Micronutrient supplementation may reduce symptoms of depression in Guatemalan women Potencial reducción de síntomas de depresión en mujeres en Guatemala mediante la suplementación con micronutrientes

Evidence for the impact of micronutrient supplementation trials on depression in women from developing countries is limited. This study examines this association and compares the impact of weekly versus daily combinations of micronutrient supplements on symptoms of depression. A randomized, positive-controlled trial was conducted in Guatemala. A total of 459 women were assigned randomly to 4 groups to receive weekly (5,000 or 2,800µg) or daily (400 or 200 µg) folic acid (FA) plus iron, zinc and vitamin B-12 for 12 weeks. Depression was measured using the Center for Epidemiologic Studies-Depression 20-item Scale (CES-D). A score=16 was used as an indication of depression. The association between micronutrient status and depression was assessed using baseline data. Generalized linear regression models were used to assess treatment effects. The baseline mean CES-D score was 17.1±8.5 and the prevalence of depression was 49.3%. Women in the lowest tertile of red blood cell folate (RBC) were 1.7 times more likely to be depressed than those in the highest tertile (OR=1.71; 95% CI: 0.91, 3.18). There were no associations between depression and serum folate, homocysteine, vitamin B-12, hemoglobin, ferritin or zinc (p > 0.05). Mean depression scores decreased by 2.3 points post-intervention and depression decreased to 37.7%, with no differences in degree of improvement by group (p = 0.64). Low RBC folate was associated with elevated symptoms of depression at baseline. Supplementation with FA-containing micronutrients may be equally efficacious in improving symptoms of depression when provided daily or weekly. Our findings that poor folate status may increase depression needs to be further investigated.La evidencia del impacto de ensayos de suplementación con micronutrientes en mujeres con depresión en países en desarrollo es limitada. El presente estudio examina esta asociación y compara el impacto de varias combinaciones de micronutrientes proporcionadas de manera semanal o diaria en los síntomas de depresión, utilizando datos de un ensayo controlado (control positivo) y aleatorizado realizado en Guatemala. Un total de 459 mujeres fueron asignadas al azar entre cuatro grupos para recibir semanalmente (5.000 o 2.800 µg) o diariamente (400 o 200 µg) de ácido fólico (AF) combinado con hierro, cinc y vitamina B-12 durante 12 semanas. La depresión fue medida utilizando la escala de 20 ítems del Centro de Estudios Epidemiológicos de la Depresión (CES-D). Un puntaje =16 f