Major depressive disorder (MDD) remains a leading cause of disability worldwide, and innovative adjunctive strategies are needed to enhance treatment outcomes. This critical appraisal examines a recen Show more
Major depressive disorder (MDD) remains a leading cause of disability worldwide, and innovative adjunctive strategies are needed to enhance treatment outcomes. This critical appraisal examines a recent pilot study by Decker et al., which evaluated a 10-12 week well-formulated ketogenic diet (WFKD) as an adjunct therapy for college students with MDD. In this uncontrolled cohort (n = 16 completers), mean PHQ-9 and HRSD scores decreased by approximately 69-71% (p < 0.001), accompanied by notable improvements in self-reported wellbeing, cognitive performance, body composition, and metabolic biomarkers (e.g., leptin reduction, BDNF increase). These findings suggest that metabolic interventions may exert clinically meaningful antidepressant effects comparable to conventional therapies. However, as a single-arm study with a small, self-selected sample, causality cannot be established, and placebo effects or concurrent counseling may have contributed to outcomes. The authors appropriately call for larger, randomized controlled trials with longer follow-up and diverse populations to confirm efficacy, explore underlying mechanisms (e.g., neuroinflammation, gut-brain axis modulation), and optimize implementation. If validated, integrating dietary strategies into psychiatric and college counseling programs could offer a low-risk, holistic approach to improving mental health outcomes. Show less
Pomegranate (Punica granatum L.) extract has been reported to inhibit cholinesterase and the β-site amyloid precursor protein cleaving enzyme 1 (BACE1); however, most of its constituents' potential in Show more
Pomegranate (Punica granatum L.) extract has been reported to inhibit cholinesterase and the β-site amyloid precursor protein cleaving enzyme 1 (BACE1); however, most of its constituents' potential inhibition of these enzymes remains unknown. Thus, we investigated the anti-Alzheimer's disease (anti-AD) potential of 16 ellagitannin and gallotannin, and nine anthocyanin derivatives' inhibition of BACE1, AChE, and BChE, and gallagic acid inhibited both the best. Further, a kinetic study identified different modes of inhibition, and a molecular docking simulation revealed that active compounds inhibited these three enzymes with low binding energy through hydrophilic and hydrophobic interactions in the active site cavities. Gallagic acid and castalagin decreased Aβ peptides secretion from neuroblastoma cells that overexpressed human β-amyloid precursor protein significantly by 10 μM. Further, treatment with gallagic acid and castalagin reduced BACE1 and APPsβ expression levels significantly without affecting amyloid precursor protein (APP) levels in the amyloidogenic pathway. Co-incubation of Aβ42 with gallagic acid reduced Aβ42-induced intracellular reactive oxygen species (ROS) production significantly. Our results suggest that pomegranate constituents, specifically gallagic acid, may be useful in developing therapeutic treatment modalities for AD. Show less