Overweight needed more EPA (4 grams) to fight depression – RCT

Omega-3 Fatty Acids for Major Depressive Disorder With High Inflammation: A Randomized Dose-Finding Clinical Trial

J Clin Psychiatry. 2022 Aug 22;83(5):21m14074. doi: 10.4088/JCP.21m14074. PDF is behind a $40 paywall

David Mischoulon 1 2 3 , Boadie W Dunlop 4 2 , Becky Kinkead 4 , Pamela J Schettler 4 , Stefania Lamon-Fava 5 , Jeffrey J Rakofsky 4 , Andrew A Nierenberg 1 , Alisabet J Clain 1 , Tanja Mletzko Crowe 4 , Andrea Wong 4 , Jennifer C Felger 4 , Lisa Sangermano 1 , Thomas R Ziegler 6 , Cristina Cusin 1 , Lauren B Fisher 1 , Maurizio Fava 1 7 , Mark Hyman Rapaport 4 8 7

Objective: This study compared the impact of 3 eicosapentaenoic acid (EPA) doses versus placebo on inflammatory biomarkers and depressive symptoms.

Methods: Sixty-one unmedicated adults (75% female; 45.5 ± 13.8 years) with DSM-5 major depressive disorder (MDD), body mass index > 25 kg/m2, and plasma high-sensitivity C-reactive protein (hs-CRP) ≥ 3.0 mg/L were randomly assigned to receive EPA 1 g/d, 2 g/d, or 4 g/d or placebo for 12 weeks. Prespecified endpoints were a ≥ 0.40 effect size decrease in plasma interleukin (IL)-6, peripheral blood mononuclear cell (PBMC) cytokines, and lipopolysaccharide-stimulated tumor necrosis factor (TNF) production. Response was defined as a ≥ 50% decrease of Inventory of Depressive Symptomatology, Clinician-Rated version (IDS-C30) scores. We compared outcomes for the 3 EPA doses versus placebo.

Results: In 45 completers, only median PBMC TNF decreased at 2 g/d EPA. No EPA dose produced a ≥ 0.35 effect size reduction in plasma IL-6 or mitogen-stimulated TNF. Response rates for EPA 4 g/d were 64%, versus 40% for placebo (odds ratio [OR] = 2.63; Cohen d = 0.53), 38% for EPA 1 g/d, and 36% for EPA 2 g/d (all P > .05). EPA 4 g/d showed a significant correlation between percent decrease in plasma hs-CRP and IDS-C30 symptom reduction at 12 weeks (Spearman ρ = 0.691, P = .019).

Conclusions: EPA 4 g/d demonstrated a medium effect size for response rates versus placebo. This dose may alleviate MDD in overweight individuals with elevated inflammatory markers, and change in hs-CRP may be correlated with clinical response.

VitaminDWiki - studies in both categories Omega-3 and Depression

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VitaminDWiki - studies in both categories Omega-3 and Obesity

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Obese tend to consume more Omega-6, so need more Omega-3

Omega-3 index is the important measure ignored by this paper.

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