The SMILES trial: An important first step

Jacka, F, O'Neil, Adrienne, Itsiopoulos, Catherine, Opie, Rachelle, Cotton, Susan, Mohebbi, M, Castle, David J, Dash, Sarah ORCID: 0000-0002-7694-3027, Mihalopoulos, Cathrine, Chatterton, Mary Lou, Brazionis, Laima, Dean, OM, Hodge, Allison and Berk, Michael (2018) The SMILES trial: An important first step. BMC Medicine, 16 (1). ISSN 1741-7015


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.

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Item type Article
DOI 10.1186/s12916-018-1228-y
Official URL
Subjects Current > FOR (2020) Classification > 3210 Nutrition and dietetics
Current > FOR (2020) Classification > 5203 Clinical and health psychology
Current > Division/Research > Institute for Health and Sport
Keywords dietary change, depression management, symptoms, randomised controlled trial, diet, nutrition research, lifestyle, behavioural medicine
Citations in Scopus 4 - View on Scopus
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