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Background: The effect of an intervention based on Mediterranean diet on reducing recurrence risk or subsyndromal depressive symptoms in recovered depressed patients has not been explored., Methods: The PREDIDEP study was a two-year randomized trial designed to assess the effect of the Mediterranean Diet enriched with extra virgin olive oil on depression recurrence. At baseline and at four, eight, 16, 20, and 24 months of follow-up, depressive symptoms were evaluated through the Beck Depression inventory. Cox regression analysis was fitted to assess the role of dietary intervention on the risk of depression recurrence. Mixed effects linear models were used to assess changes in depressive subsyndromal symptoms according to the intervention., Results: After two years of intervention, the dietary intervention group ( n  = 103) compared to the control group ( n  = 93) showed no differences regarding depression recurrence risk as main outcome. As secondary outcomes, an improvement of depressive symptoms was yielded at four (-2.15; 95% CI = -4.00 to -0.29) and eight months (-2.42; 95% CI = -4.17 to -0.67) in the intervention group, with no changes in control group. Moreover, at 20 months, significant differences were found between groups (-3.35; 95% CI = -6.08 to -0.61)., Conclusions: An intervention with Mediterranean diet in patients with previous depressive episodes might contribute to the reduction of depressive subsyndromal symptoms.

Background: There is substantial evidence supporting that remote interventions are useful to change dietary habits. However, the effect of a remote intervention based on Mediterranean diet (MD) in depressive patients has been less explored., Objective: This study aims to assess the effectiveness of a remotely provided Mediterranean diet-based nutritional intervention in the context of a secondary prevention trial of depression., Methods: The PREDIDEP study was a 2-year multicenter, randomized, single-blinded trial designed to assess the effect of the MD enriched with extra virgin olive oil (EVOO) on the prevention of depression recurrence. The intervention group received usual care for depressed patients and remote nutritional intervention every three months which included phone contacts and web-based interventions; and the control group, usual care. At baseline and at 1-year and 2-year follow-up, the 14-item MD Adherence Screener (MEDAS) questionnaire and a semiquantitative food frequency questionnaire (FFQ) were collected by a dietitian. Mixed effects linear models were used to assess changes in nutritional variables according to the group of intervention. The trial was registered at ClinicalTrials.gov NCT03081065., Results: Compared with control group, the MD intervention group showed more adherence to MD (between-group difference: 2.76; 95% CI 2.13-3.39; p  < 0.001); and a healthier diet pattern with a significant increase in the consumption of olive oil ( p  < 0.001), and a significant reduction in refined cereals ( p  = 0.031) after 2 years of intervention., Conclusions: The remote nutritional intervention increases adherence to the MD among recovered depression patients. Trial registration: ClinicalTrials.gov identifier: NCT03081065.