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Periodic Report Summary 3 - 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:
WP1 The new scientific results strengthen the suggestions from our earlier work that specific ‘healthy’ dietary patterns are associated with lower depressive symptoms, less major depressive disorder, and a lower incidence of depression. The preliminary results of our unique harmonized meta-analysis suggest that a higher score on all three á priori dietary patterns (the MDS, the AHEI-2010 and the DASH) is associated with lower depressive symptoms and less depression. Other results also confirm our earlier findings that higher levels of vitamin D and omega-3 PUFA levels are associated with lower depressive symptoms. However, when looking prospectively at change in vitamin D levels, an association was not observed. Vitamin B12 levels do not seem to be associated with depressive symptoms. Our work also shows the strong association between obesity and incident depression, which was however not observed for all ethnic groups. Prospective results did not show evidence of an inverse association – depression leading to subsequent weight gain. Several studies were conducted to explore the underlying mechanisms for the association between obesity and depression, including cognitive vulnerabilities, neuroticism, extraversion and psychological eating styles. WP2 The findings from the conducted survey verify the link between food use/food-related behaviours and depressive symptoms. A new scale to measure mindful eating (MEBS) has been developed to improve the distinction between the different aspects of mindful eating. This scale has been validated and used in analysing the relationship between depressive symptoms and mindful eating and the results show that higher scores on mindful eating are linked to lower depressive symptoms. The results from the ongoing intervention study will be transformed into guidelines that can be used in assessing the feasibility of behaviour change in future planned interventions. WP3 The main purpose of WP3 is the execution of the 1-year multi-country randomized controlled prevention trial to test different nutritional strategies for the prevention of depression. Standardized protocols for screening, recruitment, randomization, data collection and data entry were developed to ensure standardized and high quality data. The MooDFOOD prevention trial started in July 2015 in Leipzig and in September 2015 in Mallorca, Exeter and Amsterdam. On October 10th 2016, we reached the target: 1025 participants were randomized. Currently, baseline interviews and 3 and 6-month follow-up assessments have all been performed. WP4 All locally collected MooDFOOD prevention trial data (e.g. depression outcome, food intake and food-related behaviour, body weight and sustainability results) are aggregated and integrated in WP4. A dedicated infrastructure for delivery, storage and issuing of data was developed for the trial. WP5 All the scientific knowledge obtained in the project is directly communicated between partners and work packages. With their collaborative approach WP5 monitors inter WP alignment, obtains and translates scientific knowledge, and communicates scientific information towards relevant scientific communities, opinion leaders and the general public. WP6 The tasks in WP6 center around the ongoing implementation of the project dissemination and communications plan during the period, and planning for the next crucial phase for WP6. A collaborative approach is used to disseminate project results and actions, with all partners involved in developing strategies and undertaking actions. WP7 The main task for WP7 is monitoring the central project management. The MooDFOOD project thus far has achieved all objectives with only minor deviations.
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:
http://moodfood-vu.eu/

Reported by

STICHTING VU
Netherlands
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