Plain language summary
Depression is associated with poorer outcomes in people with heart disease. Substantial evidence suggests a link between dietary factors and mental health. The objective of this study was to examine the effects of supplementation with B vitamins or omega-3 (n-3) fatty acids on depressive symptoms in people with heart disease. Adults aged 45-80 years with cardiovascular disease were randomly assigned to receive 0.56mg folate (as 5-methyl-tetrahydrofolate), 3mg vitamin B6 and 0.02mg vitamin B12 ; 600mg EPA and DHA (in a 2:1 ratio); B vitamins plus n-3 fatty acids; or a placebo. Depressive symptoms were measured at years 3 and 5 using the Geriatric Depression Scale. There was no association between supplementation with B vitamins and depressive symptoms. However, men who took n-3 fatty acid supplements had a 28% higher risk of experiencing symptoms of depression. There was no such association observed in women. The authors concluded that the results of the study do not support the use of B vitamin or n-3 supplements for the prevention of depression in CVD survivors.
Abstract
BACKGROUND Dietary factors might affect depressive symptoms. OBJECTIVE In secondary data analyses, we examined effects of supplementation with B vitamins or n-3 (omega-3) fatty acids on depressive symptoms in cardiovascular disease survivors. DESIGN The SUpplementation with FOLate, vitamins B-6 and B-12 and/or OMega-3 fatty acids (SU.FOL.OM3) trial was a secondary prevention trial (2003-2009; n = 2501) in which individuals aged 45-80 y were randomly assigned, by using a 2 × 2 factorial design, to receive 0.56 mg 5-methyl-tetrahydrofolate and vitamins B-6 (3 mg) and B-12 (0.02 mg); EPA and DHA (600 mg) in a 2:1 ratio; B vitamins and n-3 fatty acids; or a placebo. Depressive symptoms were evaluated at years 3 and 5 with the 30-item Geriatric Depression Scale (GDS). Overall and sex-specific ORs and 95% CIs were estimated in 2000 participants by using factorial logistic regression. RESULTS After a median of 4.7 y of supplementation, there was no association between allocation to receive B vitamins and depressive symptoms. However, the allocation to receive n-3 fatty acids was positively associated with depressive symptoms (GDS >10) in men (adjusted OR: 1.28; 95% CI: 1.03, 1.61) but not in women. CONCLUSIONS We showed no beneficial effects of a long-term, low-dose supplementation with B vitamins or n-3 fatty acids on depressive symptoms in cardiovascular disease survivors. The adverse effects of n-3 fatty acids in men merit confirmation.
Methodological quality
Jadad score
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5
Allocation concealment
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Yes
