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Periodic Report Summary 1 - MOODFOOD (Multi-country cOllaborative project on the rOle of Diet, FOod-related behaviour, and Obesity in the prevention of Depression (MooDFOOD))

Project Context and Objectives:
MooDFOOD: Multi-country cOllaborative project on the rOle of Diet, Food-related behaviour, and Obesity in the prevention of Depression.

Depression is one of the most prevalent and disabling disorders in the EU and it places a heavy burden on individuals and their families. A large proportion of the EU population is overweight which increases depression risk. Improvement of food-related behaviour and nutrient status may prevent depression, specifically for people prone to being overweight. Unravelling the different pathways that link nutritional behaviour to the development of depression and identifying potential psychological, lifestyle, and environmental mechanisms is exactly at the centre of the MooDFOOD project. MooDFOOD is one of the largest consortia investigating depression and the first to address how food intake, nutrient status, food-related behaviour and obesity are linked to the development of depression.

The MooDFOOD consortium combines expertise in nutrition, consumer behaviour, psychiatry and preventive psychology. MooDFOOD employs an unique approach where high quality data from longitudinal prospective European cohort studies will be combined with new data from surveys, short-term experiments and a multi-centre long-term preventive intervention study to unravel these multifaceted links of food intake, nutrient status, food-related behaviour and obesity with depression. The obtained scientific evidence will be integrated with information from stakeholders regarding future implementation as well as information regarding demographic trends, sustainability and planned policy measures will allow the development of innovative nutritional strategies for the prevention of depression and contribute to the overall health of EU-citizens.

To finally understand how food intake, nutrient status, food-related behaviour and obesity are linked to the development of depression. MooDFOOD will pursue the following two objectives:
1. To gain a better understanding of the psychological, lifestyle and environmental pathways underlying the multi-faceted, bidirectional links of food intake,nutrient status, food-related behaviour and obesity with depression.
a. To gain a better understanding of the bidirectional links of food intake, nutrient status, food-related behaviour and obesity with depression.
b. To determine the underlying lifestyle, environmental and psychological pathways of these links.

2. To develop innovative evidence-based, feasible, effective and sustainable nutritional strategies for the prevention of depression in EU citizens.
a. To establish the feasibility and effectiveness of nutritional strategies on the prevention of depression.
b. To develop optimal, sustainable, and evidence-based nutritional strategies for the prevention of depression.
c. To provide and promote guidelines and practical tools for stakeholders which will improve implementation and thus contribute to nutrition-related prevention of depression.

Project Results:
The primary activities since the start of the project have been the collection of epidemiological evidence for the bidirectional link between food intake, nutrient status and obesity with depression in WP1 and the identification of food-related behaviours that largely explain the link between food and depression in WP2. Through a scientific integration process (WP5), results of WP1 and WP2 were used for the development of a multi-country randomized controlled prevention trial in WP3. The trial (start July 2015) will determine whether multi-nutrient supplementation and/or food-related behaviour change are effective in preventing the development of depression as well as whether the latter is also effective in reducing the environmental burden of the diet (WP4). The key scientific results of the project are disseminated by WP6 and the project is coordinated in WP7. WP1 By performing statistical analyses of existing data, the MooDFOOD research team already identified several food characteristics that are associated with more depressive symptoms. The bi-directional role of obesity with depression has been negated by identifying no role of body weight changes in the development of depression, but established by the finding that current depressive disorder patients do have greater odds or either gaining or losing weight over a 2-year period. In depressed and/or anxious persons, obesity was also found to be accompanied with increased cognitive vulnerability and psychopathology symptomatology. WP2 The preliminary results indicate that food intake and food-related behaviours are linked with the depressive symptoms; higher use of fruit and vegetables, lower frequency of snacking, more frequent main meals are all linked to lower depressive symptoms. From the food-related behaviours, those with better cooking skills used more frequently fruit and vegetables and less frequently snacks, whereas higher score on impulse buying increased snacking. The snacking was more frequent among those who reported to purchase food from kiosks and fast food outlets more often. Lower scores on mindful eating and higher scores on emotional eating reported more depressive symptoms. Those with higher body mass index reported more depressive symptoms and this link was fully mediated by emotional eating. WP3 The preparation of a multi-country randomized controlled prevention trial to test two different nutritional strategies for the prevention of depression is well under way. Standardized protocols for screening, recruitment, randomization, conducting the 4 intervention arms of the trial, data collection and data entry have been developed to ensure standardized and high quality data. WP4 All locally collected prevention trial data (e.g. depression outcome, food intake and food-related behaviour, body weight and sustainability results) are aggregated and integrated. To enable uniformity in the aggregated database and to facilitate data management and integration, a web-based infrastructure for delivery, storage and issuing of data has been developed. WP5 All the scientific knowledge obtained in the project (WP1-4) is directly communicated between partners/work packages and is integrated as a first step in the development of our nutritional strategies. This collaborative approach brings partners together and facilitates our ambitious approach. Moreover, through a watchbook societal trends in nutrition and depression are continuously being monitored. WP6 The current tasks for dissemination center around the development and the implementation of our dissemination/communications plan. The MooDFOOD logo and website design are visually appealing and have a positive impact on the project. WP7 The MooDFOOD Project Office coordinates all WPs, maintains internal and external project management, steers and controls the progress of the project and communicates regularly with all partners. The project is progressing as planned and is currently on schedule and on budget.

Potential Impact:
The MooDFOOD project will result in fundamental insights into the mechanisms behind nutrition and the development of depression. We will deliver scientific output based on a unique combination of six cohort studies and based on a series of short experiments as well as a multi-country prevention trial establishing the causality of the link between food and depression. MooDFOOD will deliver:
- Elucidation of the impact of food intake, nutrient status, food-related behaviour, and obesity on the prevention of depression
- Identification of the impact of depression on food intake, nutrient status, food-related behaviour and obesity
- Insight into psychological, lifestyle, and environmental pathways underlying the bi-directional link of food intake, nutrient status, food-related behaviour and obesity with depression
- Identification of which modifications in food-related behaviours and nutrient status related to depression may lead to beneficial dietary changes and a lower environmental burden of the diet
- Important insight into the causality of the observed associations and underlying pathways

This knowledge on causal relationships will finally enable the development of feasible, effective and sustainable nutritional strategies for the prevention of depression and the translation of these strategies to practical tools with active input from relevant stakeholders. MooDFOOD will translate these nutritional strategies into evidence-based practical tools and guidelines related to the prevention of depression by nutrition. The results of MooDFOOD will be delivered as scientific publications, web based applications and different sorts of classical and non-classical dissemination materials that are specifically tailored to different interest groups and stakeholders. All our dissemination materials will be evidence-based on the results of MooDFOOD and other European and national projects and will provide advice, suggestions and reference to best practices. Examples:
- Treatment guidelines and practical tools for health professionals targeting food intake and food-related behaviour for the prevention of depression symptoms in non-depressed and depressed consumers
- Evidence-based nutritional guidelines for EU citizens including the whole diet as well as nutrient supplement use and dietary behaviour
- Food product development recommendations and scientific evidence supporting health claims for the food industry
- Policy advice and recommendations to promote healthy eating and prevent depression for individual Member States and the EU

Promoting these guidelines and practical tools through extensive European networks, MooDFOOD will in the long run contribute importantly towards improving the diet of all EU citizens in a sustainable way and towards preventing the third leading contributor to the global disease burden, with enormous emotional, physical, economic and social benefits.

List of Websites:
www.moodfood-vu.eu

Reported by

STICHTING VU-VUMC
Netherlands
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