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

Objective: Obesity, 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. Methods: 273 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). Results: At 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. Conclusions: Obesity 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. (C) 2016 Elsevier B.V. All rights reserved.