title: Fat food for a bad mood. Could we treat and prevent depression in Type 2 diabetes by means of omega-3 polyunsaturated fatty acids? A review of the evidence.
abstract: OBJECTIVE
  Evidence strongly suggests that depression is a common complication of Type 2 diabetes mellitus. However, there is considerable room to improve the effectiveness of pharmacological antidepressant agents, as in only 50-60% of the depressed subjects with diabetes does pharmacotherapy lead to remission of depression. The aim of the present paper was to review whether polyunsaturated fatty acids (PUFA) of the omega-3 family could be used for the prevention and treatment of depression in Type 2 diabetes.
  
  
  METHODS
  MEDLINE database and published reference lists were used to identify studies that examined the associations between omega-3 PUFA and depression. To examine potential side-effects, such as on glycaemic control, studies regarding the use of omega-3 supplements in Type 2 diabetes were also reviewed.
  
  
  RESULTS
  Epidemiological and clinical studies suggest that a high intake of omega-3 PUFA protects against the development of depression. There is also some evidence that a low intake of omega-3 is associated with an increased risk of Type 2 diabetes, but the results are less conclusive. Results from randomized controlled trials in non-diabetic subjects with major depression show that eicosapentaenoic acid is an effective adjunct treatment of depression in diabetes, while docosahexanoic acid is not. Moreover, consumption of omega-3 PUFA reduces the risk of cardiovascular disease and may therefore indirectly decrease depression in Type 2 diabetes, via the reduction of cardiovascular complications.
  
  
  CONCLUSIONS
  Supplementation with omega-3 PUFA, in particular eicosapentaenoic acid, may be a safe and helpful tool to reduce the incidence of depression and to treat depression in Type 2 diabetes. Further studies are now justified to test these hypotheses in patients with Type 2 diabetes.
authors.affiliation: Vrije Universiteit Medical Centre, Department of Medical Psychology, EMGO Institute, Amsterdam, the Netherlands. f.pouwer@vumc.nl
authors.forename: F
authors.initials: F
authors.lastname: Pouwer
authors.forename: G
authors.initials: G
authors.lastname: Nijpels
authors.forename: A T
authors.initials: AT
authors.lastname: Beekman
authors.forename: J M
authors.initials: JM
authors.lastname: Dekker
authors.forename: R M
authors.initials: RM
authors.lastname: van Dam
authors.forename: R J
authors.initials: RJ
authors.lastname: Heine
authors.forename: F J
authors.initials: FJ
authors.lastname: Snoek
mesh_terms: D000328:Adult; D003866:Depressive Disorder / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy / Q000523:psychology*; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic
chemical_list: D015525:Fatty Acids, Omega-3