Table 3.
Characteristics of included studies evaluating the associations between nutrition intervention and SAD.
| First author, year, country | Study design, SAD screen tool | Total N, age (mean) | Interv, dosage/d, duration | Ctrl | Interv N | Ctrl N | Outcome, outcome assessment tool | (Mean ± SD)/frequency in interv group | (Mean ± SD)/frequencies in ctrl group | Compare, p-values | Conclusion |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Frandsen TB, 2014, Denmark | RCT, SPAQ |
43, 44.2 | Vitamin D, 70 μg, 3 months | Placebo | 22 | 21 | Depression severity, SIGH-SAD | −6.4 ± 3.3* | −6.8 ± 9.5* | Interv vs. ctrl, p = 0.7 | One-way ANOVA analysis showed that compared with the control group, vitamin D supplementation presented no effect in impeding SAD. |
| Mischoulon D, 2010, USA | RCT, crossover, SCID | 18, 43 | High carba for phase I and ctrlb for phase II, Twice, 12 days for each phase | Ctrlb for phase I and high carba for phase II | 10 | 8 | Depression severity, Hamilton-D-28 scale | 6.5 ± 3.8 at the end of phase I, and 4.6 ± 3.9 at the end of phase II | 9.3 ± 4.4 at the end of phase I, and 7.9 ± 5.3 at the end of phase II | Interv vs. ctrl, p = 0.09 | Repeated measure ANOVA showed that the high-carbohydrate mix group did not significantly decrease depression symptom or remission compared with the control group. |
| Remission rates, Hamilton-D-28 scale | 50% at the end of phase I, and 88% at the end of phase II | 38% at the end of phase I, and 50% at the end of phase II | Interv vs. ctrl, p = 0.66 at the end of phase I, and p = 0.28 at the end of phase II | ||||||||
| RCT, SCID | 32, 46 | High carbc, Twice, 21 days | ctrlb | 15 | 17 | Depression severity, Hamilton-D-28 scale | 6.4 ± 5.8 | 6.1 ± 4.4 | Interv vs. ctrl, p = 0.88 | Repeated measure ANOVA showed that the high-carbohydrate mix group did not significantly decrease depression symptom or remission compared with the control group. | |
| Remission rates, Hamilton-D-28 scale | 71% | 71% | Interv vs. ctrl, p = 1 | ||||||||
| Danilenko KV, 2008, Russia | RCT, DSM-IV | 22, 37.8 | High carb (morning), NA, 9 days | NA | 9 | NA | Depression severity, SIGH-SAD | NR | NR | [High carb (morning) vs. high carb (evening) vs. high protein] × time, p = 0.61 | Repeated measure ANOVA showed that no differential effects of diet on depression were found between high carb diet vs. high protein diet. However, participants from all groups had an improved SIGH-SAD score. |
| High carb (evening), NA, 9 days | NA | 6 | NA | ||||||||
| High protein, NA, 9 days | NA | 7 | NA | ||||||||
| Emotional eating, DEBQ | NR | NR | [High carb (morning) vs. high carb (evening) vs. high protein] × time, p = 0.014 | Repeated measure ANOVA revealed that subjects' ratings of the 'emotional' factor increased after the CHO-morning diet, decreased after the CHO-evening diet, and remained unchanged after the high-protein diet. Diet significantly affected subjects' eating behavior, and such impact was affected by time. Ratings of restrained and external eating factors were similar before and after the diets, and there was no significant difference among meal groups. | |||||||
| External eating, DEBQ | NR | NR | [High carb (morning) vs. high carb (evening) vs. high protein] × time, p > 0.05 | ||||||||
| Restraint eating, DEBQ | NR | NR | [High carb (morning) vs. high carb (evening) vs. high protein] × time, p > 0.05 | ||||||||
| Oren DA, 1994, USA | RCT, DSM-III-R | 27, 48 | Vitamin B12, 4.5 mg, 2 weeks | Placebo | 14 | 13 | Depression severity, SIGH-SAD | 18 ± 8 | 21 ± 10 | Interv vs. ctrl, p > 0.25 | Repeated measure ANOVCA showed that cyanocobalamin supplementation did not change SIGH-SAD rating scores between interventional group and control group. |
| Rosenthal NE, 1988, USA | RCT, crossover, DSM-III | 32 (16 SAD patients and 16 non-clinical subjects), 40 | High carb dietb follows High protein diet (sequence 1), NA, one-time intervention | High protein dietc follows High carb diet (sequence 2) | 16 | 16 | Tension, POMS | NR | NR | Meal (carb vs. prot) x sequence, p < 0.04 | Repeated measure ANOVA showed that the high-carb meal significantly decreased tension, depression, and anger scores, whereas the protein-rich meal had the opposite effect. The effect of the meals was affected by sequence. Fatigue values increased following the protein-rich meal in both patients and controls. High carb diet decreased fatigue in patients but not in control. Vigor declined in the first 2 h after both meals, but the decline was less marked in the SAD group than in normal controls after high carb diet. |
| Depression, POMS | NR | NR | Meal x sequence, p < 0.02 | ||||||||
| Anger, POMS | NR | NR | Meal x sequence, p < 0.05 | ||||||||
| Fatigue, POMS | NR | NR | Meal x group (SAD vs. ctrl) x time, p < 0.02 | ||||||||
| Vigor, POMS | NR | NR | Diet x sequence, p < 0.05 |
Interv, intervention; Ctrl, control; FFQ, Food Frequency Questionnaire; SPAQ, Seasonal Pattern Assessment Questionnaire; GSS, Global Seasonality Score; DSM, Diagnostic and Statistical manual of Mental disorders; M-CIDI, The World Health Organization Composite International Diagnostic Interview, the Munich version; ADD, Alcohol dependence disorder in lifetime; AUD, Alcohol use disorder in lifetime; SIGH-SAD, Structured Interview Guide for the Hamilton Depression Rating Scale, Seasonal Affective Disorders; SCID, DSM-IV Structured Clinical Interview for Depression; NR, Not report; Underscored context, detailed data not shown; Bold text, Statistically significant.
Mean of difference ± SD.
40 grams of a mixture of potato starch, maltodextrin, dextrose, and dextrin.
Carbohydrate-protein mix consisting of 15 g milk protein casein and 25 g carbohydrate mixture.
Contains 105 g of carbohydrate, 0.7 g of protein, and 42.7 g of fat.
Contains 105 g of protein, 15 g of carbohydrates, and 33.3 of fat.