MooDFOOD Project Update - January 2018

Post date: 03 Feb 2018

In July 2015, the first participants were introduced to the MooDFOOD study in Germany. Since then, almost 6000 persons have been screened to determine whether they were appropriate candidates to participate in the study; ultimately 1025 were included over four participating countries: 277 participants from Germany, 254 participants from the United Kingdom, 252 participants from Spain, and 242 from the Netherlands.

We are excited to share information with you about baseline characteristics of the 1025 participants. At the start of the study. most participants were female (75%) and Caucasian (95%); these characteristics did not differ between the four countries. The average age of participants was 46. Approximately one out of three participants had a history of depression, though this percentage differed among the four countries, which may have been caused by differences in the process of recruiting volunteers for the study. The average body mass index (BMI) of all participants, calculated as body weight in kilograms divided by height in meters squared, was 31 kg/m2. For reference, the threshold BMI for obesity is 30.

October 13th, 2017 the final participant had his/her last MooDFOOD measurement at the research centre. During the past 27 months, the research team has received tremendous interest and cooperation from all of you who have participated in this important study. In addition, the research teams within all four participating countries worked diligently and efficiently — making regular appointments with all of you, providing participants with pill containers, supervising therapy sessions, and collecting all the data required for our research. This data is needed to answer this key question: ‘Will a lifestyle and behavioural coaching programme and/or the daily use of multivitamin and mineral supplements for a period of one year improve mood and lower the risk of experiencing an episode of depression?’

Everyone is anxiously awaiting the project results for the answer to this question. When presenting the design of the MooDFOOD study at national and international meetings, scientific colleagues and health professionals are extremely interested and the first question we often receive is: ‘When will the results of this trial become available?’ The MooDFOOD project team is currently working hard to get all the datasets ready for the upcoming statistical analyses and we expect the answer to our research question in 2018. Certainly you, as a valued participant, will be among the first to be informed when the results become available.

MooDFOOD at ECO2017

Post date: 11 Oct 2017


Post date: 11 Jul 2017

MooDFOOD is delighted to be presenting the project at the first International Society of Nutritional Psychiatry Research this summer.

This meeting will reflect the broad spectrum of research, from the sub-cellular to translation and implementation science and will cater to multidisciplinary interests. Researchers and clinicians from the fields of public health, diabetes, cardiovascular disease, obesity and dietetics, as well as psychiatry and psychology will participate. There will also be a strong focus on basic science and the biological processes and factors that underpin the links between diet, nutrition and mental health, including the brain-gut-microbe axis, immunology and metabolic processes and molecular science. An important aspect of the ISNPR conference will be workshops which will offer training from skilled and highly experienced psychiatrists and dietitians. These workshops will focus on the practical aspects of nutrition and clinical care for those with mental disorders. Learn more about ISNPR and the meetings on the conference website

Learn more about the MooDFOOD lecture

Project MooDFOOD: Meet Esther Vermeulen

Post date: 14 Jun 2017

Esther, please describe the project and your role in it

MooDFOOD is a multidisciplinary consortium involving 13 organisations in 9 European countries, using a unique integrative approach which combines expertise in nutrition, consumer behaviour, psychiatry and preventive psychology. By integrating epidemiological evidence and performing a multi‐centre prevention trial, we employ a unique approach to unraveling the multifaceted links between food intake, nutrient status, food‐related behaviour and obesity with depression.

In turn, this evidence will be used to develop guidelines and practical tools. In collaboration with a diverse group of experts and other stakeholders, this resource will be used to provide policy guidance at both the EU- and Member State level. The main goal of MooDFOOD is to deliver sustainable, evidence‐based nutritional strategies for the effective prevention of depression among EU citizens.

My role is to deliver observational evidence for the relationship between food consumption patterns and depression. This information was among several elements used for the development of dietary advice given to people participating in the MooDFOOD trial. Furthermore, my role is to disseminate the obtained knowledge about this topic to other experts, by giving presentations at  congresses, and by collaborating with other MooDFOOD partners in Europe.

Please describe your paper and its relevance to the project.

In my paper I investigated the association between a healthy dietary pattern and depressive symptoms over time among older adults in Tuscany, Italy. We observed that a dietary pattern, typical for the Tuscan population, which is high in vegetables, olive oil, fish, fruit, cereals, eggs, potatoes and moderate intakes of wine, red and processed meat consistently lowers depressive symptoms over a 9-year period. In other words, not only the typically known ‘healthy foods’ like olive oil, fish and vegetables, but also intakes of food  generally considered ‘less healthy’ such as red and processed meat, are important and are part and parcel of a dietary pattern associated with lower depressive symptoms. The most important implication for practice is that diet could be used as a plausible tool to test in practice to lower depressive symptoms.

The association between dietary patterns derived by reduced rank regression and depressive symptoms over time: the Invecchiare in Chianti (InCHIANTI) study

MooDFPPD at IUNS 2017

Post date: 18 Dec 2017

MooDFOOD at IUNS 2017 in Buenos Aires, Argentina

MooDFOOD colleague Laura Winkens recently presented at the IUNS symposium, the 21st International Congress of Nutrition. The theme of the meeting was “from sciences to nutritional security.” Following the meeting, Dr Winkens was interviewed by a Brazilian journalist. The text of the interview is below and is accompanied by an English translation. Read More

Eating with attention identified as one of the keys to combating depression

Luciana Mastrorosa
Collaboration for UOL in Buenos Aires
10/17/2017 10:00 AM

There is lots of talk recently about mindfulness. "Mindfulness" is a meditative practice to help people deal with everyday situations. The concept is also used in food and "eating with conscience" and can reduces symptoms of depression, according to research released on Monday, 16, at the 21st International Congress of Nutrition (IUNS 2017), which takes place in Buenos Aires, Argentina.

The so-called "mindful eating" would help you watch what you eat. According to the author of the study, Laura Winkens, from the Vrije Universiteit in Amsterdam, the Netherlands, who is part of the MooDFOOD consortium, instead of eating automatically identifying hunger and focusing on the act of eating with intention could be an important ally in combating depression.

In a conversation with UOL, the researcher explained that she used the "Mindful Eating Behaviour” scale, a specific questionnaire which investigates behaviours related to eating with mindfulness.

This instrument is composed of four domains:

  • "focused eating,”,referring to perceiving the aromas and flavours of food during a meal;
  • "suggestions of hunger and satiety," which refers to trusting and listening to the signals the body sends when it is hungry or not;
  • "eating with awareness,” which involves avoiding eating automatically but instead paying attention to what is ingested;
  • "eating without distractions,” which refers to eating meals sitting at the table rather than doing numerous tasks at the same time, such as watching TV or using a cell phone

Three of these domains showed an association with a decrease in the symptoms of depression: eating concentration, eating consciously and eating without distraction Because of these results, the researcher is now dedicated to understanding the mechanisms that generate this association, which may also possibly be related to the amount of food consumed This is because those who "eat with focus" or "eat without distraction" eat less calories. And that is where the explanation for the change in depressive symptoms may be. "We still do not know if mindful eating leads to better food choices, or to eating less, and therefore with losing weight, and this all ends up reflecting on depression." She says. “There are a number of factors that can influence the process. " Depression, is now one of the most prevalent and crippling diseases in the world.

A project to investigate nutrition and depression

Laura is part of the MooDFOOD Project, a collaborative project between several countries, dedicated to investigating the prevention of depression through nutritional strategies. The group also presented an investigation that pointed out that following a healthy diet throughout life, rich in fruits, vegetables, vegetables, fish, reduces the risk of depression in the elderly

Mindful eating in a few steps

  • Be aware of how you eat, pay attention to the food on the plate
  • Detect the thoughts you have in relation to food
  • Experience the foods fully, connecting with the sensations, emotions and thoughts that they provoke
  • Attend to the signs of hunger and satiety that the body sends out
  • Accept yourself, your body and the way you relate to food
  • Observe the situations and emotions that drive the decision to eat or not to eat

Fonte: Livro "Mindful Eating - El Sabor de la Atención", Dos Autores Javier García Campayo, Héctor Morillo, Alba López-Montoyo and Marcelo Demarzo (Editorial Siglantana, 2017)

Meet MooDFOOD Consortium Partner Liisa Lähteenmäki

Post date: 11 Sep 2017

I am delighted to share this conversation with Liisa Lähteenmäki, the principal investigator for WP1 of the EU MooDFOOD project. This part of the project is looking at both observational and experimental evidence on the bi-directional link between depression and food behaviour.

Liisa, can you please tell us about the scientific approach you are taking to understand the observational relationship of food-related behaviour with depression?

We are interested in how individuals’ food-related practices are related to depressive symptoms and therein the risk of depression. Several studies have found a link between depression and snacking or skipping meals such as not having breakfast. These food-related practices result in complex networks where options and choices around food purchases, food preparation practices and meal patterns are woven to daily and weekly routines that often define what we eat and when.

In the past, most studies have been interested in nutritional composition of diet or food intake per se without considering them as results of these various daily practice. We aim to study how different practices contribute to diet quality and thereby to the link between diet and depression.

At Aarhus University we are mainly interested in these food-related practices and at Vrije University of Amsterdam the primary focus is on psychological factors e.g. individual tendency to eat when having negative feelings or whether mindfulness has an impact on depression and depressive symptoms.

One of the key components of the project is the web-based intervention study your team is conducting. Can you tell us about how this was developed and implemented? And what is the significance for the project?


Using a web-based intervention, we are studying how people experience different kinds of suggested behaviour changes. Participants are offered advice on either changing their food choices, meal patterns, food provisioning practices, or training in mindful eating. Most nutrition interventions target food choices, but our interest is in whether targeting the behaviours around eating would be easier to make. The assumption is that making changes in shopping routines or meal patterns will also result changes in food intake without a need to think about single foods as good or bad choices.

Mindfulness, on the other hand, can help one pay more attention to eating and reduce ‘mindless eating,’ which often involves consuming energy dense options. As a control we run an intervention on sustainability advice which is not food-related.

In our interventions we provide participants advice, tips to follow and exercises to promote behaviour change. Our interventions are short term and we are mainly interested in the perceived ease of making changes in behaviour and whether the perceived ease is related to depressive symptoms. We hope that to find out if this type of on-line intervention increases individuals’ confidence in making changes in their food-related behaviour.

Food-related behaviours are embedded in our social environments and have several roles in addition to providing energy to the body. These activities can also have recreational functions and these functions can play a role in mental well-being that goes beyond diet quality.

We hope that our research results will widen our perspective in how to approach giving food and health-related advice to individuals and find out how targeting food-related behaviours can contribute to our mental well-being.

Liisa Lähteenmäki is Professor in Consumer Behaviour and Food Choice at the MAPP Centre, Aarhus University in Denmark. Her background iis n Human Nutrition and Psychology with a special interest in the role of health, novelty, and sustainability in food-related behaviours, widening the perspective from choices to food provisioning practices and routines, including studies on factors explaining food waste in households.

New research from the MooDFOOD team: High sugar intake linked with poorer long-term mental health

Post date: 28 Jul 2017

Men with high sugar intakes have an increased likelihood of common mental disorders (such as anxiety and depression) after 5 years compared to those with low intakes, according to UCL research. The study also showed that having a mood disorder did not make people more inclined to eat foods with a high sugar content. 

The report, published today in Scientific Reports used data from the Whitehall II cohort and analysed the sugar intake from sweet food and beverages and occurrence of common mental disorders in over 5000 men and over 2000 women for a period of 22 years between 1983 and 2013. 

Although previous studies have found an increased risk of depression with higher consumption of added sugars, none examined the role of ‘reverse causation’. If people with anxiety and/or depression tended to consume more sugary foods and drinks, this could be the real reason why a link between sugar intake and poorer mental health is observed. Although the study looked for this link, it was not seen in the data: men and women with mental disorders were not more likely to consume more sugar. As a result, the evidence that mental health is adversely affected by a high sugar intake is strengthened.

The study categorised daily sugar intake (in grams) from sweet food and beverages into three similar sized groups. Men in the top third, who consumed more than 67g, had a 23% increased chance of incident common mental disorders after five years, (independent of health behaviours, socio-demographic and diet-related factors, adiposity and other diseases) compared to those in the bottom third, who consumed less than 39.5 g. According to the National Diet and Nutrition Survey published in 2013 men in the UK consume an average 68.4 grams of added sugar per day (75 per cent from sweet foods and beverages).

Men and women with mood disorders and high sugar consumption also had an increased chance of being depressed again after 5 years compared to those with lower intakes, but this finding was not independent of other socio-demographic, health and diet-related factors.

Anika Knüppel (UCL Institute of Epidemiology and Public Health), lead author of the paper said: “High sugar diets have a number of influences on our health but our study shows that there might also be a link between sugar and mood disorders, particularly among men. There are numerous factors that influence chances for mood disorders, but having a diet high in sugary foods and drinks might be the straw that breaks the camel's back. The study found no link between sugar intake and new mood disorders in women and it is unclear why. More research is needed to test the sugar-depression effect in large population samples.

Anika Knüppel (UCL Institute of Epidemiology and Public Health), lead author of the paper said: “High sugar diets have a number of influences on our health but our study shows that there might also be a link between sugar and mood disorders, particularly among men. There are numerous factors that influence chances for mood disorders, but having a diet high in sugary foods and drinks might be the straw that breaks the camel's back. The study found no link between sugar intake and new mood disorders in women and it is unclear why. More research is needed to test the sugar-depression effect in large population samples.

Anika Knüppel (UCL Institute of Epidemiology and Public Health), lead author of the paper said: “High sugar diets have a number of influences on our health but our study shows that there might also be a link between sugar and mood disorders, particularly among men. There are numerous factors that influence chances for mood disorders, but having a diet high in sugary foods and drinks might be the straw that breaks the camel's back. The study found no link between sugar intake and new mood disorders in women and it is unclear why. More research is needed to test the sugar-depression effect in large population samples.

Anika Knüppel (UCL Institute of Epidemiology and Public Health), lead author of the paper said: “High sugar diets have a number of influences on our health but our study shows that there might also be a link between sugar and mood disorders, particularly among men. There are numerous factors that influence chances for mood disorders, but having a diet high in sugary foods and drinks might be the straw that breaks the camel's back. The study found no link between sugar intake and new mood disorders in women and it is unclear why. More research is needed to test the sugar-depression effect in large population samples.



Post date: 30 Jun 2017

Professor Marjolein Visser is a nutritionist and epidemiologist and professor of Healthy Ageing with specific attention to nutrition and clinical dietetics at the Department of Health Sciences of the VU University in Amsterdam, as well as the Department of Internal Medicine, VU Medical Center. Her research interests are nutritional and other lifestyle determinants of healthy ageing. Important research areas are malnutrition, obesity, sarcopenia and depression. She is involved in (inter)national ageing studies and lifestyle intervention studies and is a member of the Health Council of the Netherlands.

Professor Visser is the coordinator of three large EU consortia: MooDFOOD, focusing on the role of nutrition in the prevention of depression, PROMISS, focusing on the prevention of malnutrition in older adults, and the JPI MaNuEL, a HDHL Knowledge Hub focusing on malnutrition in older adults. She has authored over 230 scientific publications (H-index 70) and serves on the editorial boards of several international scientific journals.

She has been invited to present MooDFOOD in August 2017 in Washington DC at International Society for Nutritional Psychiatry Research

Professor Visser, congratulations on your upcoming plenary session at the first major international meeting of the International Society for Nutritional Psychiatry Research, outside of Washington, DC, this August. ISNPR is a relatively new organisation in this emerging field, is that right?

During recent years, there has been increasing attention to investigating the link between nutrition and mental diseases. Our MooDFOOD project, which started about 3 years ago, is a unique contributor to this new research field. The recent establishment of a society focusing specifically on the relationship between nutrition and psychiatric disorder will help to give this research field the attention it deserves. Furthermore, it will enable researchers to meet at its first meeting and share their research findings and ideas. I am looking forward to this meeting and would like to stimulate those working in this field and those who are interested in the role of nutrition in psychiatric diseases to attend.

This seems like a uniquely multi-disciplinary conference. Please tell us what you have planned for the session, particularly around recent developments in the MooDFOOD project:

During my lecture I will first introduce the MooDFOOD project to the audience. We are really proud of this important project and its team, and the results of this project will certainly contribute to the field. Of course I will also present some results of the project. These will be the results of our observational research as the intervention studies conducted within the MooDFOOD project are still running and results cannot be expected until 2018. I will present the results of a unique harmonized meta-analysis that we are conducting in collaboration with 6 cohort studies and which is coordinated by dr. Mary Nicolaou. In each of these cohorts, a local investigator has investigated the association between three dietary indices and depression using a standardized protocol. We used the MDS (Mediterranean Diet Score), AHEI-2010 (Alternative Healthy Eating Index) and DASH (Dietary Approaches to Stop Hypertension) indices, which all differ slightly in the healthy and unhealthy food products and nutrients they include in their score. These scores generally indicate how ‘healthy’ the diet of a person is. In a next step, the results of these local analyses are combined in a meta-analysis. This will give us important evidence on whether dietary patterns are linked to depression, whether this is consistent across cohorts (that differ in age, country and other characteristics), and which of these dietary patterns is most strongly associated with depression.

Has the MooDFOOD team presented at other interesting conferences recently?

On May 18th, 2017, the MooDFOOD team organized a symposium during ECO2017, the 24th European Congress on Obesity, held in Porto, Portugal. Since obesity is linked to both diet and depression, and thus is an important factor in all the research that we perform within the MooDFOOD project, we feel that our project is very relevant for the obesity research community. Laura Winkens presented the Mindful Eating Behaviour Scale that she developed within the MooDFOOD project and showed its association with the body mass index. Nadine Paans talked about weight gain in depressed persons and which biopsychosocial variables contribute to this weight gain. Deborah Gibson-Smith presented her work on the association between obesity and depressive symptoms and whether this association differs between different ethnic groups. And finally, Anika Knüppel talked about the bidirectional association of body weight and waist circumference with change in common mental disorder. The symposium was very well attended and even attracted some media attention.

EU Project MooDFOOD- new nutritional science research on sugar and mental health from Anika Knüppel

Post date: 30 May 2017

According to the WHO, mental disorders are one of the top public health challenges in the European region. While nutrition has been shown to be a key factor in physical health the MoodFOOD project addresses the role of nutrition in mental health. The first Work Package of the MoodFOOD project aims to investigate the bidirectional association of diet and obesity with depression using observational evidence. The goal here is to identify any food patterns, groups and/or nutrients that could have the potential to reduce or increase the risk of depression. The project also recognises that depression, or depressed mood, may change or influence food consumption and takes this into account in research.

From London, Anika is working with observational data from the Whitehall II study, which is a cohort of over 10.000 British Civil Servants who have been completing questionnaires and taking part in health screenings over the last 30 years (find out more on: This rich dataset permits Anika and her colleagues to view the sequence of health events and health behaviours.

The UCL team, led by Anika Knüppel, have a paper under review reporting on the associations between sugar intake from sweet food and drinks with common mental disorders and depression. The analysis is based on 22 years of follow up and 7 waves of data from the Whitehall II study.

The analyses suggest an adverse effect of the consumption of sweet foods and beverages on long-term psychological health, with higher consumption linked with greater odds of depression 5 years later.
Poor mental health was not associated with high sweet food and drink intake 5 years later. That there was no effect of depression on later sweet food and drink intake, means that ‘reverse causation’ is not likely to account for the association. It appears that the link observed is due to the effect of diet on mental health, rather than the other way around.

In conjunction with other research, these findings indicate lower sugar intake might not only be favourable for physical health but also mental health. In the light of public health initiatives on sugar intake, Anika’s results lend added support for interventions that aim to reduce sugar intake on a population level.

Further details of the study will become available when the research is accepted for publication.

Anika Knüppel is a PhD student in Epidemiology and Public Health at University College London (UCL) in the UK. She is working on findings for the first Work Package of the European MoodFOOD project. Anika holds a BSc and MSc in Nutritional Sciences from Martin Luther University Halle-Wittenberg in Germany and has had additional training in nutritional epidemiology.