Overview
The aim of the study conducted by Jacka, O’ Neil, & Opie, et al., (2017) gravitates towards investigating into the impact of dietary changes on adults suffering from depression. The authors termed their investigation “SMILES” and entailed a “12-week parallel group, single blind randomized controlled trial” (Jacka, O’Neil, & Opie, et al., 2017). It is important to indicate that participants selected to take part had an access to “seven nutritional consulting sessions delivered by a clinical dietitian” (Jacka, O’Neil, & Opie, et al. 2017). To evaluate improvement, the authors employed the Montgomery-Asberg Depression Rating Scale (MADRS) and placed special emphasis on observing clinical features of depression or comorbid symptoms. Overall, the survey aims to confirm that dietary improvement is likely to contribute positively to the treatment of mental disorders often seen among 21st century adults.
Participants
While 166 participants were primarily selected for review by the authors, the researchers only came across 67 who, from their standpoint, appeared to be appropriate for the study; consequently, it was agreed to enrol these participants in the investigation. A peculiar thing is that 33 of them received the dietary intervention (Jacka, O’Neil, & Opie et al., 2017). As many experts report, the current sample size is extremely effective for a study despite being relatively small indeed. Sinking deep into the very survey, one cannot but encounter the fact that the authors sharpened their focus on elucidating the impact of dietary changes on mental illnesses. Significantly, the survey rested upon a well-designed research tool, which in turn gave the chance to unearth the efficiency of a dietary improvement program. Based on conducting separate nutritional consulting sessions, the survey has proved efficient.
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Study Design
The researchers selected a single blind, randomised controlled trial to investigate participants involved. In fact, the given type of study incorporates a substantial drawback; the thing is, it reduces bias among the researchers. After a thorough consideration, one can assume that it would have been prudent to focus on double-blind, randomised controlled trial. Once randomization is achieved, the authors can engage in sound and methodologically current practice that includes a parallel or control group for this study. As a matter of fact, no one can fail to note that a participant group was blind. As the authors asserted, they used an alternative term to label the social support group involved in psychopharmacological medication use to not arouse suspicion, with research assistants working with this group informed that they were investigating the impacts of social support rather than some other variable on participant outcomes. The researchers appeared to follow proper protocol for partial blinding for this study.
The method adopted included providing the group not receiving dietary intervention with social support, in the way of offering friendly support by engaging in conversation, the use of cards, board games and other material. In reviewing the study, it may be argued that depression symptomatology served as the major endpoint. Throughout the survey, the assistants did not engage in therapy as a means of social support. The researchers did not indicate whether the individuals participating in the study lacked social support before the intervention. One cannot but give the authors credit for shedding the light on fact that the participants selected for the study had a poor diet indeed. Basically, they consumed a high amount of sweets, processed foods, or fast foods as described by the authors. Hence, it is hard to determine the relevancy of support in the way of playing cards or keeping the support group ‘positive’ compared with the group receiving dietary support. The problem is that the researchers provide no indication that the group receiving social support lacked this before the trial. There is no doubt that employing a randomised controlled trial (RCT) design does make sense in terms of determining whether a dietary program deserves a careful regard. Anyway, one can conclude that the survey lacks the precision of data.
In addition to using the depression scale, the researchers also reported using an anxiety and depression scale named HADS, administering this to participants using a self-report questionnaire. The use of the POMS, a revolutionary new psychological rating scale to expand the insight into both transient and distinct mood states, was employed as well. The goal the researchers reported in using these secondary items was to determine whether secondary outcomes or the effect of their study on other factors including anxiety, maybe assessed. Physical activity was assessed; and among primary objectives of the study was the evaluation of the impact that physical activity might have on participants themselves.
The researchers did note that the original calculation suggested that 88 people were required per group; of course, the results of this study should not be underestimated from the perspective of enlightening the public on the ways to improve the quality of life. The study’s findings are important within the context of enlightening the masses on the concise knowledge to cope with common co-morbidities; based on the results, there is a clear case to be made for dietary improvement standing out as a good approach to battling severe mental disorders.
Conclusions
The researchers gave priority attention to conducting a thotough statistical analysis tools in order to clarify the impact of the intervention for each of the groups. The participant’s results were gauged for 12 weeks from the start of the study, and researchers followed up for a 3-year period. A 12-week survey was done in compliance with the Consolidated Standards of Reporting Trials. The quality of the study and approach the researchers used to calculate the effects of dietary intervention on depression were solid and backed by scientific methodology, likely allowing for the high confidence interval. The researchers also controlled for variables that included general education, age, and even physical activity, although the researchers were not or did not intend to measure physical activity and the participants in the dietary group were instructed not to diet, and that the purposes of this study were not to assess the impact of diet on weight or similar factors. The study suggests that the participants had relatively high (over 25) BMI, suggesting that participants were unhealthy to begin with. As a result, it is difficult to analyze the results regarding whether dietary changes would have impacted a similar population with unhealthy BMI and other routine habits including smoking. All things considered, the dietary intervention that the survey centred around gave reasonable grounds for submitting that there is some correlation between eating habits and a quality of life. Notwithstanding this, however, failed to produce all the data necessary to fully answer the research question.
Relativity
Despite all the drawbacks, the results of the study prove promising, confirming other research as highlighted by the authors, suggesting that dietary improvement may constitute the major step towards winning the battle over mental disorders. Yet, additional research is needed so as to confirm the results to a larger population and determine whether diet may influence other symptoms including anxiety, as the researchers suggest. Broadly speaking, it is unclear whether the results are valid for generalizing to other populations, apart from individuals with depression.
- Jacka, F. N. et al. (2017). A Randomized Controlled Trial of Dietary Improvement for Adults with Major Depression 9the’SMILES’ trial). BMC Medicine, 15: 23.
