Trial Outcomes & Findings for Omega-3 Supplementation and Depression Clinical Trial (NCT NCT01614249)

NCT ID: NCT01614249

Last Updated: 2018-06-28

Results Overview

Depressive symptoms were assessed by Beck Depression Inventory Second Edition (BDI-II) Scoring scale at Baseline and end of study during the 8- week study period. The BDI-II Scale is a 21-item scoring tool which measures the existence and severity of symptoms of depression. Each of the 21 items on BDI-II tool represent a depressive symptom. The symptoms are each scored on a 4-point Likert scale of 0 to 3 (0=symptom is absent; 3=symptom is severe).Scores for each symptom are added up to obtain the total scores for all 21 items, which are interpreted as follows: Scores of 0-13: minimal depression; 14-19: mild depression; 20-28: moderate depression and 29-63: severe depression. The change in BDI-II scores were computed from post-intervention scores at week 8 and baseline BDI-II scores at week 0.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

216 participants

Primary outcome timeframe

8 weeks

Results posted on

2018-06-28

Participant Flow

Women who met the trial inclusion criteria were recruited from clinic registers at their respective Prevention of mother-to-child transmission program clinics from July 2012 to May 2013 with assistance from mentor-mothers in the clinics. Women visiting the clinics first time were included in clinic registers and invited to participate in the trial.

Participants were assigned to either of the trial arms soon after enrollment to minimize drop-outs which might have occurred if enrolled participants exceeded gestation age or gave birth before randomization.

Participant milestones

Participant milestones
Measure
Soybean Oil Soft Gels Control Group
As a control group, participants received OmegaVia soybean oil soft gels for eight weeks with regular cell-phone and bi-weekly face-to-face follow-up visits. During each follow-up visit, participants were re-supplied with soft-gels and monitored for side effects and compliance. Each participant randomly received a sequentially numbered, securely sealed opaque plastic bottle containing soybean oil soft gels to take for two weeks before returning for re-supply. Three soft gels of soybean oil were taken by each participant per day. Each soft gel contained saturated fatty acids (0.178 grams), monounsaturated fatty acids (0.299 grams) and polyunsaturated fatty acids (0.985 grams) with traces of eicosapentaenoic acid (EPA), of 0.115 grams. The soft gels were taken orally, one soft gel taken three times per day in the morning, mid-day and in the evening after meals for a period of 8 weeks.
Fish Oil Omega-3 EPA-rich Experimental Group
As the experimental group, participants received dietary supplement of OmegaVia fish oil omega-3 EPA-rich soft gels to take orally for eight weeks with bi-weekly follow-up visits. During each follow-up visit, participants were re-supplied with soft-gels and monitored for side effects and compliance. Each participant randomly received a sequentially numbered, securely sealed opaque plastic bottle containing fish oil omega-3 EPA-rich soft gels to take for two weeks before returning for re-supply. Three soft gels of fish oil omega-3 fatty acid were taken by each participant per day. Each soft gel contained more eicosapentaenoic acid (EPA) of 0.715 grams than docosahexaenoic acid (DHA) of 0.340 grams. The soft gels were taken orally, one soft gel taken three times per day in the morning, mid-day and in the evening after meals for a period of 8 weeks.
Overall Study
STARTED
107
109
Overall Study
At Week-4
98
92
Overall Study
At Week-8 (End of Study Period)
96
86
Overall Study
COMPLETED
96
86
Overall Study
NOT COMPLETED
11
23

Reasons for withdrawal

Reasons for withdrawal
Measure
Soybean Oil Soft Gels Control Group
As a control group, participants received OmegaVia soybean oil soft gels for eight weeks with regular cell-phone and bi-weekly face-to-face follow-up visits. During each follow-up visit, participants were re-supplied with soft-gels and monitored for side effects and compliance. Each participant randomly received a sequentially numbered, securely sealed opaque plastic bottle containing soybean oil soft gels to take for two weeks before returning for re-supply. Three soft gels of soybean oil were taken by each participant per day. Each soft gel contained saturated fatty acids (0.178 grams), monounsaturated fatty acids (0.299 grams) and polyunsaturated fatty acids (0.985 grams) with traces of eicosapentaenoic acid (EPA), of 0.115 grams. The soft gels were taken orally, one soft gel taken three times per day in the morning, mid-day and in the evening after meals for a period of 8 weeks.
Fish Oil Omega-3 EPA-rich Experimental Group
As the experimental group, participants received dietary supplement of OmegaVia fish oil omega-3 EPA-rich soft gels to take orally for eight weeks with bi-weekly follow-up visits. During each follow-up visit, participants were re-supplied with soft-gels and monitored for side effects and compliance. Each participant randomly received a sequentially numbered, securely sealed opaque plastic bottle containing fish oil omega-3 EPA-rich soft gels to take for two weeks before returning for re-supply. Three soft gels of fish oil omega-3 fatty acid were taken by each participant per day. Each soft gel contained more eicosapentaenoic acid (EPA) of 0.715 grams than docosahexaenoic acid (DHA) of 0.340 grams. The soft gels were taken orally, one soft gel taken three times per day in the morning, mid-day and in the evening after meals for a period of 8 weeks.
Overall Study
Lost to Follow-up
11
23

Baseline Characteristics

Omega-3 Supplementation and Depression Clinical Trial

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Soybean Oil Soft Gels Control Group
n=107 Participants
As a control group, participants received OmegaVia soybean oil soft gels for eight weeks with regular cell-phone and bi-weekly face-to-face follow-up visits. During each follow-up visit, participants were re-supplied with soft-gels and monitored for side effects and compliance. Each participant randomly received a sequentially numbered, securely sealed opaque plastic bottle containing soybean oil soft gels to take for two weeks before returning for re-supply. Three soft gels of soybean oil were taken by each participant per day. Each soft gel contained saturated fatty acids (0.178 grams), monounsaturated fatty acids (0.299 grams) and polyunsaturated fatty acids (0.985 grams) with traces of eicosapentaenoic acid (EPA), of 0.115 grams. The soft gels were taken orally, one soft gel taken three times per day in the morning, mid-day and in the evening after meals for a period of 8 weeks.
Fish Oil Omega-3 EPA-rich Soft Gels Experimental Group
n=109 Participants
As the intervention group, participants received a dietary supplement of Omega Via fish oil omega-3 EPA-rich soft gels to take orally for eight weeks with bi-weekly follow-up visits to resupply the soft-gels, monitoring of side effects and compliance and data collection. Each participant randomly received a sequentially numbered, securely sealed opaque plastic bottle containing fish oil omega-3 EPA-rich soft gels to take for two weeks before returning for re-supply. Each participants took three soft gels of fish oil omega-3 fatty acid per day, each containing more EPA (0.715 grams) than docosahexaenoic acid (DHA) of 0.340 grams. The soft gels were taken orally, one soft gel taken three times per day in the morning, mid-day and in the evening after meals for a period of 8 weeks.
Total
n=216 Participants
Total of all reporting groups
Age, Categorical
<=18 years
5 Participants
n=99 Participants
5 Participants
n=107 Participants
10 Participants
n=206 Participants
Age, Categorical
Between 18 and 65 years
102 Participants
n=99 Participants
104 Participants
n=107 Participants
206 Participants
n=206 Participants
Sex: Female, Male
Female
107 Participants
n=99 Participants
109 Participants
n=107 Participants
216 Participants
n=206 Participants
Age, Categorical
>=65 years
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Age, Continuous
26 Years
n=99 Participants
26 Years
n=107 Participants
26 Years
n=206 Participants
Sex: Female, Male
Male
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Region of Enrollment
Kenya
107 participants
n=99 Participants
109 participants
n=107 Participants
216 participants
n=206 Participants
Gestation age
22 Weeks
n=99 Participants
22 Weeks
n=107 Participants
22 Weeks
n=206 Participants
Cluster of differentiation 4 (CD4) cell count
360 cells/µl
n=99 Participants
361 cells/µl
n=107 Participants
360 cells/µl
n=206 Participants
Mid-upper-arm circumference (MUAC)
26.0 cm
n=99 Participants
26.0 cm
n=107 Participants
26.0 cm
n=206 Participants
BDI-II depressive symptom scores
21 Scores on a scale
n=99 Participants
20 Scores on a scale
n=107 Participants
21 Scores on a scale
n=206 Participants
Marital status
Single (not married, divorced, widowed
22 participants
n=99 Participants
27 participants
n=107 Participants
49 participants
n=206 Participants
Marital status
Married
85 participants
n=99 Participants
82 participants
n=107 Participants
167 participants
n=206 Participants
Parity
First pregnancy
24 participants
n=99 Participants
24 participants
n=107 Participants
48 participants
n=206 Participants
Parity
Not first pregnancy
83 participants
n=99 Participants
85 participants
n=107 Participants
168 participants
n=206 Participants
Education status
No High school education
55 participants
n=99 Participants
55 participants
n=107 Participants
110 participants
n=206 Participants
Education status
At least High school education
52 participants
n=99 Participants
54 participants
n=107 Participants
106 participants
n=206 Participants
Employment status
Not in gainful employment
64 participants
n=99 Participants
61 participants
n=107 Participants
125 participants
n=206 Participants
Employment status
In gainful employment with income
43 participants
n=99 Participants
48 participants
n=107 Participants
91 participants
n=206 Participants
Household income per month
5025 Kenya Shillings (Ksh.)
n=99 Participants
6000 Kenya Shillings (Ksh.)
n=107 Participants
5050 Kenya Shillings (Ksh.)
n=206 Participants
HIV status knowledge before pregnancy
No, newly tested less than 6 months
56 participants
n=99 Participants
56 participants
n=107 Participants
112 participants
n=206 Participants
HIV status knowledge before pregnancy
Yes, known positive, 6 months plus
51 participants
n=99 Participants
53 participants
n=107 Participants
104 participants
n=206 Participants
HIV status disclosure to anyone
Not disclosed
25 participants
n=99 Participants
18 participants
n=107 Participants
43 participants
n=206 Participants
HIV status disclosure to anyone
Disclosed to someone
82 participants
n=99 Participants
91 participants
n=107 Participants
173 participants
n=206 Participants
prevention of mother-to-child transmission program m2m support group meeting attendance
Not attended
54 participants
n=99 Participants
62 participants
n=107 Participants
116 participants
n=206 Participants
prevention of mother-to-child transmission program m2m support group meeting attendance
Attended
53 participants
n=99 Participants
47 participants
n=107 Participants
100 participants
n=206 Participants
Experienced stressful life event
None 2 weeks before study
75 participants
n=99 Participants
73 participants
n=107 Participants
148 participants
n=206 Participants
Experienced stressful life event
Yes, 2 weeks before study
32 participants
n=99 Participants
36 participants
n=107 Participants
68 participants
n=206 Participants
Dietary vitamin C
Below Estimated Average Requirement (EAR)
59 participants
n=99 Participants
62 participants
n=107 Participants
121 participants
n=206 Participants
Dietary vitamin C
At least EAR for pregnant women
48 participants
n=99 Participants
47 participants
n=107 Participants
95 participants
n=206 Participants
Dietary vitamin B1
Below Estimated Average Requirement (EAR)
67 participants
n=99 Participants
73 participants
n=107 Participants
140 participants
n=206 Participants
Dietary vitamin B1
At least EAR for pregnant women
40 participants
n=99 Participants
36 participants
n=107 Participants
76 participants
n=206 Participants
Dietary vitamin B6
Below Estimated Average Requirement (EAR)
87 participants
n=99 Participants
85 participants
n=107 Participants
172 participants
n=206 Participants
Dietary vitamin B6
At least EAR for pregnant women
20 participants
n=99 Participants
24 participants
n=107 Participants
44 participants
n=206 Participants
Dietary vitamin B12
Below Estimated Average Requirement (EAR)
94 participants
n=99 Participants
97 participants
n=107 Participants
191 participants
n=206 Participants
Dietary vitamin B12
At least EAR for pregnant women
13 participants
n=99 Participants
12 participants
n=107 Participants
25 participants
n=206 Participants
Dietary folate
Below Estimated Average Requirement (EAR)
91 participants
n=99 Participants
98 participants
n=107 Participants
189 participants
n=206 Participants
Dietary folate
At least EAR for pregnant women
16 participants
n=99 Participants
11 participants
n=107 Participants
27 participants
n=206 Participants
Dietary Iron
Below Estimated Average Requirement (EAR)
107 participants
n=99 Participants
109 participants
n=107 Participants
216 participants
n=206 Participants
Dietary Iron
At least EAR for pregnant women
0 participants
n=99 Participants
0 participants
n=107 Participants
0 participants
n=206 Participants
Dietary vitamin E
Below Estimated Average Requirement (EAR)
87 participants
n=99 Participants
89 participants
n=107 Participants
176 participants
n=206 Participants
Dietary vitamin E
At least EAR for pregnant women
20 participants
n=99 Participants
20 participants
n=107 Participants
40 participants
n=206 Participants
Dietary calcium
Below Estimated Average Requirement (EAR)
79 participants
n=99 Participants
78 participants
n=107 Participants
157 participants
n=206 Participants
Dietary calcium
At least EAR for pregnant women
28 participants
n=99 Participants
31 participants
n=107 Participants
59 participants
n=206 Participants
Dietary selenium
Below Estimated Average Requirement (EAR)
76 participants
n=99 Participants
82 participants
n=107 Participants
158 participants
n=206 Participants
Dietary selenium
At least EAR for pregnant women
31 participants
n=99 Participants
27 participants
n=107 Participants
58 participants
n=206 Participants
Dietary zinc
Below Estimated Average Requirement (EAR)
105 participants
n=99 Participants
109 participants
n=107 Participants
214 participants
n=206 Participants
Dietary zinc
At least EAR for pregnant women
2 participants
n=99 Participants
0 participants
n=107 Participants
2 participants
n=206 Participants
Dietary total omega-3
Below Recommended daily intake
89 participants
n=99 Participants
99 participants
n=107 Participants
188 participants
n=206 Participants
Dietary total omega-3
At least recommended daily intake
18 participants
n=99 Participants
10 participants
n=107 Participants
28 participants
n=206 Participants

PRIMARY outcome

Timeframe: 8 weeks

Population: Only participants who completed the 8-weeks trial period were included in the final analysis of primary outcome. Per protocol analysis Post-intervention BDI-II scores at week 8 minus baseline BDI-II scores at week 0

Depressive symptoms were assessed by Beck Depression Inventory Second Edition (BDI-II) Scoring scale at Baseline and end of study during the 8- week study period. The BDI-II Scale is a 21-item scoring tool which measures the existence and severity of symptoms of depression. Each of the 21 items on BDI-II tool represent a depressive symptom. The symptoms are each scored on a 4-point Likert scale of 0 to 3 (0=symptom is absent; 3=symptom is severe).Scores for each symptom are added up to obtain the total scores for all 21 items, which are interpreted as follows: Scores of 0-13: minimal depression; 14-19: mild depression; 20-28: moderate depression and 29-63: severe depression. The change in BDI-II scores were computed from post-intervention scores at week 8 and baseline BDI-II scores at week 0.

Outcome measures

Outcome measures
Measure
Soybean Oil Soft Gels Control Group
n=96 Participants
As a control group, participants received OmegaVia soybean oil soft gels for eight weeks with regular cell-phone and bi-weekly face-to-face follow-up visits. During each follow-up visit, participants were re-supplied with soft-gels and monitored for side effects and compliance. Each participant randomly received a sequentially numbered, securely sealed opaque plastic bottle containing soybean oil soft gels to take for two weeks before returning for re-supply. Three soft gels of soybean oil were taken by each participant per day. Each soft gel contained saturated fatty acids (0.178 grams), monounsaturated fatty acids (0.299 grams) and polyunsaturated fatty acids (0.985 grams) with traces of eicosapentaenoic acid (EPA), of 0.115 grams. The soft gels were taken orally, one soft gel taken three times per day in the morning, mid-day and in the evening after meals for a period of 8 weeks.
Fish Oil Omega-3 EPA-rich Soft Gels Experimental Group
n=86 Participants
As the experimental group, participants received dietary supplement of OmegaVia fish oil omega-3 EPA-rich soft gels to take orally for eight weeks with bi-weekly follow-up visits. During each follow-up visit, participants were re-supplied with soft-gels and monitored for side effects and compliance. Each participant randomly received a sequentially numbered, securely sealed opaque plastic bottle containing fish oil omega-3 EPA-rich soft gels to take for two weeks before returning for re-supply. Three soft gels of fish oil omega-3 fatty acid were taken by each participant per day. Each soft gel contained more eicosapentaenoic acid (EPA) of 0.715 grams than docosahexaenoic acid (DHA) of 0.340 grams. The soft gels were taken orally, one soft gel taken three times per day in the morning, mid-day and in the evening after meals for a period of 8 weeks.
Change in BDI-II Depressive Symptom Scores
-13.9 scores on BDI-II scale
Interval -15.3 to -12.6
-13.3 scores on BDI-II scale
Interval -14.9 to -12.0

Adverse Events

Soybean Oil Soft Gels

Serious events: 0 serious events
Other events: 15 other events
Deaths: 0 deaths

Fish Oil Omega-3 EPA-rich Soft Gels

Serious events: 0 serious events
Other events: 24 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Soybean Oil Soft Gels
n=107 participants at risk
Participants on this arm received a dietary supplement of OmegaVia soybean oil soft gels as a placebo for 8 weeks with bi-weekly follow-up visits to monitor side effects and compliance. Soybean oil soft gels: Each participant received OmegaVia soybean oil soft gels to take orally, one soft gel taken three times per day in the morning, mid-day and in the evening after meals for a period of 8 weeks.
Fish Oil Omega-3 EPA-rich Soft Gels
n=109 participants at risk
Participants received OmegaVia fish oil omega-3 EPA-rich soft gels to take orally for eight (8) weeks with bi-weekly follow-up visits for monitoring of side effects and compliance and data collection. Fish oil omega-3 EPA-rich soft gels: A total of 3.0g of OmegaVia fish oil omega-3 EPA-rich soft gels was taken orally per day as one soft gel in the morning, mid-day and evening after meals for 8 weeks with bi-weekly follow-up visits.
Gastrointestinal disorders
Nausea with fishy-after-taste
4.7%
5/107 • Both known and unknown possible Adverse Events were closely monitored through out the eight-weeks study period for each participant by phone or face-to-face individual interviews and observations.
9.2%
10/109 • Both known and unknown possible Adverse Events were closely monitored through out the eight-weeks study period for each participant by phone or face-to-face individual interviews and observations.
Gastrointestinal disorders
Occasional vomitting in the morning after taking soft gel
2.8%
3/107 • Both known and unknown possible Adverse Events were closely monitored through out the eight-weeks study period for each participant by phone or face-to-face individual interviews and observations.
5.5%
6/109 • Both known and unknown possible Adverse Events were closely monitored through out the eight-weeks study period for each participant by phone or face-to-face individual interviews and observations.
Gastrointestinal disorders
Occasional heartburn
4.7%
5/107 • Both known and unknown possible Adverse Events were closely monitored through out the eight-weeks study period for each participant by phone or face-to-face individual interviews and observations.
2.8%
3/109 • Both known and unknown possible Adverse Events were closely monitored through out the eight-weeks study period for each participant by phone or face-to-face individual interviews and observations.
Gastrointestinal disorders
Occasional bloated stomach
0.00%
0/107 • Both known and unknown possible Adverse Events were closely monitored through out the eight-weeks study period for each participant by phone or face-to-face individual interviews and observations.
1.8%
2/109 • Both known and unknown possible Adverse Events were closely monitored through out the eight-weeks study period for each participant by phone or face-to-face individual interviews and observations.
Gastrointestinal disorders
Occasional loose stool
0.93%
1/107 • Both known and unknown possible Adverse Events were closely monitored through out the eight-weeks study period for each participant by phone or face-to-face individual interviews and observations.
0.00%
0/109 • Both known and unknown possible Adverse Events were closely monitored through out the eight-weeks study period for each participant by phone or face-to-face individual interviews and observations.
Skin and subcutaneous tissue disorders
Occasional itchy skin
0.93%
1/107 • Both known and unknown possible Adverse Events were closely monitored through out the eight-weeks study period for each participant by phone or face-to-face individual interviews and observations.
1.8%
2/109 • Both known and unknown possible Adverse Events were closely monitored through out the eight-weeks study period for each participant by phone or face-to-face individual interviews and observations.
Blood and lymphatic system disorders
Nose Bleeding once
0.00%
0/107 • Both known and unknown possible Adverse Events were closely monitored through out the eight-weeks study period for each participant by phone or face-to-face individual interviews and observations.
0.92%
1/109 • Both known and unknown possible Adverse Events were closely monitored through out the eight-weeks study period for each participant by phone or face-to-face individual interviews and observations.

Additional Information

Mrs. Rose Okoyo Opiyo

University of Nairobi

Phone: +254 020 2726300

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place