Category Archives: mental health

Omega 3 and Depression in the Elderly

Chances are you have already heard of omegas, especially if you are health conscious or have read previous posts on this blog. The mighty essential fatty acids omega 3 and 6 are power houses of energy and also have a fantastic range of health benefits which covers the whole body (from head to toe).

Awareness of these omegas (which have to be ingested as the body cannot make them – hence the term “essential” fatty acids) is fast increasing in the nutrition world and they are already celebrated for their anti-inflammatory effects. They also benefit our cardiovascular health, for example they help to reduce risks of high cholesterol, hypertension and diabetes, as well as playing a large role in the function of our central nervous system and possessing growth and development properties.

Fish and Flax Seed Oil Capsules
Fish or Flax Seed Oil Supplements may help increase your intake of essential fatty acids, specifically Omega 3.

However, our 21st century diets have created a reduced ratio of omega 3 to omega 6 (meaning we are consuming more foods such as olive oil, peanuts, sunflower seeds, bacon and margarine and less sardines, salmon, flax seeds and walnuts) which has disturbed the omega balance and leaves many of us deficient in omega 3.

A research paper published in the the Journal of Nutrition, Health & Aging in 2011 (1) has highlighted this decrease in the level of omega 3 in our diets and related it to the decline of our mental health. More specifically, the paper discusses the link between this dietary change and higher levels of depression as omega 3 deficiency can cause abnormal neurotransmitter activity. The hormones serotonin and dopamine are affected by this disturbance and these play a large role in the control and stability of our mind, cognition, mood, personality and overall mental state. Hence Omega 3 deficiency could leave us at risk of cognitive health problems.

The research paper (1) focuses on the elderly, who universally have concerns over independence, social life and functional decline which can all influence the onset of depression in the individual. Conversely, depression can also cause these concerns to become substantially worse and depression is associated with a higher mortality rate in the elderly compared with those that are not depressed. This highlights how important and prevalent this issue is for this age group.

The study supplemented depressed elderly women aged between 65-95 years who were residents of a care home with 2.5g/day of omega 3 or a placebo for 8 weeks. The researchers investigated the effects of supplementation on depressive symptoms measured by Geriatric Depression Scale (GDS). After the 8 weeks of supplementation the authors reported that those who were supplemented with omega 3 had significant reductions in their GDS scores, while the placebo group did not experience such a reduction. It could be that these individuals were deficient in omega 3 and this explains why supplementing their diets caused such an improvement in their depressive states. These findings have fantastic potential for the prevention and improvement of such cognitive disturbances in all age groups including the elderly, and shows that it is never too late to try to improve health.

If you don’t eat more than 2 portions of oily fish per week (such as sardines and salmon) or include plenty of flax and pumpkin seeds in your diet then you may like to consider trying a fish oil or flax seed supplement to increase your omega 3 intake. You should always consult your Health Advisor or GP before starting any new supplement regimen.

Written by Lauren Foster

(1) RONDANELLI, M., GIACOSA, A., OPIZZI, A., PELUCCHI, C., LA VECCHIA, C., MONTORFANO, G., NEGRONI, M., BERRA, B., POLITI, P. & RIZZO, A.M. (2011). Long chain omega 3 polyunsaturated fatty acid supplementation in the treatment of elderly depression.The Journal of Nutrition, Health & Aging, 15, 1, 37-44.

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Omega-3 supplements buffer the effect of mental stress

Mental stress is known to have a negative effect on heart health, and unmanaged stress is linked with increased blood pressure, an important predictor of heart disease. Managing mental stress can be a huge help to those looking to support their cardiovascular health. Of course this is often easier said than done. After all, stress is a part of everyday life and it cannot be eliminated entirely.

However, managing our physical reaction to mental stress may be one way to support heart health.

High EPA
Omega 3 supplements high in EPA can be good for mental stress and heart health

With this in mind, a team of researchers at Alleghany College in the US recently investigated the effects of an omega-3 supplement on the effect of mental stress in adults. The team gave a group of 43 college students either a daily omega-3 supplement or a daily placebo supplement for three weeks. They then measured blood pressure and heart rate of the students at rest and during a mental arithmetic task. The stress response to the maths test in the omega-3 group was found to be significantly lower than that of those in the placebo group.

The authors concluded that supplementation of omega-3 fatty acids may reduce cardiovascular reactivity to stress.
The study is preliminary and will hopefully encourage further research to clarify the role of omega-3 in cardiovascular health.

The supplement used in the study provided a daily dose of 1400mg omega-3 (1000mg EPA and 400mg DHA). This intake is fairly normal for adults living in countries such as Japan where fish, seafood and tofu are a major part of the diet. In the UK, however, the level of omega-3 in the diet is far lower and is estimated at an average of 244mg daily.

Options for increasing EPA and DHA intakes include use of fish oil supplements, increased consumption of fish or consumption of foods enriched with omega 3 such as omega-3 enriched eggs.

Those considering taking fish oil supplements should first check with their GP, especially if they are taking medications such as anticoagulants. Also, be sure to choose a good quality oil that has been screened for contaminants. Finally, if your fish oil supplement leaves you with a fishy aftertaste this is a sign that the oil has oxidised (‘gone off’). I tend to favour omega-3 oils that can be taken straight from the spoon, such as the Eskimo brand, so that I can be sure on tasting that it is a good quality, fresh oil.

Written by Nadia Mason, BSc MBANT NTCC CNHC

References
Ginty AT, Conklin SM. Preliminary Evidence that Acute Long-Chain Omega-3 Supplementation Reduces Cardiovascular Reactivity to Mental Stress: A Randomized and Placebo Controlled Trial. Biol Psychol. 2012, Jan. 89(1):269-72.

 

 

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Nutrient levels linked to brain health

I recently wrote about the reported benefits of the nutrient choline for improved memory and brain health. A new study, soon to be published in the journal Neurology, has now investigated the link between brain health and other nutrients in the diet, including Vitamins B, C, D and E, omega 3 and trans fats.

The study measured indicators of Alzheimer’s such as cognitive difficulties, brain shrinkage and memory problems. It found that nutrition could play nearly as strong a role as other factors such as age and high blood pressure.

A healthy diet rich in vitamins, antioxidants and omega 3 may help reduce brain shrinkage in older life
A healthy diet rich in vitamins, antioxidants and omega 3 may help reduce brain shrinkage in older life

The researchers tested a group of 104 elderly people with average age of 87. They then tested the blood of each participant for levels of vitamins B, C, D and E, saturated fats, carotenoids, omega-3 fatty acids, cholesterol and trans fats. Each participant also undertook mental function tests including tests of memory, language skills and spatial skills. Finally each participant underwent an MRI scan to look at the size of certain brain structures related to Alzheimer’s.

The team found that those who had higher blood levels of vitamins B, C, D and E and omega-3 fatty acids scored higher on the mental-function tests than those with lower levels of these nutrients. In contrast, those with higher levels of trans fats in their blood scored lower on these tests; they had more trouble with memory and language skills and were slower in completing the tests.

Brain scans were then carried out on 42 of the participants, and found that those with nutrient-rich diets had larger brains as well as higher test scores. Again, the scans of those with high levels of trans fats in their blood also showed more brain shrinkage.

A huge benefit of this study is that it used measurements of nutrients in people’s blood, rather than relying on individual’s food diaries and recall. As all nutritionists know, even with the best of intentions, food diaries and questionnaires can be inaccurate and misleading.

The researchers, however, didn’t distinguish between nutrient levels raised due to foods rather than supplements. It’s therefore difficult to say whether taking supplements can reduce the risk of Alzheimer’s as effectively as a nutrient-rich diet.

Diets rich in fruit, vegetables, whole grains and oily fish provide good levels of vitamins and omega-3 fats. Trans fats are unhealthy ‘damaged’ fats found in margarine, some packaged food, fast food and baked goods.

“These results need to be confirmed, but obviously it is very exciting to think that people could potentially stop their brains from shrinking and keep them sharp by adjusting their diet,” said study author Gene Bowman, a professor of public health at Oregon Health & Science University in Portland.

The study team concluded that the findings suggest that nutrients work “in synergy” with one another to be protective of brain health.  Bowman concluded that “the combination of the B vitamins, the antioxidants C and E, plus vitamin D was the most favorable combination of nutrients in the blood for healthy brain aging in our population.”

Written by Nadia Mason, BSc MBANT NTCC CNHC

References
G.L. Bowman, L.C. Silbert, D. Howieson, H.H. Dodge, M.G. Traber, B. Frei, J.A. Kaye, J. Shannon, J.F. Quinn. Nutrient biomarker patterns, cognitive function, and MRI measures of brain aging. Neurology E-published ahead of print December 28, 2011.

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Choline: The Brain Food

A new study conducted at the Boston University School of Medicine suggests that the nutrient choline may improve cognitive function in healthy adults.

Choline is a precursor to the neurotransmitter acetylcholine, which plays a part in memory and other cognitive functions. Low acetylcholine levels are linked with Alzheimer’s.

A group of 1391 healthy (dementia-free) adults completed a food-frequency questionnaire administered from 1991 to 1995 and at a later date from 1998 to 2001. Each adult underwent cognitive tests and brain scans (MRI) at the later date. The tests measured factors such as verbal and visual memory. The brain scan also measured white matter hyperintesity (WMHI) – changes in the brain’s blood vessels that can predict conditions such as dementia and stroke.

Broccoli is high in Choline
Broccoli is a well known "super food" and is also high in Choline which may be good for brain health

The researchers used the adults’ food questionnaires to determine whether dietary choline intake had an effect on brain function. The results found that adults whose choline intake was highest did better on tests of memory. Brain scans in this group of adults were also less likely to show areas of WMHI, indicating a decreased risk of dementia or stroke.

The differences in test performance were small. “As far as your day-to-day functioning, it would not be an appreciable difference,” says senior researched Rhoda Au. However, she added, the findings suggest that people with lower choline intakes were more likely to be on a “pathway” toward mental decline than their counterparts with higher intakes.

We cannot yet say for certain that choline in itself protects memory or wards off unhealthy brain changes. One possibility, Au noted, is that some other nutrients present along with choline are responsible. The study took into account factors such as calorie intake, fat intake, and levels of nutrients such as Vitamins B6 and B12. Even after adjustments were made for these factors, choline was still linked to improved test performance. However, further human studies would be needed to back up these research finding.

It is generally recommended that men require 550 milligrams of choline per day, while women should get 425 milligrams. Several studies have found that generally choline intake in adults does not meet these requirements (2,3). To ensure an adequate supply of choline, you should ensure that your daily diet includes sources of choline such as salt-water fish, eggs, liver, chicken, beef, peanut butter, milk, broccoli and certain legumes, including soy and kidney beans. The supplement soy lecithin is also a good source.

 

Written by Nadia Mason, BSc MBANT NTCC CNHC

References
(1.) Poly C, Massaro JM, Seshadri S, Wolf PA, Cho E, Krall E, Jacques PF, Au R. The relation of dietary choline to cognitive performance and white-matter hyperintensity in the Framingham Offspring Cohort Am J Clin Nutr December 2011 vol. 94 no. 6 1584-1591

(2.) Bidulescu A, Chambless LE, Siega-Riz AM, Zeisel SH, Heiss G (2009). “Repeatability and measurement error in the assessment of choline and betaine dietary intake: the Atherosclerosis Risk in Communities (ARIC) study”. Nutrition Journal 8 (1): 14.

(3.) Bidulescu A, Chambless LE, Siega-Riz AM, Zeisel SH, Heiss G. Usual choline and betaine dietary intake and incident coronary heart disease: the Atherosclerosis Risk in Communities (ARIC) Study. BMC Cardiovascular Disorders 2007, 7:20

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B Vitamins may be important for people with memory problems

In older individuals, especially those who are suffering from cognitive (brain function) decline, there is often an increased rate of brain wastage/shrinking (atrophy).  Previous studies have found that homocysteine is a risk factor for brain atrophy, cognitive impairment and dementia.  It is also known that blood plasma concentrations of homocysteine can be lowered by dietary administration of B vitamins.

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 heart disease and other 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.  The evidence, however is still controversial (please read my prevous posts on homocycteine).

A recent, two year, study (1) was carried out in order to determine whether supplementation with B vitamins that lower levels of plasma total homocysteine can slow the rate of brain atrophy in subjects with mild cognitive impairment.  High doses of folic acid (0.8mg/d), vitamins B6 (20mg/d) and B12 (0.5mg/d) were used in the study and participants, who were all over 70 years old, had brain MRI scans both at the start and end of the study in order to track brain shrinkage.   The dose of B vitamins in the supplement pills was high, they contained around 300 times the recommended daily intake of B12, four times daily advised folate levels and 15 times the recommended amount of B6.

The results of the study showed that individuals (1) receiving the B vitamins had a significantly reduced rate of brain atrophy per year when compared to those individuals taking the placebo.  Brain atrophy was related to the homocysteine levels at the start of the study: the rate of atrophy in participants with homocysteine levels greater than >13 µmol/L was 53% lower in the group receiving the B vitamins.   A greater rate of brain shrinkage was associated with a lower final cognitive test scores.   The authors conclude that “The accelerated rate of brain atrophy in elderly with mild cognitive impairment can be slowed by treatment with homocysteine-lowering B vitamins. Sixteen percent of those over 70 y old have mild cognitive impairment and half of these develop Alzheimer’s disease. Since accelerated brain atrophy is a characteristic of subjects with mild cognitive impairment who convert to Alzheimer’s disease, trials are needed to see if the same treatment will delay the development of Alzheimer’s disease”.

For more on Alzheimer’s disease please read my previous posts on the topic.  Individuals with mild cognitive impairment tend to experience problems with memory, language, or other mental functions, but not to a degree that interferes with daily life. Around half of people with mild cognitive impairment go on to develop dementia , mainly Alzheimer’s disease,  within five years of diagnosis (2).  Alzheimer’s is a mind-wasting disease for which there are few treatments and no cure, and which affects 26 million people around the world.

In a press release (2) one of the study authors,  Professor David Smith of the Department of Pharmacology at Oxford University, said “It is our hope that this simple and safe treatment will delay the development of Alzheimer’s disease in many people who suffer from mild memory problems” “Today there are about 1.5 million elderly in UK, 5 million in USA and 14 million in Europe with such memory problems”.  “These are immensely promising results but we do need to do more trials to conclude whether these particular B vitamins can slow or prevent development of Alzheimer’s. So I wouldn’t yet recommend that anyone getting a bit older and beginning to be worried about memory lapses should rush out and buy vitamin B supplements without seeing a doctor

Rebecca Wood, Chief Executive of the Alzheimer’s Research Trust said (2): “These are very important results, with B vitamins now showing a prospect of protecting some people from Alzheimer’s in old age. The strong findings must inspire an expanded trial to follow people expected to develop Alzheimer’s, and we hope for further success.  We desperately need to support research into dementia, to help avoid the massive increases of people living with the condition as the population ages. Research is the only answer to what remains the greatest medical challenge of our time

The findings of this trial are indeed very encouraging, further large-scale research is needed in order to test whether B vitamins can be recommended as a suitable treatment for the prevention of cognitive decline and dementia. 

Vitamin B6 is found in foods like potatoes, bananas, beans and chickpeas, avocados, fish and poultry.  Vitamin B12 is found mainly in meat, fish and poultry.  Eggs and cheese also contain B12 as does brewer’s yeast.  Many vegetarians and vegans have very low intakes of this vital nutrient and may wish to consider a multi-B vitamin supplement.  Folic acid is found in beans, green vegetables and wholegrains.  Supplements should never be seen as an alternative to a healthy diet and as Professor Smith said in the press release, if you wish to investigate the option of taking B vitamins it is best to discuss this with your medical doctor first.   

(1)Smith AD et al.  2010. Homocysteine-Lowering by B Vitamins Slows the Rate of Accelerated Brain Atrophy in Mild Cognitive Impairment: A Randomized Controlled Trial. PLoS ONE, 2010; 5 (9): e12244 DOI: 10.1371/journal.pone.0012244

(2)Press Release.  University of Oxford (2010, September 12). B vitamins slow brain atrophy in people with memory problems. ScienceDaily. Retrieved September 13, 2010, from http://www.sciencedaily.com­ /releases/2010/09/100912213050.htm

 

Written by Ani Kowal

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Nutrient supplements might impact brain function

 Nutrition impacts all aspects of health and the body.  What we eat can impact brain function and our mood and new research is constantly being released which indicates that having a good diet and a good supply of nutrients can impact our mental state.

Recently a double-blind placebo-controlled study (1) was conducted to investigate the effect of a multi-vitamin and mineral supplement on cognitive (brain) function and fatigue in over 200 healthy female individuals aged between 25 and 50 years old.  The participants were tested before and 9 weeks after starting the multi-vitamin and mineral supplement.  The tests that the women underwent included brain function tests and tasks related to mood and fatigue.   The group taking the multi-vitamin and mineral supplement had improved multi-tasking performance and better accuracy across the tasks compared to the placebo group.  The women taking the supplements also did better in terms of their mood and fatigue levels after performing the brain function tests.  The authors conclude that “These findings suggest that healthy members of the general population may benefit from augmented levels of vitamins/minerals via direct dietary supplementation”.

Another recent study (2) looked at the cognitive and mood effects of a high dose B-vitamin and mineral supplement in 215 men aged 30-55 years old.  The men completed assessments and tests prior to and on the last day of a 33-day supplement period.   Those men taking the supplement, compared to those taking the inactive placebo, had significant improvements in ratings on the stress test and the general health questionnaire as well as certain aspects of the mood test.  The men taking the supplement also rated themselves as less ‘mentally tired’ both before and after completing a cognitive (brain function) test.  The authors of this test conclude “Healthy members of the general population may benefit from augmented levels of vitamins/minerals via direct dietary supplementation. Specifically, supplementation led to improved ratings of stress, mental health and vigour and improved cognitive performance during intense mental processing”.

The authors of this study also write “Taken together with previous results showing beneficial effects of vitamin/mineral supplementation in healthy children and adults, these findings further suggest that augmenting vitamin/mineral levels in healthy, normal populations may provide beneficial effects in terms of brain function. It is unclear whether these effects represent a an offset of impairment due to marginal deficiencies or an improvement due to sub-optimal levels that would not, under current guidelines, be classed as deficiency. However, given that a large section of the population are unable or unwilling to eat the adequately balanced diet that would satisfy their micronutrient requirements, it seems that supplementation with multi-vitamins/minerals may be a useful and possibly necessary option for this portion of the population

This research is certainly interesting but further larger trials are be needed before making any recommendations for nutrient supplementation in order to enhance brain function and mood.  Always check with your medical doctor prior to taking any supplements.  Supplements should never be seen as an alternative to a healthy, balanced diet, however they can be useful to cover any shortfalls.  This research certainly highlights how nutrition can impact the brain and mood states.  Optimum functioning of the brain is dependent on a wide range nutrients and as the authors state, many people do not eat healthy balanced diets and may therefore be lacking in vitamins and minerals. Eating a nutrient dense diet which is rich in vegetables, fruits, unprocessed meat and fish, especially oily fish, nuts/seeds, beans and unprocessed wholegrains is a great way to ensure a plentiful supply of vitamins, minerals and essential fatty acids to the body and brain.

 

(1)Haskell CF et al.  2010.  Effects of a multi-vitamin/mineral supplement on cognitive function and fatigue during extended multi-tasking.  Hum Psychopharmacol. 25(6):448-61.

(2) Kennedy DO et al.  2010.  Effects of high-dose B vitamin complex with vitamin C and minerals on subjective mood and performance in healthy males. Psychopharmacology (Berl).   211(1):55-68.

 

 

Written by Ani Kowal

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Healthy diet, healthy mind

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.

Healthy Food Healthy Mind
Studies have found a link between diet and mental health.

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.

References

(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

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Exercise found to protect and even improve the aging brain

Exercise and healthy eating are great ways to vitalise life.  This month two new studies (1,2) published in the Archives of Neurology add to the evidence which suggests that regular exercise can help prevent the problems that often occur in thinking and memory that can come with age and also may help to turn back the clock on brain aging.



The first study(1) was set up to examine the effects of exercise on cognition (mental function) and other factors associated with Alzheimer’s disease in older adults suffering with mild cognitive impairments. 



Mild cognitive impairment typically means the individual will have some memory difficulties such as forgetting names or forgetting where things have been placed.  Around 10-15% of individuals with this kind of mild cognitive impairment will go on to develop dementia – this is in contrast to about 1-2% of the general population.



The study(1) was small but well designed.  Participants were assigned to either a high-intensity aerobic exercise or stretching group (the control group).  The exercise group were under the supervision of a fitness trainer and exercised at 75% to 85% of heart rate for 45 to 60 minutes, 4 days per week for 6 months.  The exercise was done using a treadmill or an exercise bike. The control group carried out supervised stretching activities according to the same schedule but maintained their heart rate at or below 50%.  At the start of the study and then at 3 months and 6 months blood was collected and cognitive tests were taken. 



The results(1) at 6 months found that there were sex-specific positive effects, in women,  on cognition as well as various blood-results (mainly related to blood sugar and stress hormones).  6 months of intense aerobic exercise was found to improve cognitive abilities of attention and concentration, organization, planning, and multi-tasking.  In the stretching ‘control group’ cognitive function test scores continued to decline.  Women seemed to benefit a little more from the exercise than men – the reason is not entirely known although in women the exercise also seemed to improve the cells sensitivity to the hormone insulin, men did not show the same improvement in insulin sensitivity.



This is a preliminary study into exercise and brain function and it may well be that the brain can benefit from lower intensity aerobic exercise – current research is underway to find out how much exercise is deemed to be ‘enough’ to benefit the brain.
 


The other study (2) showed that engaging in moderate physical activity such as brisk walking, swimming, or yoga in midlife or later could cut the risk of developing mild thinking problems.  The study involved over 1300 people without dementia who completed a Physical Exercise Questionnaire.  The frequency of physical exercise among 198 individuals with mild cognitive decline was compared to 1126 with normal cognition.  The results showed that, in both men and women, any frequency of moderate exercise performed in midlife or late life was associated with a reduced risk of having mild cognitive impairment.  Specifically moderate exercise in midlife was associated with a 39% reduced likelihood of developing mild cognitive impairment, and moderate exercise in late life was associated with a 32% reduced likelihood of mental decline.



These two studies support the growing body of evidence showing the benefits of a physically active lifestyle on the brain.  In conjunction with good nutrition I believe that there really are tangible ways to keep the brain healthy.  Please read my previous posts relating to brain health.



(1)Baker LD et al.  2010.  Effects of aerobic exercise on mild cognitive impairment: a controlled trial. Arch Neurol.  67(1):71-9.
(2) Geda YE et al.  2010.  Physical exercise, aging, and mild cognitive impairment: a population-based study. Arch Neurol.  67(1):80-6.
Written by Ani Kowal

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Can taking a daily fish oil supplement prevent mental illness in high risk individuals?

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

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Vitamin D may help to improve mood

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

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