Diet quality, dietary inflammatory index and body mass index as predictors of response to adjunctive N-acetylcysteine and mitochondrial agents in adults with bipolar disorder: A sub-study of a randomised placebo-controlled trial

Ashton et al. (2020) examined a randomized controlled trial on the impact of several nutraceutical treatments on patients with bipolar depression. The 133 participants received 16 weeks adjunctive treatment of either placebo or N-acetylcysteine (alone or combined with mitochondrial-enhancing nutraceuticals). Four weeks after stopping the treatment, the subjects were assessed on diet (quality, inflammatory potential), body mass index, and other significant outcomes (depression symptoms, clinician-rated improvement, and functioning measures). Neither the Australian Recommended Food Score (measure of diet quality), dietary inflammatory index, nor body mass index scores could predict change in depression scores when comparing the combination treatment group with the placebo group. However, participants with better diet quality showed reduced general depression, bipolar disorder symptoms, and greater clinician-rated improvements, regardless of treatment and time. Moreover, a more anti-inflammatory diet (lower dietary inflammatory index score) was linked with less impairment in functioning. It was also suggested that the combination treatment of nutraceuticals may reduce the adverse effects of the pro-inflammatory diet on functioning. Furthermore, cohorts with lower BMIs who were given the combination therapy or N-acetylcysteine alone were reported to show better improvements by the clinicians. Although these results should be interpreted cautiously because of limitations, the data implies that there is an association between quality and inflammatory potential of diet, BMI, and the response to nutraceutical treatment for bipolar disorder in this clinical trial. [NPIDs: insomnia, sleep, sleep disorders, inflammation, depression, Australia, diet quality, bipolar, nutraceuticals, N-acetylcysteine]

Year: 2020

Reference: Ashton, M. M., Dean, O. M., Marx, W., Mohebbi, M., Berk, M., Malhi, G. S., Ng, C. H., Cotton, S. M., Dodd, S., Sarris, J., Hopwood, M., Faye-Chauhan, K., Kim, Y., Dash, S. R., Jacka, F. N., Shivappa, N., Hebert, J. R., & Turner, A. (2020). Diet quality, dietary inflammatory index and body mass index as predictors of response to adjunctive N-acetylcysteine and mitochondrial agents in adults with bipolar disorder: A sub-study of a randomised placebo-controlled trial. The Australian and New Zealand journal of psychiatry, 54(2), 159–172. https://doi.org/10.1177/0004867419882497