Nutrition and eating for the brain and mental health are topics I have written about regularly here.  Our mood can have powerful influences on many aspects of life and eating for a healthy body naturally impacts the brain.  A recently published study (1) highlights the importance of eating for mental health by demonstrating that there is an association between diet quality and the prevalence of mental disorders in women.  The study is preliminary and certainly warrants further investigative trials but the data is important to note.

The study authors wanted to examine the extent to which the high prevalence of mood disorders are related to diet/eating habits.  The research involved 1,046 women between the ages of 20 and 93 who were randomly selected.  A diet quality score was devised and the habitual eating patterns of the women were analysed.  The women also underwent a specialised questionnaire and clinical interview to assess their psychological health.  Current depressive and anxiety disorders were recorded.  The researchers found that a traditional western diet which includes processed/fried foods, refined grains, sugary products and beer was associated with anxiety and depression.  The results were not confounded by age, education or a variety of other behaviours, indicating that diet was having a very real impact on mood (1).

Eating a ‘traditional western diet’ was associated with more than a 50% increased likelihood for depressive disorders in the women involved in the study.  Depression and anxiety disorders were around 30% less likely among women who ate a healthier diet which consisted mainly of vegetables, fruits, fish and unrefined wholegrains (1) 

The authors suggest that further investigations are needed to determine whether unhealthy eating leads to declining mental health or whether declining mental health leads to unhealthier eating.  It is probable that these events are not mutually exclusive.  Feeling good often means that a better quality diet is eaten, self-esteem is high and we tend to look after our bodies and feed them healthfull foods.  Feeling ‘low’ may lead to lowered self-esteem and poorer quality food choices at a time when high quality foods would probably make a difference to mind and body.

As my previous posts relating to mood and mental health aim to highlight, a healthy diet and lifestyle which includes some regular exercise really can go far in impacting mental health.  Diets rich in vegetables, fruit, unrefined meats, fish, and wholegrains are a good basis health.  Omega 3 fats from oily fish and/or supplements seem particularly important for the brain and mood elevation.

(1) Jacka FN et al.  2010.  Association of Western and Traditional Diets With Depression and Anxiety in Women.  Am J Psychiatry (published online January 4, 2010; doi:10.1176/appi.ajp.2009.09060881)

Written by Ani Kowal

Many of us experience a certain level of anxiety at some point or another but for some individuals anxiety can become a debilitating problem.  Generalised Anxiety Disorder, or GAD, “can be defined as a disorder in which the sufferer feels in a constant state of high anxiety” according to the charity Anxiety UK.  “The anxiety experienced is not as a result of any specific trigger, but those with this condition feel that they are on edge all the time for no specific reason. GAD is often accompanied by depression. GAD is sometimes called 'free-floating' anxiety condition”.  For further, more specific information on GAD please visit the Anxiety UK website

Anxiety UK is a national registered charity formed 30 years ago by a sufferer of agoraphobia for those affected by anxiety disorders. Today the charity is still a user-led organisation, run by sufferers and ex-sufferers of anxiety disorders supported by a high-profile medical advisory panel.  The ANXIETY UK works to relieve and support those living with anxiety disorders by providing information, support and understanding via an extensive range of services, including 1:1 therapy services.  The charity can provide support and help to those who have been diagnosed with, or suspect they may have an anxiety condition.

For many years people have advocated having a cup of chamomile (Matricaria recutita) tea to help soothe and calm nerves.  I was interested to find that recently (1) a study showed that chamomile may be useful to those suffering from mild to moderate GAD.  The study was well designed and looked at the usefulness of chamomile extract therapy in individuals suffering with mild to moderate GAD.  Individuals in the study received chamomile extract or placebo (inactive dummy pill) for 8 weeks.

The research was designed to detect changes in clinical anxiety ratings using special, professionally recognised, anxiety scores.  The results(1) showed that there was a significantly greater reduction in the anxiety scores during the chamomile therapy when compared to the placebo.  This was the first controlled clinical trial of chamomile extract for the treatment of GAD and the results suggest that chamomile may well have modest anti-panic activity in treating GAD in patients with mild-to moderate GAD.  Further clinical trials are needed to confirm these results and before any recommendations can be made. 

These results are particularly interesting since many individuals suffering from anxiety disorders would prefer not to take pharmaceutical drugs for their condition.  I have previously written a little about anxiety in my posts – gentle exercise such as yoga and Tai Chi, healthy diet (especially managing blood sugar levels) and magnesium may also be useful in anxiety disorders.  Caffeine is also known to aggravate anxiety in many individuals so having chamomile tea is a good alternative.  Supplements containing chamomile are available and often these are marketed as ‘calming’ these supplements have not been tested specifically for anxiety disorders but if you wish to try them to see if they have a soothing effect then please follow the manufacturers guidelines.

(1)Amsterdam JD et al.  2009.  A Randomized, Double-Blind, Placebo-Controlled Trial of Oral Matricaria recutita (Chamomile) Extract Therapy for Generalized Anxiety Disorder.  Journal of Clinical Psychopharmacology. 29(4):378-382
Written Ani Kowal

A new study (1) has found that taking a daily fish oil supplement that is rich in long-chain omega 3 fatty acids may help to prevent against psychotic disorders.

The study(1) was carried out to see whether a daily long chain omega 3 fatty acid supplement could help reduce the rate of progression to psychotic disorders in adolescents and young adults, aged 13-25 years old, who were at high risk of developing a psychiatric condition.  Long chain omega 3 fatty acids, EPA and DHA, are naturally found in oily fish such as salmon, trout, mackerel and sardines.  There have been numerous studies linking these fatty acids to reduced incidence of depression and other mood related disorders. 

This study (1) was well designed and carried out between 2004 and 2007 and involved 81 individuals at, what the authors describe as, ultra-high risk of psychotic disorder.  The researchers included people who met at least one of the following three criteria: having low-level psychotic symptoms; having transient psychotic symptoms; or having a schizophrenia-like personality disorder or a close relative with schizophrenia, along with a sharp decline in mental function within the past year.  These are individuals which may have weak or transient psychotic symptoms, and already show schizophrenia-like brain changes.  Psychiatrists now know how to identify these at-risk individuals but at the moment they don't really know how best to treat them in order to prevent disease progression. Prescribing antipsychotic medications is often the course of action and could be helpful, however, these medications have serious side effects, and can also be stigmatizing.  Many individuals also do not wish to take these kinds of medications and look for safer, more natural alternatives.  Also this kind of preventative anti-psychotic medication may not be necessary, since only about a third of people at high risk for psychotic disorders will go on to develop full-fledged mental illness in a given year.  For these reason the authors of the study (1) tested fish oils, a natural and safe option.  The authors of the study note that there is considerable evidence that abnormal fatty acid metabolism may contribute to the development of schizophrenia – that is why they designed the trial

Participants (1) received either 1.2g per day of long chain omega 3 fatty acids or a placebo (inactive dummy pill) for 12 weeks.  This was followed by 40 weeks of monitoring.  Blood tests were used to look at the level of fatty acids in the red blood cells before and after treatment.  At the end of the study 2 out of the 41 individuals (4.9%) in the omega-3 supplement group had transitioned to having a psychotic disorder compared to 11 out of the 40 (27.5%) in the placebo group.  Individuals taking fish oil also showed significant reductions in their psychotic symptoms and improvements in function.

The authors(1) conclude that long chain omega 3 fatty acids reduce the risk of progression to psychotic disorder in young people at risk of developing these disorders.  The researchers note that fish oil could also potentially be used to prevent or delay the onset of chronic depression, bipolar illness, and substance abuse disorder, all of which are far more common than psychotic illness.  They also say that these fatty acid supplements are safe and effective and are now planning a large, multicenter trial, of fish oil supplementation for the prevention of psychotic illness in 320 at-risk people.

It is not exactly known how the fatty acids are working to prevent psychotic illness, however readers of this blog will already be aware of the mounting evidence for the essential health benefits of omega 3 fatty acids.  These fatty acids are essential for the structure and proper functioning of the brain.  They are also key to the proper functioning of two specific brain chemical signalling systems: the dopamine and serotonin systems, which have been implicated in schizophrenia.  Fish oil also boosts levels of the antioxidant glutathione.  Glutathione protects the brain against oxidative stress.

In a BBC News article (2), Alison Cobb, of the mental health charity Mind, said: "If young people can be treated successfully with fish oils, this is hugely preferable to treating them with antipsychotics, which come with a range of problems from weight gain to sexual dysfunction, whereas omega-3s are actually beneficial to their general state of health.  These are promising results and more research is needed to show if omega-3s could be an alternative to antipsychotics in the long term."

Since Omega 3 fatty acids are so vital for health, as I have previously recommended, it may be worth considering a daily fish oil supplement - especially if you do not regularly (at least twice weekly) consume oily fish.  For vegans and vegetarians a flaxseed oil supplement may be considered.  Unfortunately the shorter chain omega 3 fats (alpha linolenic) provided by flaxseeds are not easily converted by the body into the longer chain forms found in fish oils, but having a dietary source of omega 3 is essential to health.  There are now some EPA/DHA supplements available for vegetarians/vegans that are made from algae.

(1)Amminger GP et al.  Long-chain omega-3 fatty acids for indicated prevention of psychotic disorders: a randomised, placebo-controlled trial.  Arch Gen Psychiatry.  67:146-154
(2)BBC News.  http://news.bbc.co.uk/1/hi/health/8490937.stm  Fish Oil Supplements ‘beat psychotic illness’.  Tuesday 02 February 2010.
Written by Ani Kowal

Vitamin D has been a major topic of research over the last 2 years.  It seems as though this vitamin is essential to many aspects for health from bone to brain.  Low blood serum levels of vitamin D have been associated with increased risk for several diseases e.g. cardiovascular diseases, diabetes, depression, dental caries, osteoporosis, and periodontal disease.  Today I wanted to look further into the role that vitamin D may play in helping individuals who suffer from low mood or depression.  Previously I mentioned that vitamin D may be helpful to individuals suffering with Seasonal Affective Disorder (SAD) and have also written about vitamin D for healthy brain function and possible prevention of dementia/Alzheimer’s Disease.

There are ‘receptors’ for vitamin D within the brain and this may be the reason why recent research is discovering a link between vitamin D and mood.  In 2006(1) a study found that low levels of vitamin D (serum 25-hydroxyvitamin D) was significantly associated with a high depression score.  Other studies (e.g. 2,3,4) have found similar associations between low vitamin D levels and poor mood.

Vitamin D, acts as a multipurpose steroid hormone within the body and is vital to health.  A lack of vitamin D, or low vitamin D levels, particularly among older adults, have been linked to cognitive (brain) function, depression, bipolar disorder, and schizophrenia.  As mentioned above vitamin D activates receptors on neurons in regions of the brain which are implicated in the regulation of behaviour.  Vitamin D also acts to protect the brain by balancing antioxidant and anti-inflammatory defences (5).

The association studies mentioned above are interesting but don’t prove that vitamin D can help treat depression.  Interestingly, a study took place last year (6) which looked at vitamin D supplementation and depression in overweight and obese individuals.  The study involved over 400 individuals who were given high dose vitamin D supplementation: 20,000iu per week, 40,000iu per week or a placebo for one year.  Depression was rated using a special scale called the Beck Depression Inventory (BDI).  The first observation that was made by the research scientists was that individuals with the lowest vitamin D levels scored significantly higher in the depression scale than those with better vitamin D levels.  After one year of supplementation the two groups given vitamin D had significant improvements in BDI scores, this did not occur in the placebo group.  Vitamin D supplementation seemed to be positively affecting mood.  The authors conclude that “It appears to be a relation between serum levels of [vitamin D] 25(OH)D and symptoms of depression. Supplementation with high doses of vitamin D seems to ameliorate these symptoms indicating a possible causal relationship”. The research was carried out in overweight and obese individuals and further trials are necessary in normal-weight individuals. 

These results suggest that vitamin D deficiency could have the ability to cause depression and that ensuring good vitamin D levels in the body could help to prevent/treat depression.  Here in the UK that would seem particularly vital in the autumn and winter months when there is less sunlight and vitamin D levels tend to drop to their lowest.

Evidence for the use of vitamin D in depression and mood disorders is preliminary and not yet conclusive.  Further evidence is needed to see whether vitamin D is as useful in cases of moderate-to severe depression as it is in mild cases.  However, as I have previously written many of us in the UK have very low vitamin D levels.  If you rarely get out into the sunlight you may wish to consider taking a vitamin D supplement which provides around 12mcg of the nutrient per day (around 500iu).  Only small amounts of vitamin D are found in food sources such as oily fish (mackerel, salmon and sardines) and egg yolks.  Vitamin D supplements may be particularly useful during the autumn and winter months and for individuals who have darker skins or who don’t go outside regularly.  If you think you want to supplement much higher levels (more than 1000iu daily) then please visit your doctor since vitamin D is a fat soluble vitamin and it is possible to take too much.  When looking for vitamin D supplements two forms are generally available.  Cholecalciferol, known as vitamin D3, and ergocalciferol or vitamin D2. Cholecalciferol is generally taken to be the more potent, easily absorbed and preferred form of vitamin D

(1)Jorde R et al.  2006.  Neuropsychological function in relation to serum parathyroid hormone and serum 25-hydroxyvitamin D levels:  The Tromso study.  Journal of Neurology.  253(4):464-70
(2)Wilkins CH et al.  2006.   Vitamin D deficiency is associated with low mood and worse cognitive performance in older adults. Am J Geriatr Psychiatry. 14(12):1032-40.
(3)Murphy PK et al.  2008.  Vitamin D and mood disorders among women: an integrative review. J Midwifery Womens Health.  53(5):440-6.
(4) Hoogendijk WJ et al.  2008.  Depression is associated with decreased 25-hydroxyvitamin D and increased parathyroid hormone levels in older adults. Arch Gen Psychiatry.  65(5):508-12.
(5)Cherniack EP et al.  2009.  Some new food for thought: the role of vitamin D in the mental health of older adults.  Curr Psychiatry Rep. 11(1):12-9.
(6)Jorde R et al.  2008.  Effects of vitamin D supplementation on symptoms of depression in overweight and obese subjects: randomised double blind trial.  J Intern Med.  264:599-609
Written by Ani Kowal

On Monday I wrote about omega 3 fats and how they are important for brain function and in protecting against and treating depression.  Today I wanted to look at a UK study which has just been published in the British Journal of Psychiatry (1).

The study authors (1) wanted to examine the association between overall dietary patterns and depression.  Data from over 3000 participants aged around 55 years was analysed.  Two main dietary patterns were found in the participants.  A ‘whole food’ pattern which was high in vegetables, fruit and fish and a ‘processed food’ pattern which was high in sweetened desserts, friend foods, processed meats, refined grains and high-fat dairy products.  Self reported depression was assessed in the study participants 5 years after the initial dietary analysis.  A special reputable scale, called the Center for Epidemiologic Studies – Depression (CES–D) scale, was used to make the assessment.  The study showed that participants who adhered most strongly to the ‘whole food’ pattern of eating had a significantly lower risk of depression.  Those individuals with the highest consumption of processed foods had the highest risk of depression.  The authors conclude “In middle-aged participants, a processed food dietary pattern is a risk factor for CES–D depression 5 years later, whereas a whole food pattern is protective”.(1)

The study is interesting as it looks at diet as a whole rather than individual nutrients or components.  The study shows that eating healthily and including a high proportion of vegetables, fruits and fish is associated with protection against depression in middle-age.  Processed and refined foods can not only damage our health they also seem to impact our mood.   Specifically, the researchers in the study found that (1) participants whose diet was high in processed foods had a 58% higher risk of receiving a CES-D depression rating five years later.  The study does not prove that a processed food diet causes depression, it simply shows an association or a link, it could be, for example, that people who become depressed become inclined to eat more processed foods or that there is a yet undiscovered factor behind the association.

However, the results of this study show a strong association and are interesting, when added to results from several other studies there is certainly a suggestion that a healthy diet does protect against mental illness.  Eating a high quality, healthy and nutritious diet is important for overall health an wellbeing.  Vegetables, fruits, beans/pulses, unprocessed meats and oily fish are important components to consider.  If you are concerned that your diet consistently falls short then you may wish to consider taking an omega 3 fatty acid supplement together with a good quality food-state multivitamin and mineral supplement.  It is important to be clear that supplements can never be viewed as a replacement for a healthy diet.

(1)Akbaraly TN et al.  2009.  Dietary pattern and depressive symptoms in middle age.  The British Journal of Psychiatry.  195:408-413
Written by Ani Kowal

If you were to search this blog you would notice that I have written extensively about mood, depression, mental health and the brain.  This area of nutrition excites and intrigues me greatly and I have specifically researched it and kept up to date with it, for over eight years now.  A key factor for mental health appears to be omega 3 fatty acids, specifically the long chain forms EPA and DHA (eicosapentaenoic acid and docosahexaenoic acid) found in oily fish.

A professor that lectured me during my MSc (Nutritional Medicine) course back in 2001, Professor Basant Puri wrote a fabulous book that was published in 2005 entitled “The natural way to beat depression: the groundbreaking discovery of EPA to successfully conquer depression”  it details how the long chain omega 3 fatty acid, EPA can be used, in conjunction with other therapeutic techniques, to successfully treat depression.  At the time of publication Professor Puri had a 100% success rate of treating individuals with depression who had been unresponsive to other treatment.  An amazing statistic.  He has also written about the usefulness of omega 3 fats in the treatment of ADHD and chronic fatigue syndrome and was the first recorded person to use omega 3 fats to treat a depressive patient.

Today I wanted to look briefly at a few recent studies that have shown how useful long chain omega 3 fatty acids can be in the treatment of mood disorders.

Firstly (1) a study this year found that dietary intakes of fish and long-chain omega-3 fatty acids may be associated with a reduced risk of chronic depressive symptoms, especially in women.  The authors assessed the associations between fish consumption and dietary intakes of EPA and DHA with depressive symptoms in a population-based sample of 3317 men and women.  As a whole (in men and women together), the highest intakes of EPA, DHA, and EPA + DHA were associated with a lower risk of depressive symptoms after 10 years, with the observed associations being more pronounced in women.  This is an interesting association (but does not prove cause and effect) which adds to the building evidence base.

A review of 3 studies (2) found that omega-3 fatty acids were shown to be more effective than placebo for depression in both adults and children and in a study of bipolar depression. No significant side effects were reported in any of the studies.

Another study (3) looked specifically at psychological distress and depressive symptoms, which commonly occur in women during menopausal transition.  The authors of the study wanted to see whether treatment with EPA, compared to inactive placebo, was helpful to women with moderate to severe psychological distress.  This was the first study to look at omega 3 supplementation in the treatment of psychological distress in middle-aged women and it found that EPA was significantly more helpful than placebo to women with psychological distress symptoms (without major depressive episodes) after just 8 weeks of supplementation.

The evidence that depression is associated with abnormalities in fatty acid metabolism and deficiencies in omega 3 dietary fatty acid intake is accumulating and cannot be ignored.  The key important fatty acids are EPA and DHA, found in oily fish (e.g. salmon and mackerel).  If you do not regularly eat oily fish, such as salmon, trout, mackerel and sardines you may wish to seriously consider taking a daily fish oil supplement.  For vegetarians and vegans a flaxseed oil supplement could be considered. Also, there are now a couple of companies who make vegetarian and vegan EPA and DHA from algal sources, a very exciting development and well worth investigating if you wish to take an omega 3 supplement.

Some very interesting links concentrating on nutrition and mental health:

Mental health foundation, food and mental health campaign

Food and behaviour research

Food for the brain

(1)Colangelo LA et al.  2009.  Higher dietary intake of long-chain omega-3 polyunsaturated fatty acids is inversely associated with depressive symptoms in women. Nutrition. 25(10):1011-9.
(2)Osher Y, Belmaker RH.  2009.  Omega-3 fatty acids in depression: a review of three studies. CNS Neurosci Ther. Summer;15(2):128-33.
(3) Lucas M et al.  2009.  Ethyl-eicosapentaenoic acid for the treatment of psychological distress and depressive symptoms in middle-aged women: a double-blind, placebo-controlled, randomized clinical trial. Am J Clin Nutr. 89(2):641-51.
Written by Ani Kowal

A common problem for women going though the menopause is the experience of psychological symptoms such as anxiety, mood swings and depression.  Hormone replacement therapy (HRT) and/or antidepressant medication is often offered to women going through the menopause in order to address such features.  These medications are linked with a variety of side effects and often women prefer to seek more natural alternatives in order to deal with their symptoms. 

A very recent study (1) has indicated the usefulness of the long chain omega 3 fatty acids EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), naturally found in oily fish such as salmon, mackerel, trout and sardines, in the protection against depressive and mood related symptoms in menopausal women.  The study involved 120 women with moderate-to-severe psychological distress.  These individuals were randomly assigned to receive either an omega 3 supplement (containing EPA and DHA) or a placebo supplement (containing sunflower oil) for 8 weeks.  Changes in psychological wellbeing and depressive symptoms was assessed in these women via the use of specific medical scales and questionnaires.

Previous studies have shown the usefulness of using omega 3 fatty acids in the treatment of depression and mood disorders but this was the first trial using omega 3 fats in the treatment of psychological distress and depressive symptoms in menopausal women.  The results were useful and positive.  In a press release (2) the lead study scientist, Dr Lucas, said that the test results before and after the eight-week period indicate that omega-3s significantly improved the condition of women suffering symptoms of psychological distress and mild depression.  (No positive effect was observed among a small sub-group of women with more severe depressive symptoms). These results suggest that omega-3 supplementation may be beneficial for improving the psychological wellbeing of some menopausal women.

Women with hot flashes also noted that their condition improved after consuming omega-3 fatty acids.  The change that could be attributed to the use of omega-3 fats was equivalent to results obtained with hormone therapy and antidepressants (1,2).

The results do not surprise me.  There is now mounting evidence to support the use of omega 3 fatty acids in the treatment and prevention of anxiety and depression/depressive symptoms in a range of individuals (including children with ADHD).  Omega 3 fatty acids are absolutely essential for healthy brain structure and function.  Our bodies cannot make these essential omega 3 fatty acids (that is why they are known as essential fats), they must be taken in through the diet and are vital to numerous aspects of health.  We really do need to feed our brains!

If you do not regularly eat oily fish you may wish to consider a fish oil supplement providing around 350mg EPA and 350mg DHA daily.  Vegetarians may wish to think about taking a flaxseed oil supplement providing 500-1000mg alpha linolenic acid daily.  In the UK, and western world as a whole, most of us do not get enough omega 3 fats from our diets.  A supplement could be very useful to provide widespread health benefits.  As you will notice from my previous blog posts I mention omega 3 fatty acids regularly and am incredibly interested in the ongoing medical research surrounding these fats.

(1)Lucas M et al.  2009.  Ethyl-eicosapentaenoic acid for the treatment of psychological distress and depressive symptoms in middle-aged women: a double-blind, placebo-controlled, randomized clinical trial. Am J Clin Nutr 89: 641-651.
(2)Université Laval (2009, February 1). Omega-3 Fatty Acids Ease Depressive Symptoms Related To Menopause. ScienceDaily. Retrieved February 2, 2009,

Written by Ani Kowal

On 15th October I wrote about the connection between B vitamins and healthy bones and I also mentioned how elevated homocysteine levels may be implicated in bone deterioration and heart disease.  Today I want to look at the link between elevated homocysteine levels, low vitamin B12 levels and cognitive (mental) decline.

To recap: Homocysteine is produced when the amino acid (the building blocks of protein) methionine is broken down in the body.  Normal levels of homocysteine are important to help build and maintain body tissues, however elevated concentrations in the blood can be harmful and have been associated with an increased risk of many disorders.  At normal levels homocystein can be converted in the body into a harmless substance called cystanthionine.  The conversion of homocysteine into this harmless substance depends upon various B vitamins  (B6, B12 and folic acid).  Having good levels of these B vitamins appears to be a very good way of preventing high homocysteine levels and low levels of B vitamins have been associated with raised homocysteine levels.

A new study (1) was recently published which showed that older adults who have vitamin B12 levels that are low, but still within the normal range, may exhibit a quicker rate of brain shrinkage (brain volume loss) as they age compared to those who have good levels.  The authors wanted to investigate the association between vitamin B12 status and brain volume loss in a population of adults aged 61-87 over a 5 year period.  The participants were free of cognitive impairment (they were free of dementia) at the start of the study.  Those with lower vitamin B12 levels at the start of the study experienced the greatest decrease in brain volume over the 5 year period.  This was only a small preliminary study involving 107 individuals, the authors suggest that low vitamin B12 status should be further investigated and that trials with vitamin B supplements would be useful.

A loss in brain volume has been linked to a faster rate of mental decline and progression to diseases such as Alzheimer’s disease and dementia.  Vitamin B12 is extremely important in order to keep nerve cells healthy.  The study mentioned above (1) suggests, but does not prove, that modifying vitamin B12 status could be important in protecting the brain and preventing cognitive decline.  The results of the study do suggest that it is important to keep our vitamin B12 levels higher than just the minimum.

A study last year (2) looked at the association between cognitive decline and vitamin B12.  The study included 1684 individuals who were followed for 10 years.  Mental state (cognition) was examined a minimum of 3 times over the 10 years as were serum vitamin B12 concentrations.  Analysis of the results found that reduced vitamin B12 status was associated to cognitive decline.  The investigators also found that a high homocysteine level was associated with a greater rate of cognitive decline.  Again the authors indicate the need for further studies and supplementation trials for the prevention of dementia.

A review (3) paper published this year discussed the importance of vitamin B12 for brain health throughout life from infancy to adulthood.  In childhood low vitamin B12 levels may be related to behavioural problems and in adults it seems to be related to social development, depression and cognitive problems.  It seems as though this nutrient really is vital throughout our lifespan. 

Many older adults in the UK have lowered vitamin B12 levels.  In the diet, B12 comes from meat, fish, dairy, other animal products, and fortified breakfast cereals. Strict vegetarians, who avoid meat, and vegans, who avoid all animal products, are also at risk of B12 deficiency.  Studies seem to suggest that anything in the stomach that affects the normal acidity and digestive processes, ranging from infections to acid reflux medications to aging, may also interfere with the absorption of vitamin B12. 

The vitamin B group work very well as a team and interact in many processess, if you decide to take a supplement it may well be worth considering a multi-B vitamin supplement rather than single B vitamin supplement, or a broad spectrum multi-nutrient supplement (I prefer food state supplements which appear to be more easily absorbed by the body).

(1) Vogiatzoglou A et al.  2008.  Vitamin B12 status and rate of brain volume loss in community-dwelling elderly.  Neurology.  71:826-832
(2)Clarke R et al.  2007.  Low vitamin B-12 status and risk of cognitive decline in older adults.  Am J Clin Nutr.  86:1384-1391
(3)Black MM.  2008.  Effects of vitamin B12 and folate deficiency on brain development in children.  Food Nutr Bull.  29:S126-131

Written by Ani Kowal

On the 22 October I mentioned the potential use of Vitamin D supplements for helping individuals suffering from the mood disorder SAD (seasonal affective disorder).  This year a number of papers have been published (1,2,3,4) which suggest that vitamin D could potentially be useful for the treatment of other mood disturbances and depressive episodes.

In 2007 a review paper was published (5) which suggested that vitamin D deficiency may play a role in depression and other mood and mental health disturbances, especially in the elderly where low vitamin D levels are commonly found.  The paper highlighted a number of trials that which showed that vitamin D supplementation appeared to be useful in the treatment of depression but expressed a need for further studies.

Vitamin D seems to be a hot topic this year and I have written about it a number of times in my blog posts.  Low vitamin D levels seem to be linked to cancer, heart disease, SAD, chronic fatigue syndrome, migraine headaches and various other diseases, not only bone conditions such as osteoporosis and osteoarthritis.  It is becoming glaringly obvious that this ‘sunshine vitamin’ is more important than we once thought. 

Two studies this year have linked low vitamin D status, as measured by low circulating blood levels of vitamin D, with depressive symptoms.  One study (1) was carried out in overweight and obese individuals and the other (3) in older adults (aged 65 – 95 years).  Both studies found that there was an association between depression status and severity with decreased serum (blood) vitamin D levels.  In the study with overweight/obese participants high-dose vitamin D supplementation led to significant improvements in depressive symptoms, compared to placebo, during the study.  The studies so not prove a causal relationship between low vitamin D and depression but they do add to the mounting evidence which suggests a very real link.  Further, larger studies will be needed to verify the information and investigate this exciting association further.

It is not currently known why vitamin D may be useful in treating mood disorders or why low levels may have a part to play in causing mood problems.  It may be that vitamin D has an effect on hormones linked to mood.  Studies are bound to unravel the mystery over the next few years!

A recent analysis(6) found that there is a global widespread insufficiency of vitamin D and there is evidence from the National Diet and Nutrition Surveys (NDNS) which suggests that in the UK deficiency of this vital nutrient is a real problem (7,8,9,10).  The problem is made worse in the older generations, as we age our bodies find it increasingly difficult to manufacture vitamin D.  In the UK many of us do not get enough sunlight exposure to generate decent levels of vitamin D in our bodies, especially in the autumn and winter months when we cover our bodies up and don’t get out during the daylight hours very often. 

Walking and exercise have also been linked to improved mood, so a lunchtime walk, in daylight, may bring added mood lifting benefits.  Only small amounts of vitamin D are found in food sources such as oily fish (mackerel, salmon and sardines) and eggs.  As many of us in the UK are falling short of recommended vitamin D levels, if you rarely get out into the sun, you may wish to consider a vitamin D supplement which provides around 12mcg/day (around 500iu a day).  Such a supplement may be particularly useful during the autumn and winter months.

You may also want to think about getting a daylight lamp for your work desk to help improve mood.  Some of these lamps produce light that the body can use for vitamin D production (check with the manufacturer of the lamp).

For more interesting information about the benefits of vitamin D and sunlight for health please visit the Sunlight Nutrition And Health Research Centre, the information there is well presented and backed up by significant amounts of good evidence.

(1)Jorde R et al.  2008.  Effects of vitamin D supplementation on symptoms of depression in overweight and obese subjects: randomized double blind trial.  J Intern Med. Sep 10. [Epub ahead of print]
(2)Murphy PK & Wagner CL.  2008.  Vitamin D and mood disorders among women: an integrative review.  J Midwifery Womens Health.  53:440-446
(3)Hoogendijk WJ et al.  2008.  Depression is associated with decreased 25-hydroxyvitamin D and increased parathyroid hormone levels in older adults. Arch Gen Psychiatry. 65(5):508-12.
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Written by Ani Kowal