Feasibility of a randomised controlled nutrition intervention for depression with a strength-based counselling approach

Abstract

Emerging evidence suggests that nutrition interventions produce beneficial effects for people with Major Depressive Disorder (MDD). However, limited research has been published about their feasibility and acceptability from the patient’s perspective. This 8-week randomised controlled pilot study with two parallel groups aimed to assess recruitment capability, intervention acceptability, and intervention effect on diet quality and depressive symptoms. In total, 51 people aged 20–64 years with moderate or severe depression were randomised either into a group-based nutrition intervention (n=26) or a social support intervention (n=25). Recruitment capability was evaluated from the participant flow data, acceptability with a questionnaire based on Sekhon’s Theoretical Framework of Acceptability, diet with the Index of Diet Quality (IDQ), and depressive symptoms with the Center for Epidemiologic Studies Depression (CES-D) Scale. Mann-Whitney U tests and Linear Mixed Models were used to analyse outcomes. Recruitment proved extremely challenging despite using multiple recruitment channels and collaboration with healthcare organisations. Five groups in each arm completed the intervention. Only 23% of the participants in the nutrition and 16% in the social support intervention attended all sessions. The nutrition intervention was considered acceptable, with higher acceptability ratings than the social support intervention (mean 4.41 vs. 3.66, p<0.001). The mean IDQ at baseline was 8.37 (SD 2.0) and CES-D 30.0 (SD 10.9, range 4–50), with no statistically significant changes post-intervention in either intervention arm. Future research should focus on co-designing the interventions and targeted recruitment strategies and considering new approaches for delivering interventions to promote participant engagement and lifestyle changes.