Anthony Villani

A Mediterranean-style dietary intervention supplemented with fish oil improves diet quality and mental health in people with depression: A randomized controlled trial (HELFIMED)

Objectives: We investigated whether a Mediterranean-style diet (MedDiet) supplemented with fish oil can improve mental health in adults suffering depression. Methods: Adults with self-reported depression were randomized to receive fortnightly food hampers and MedDiet cooking workshops for 3 months and fish oil supplements for 6 months, or attend social groups fortnightly for 3 months. Assessments at baseline, 3 and 6 months included mental health, quality of life (QoL) and dietary questionnaires, and blood samples for erythrocyte fatty acid analysis. Results: n = 152 eligible adults aged 18–65 were recruited (n = 95 completed 3-month and n = 85 completed 6-month assessments). At 3 months, the MedDiet group had a higher MedDiet score (t = 3.95, P < 0.01), consumed more vegetables (t = 3.95, P < 0.01), fruit (t = 2.10, P = 0.04), nuts (t = 2.29, P = 0.02), legumes (t = 2.41, P = 0.02) wholegrains (t = 2.63, P = 0.01), and vegetable diversity (t = 3.27, P < 0.01); less unhealthy snacks (t = −2.10, P = 0.04) and red meat/chicken (t = −2.13, P = 0.04). The MedDiet group had greater reduction in depression (t = −2.24, P = 0.03) and improved mental health QoL scores (t = 2.10, P = 0.04) at 3 months. Improved diet and mental health were sustained at 6 months. Reduced depression was correlated with an increased MedDiet score (r = −0.298, P = 0.01), nuts (r = −0.264, P = 0.01), and vegetable diversity (r = −0.303, P = 0.01). Other mental health improvements had similar correlations, most notably for increased vegetable diversity and legumes. There were some correlations between increased omega-3, decreased omega-6 and improved mental health. Discussion: This is one of the first randomized controlled trials to show that healthy dietary changes are achievable and, supplemented with fish oil, can improve mental health in people with depression.

Attitudes and beliefs of Australian adults on reality television cooking programmes and celebrity chefs. Is there cause for concern? Descriptive analysis presented from a consumer survey

BACKGROUND There is evidence suggesting that the nutritional content of recipes promoted by celebrity chefs or television cooking programmes contradict healthy eating guidelines. This study aims to investigate peoples attitudes and beliefs about popular television cooking programmes and celebrity chefs. METHODS Males and females who watch television cooking programmes were recruited to participate in a self-administered online questionnaire (22-items) which included multiple-choice and rank order questions. RESULTS A total of n = 207 participants undertook the questionnaire with fully completed questionnaires available for n = 150 participants (Males, n = 22; Females, n = 128; aged 38.4 ± 14 years). The majority of respondents watch ≤30 minutes of television cooking programming per day (total responses, n = 153/207; 74%) with almost three-quarters (total responses, n = 130/175; 74%) having attempted a recipe. New cooking ideas (total responses, n = 81/175; 46%) and entertainment (total responses, n = 64/175; 36.5%) were the two main reasons participants gave for watching these programmes. Significantly more respondents believed recipes use excessive amounts of unhealthy fat, sugar or salt (unhealthy: 24%; healthy: 7%; P < 0.0001). Almost half of all respondents (total responses, n = 67/151; 44%) believed these programmes have no impact on their habitual diet. DISCUSSION AND CONCLUSION Our results suggest television cooking programmes and celebrity chefs are unlikely to impact habitual dietary intake; rather, vicarious viewing and entertainment appear important factors relating to why people watch these programmes. However results generated from the present study are descriptive and subjective and further investigation into the impact of television cooking programmes and celebrity chefs on behavioural change requires attention. Further investigation including a systematic investigation into the dietary quality of recipes promoted by celebrity chefs against national healthy eating benchmarks is also warranted.

Mediterranean Diet attenuates risk of frailty and sarcopenia: New insights and future directions

Sarcopenia and physical frailty are associated with progressive disability and predictive of negative health outcomes. Dietary interventions are considered the cornerstone in the management of sarcopenic symptomology and physical frailty. However few studies have investigated preventative strategies. Moreover, most studies have focused on the efficacy of individual nutrients or supplements rather than dietary patterns. The Mediterranean Diet (MedDiet) is a dietary pattern that provides evidence for an association between diet quality, healthy ageing and disease prevention. The purpose of this paper was to examine, synthesise and develop a narrative review of the current literature, investigating the potential benefits associated with adherence to a MedDiet and attenuation of physical frailty and sarcopenic symptomology in older adults. We also explored the underlying mechanisms underpinning the potential benefits of the MedDiet on ameliorating physical frailty and sarcopenic symptomology. Synthesis of the reviewed literature is suggestive of a decreased risk of physical frailty and sarcopenic symptomology with greater adherence to a MedDiet. We identified the anti‐inflammatory and high antioxidant components of the MedDiet as two potential biological mechanisms involved. Due to a lack of evidence from RCTs to support the proposed physiological mechanisms, we suggest investigating these observations in older adults with type 2 diabetes (T2DM) whom are vulnerable to physical frailty and disability. A number of biological mechanisms describing the pathway to disability in older adults with T2DM have been postulated with many of these mechanisms potentially mitigated with dietary interventions involving the MedDiet. Exploring these mechanisms with the use of well‐designed, longer‐term dietary intervention studies in older adults with an increased vulnerability to physical frailty and sarcopenia is warranted.

Differences in the interpretation of a modernized Mediterranean diet prescribed in intervention studies for the management of type 2 diabetes: how closely does this align with a traditional Mediterranean diet?

Purpose and MethodsAdherence to Mediterranean diet (MedDiet) is associated with the prevention and management of type 2 diabetes mellitus (T2DM). However, in intervention studies, there is discordance in the interpretation of a MedDiet. The purpose of this paper was to examine, synthesize, and develop a narrative review, exploring the qualitative differences in the interpretation of a modernized MedDiet prescribed as an intervention in clinical trials for the management of T2DM, and how closely this aligns with a traditional MedDiet. The ‘traditional’ MedDiet is often described as a dietary pattern high in unprocessed plant foods (fruits, vegetables, legumes, nuts, wholegrain cereals, and olive oil); moderate consumption of wine; low moderate in fish/shellfish; and an infrequent consumption of red meat, animal fats, vegetable oils, and processed foods.Results and ConclusionsSynthesis of the reviewed literature demonstrates considerable variation in the qualitative interpretation of a MedDiet. We also identified inadequate reporting of MedDiet interventions, despite a number of studies referring to their intervention as a ‘traditional’ MedDiet. The majority of studies emphasized the same key dietary components and principles: an increased intake of vegetables, wholegrains, and the preferential consumption of white meat in substitute of red and processed meat and abundant use of olive oil. However, the reporting of specific dietary recommendations for fruit, legumes, nuts, bread, red wine, and fermentable dairy products were less consistent or not reported. Irrespective of the discordance in the interpretation of a MedDiet, a number of studies included in the present review reported improved glycaemic control and favorable cardiovascular outcomes with adherence to a Mediterranean-style diet. Nevertheless, greater clarity and depth of reporting amongst intervention studies is warranted for the refinement of a modernized MedDiet definition that is distinct from a prudent dietary pattern.

Effects of a Mediterranean-style diet on mental health and quality of life in people with depression

Background/Aims: Poor diets are an independent risk factor for depression while healthy diets are protective. Traditional Mediterranean diets (MedDiet) are associated with reduced cardiovascular disease risk which overlaps with depression. We investigated whether MedDiet can improve mental health. Methods: A total of 163 adults aged 18-65 with self-reported depression participated in a randomised controlled trial (RCT) providing nutrition education and fortnightly food hampers and cooking workshops for 3 months with 6 months follow-up. The control group attended fortnightly social groups. Participants completed mental health, quality of life (QoL) and dietary questionnaires. Data were analysed using linear mixed modelling and Pearson correlations. Results: In comparison to the control group at 3 months the treatment group had a higher MedDiet score (t = 4.27, p < 0.001), consumed more vegetables (t = 3.95, p < 0.001), fruit (t = 2.11, p = 0.037), nuts (t = 2.43, p = 0.016), wholegrains (t = 2.39, p = 0.018) and legumes (t = 2.45, p = 0.016), greater diversity of vegetables (t = 3.46, p = 0.001) and fruit (t = 2.08, p = 0.040) and less unhealthy snacks (t = -2.20, p = 0.030) and red meat/chicken (t = -2.25, p = 0.026). The treatment group had reduced depression scores (t = -2.02, p = 0.045), and higher mental health QoL scores (t = 2.17, p = 0.032). Reduced depression scores were correlated with increased MedDiet (r = -0.275, p = 0.006), consumption of nuts (r = -0.251, p = 0.011), legumes (r = -0.233, p = 0.018), and greater diversity of vegetables (r = -0.284, p = 0.004). Similar correlations were seen with other mental health and QoL improvements, particularly for legumes and diversity of vegetables and fruit. All changes were sustained at 6 months. Conclusions: This is one of the first RCTs to show a benefit of diet for mental health.;