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BMC Med. 2018 Dec 28;16(1):237. doi: 10.1186/s12916-018-1228-y.

The SMILES trial: an important first step.

Author information

1
IMPACT Strategic Research Centre, Deakin University, Geelong, VIC, Australia. f.jacka@deakin.edu.au.
2
Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia. f.jacka@deakin.edu.au.
3
Black Dog Institute, Randwick, NSW, Australia. f.jacka@deakin.edu.au.
4
IMPACT Strategic Research Centre, Deakin University, Geelong, VIC, Australia.
5
School of Population Health, The University of Melbourne, Melbourne, VIC, Australia.
6
Department of Rehabilitation, Nutrition and Sport, La Trobe University, Melbourne, VIC, Australia.
7
Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia.
8
Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.
9
Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia.
10
Biostatistics Unit, Faculty of Health, Deakin University, Geelong, VIC, Australia.
11
Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia.
12
St Vincent's Hospital, Melbourne, VIC, Australia.
13
Centre for Population Health Research, Deakin University, Geelong, VIC, Australia.
14
Department of Medicine, The University of Melbourne, Melbourne, VIC, Australia.
15
The Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia.
16
Cancer Intelligence and Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia.
17
Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.

Abstract

The SMILES trial was the first intervention study to test dietary improvement as a treatment strategy for depression. Molendijk et al. propose that expectation bias and difficulties with blinding might account for the large effect size. While we acknowledge the issue of expectation bias in lifestyle intervention trials and indeed discuss this as a key limitation in our paper, we observed a strong correlation between dietary change and change in depression scores, which we argue is consistent with a causal effect and we believe unlikely to be an artefact of inadequate blinding. Since its publication, our results have been largely replicated and our recent economic evaluation of SMILES suggests that the benefits of our approach extend beyond depression. We argue that the SMILES trial should be considered an important, albeit preliminary, first step in the field of nutritional psychiatry research.

KEYWORDS:

Depression; Diet; Nutrition; Randomised controlled trial

PMID:
30591059
PMCID:
PMC6309069
DOI:
10.1186/s12916-018-1228-y
[Indexed for MEDLINE]
Free PMC Article

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