| Summary: | Abstract Depressive patients often experience difficulty in performing exercise due to physical and psychological barriers. We examined the effects of 5-aminolevulinic acid (ALA) with sodium ferrous citrate (SFC) supplementation during home-based walking training in middle-aged depressive women. Nine outpatients [53 ± 8 (SD) yr] with major depressive disorder participated in the pilot study with randomized, placebo-controlled, double-blind crossover design. They underwent two trials for 7 days, each performing interval walking training (IWT) with ALA + SFC (ALA + SFC) or placebo supplement intake (PLC) intermittently with >a 10-day washout period. For the first 6 days of each trial, exercise intensity for IWT was measured by accelerometry. Before and after each trial, subjects underwent a graded cycling test, and lactate concentration in plasma ([Lac−]p), oxygen consumption rate ($${\dot{{\bf{V}}}{\bf{O}}}_{{\bf{2}}}$$ V˙O2 ), and carbon dioxide production rate ($${\dot{{\bf{V}}}{\bf{\text{CO}}}}_{{\bf{2}}}$$ V˙CO2 ) were measured with depression severity by the Montgomery–Åsberg Depression Rating Scale (MADRS). We found that the increases in [Lac−]p, $${\dot{{\bf{V}}}{\bf{O}}}_{{\bf{2}}}$$ V˙O2 and $${\dot{{\bf{V}}}{\bf{\text{CO}}}}_{{\bf{2}}}$$ V˙CO2 during the test were attenuated only in ALA + SFC ([before vs. after] × workload; all, P < 0.01), accompanied by increased training days, impulse, and time at fast walking during IWT (all, P < 0.05) with decreased MADRS-score (P = 0.001). Thus, ALA + SFC supplementation increased IWT achievement to improve depressive symptoms in middle-aged women.
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