Effectiveness of a remote nutritional intervention to increase the adherence to the Mediterranean diet among recovered depression patients

Background: There is substantial evidence supporting that remote interventions are useful to change dietary habits. However, the effect of a remote intervention based on Mediterranean diet (MD) in depressive patients has been less explored. Objective: This study aims to assess the effectiveness of a remotely provided Mediterranean dietbased nutritional intervention in the context of a secondary prevention trial of depression. Methods: The PREDIDEP study was a 2-year multicenter, randomized, single-blinded trial designed to assess the effect of the MD enriched with extra virgin olive oil (EVOO) on the prevention of depression recurrence. The intervention group received usual care for depressed patients and remote nutritional intervention every three months which included phone contacts and webbased interventions; and the control group, usual care. At baseline and at 1-year and 2-year follow-up, the 14-item MD Adherence Screener (MEDAS) questionnaire and a semiquantitative food frequency questionnaire (FFQ) were collected by a dietitian. Mixed effects linear models were used to assess changes in nutritional variables according to the group of intervention. The trial was registered at ClinicalTrials.gov NCT03081065. Results: Compared with control group, the MD intervention group showed more adherence to MD (between-group difference: 2.76; 95% CI 2.13–3.39; p < 0.001); and a healthier diet pattern with a significant increase in the consumption of olive oil (p < 0.001), and a significant reduction in refined cereals (p = 0.031) after 2 years of intervention. Conclusions: The remote nutritional intervention increases adherence to the MD among recovered depression patients. Trial registration: ClinicalTrials.gov identifier: NCT03081065.This study is externally funded by the Spanish Ministry of Economy and Competitiveness (ISCIII), PI16/01274. The Interprofesional del Aceite de Oliva-Aceites de Oliva de España (Madrid, Spain) donated the olive oil used in the study. Open access funding provided by Universidad Pública de Navarra