies finally included, DHA plasma levels with or without other polyunsaturated omega-3 fatty acids were significantly lower in pregnant women with depressive and anxiety symptoms. However, no study reported a beneficial effect of DHA on mental health during the postpartum period. The majority used detection method was the Edinburgh Postpartum Depression Scale (n = 11). The prevalence of depressive symptoms ranged between 5.9 % and 50 %. As a conclusion, although more research is needed in this area, these exploratory results suggest that DHA could play an important role in preventing the pathogenesis of depression and anxiety during gestation.
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Affiliation(s)
- Olga Masot
- Department of Nursing and Physiotherapy. Universidad de Lleida. Health Care Research Group (GRECS). Instituto de Investigación Biomédica de Lleida Fundación Dr. Pifarré. IRBLleida
| | - Julio José Ochoa Herrera
- Instituto de Nutrición y Tecnología de los Alimentos José Mataix Verdú (INYTA). Department of Physiology. Universidad de Granada
| | - Elena Paraíso Pueyo
- Department of Nursing and Physiotherapy. Universidad de Lleida. Health Care Research Group (GRECS). Instituto de Investigación Biomédica de Lleida Fundación Dr. Pifarré. IRBLleida
| | - Judith Roca
- Department of Nursing and Physiotherapy. Universidad de Lleida. Health Care Research Group (GRECS). Instituto de Investigación Biomédica de Lleida Fundación Dr. Pifarré. IRBLleida
| | - Jéssica Miranda
- Department of Nursing and Physiotherapy. Universidad de Lleida. Health Care Research Group (GRECS). Instituto de Investigación Biomédica de Lleida Fundación Dr. Pifarré. IRBLleida
| | - Ana Lavedán
- Department of Nursing and Physiotherapy. Universidad de Lleida. Health Care Research Group (GRECS). Instituto de Investigación Biomédica de Lleida Fundación Dr. Pifarré. IRBLleida
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Jiang Y, Chen Y, Wei L, Zhang H, Zhang J, Zhou X, Zhu S, Du Y, Su R, Fang C, Ding W, Feng L. DHA supplementation and pregnancy complications. J Transl Med 2023; 21:394. [PMID: 37330569 PMCID: PMC10276458 DOI: 10.1186/s12967-023-04239-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 05/31/2023] [Indexed: 06/19/2023] Open
Abstract
Docosahexaenoic acid (DHA) supplementation is recommended for women during pregnancy because of its neurological, visual, and cognitive effects. Previous studies have suggested that DHA supplementation during pregnancy may prevent and treat certain pregnancy complications. However, there are contradictions in the current related studies, and the specific mechanism by which DHA acts remains unclear. This review summarizes the research on the relationship between DHA intake during pregnancy and preeclampsia, gestational diabetes mellitus, preterm birth, intrauterine growth restriction, and postpartum depression. Furthermore, we explore the impact of DHA intake during pregnancy on the prediction, prevention, and treatment of pregnancy complications as well as its impact on offspring neurodevelopment. Our results suggest that there is limited and controversial evidence for the protective effect of DHA intake on pregnancy complications, with the exception of preterm birth and gestational diabetes mellitus. However, additional DHA supplementation may improve long-term neurodevelopmental outcomes in the offspring of women with pregnancy complications.
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Affiliation(s)
- Yi Jiang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Yuting Chen
- Department of Obstetrics and Gynecology Ultrasound, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Lijie Wei
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Huiting Zhang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Jingyi Zhang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Xuan Zhou
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Shenglan Zhu
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Yuanyuan Du
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Rui Su
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Chenyun Fang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Wencheng Ding
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, 430030, Hubei, China.
| | - Ling Feng
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, 430030, Hubei, China.
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Chang MW, Schaffir J, Tan A, Wegener DT, Strafford K, Worly B, Sampsell C, Rosen M, Soma L. Dietary Intake of Micronutrients and Essential Fatty Acids among Overweight or Obese Pregnant Women during Early Pregnancy. JOURNAL OF PEDIATRICS, PERINATOLOGY AND CHILD HEALTH 2023; 7:55-62. [PMID: 38577312 PMCID: PMC10994147 DOI: 10.26502/jppch.74050145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
Background Dietary intake of micronutrients and essential fatty acids in overweight or obese pregnant women during early pregnancy is unknown. We investigated the proportion of pregnant women meeting recommendations for dietary intake of micronutrients and essential fatty acids and compared stress and depressive symptoms between those meeting and below recommendations. Methods Participants (N = 70) were overweight or obese pregnant women ≤16 weeks gestation. They completed two 24-hour dietary recalls and online surveys measuring stress and depressive symptoms. Micronutrients of interest included B vitamins, choline, and trace minerals (calcium, magnesium, selenium, and zinc). Essential fatty acids were docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). Results Low proportions of participants met recommendations for choline (21.4%) and folate (24.3%). Yet, the proportion of women meeting recommendations for other B vitamins and trace minerals were much better. Less than 9.0% of participants met recommendations for essential fatty acids. Compared with those below recommendations for B3 and selenium, participants meeting recommendations had significantly fewer depressive symptoms. Conclusions Low proportions of overweight or obese pregnant participants met dietary intake recommendations for micronutrients and essential fatty acids.
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Affiliation(s)
- Mei-Wei Chang
- The Ohio State University College of Nursing, 1577 Neil Avenue, Columbus, OH 43210, USA
| | - Jonathan Schaffir
- The Ohio State University, Department of Obstetrics and Gynecology, 395 West 12 Avenue Columbus, OH 43210, USA
| | - Alai Tan
- The Ohio State University College of Nursing, 1577 Neil Avenue, Columbus, OH 43210, USA
| | - Duane T Wegener
- The Ohio State University Department of Psychology, 1835 Neil Avenue, Columbus, OH 43210, USA
| | - Katherine Strafford
- The Ohio State University, Department of Obstetrics and Gynecology, 395 West 12 Avenue Columbus, OH 43210, USA
| | - Brett Worly
- The Ohio State University, Department of Obstetrics and Gynecology, 395 West 12 Avenue Columbus, OH 43210, USA
| | - Cassandra Sampsell
- The Ohio State University, Department of Obstetrics and Gynecology, 395 West 12 Avenue Columbus, OH 43210, USA
| | - Maggie Rosen
- The Ohio State University, Department of Obstetrics and Gynecology, 395 West 12 Avenue Columbus, OH 43210, USA
| | - Loriana Soma
- The Ohio State University, Department of Obstetrics and Gynecology, 395 West 12 Avenue Columbus, OH 43210, USA
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Osuna E, Symington EA, Malan L, Ricci C, Zandberg L, Smuts CM, Baumgartner J. Higher n-3 polyunsaturated fatty acid status during early pregnancy is associated with lower risk for depression at 12 months postpartum: The NuPED study. Prostaglandins Leukot Essent Fatty Acids 2023; 190:102528. [PMID: 36716632 DOI: 10.1016/j.plefa.2022.102528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 11/30/2022] [Accepted: 12/23/2022] [Indexed: 01/15/2023]
Abstract
Perinatal depression can negatively affect the health of the mother and her offspring. N-3 polyunsaturated fatty acids (PUFA) may play a role in the aetiology of depression. Therefore, we investigated the association of n-3 PUFA status during early pregnancy with perinatal depression among women living in urban Johannesburg, South Africa. For this prospective analysis, we analysed red blood cell (RBC) total phospholipid fatty acid (FA) composition (% of total FA) of 242 pregnant women at <18 weeks' gestation. We used the Edinburgh Postnatal Depression Scale (EPDS) to identify women at risk for depression (EPDS score ≥9) at <18, 22 and 36 weeks' gestation, and at 6 and 12 months postpartum. RBC EPA status was negatively (β=-0.22, p<0.05), and the AA/EPA ratio positively (β=0.24, p<0.05) associated with EPDS scores at 12 months postpartum. Higher RBC DHA and n-3 index were further associated with lower odds (OR=0.56 [95% CI: 0.32-0.91]; OR=0.63 [95% CI: 0.39-0.94]), while higher n-6/n-3 PUFA and AA/EPA ratios early in pregnancy were associated with higher odds for depression at 12 months postpartum ((OR=2.34 [95% CI: 1.12-4.97]; OR=1.02 [95% CI: 1.00-1.05]). Our results suggest that women with a higher RBC n-3 PUFA status during early pregnancy may be at lower risk for depression at 12 months postpartum.
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Affiliation(s)
- Ester Osuna
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Switzerland
| | - Elizabeth A Symington
- Department of Life and Consumer Sciences, University of South Africa, Johannesburg, South Africa
| | - Linda Malan
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
| | - Cristian Ricci
- Africa Unit for Transdisciplinary Health Research (AUTHER), North-West University, Potchefstroom, South Africa
| | - Lizelle Zandberg
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
| | - Cornelius M Smuts
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
| | - Jeannine Baumgartner
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Switzerland; Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa; Department of Nutritional Sciences, King's College London, London, United Kingdom.
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Broś-Konopielko M, Białek A, Johne M, Czajkowski K. Increased LC PUFA Levels in the Serum of Pregnant Women and Their Children as a Result of Dietary Supplementation with 'Omega' Fatty Acids. Nutrients 2023; 15:231. [PMID: 36615888 PMCID: PMC9824740 DOI: 10.3390/nu15010231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/23/2022] [Accepted: 12/30/2022] [Indexed: 01/03/2023] Open
Abstract
Essential fatty acids (EFA) and long-chain polyunsaturated fatty acids (LC PUFA) are considered the most valuable bioactive fatty acids (FA) of the greatest importance for the mother’s and child’s health (e.g., placentation process, labor course, development of the central nervous system, visual acuity, cognitive functions), which results in dietary recommendations concerning EFA and LC PUFA intake in the diet of pregnant women. In this study, we aimed to evaluate the frequency of different food products consumption and ‘omega’ dietary supplements usage in groups of pregnant women. We also measured n-3 and n-6 FA content in serum samples of pregnant women and their children with the GC-FID technique, estimated the efficacy of applied supplementation, and compared the usefulness of different dietary supplements dedicated for pregnant women. ‘Omega’ dietary supplements effectively increased LC PUFA in the maternal blood (EPA, p = 0.0379; DHA p < 0.0001; n-3 PUFA, p < 0.0001), which penetrated the umbilical cord (EPA, p = 0.0131; DHA, p = 0.0288). If fish and seafood consumption is not enough, dietary supplements of the highest quality may provide sufficient LC PUFA without apprehension of MetHg contamination. ‘Omega’ dietary supplementation seems the most efficient way of providing an optimal supply of LC PUFA for the developing child from the earliest stages of development, which will bring advantages in the child’s future life and its health.
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Affiliation(s)
- Magdalena Broś-Konopielko
- II Faculty and Clinic of Obstetrics and Gynaecology, Medical University of Warsaw, Karowa 2, 00-315 Warsaw, Poland
| | - Agnieszka Białek
- Faculty of Medical and Health Sciences, University of Economics and Human Sciences in Warsaw, Okopowa 59, 01-043 Warsaw, Poland
- The Kielanowski Institute of Animal Physiology and Nutrition, Polish Academy of Sciences, Instytucka 3, 05-110 Jabłonna, Poland
| | - Monika Johne
- Faculty of Physical Education, Józef Piłsudski University of Physical Education in Warsaw, Marymoncka 34, 00-968 Warsaw, Poland
| | - Krzysztof Czajkowski
- II Faculty and Clinic of Obstetrics and Gynaecology, Medical University of Warsaw, Karowa 2, 00-315 Warsaw, Poland
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Wang Y, Dong L, Pan D, Xu D, Lu Y, Yin S, Wang S, Xia H, Liao W, Sun G. Effect of High Ratio of n-6/n-3 PUFAs on Depression: A Meta-Analysis of Prospective Studies. Front Nutr 2022; 9:889576. [PMID: 35669073 PMCID: PMC9164255 DOI: 10.3389/fnut.2022.889576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 04/25/2022] [Indexed: 12/05/2022] Open
Abstract
Objective The aim of this systematic review and meta-analysis was to examine the association between high ratio of n-6/n-3 polyunsaturated fatty acids (PUFAs) and depression. Methods The authors conducted a meta-analysis of research articles on the association of high ratio of n-6/n-3 PUFAs with the risk of depression published in the online article database on PubMed, Embase, Cochrane library as of December 2021. Pooled odds ratios (OR) were calculated using random effects models. Publication bias was assessed visually by funnel plots and statistically by the Egger’s and Begg’s tests. Results Finally, 12 studies included in this systematic review and meta-analysis with a total of 66,317 participants (including 4,173 individuals with depression condition). The pooled results showed that high ratio of n-6/n-3 PUFAs might be positively associated with depression [OR = 1.21, 95% confidence intervals (CIs): 1.04∼1.41]. The I2 test indicated that there was a substantial statistical heterogeneity across the included studies (I2 = 54.38%, P = 0.01). Subgroup analysis showed that high ratio of n-6/n-3 PUFAs in blood had no significant association with depression (OR = 1.15, 95%CI: 0.88∼1.50), while high ratio of n-6/n-3 PUFAs in dietary supplements was positively associated with depression (OR = 1.32, 95%CI: 1.16∼1.51). Conclusion This meta-analysis confirmed the association between high ratio of n-6/n-3 PUFAs and the risk of depression. High ratio of n-6/n-3 PUFAs in dietary supplementation was positively associated with depression, but had no significant association in the blood. This study suggested that lowering the dietary intake of the ratio of n-6/n-3 PUFAs would be beneficial in the prevention of depression.
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Affiliation(s)
- Yuanyuan Wang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
| | - Lirong Dong
- Department of Integrated Service and Management, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Da Pan
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
| | - Dengfeng Xu
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
| | - Yifei Lu
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
| | - Shiyu Yin
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
| | - Shaokang Wang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
| | - Hui Xia
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
| | - Wang Liao
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
- China-DRIs Expert Committee on Macronutrients, Beijing, China
| | - Guiju Sun
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
- China-DRIs Expert Committee on Macronutrients, Beijing, China
- *Correspondence: Guiju Sun,
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Suradom C, Suttajit S, Oon-Arom A, Maneeton B, Srisurapanont M. Omega-3 polyunsaturated fatty acid (n-3 PUFA) supplementation for prevention and treatment of perinatal depression: a systematic review and meta-analysis of randomized-controlled trials. Nord J Psychiatry 2021; 75:239-246. [PMID: 33190574 DOI: 10.1080/08039488.2020.1843710] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Available interventions for preventing and treating perinatal depression remain unsatisfactory. AIMS We examined the prophylactic and therapeutic effects, as well as adverse effects, of n-3 PUFA supplementation in reducing depressive symptoms during perinatal periods. METHODS We included randomized, placebo-controlled trials that reported the changes of depression severity after the perinatal participants received n-3 PUFA supplementation. After the comprehensive searches in October 2019, we selected the trials, extracted the data, and assessed the quality of included trials. We compared the standardized mean differences (SMD) of depression score changes between groups using a random-effect model. RESULTS We included 11 trials in the meta-analysis and one more trial for qualitative analysis (N = 3,181). The pooled standardized mean of decreased depression scores revealed no statistically significant difference between the n-3 PUFA and the placebo groups (N = 920, SMDs = -0.05, 95% CI -0.20 to 0.10, I2 = 21%). The pooled SMDs showed no statistically significant efficacy of n-3 PUFA supplementation for prevention (N = 779, SMDs = -0.03, 95% CI -0.20 to 0.13, I2 = 24%) and treatment (N = 141, SMDs = -0.14, 95% CI -0.55 to 0.27, I2 = 31%) of perinatal depression. The efficacy of n-3 PUFA supplementation was not associated with the daily doses of DHA, EPA, or DHA plus EPA. No trial reported any serious adverse effect of n-3 PUFA supplements. CONCLUSIONS Although n-3 PUFA supplementation may improve maternal and infant outcomes, our meta-analysis found insufficient evidence to determine its benefit for perinatal depression.
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Affiliation(s)
- Chawisa Suradom
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Sirijit Suttajit
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Awirut Oon-Arom
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Benchalak Maneeton
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Manit Srisurapanont
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Sousa TMD, Santos LCD. Dietary fatty acids, omega-6/omega-3 ratio and cholesterol intake associated with depressive symptoms in low-risk pregnancy. Nutr Neurosci 2020; 25:642-647. [DOI: 10.1080/1028415x.2020.1792618] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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9
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Salehi‐Pourmehr H, Dolatkhah N, Gassab‐Abdollahi N, Farrin N, Mojtahedi M, Farshbaf‐Khalili A. Screening of depression in overweight and obese pregnant women and its predictors. J Obstet Gynaecol Res 2019; 45:2169-2177. [DOI: 10.1111/jog.14100] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 08/14/2019] [Indexed: 12/27/2022]
Affiliation(s)
- Hanieh Salehi‐Pourmehr
- Research Center for Evidence‐Based Medicine, Iranian EBM Centre: A Joanna Briggs Institute Affiliated GroupTabriz University of Medical Sciences Tabriz Iran
| | - Neda Dolatkhah
- Aging Research Institute, Physical Medicine and Rehabilitation Research CentreTabriz University of Medical Sciences Tabriz Iran
| | - Nafiseh Gassab‐Abdollahi
- Department of Midwifery, Faculty of Nursing and MidwiferyTabriz University of Medical sciences Tabriz Iran
| | - Nazila Farrin
- Nutrition Research CentreTabriz University of Medical Sciences Tabriz Iran
| | - Mandana Mojtahedi
- Faculty of Nursing and MidwiferyTabriz University of Medical Sciences Tabriz Iran
| | - Azizeh Farshbaf‐Khalili
- Aging Research Institute, Physical medicine and rehabilitation Research CentreTabriz University of Medical Sciences Tabriz Iran
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Robinson SL, Oliveros H, Mora-Plazas M, Marín C, Lozoff B, Villamor E. Polyunsaturated fatty acids in middle childhood and externalizing and internalizing behavior problems in adolescence. Eur J Clin Nutr 2019; 74:481-490. [PMID: 31383976 DOI: 10.1038/s41430-019-0484-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Revised: 06/25/2019] [Accepted: 07/22/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND/OBJECTIVES We sought to determine the associations of n-3 and n-6 polyunsaturated fatty acids (PUFA) in middle childhood with externalizing and internalizing behavior problems in adolescence. SUBJECTS/METHODS Using gas-liquid chromatography, we quantified n-3 and n-6 PUFA in serum samples of 444 Colombian schoolchildren aged 5-12 years at the time of enrollment into a cohort study. After a median 6 years, adolescent externalizing and internalizing behavior problems were determined with the Youth Self Report (YSR) questionnaire. We estimated adjusted mean behavior problem score differences with 95% confidence intervals (CIs) between quartiles of each PUFA using multivariable linear regression. We also considered as exposures the Δ6-desaturase (D6D) and Δ5-desaturase (D5D) enzyme activity indices. RESULTS Docosahexaenoic acid (DHA) was positively associated with externalizing problems; every standard deviation (SD) of DHA concentration was associated with an adjusted one unit higher externalizing problem score (95% CI: 0.1, 1.9). The D5D enzyme activity index was inversely related to externalizing problem scores. Alpha-linolenic acid concentration was positively associated with internalizing problem scores, whereas adrenic acid was inversely related to this outcome. CONCLUSIONS Serum PUFA in middle childhood were related to behavior problems in adolescence. Some of these associations might reflect the role of D5D enzyme activity.
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Affiliation(s)
- Sonia L Robinson
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | | | | | - Constanza Marín
- Universidad de la Sabana, Chia, Colombia.,Foundation for Research in Nutrition and Health, Bogota, Colombia
| | - Betsy Lozoff
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA.,Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Eduardo Villamor
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA.
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Drouin G, Rioux V, Legrand P. The n-3 docosapentaenoic acid (DPA): A new player in the n-3 long chain polyunsaturated fatty acid family. Biochimie 2019; 159:36-48. [DOI: 10.1016/j.biochi.2019.01.022] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 01/30/2019] [Indexed: 12/20/2022]
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12
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Berger M, Nelson B, Markulev C, Yuen HP, Schäfer MR, Mossaheb N, Schlögelhofer M, Smesny S, Hickie IB, Berger GE, Chen EYH, de Haan L, Nieman DH, Nordentoft M, Riecher-Rössler A, Verma S, Mitchell TW, Meyer BJ, Thompson A, Yung AR, McGorry PD, Amminger GP. Relationship Between Polyunsaturated Fatty Acids and Psychopathology in the NEURAPRO Clinical Trial. Front Psychiatry 2019; 10:393. [PMID: 31244693 PMCID: PMC6562242 DOI: 10.3389/fpsyt.2019.00393] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 05/17/2019] [Indexed: 12/11/2022] Open
Abstract
Background: Deficiencies in membrane polyunsaturated fatty acids (PUFA) such as omega-3 (n-3) fatty acids are thought to contribute to the pathophysiological processes underlying psychotic disorders. Emerging evidence suggests that the levels of PUFA are related to clinical symptoms but significant heterogeneity exists between studies. Here, we investigated associations of membrane PUFA with clinical symptoms and functioning in a large sample of individuals at ultra-high risk (UHR) for psychosis. Methods: A total of 285 participants of the NEURAPRO clinical trial were investigated for erythrocyte PUFA levels, including the n-3 index, n-6/n-3 PUFA ratio, docosahexaenoic acid (DHA), and eicosapentaenoic acid (EPA). Severity of general psychopathology [Brief Psychiatric Rating Scale (BPRS)], psychotic symptoms (BPRS psychosis subscale), negative symptoms [Scale for the Assessment of Negative Symptoms (SANS)], manic symptoms [Young Mania Rating Scale (YMRS)], depressive symptoms [Montgomery Asberg Depression Rating Scale (MADRS)], and functioning [Social and Occupational Functioning Scale (SOFAS), Global Functioning Social (GF-S) and Role (GF-R) scales] were assessed concurrently. Partial correlation taking into account the effects of gender, age, and smoking was used to examine the relationship between PUFAs and symptoms severity. Results: The n-3 index negatively correlated with the severity of general psychopathology, psychotic symptoms, depressive symptoms, and manic symptoms. The n-6/n-3 PUFA ratio positively correlated with severity of psychotic and depressive symptoms. The n-3 PUFA DHA negatively correlated with the severity of general psychopathology, positive, manic, and depressive symptoms. EPA negatively correlated with manic symptoms. Nervonic acid, an n-9 monounsaturated fatty acid, positively correlated with general psychopathology, positive and negative symptoms, depressive symptoms, and manic symptoms. The long-chain saturated fatty acid tetracosanoic acid positively correlated with general psychopathology, positive, manic, and depressive symptoms. Conclusions: Partially consistent with a previous study, psychotic symptoms, depressive symptoms, and symptoms of mania were associated with several classes of FAs in the present study. These findings support the relevance of membrane fatty acids for the onset of psychotic symptoms and indicate that FAs should be further evaluated as biomarkers in the UHR for psychosis group. Clinical Trial Registration: ANZCTR, identifier: 12608000475347.
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Affiliation(s)
- Maximus Berger
- Orygen-The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Barnaby Nelson
- Orygen-The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Connie Markulev
- Orygen-The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Hok Pan Yuen
- Orygen-The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Miriam R Schäfer
- Orygen-The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Nilufar Mossaheb
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University Vienna, Vienna, Austria.,Department of Child and Adolescent Psychiatry, Medical University Vienna, Vienna, Austria
| | - Monika Schlögelhofer
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University Vienna, Vienna, Austria
| | - Stefan Smesny
- Department of Psychiatry, University Hospital Jena, Jena, Germany
| | - Ian B Hickie
- Brain and Mind Research Institute, University of Sydney, Sydney, NSW, Australia
| | - Gregor E Berger
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - Eric Y H Chen
- Department of Psychiatry, University of Hong Kong, Hong Kong, Hong Kong
| | - Lieuwe de Haan
- Department of Psychiatry, Academic Medical Center, Amsterdam, Netherlands
| | - Dorien H Nieman
- Department of Psychiatry, Academic Medical Center, Amsterdam, Netherlands
| | | | | | - Swapna Verma
- Institute of Mental Health, Singapore, Singapore
| | - Todd W. Mitchell
- School of Medicine and Lipid Research Centre, University of Wollongong, Wollongong, NSW, Australia,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Barbara J. Meyer
- School of Medicine and Lipid Research Centre, University of Wollongong, Wollongong, NSW, Australia,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Andrew Thompson
- Orygen-The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Alison Ruth Yung
- Orygen-The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia.,Institute of Brain, Behaviour, and Mental Health, University of Manchester, Manchester, United Kingdom
| | - Patrick D McGorry
- Orygen-The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - G Paul Amminger
- Orygen-The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
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13
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Hsu MC, Tung CY, Chen HE. Omega-3 polyunsaturated fatty acid supplementation in prevention and treatment of maternal depression: Putative mechanism and recommendation. J Affect Disord 2018; 238:47-61. [PMID: 29860183 DOI: 10.1016/j.jad.2018.05.018] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 04/03/2018] [Accepted: 05/15/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Women are vulnerable to depression during their childbearing years, and giving birth to a child precipitates postpartum depression (PPD) in some women. This review focuses on comparing the effectiveness of omega-3 polyunsaturated fatty acid supplementation on depression during pregnancy or PPD after childbirth. METHODS MEDLINE, PubMed, PsycINFO, and the Cochrane Collaboration Registry of Controlled Trials etc. through July 2017 were searched. Studies of dietary intake and plasma and/or milk levels of omega-3 fatty acids and trials of benefits and effects of omega-3 fatty acids supplements on pregnant or postpartum women with depression were specifically selected. RESULTS Omega-3 fatty acid deficiency, due to inadequate intake, fast depletion during pregnancy and lactation, is one of the risk factors of PPD. Associations between neuroinflammation (elevated pro-inflammatory cytokines) and aberrant neurotransmission (low serotonergic transmission activity) and risk of PPD have also been reported by numerous studies. Supplementation with eicosapentaenoic acid (EPA)-rich oil can effectively reduce depression during pregnancy and PPD after childbirth. Long term treatment with docosahexaenoic acid (DHA)-rich oil can be effective in reducing the risk of PPD in healthy women, but not in lactating women. Supplementation of DHA-rich oil to women begun at pregnancy and continued after childbirth exerts no beneficial effect on depression. CONCLUSIONS Dietary supplementation with omega-3 fatty acids rich in EPA during pregnancy or postpartum reduces some symptoms associated with depression. DHA supplementation to healthy pregnant women can also reduce the risk of PPD.
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Affiliation(s)
- Mei-Chi Hsu
- Department of Nursing, I-Shou University, No. 8, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung City 82445, Taiwan, ROC.
| | - Chia-Yi Tung
- Nursing Department, E-Da Hospital, No.1, Yida Road, Jiaosu Village Yanchao District, Kaohsiung City 82445, Taiwan, ROC
| | - Hsing-E Chen
- Nursing Department, E-Da Hospital, No.1, Yida Road, Jiaosu Village Yanchao District, Kaohsiung City 82445, Taiwan, ROC
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14
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Zhang Z, Fulgoni VL, Kris-Etherton PM, Mitmesser SH. Dietary Intakes of EPA and DHA Omega-3 Fatty Acids among US Childbearing-Age and Pregnant Women: An Analysis of NHANES 2001-2014. Nutrients 2018; 10:E416. [PMID: 29597261 PMCID: PMC5946201 DOI: 10.3390/nu10040416] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 03/27/2018] [Accepted: 03/27/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The 2015–2020 Dietary Guidelines for Americans (DGA) recommend that the general population should consume about 8 ounces (oz.) per week of a variety of seafood, providing approximately 250 mg per day of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), and that pregnant and lactating women should consume 8–12 oz. per week of seafood. METHODS We determined the usual intakes, percentage not meeting recommendations, and trends in EPA and DHA intakes among childbearing-age and pregnant women (15–44 years of age) using the NHANES cycles 2001–2002 through 2013–2014. RESULTS For the childbearing-age women, the mean usual intake of seafood was 0.44 ± 0.02 oz. equivalent per day and 100% of the population was below the DGA recommendation. Mean usual intakes of EPA, DHA, and combined EPA and DHA from foods and dietary supplements combined were 26.8 ± 1.4, 62.2 ± 1.9, and 88.1 ± 3.0 mg per day, respectively. Over 95% of the sample did not meet the daily intakes of 250 mg EPA and DHA. Similar results were observed for pregnant women. After controlling for covariates, there were slight but significant increases in EPA and DHA intakes from foods and dietary supplements over the 14-year span among childbearing-age (p = 0.005) and pregnant women (p = 0.002). CONCLUSIONS It was estimated that a majority of U.S. childbearing-age and pregnant women consumed significantly lower amounts of seafood than what the DGA recommends, which subsequently leads to low intakes of EPA and DHA; in addition, dietary supplement use has not eliminated the nutrient shortfall.
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Affiliation(s)
- Zhiying Zhang
- Nutrition and Scientific Affairs, The Nature's Bounty Co., Ronkonkoma, NY 11779, USA.
| | | | - Penny M Kris-Etherton
- Department of Nutritional Sciences, Pennsylvania State University, 110 Chandlee Laboratory, University Park, PA 16802, USA.
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15
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Abstract
Pregnancy and lactation deplete nutrients essential to the neurotransmission system. This may be one reason for the increased risk of depression during the perinatal period. The objective of the present review was to systematically review the literature and summarise evidence on whether blood nutrient levels influence the risk of perinatal depression. PubMed, EMBASE and CINAHL databases were searched for studies of any design. A total of twenty-four articles of different designs were included, representing 14 262 subjects. We extracted data on study population, depression prevalence, nutrients examined, deficiency prevalence, timing of assessment, reporting, analysis strategy and adjustment factors. In all, fourteen studies found associations of perinatal depression with lower levels of folate, vitamin D, Fe, Se, Zn, and fats and fatty acids, while two studies found associations between perinatal depression and higher nutrient levels, and eight studies found no evidence of an association. Only ten studies had low risk of bias. Given the methodological limitations and heterogeneity of study approaches and results, the evidence for a causal link between nutritional biomarkers and perinatal depression is still inconclusive. High-quality studies in deficient populations are needed.
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16
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Polyunsaturated Fatty Acids in Perinatal Depression: A Systematic Review and Meta-analysis. Biol Psychiatry 2017; 82:560-569. [PMID: 28410627 DOI: 10.1016/j.biopsych.2017.02.1182] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 02/24/2017] [Accepted: 02/27/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND Omega-3 (or n-3) polyunsaturated fatty acids (PUFAs) are promising antidepressant treatments for perinatal depression (PND) because of supporting evidence from clinical trials, the advantage in safety, and their anti-inflammatory and neuroplastic effects. Although several observational studies have shown n-3 PUFA deficits in women with PND, the results of individual PUFAs from different studies were inconsistent. METHODS This systematic review and meta-analysis aims to compare the levels of PUFA indices, including eicosapentaenoic acid, docosahexaenoic acid, arachidonic acid, total n-3, total n-6, and the n-6/n-3 ratio between women with PND and healthy control subjects. The meta-analysis included 12 eligible studies available as of December 2016. The effect sizes were synthesized by using a random effects model. In addition, we performed subgroup analysis for the PUFA levels in patients with prenatal and postnatal depression, both of which were compared with healthy control subjects. RESULTS There were significantly lower levels of total n-3 PUFAs and docosahexaenoic acid and significantly increased n-6/n-3 ratios in PND patients. In the subgroup analyses, there were significantly lower levels of n-3 PUFAs, eicosapentaenoic acid, and docosahexaenoic acid in women with prenatal depression. The n-6/n-3 ratio was significantly increased in both prenatal and postnatal depression subgroups. CONCLUSIONS Our meta-analysis consolidates the important role of n-3 PUFAs in PND. Nutritional medicine is an important strategy to improve the effectiveness of treatment for depression, and our findings provide the strong rationale to conduct clinical trials to test the therapeutic and prophylactic effects of n-3 PUFAs in PND.
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17
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Vaz JDS, Farias DR, Adegboye ARA, Nardi AE, Kac G. Omega-3 supplementation from pregnancy to postpartum to prevent depressive symptoms: a randomized placebo-controlled trial. BMC Pregnancy Childbirth 2017; 17:180. [PMID: 28599630 PMCID: PMC5466796 DOI: 10.1186/s12884-017-1365-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 05/31/2017] [Indexed: 01/18/2023] Open
Abstract
Background Low n-3 polyunsaturated fatty acids (PUFAs) has been linked to depression, but the preventive effect of n-3PUFAs supplementation on maternal depression needs further investigation. We aimed to evaluate the efficacy of a daily dose of n-3 PUFAs supplementation (fish oil) on the prevention of postpartum depression (PPD). Methods A randomized, placebo-controlled, double blind trial was designed and nested into a cohort study conducted in Rio de Janeiro, Brazil. Sixty pregnant women identified as being at risk for PPD were invited and randomly assigned to receive fish oil capsules [1.8 g (1.08 g of Eicosapentaenoic (EPA) and 0.72 g of Docosapentaenoic (DHA) acids)] or placebo (control). The Edinburgh Postnatal Depression Scale (EPDS) was scored at 5–13 (T0, baseline), 22–24 (T1), 30–32 weeks of gestation (T2) and 4–6 weeks’ postpartum (T3). Supplementation started at week 22–24 of gestation (T1) and lasted for 16 weeks. Serum fatty acids were assayed to evaluate compliance. Prevalence of EPDS ≥11 was the primary outcome, and mean and changes in EPDS score, length of gestation, and birth weight the secondary outcomes. Linear mixed-effect (LME) and random-intercept logistic regression models were performed to test the effect of fish oil supplementation on prevalence of EPDS ≥11 and EPDS scores variation. Results In intention-to-treat (ITT) analysis, at 30–32 weeks’ gestation women in the fish oil presented higher serum concentration of EPA, DHA and lower n-6/n-3 ratio comparing to the control group. There were no differences between intervention and control groups in the prevalence of EPDS ≥11, EPDS scores over time, or in changes in EPDS scores from pregnancy to postpartum in either the ITT or per-protocol analyses. Women in the fish oil group with previous history of depression presented a higher reduction on the EPDS score from the second to the third trimester in the fish oil comparing to the control group in the ITT analyses [−1.0 (−3.0–0.0) vs. -0.0 (−1.0–3.0), P = 0.038). These results were confirmed on the LME model (β = −3.441; 95%CI: -6.532– -0.350, P = 0.029). Conclusion Daily supplementation of 1.8 g of n-3 PUFAs during 16 weeks did not prevent maternal depressive symptoms in a sample of Brazilian women. Trial registration ClinicalTrials.gov Identifier: NCT01660165. Retrospectively registered on 24 May 2012.
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Affiliation(s)
- Juliana Dos Santos Vaz
- Faculty of Nutrition, Pelotas Federal University, Rua Gomes Carneiro 1 - Campus Porto, Pelotas, RS, 96160-000, Brazil.
| | - Dayana Rodrigues Farias
- Institute of Nutrition, Nutritional Epidemiology Observatory, Rio de Janeiro Federal University, Avenida Carlos Chagas Filho, 367, CCS - Bloco J - 2° andar, sala 29, Cidade Universitária - Ilha do Fundão, Rio de Janeiro, RJ, 21941-590, Brazil
| | | | - Antonio Egidio Nardi
- Laboratory of Panic and Respiration, Institute of Psychiatry, Rio de Janeiro Federal University, Avenida Venceslau Braz, 71 - Botafogo, Rio de Janeiro, RJ, 22290-140, Brazil
| | - Gilberto Kac
- Institute of Nutrition, Nutritional Epidemiology Observatory, Rio de Janeiro Federal University, Avenida Carlos Chagas Filho, 367, CCS - Bloco J - 2° andar, sala 29, Cidade Universitária - Ilha do Fundão, Rio de Janeiro, RJ, 21941-590, Brazil
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