Effects of n-3 fatty acids on depressive symptoms and dispositional optimism after myocardial infarction.
What this study found
Low-dose EPA-DHA, ALA, or their combination did not improve depressive symptoms or dispositional optimism after myocardial infarction. At 40 months, depressive symptoms on the GDS-15 were not significantly different from placebo: EPA-DHA plus ALA standardized mean difference -0.025 (P = 0.57), EPA-DHA -0.048 (P = 0.28), and ALA -0.047 (P = 0.29); two-way analyses were also nonsignificant. Severe depressive symptoms remained uncommon and did not differ meaningfully from placebo: adjusted OR 1.00 for EPA-DHA plus ALA, 1.29 for EPA-DHA, and 1.40 for ALA. Dispositional optimism results were…
- Study & population
- Randomized, double-blind, placebo-controlled trial in adults after myocardial infarction, a coronary heart disease population.
- Intervention
- Participants received oral margarines for 40 months containing either 400 mg/day EPA-DHA, 2 g/day ALA, both EPA-DHA plus ALA, or placebo margarine with oleic acid substituted for the active oils.
- Key limitation
- Depressive symptoms and pessimism/optimism were low at baseline, leaving limited room for improvement.
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Open PDFOriginal abstract
BACKGROUND In patients who have experienced a myocardial infarction (MI), n-3 (omega-3) PUFA status is low, whereas the risk of depression is increased. OBJECTIVE The objective was to assess whether the plant-derived α-linolenic acid (ALA) and the fish fatty acids EPA and DHA would improve affective states. DESIGN In a secondary analysis of the randomized, double-blind, placebo-controlled Alpha Omega Trial, 4116 of 4837 (85.1%) patients (aged 60-80 y; 79.2% men) who had experienced an MI were included. Margarine spreads were used to deliver 400 mg EPA-DHA/d, 2 g ALA/d, both EPA-DHA and ALA, or a placebo for 40 mo. At 40 mo, the endpoints of depressive symptoms (15-item Geriatric Depression Scale) and dispositional optimism (a 4-item questionnaire and the Life Orientation Test-Revised) were analyzed by using a posttest-only design. RESULTS The 4 randomly assigned groups did not differ in baseline characteristics. ALA supplementation significantly increased plasma cholesteryl ester concentrations of ALA by 69%, and EPA-DHA supplementation increased plasma cholesteryl ester concentrations of EPA and DHA by 61% and 30%, respectively. Depressive symptoms or dispositional optimism did not differ between groups with the use of n-3 fatty acids compared with placebo at the 40-mo follow-up. The standardized mean (±SE) differences in depressive symptoms were as follows: for EPA-DHA plus ALA (n = 1009) compared with placebo (n = 1030), -0.025 ± 0.044 (P = 0.57); for EPA-DHA (n = 1007) compared with placebo, -0.048 ± 0.044 (P = 0.28); and for ALA (n = 1022) compared with placebo, -0.047 ± 0.044 (P = 0.29). CONCLUSIONS In patients who had experienced an MI, low-dose EPA-DHA supplementation, ALA supplementation, or a combination of both did not affect depressive symptoms and dispositional optimism. These findings are in accord with those from previous trials in individuals without psychopathology or without severe depressive symptoms. This trial was registered at clinicaltrials.gov as NCT00127452.