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Beat the winter blues: diet and SAD

admin — Wed, 12 Oct 2011 12:00:44 +0000

Previously I have written about the benefits of light therapy in treating seasonal affective disorder. Light therapy is a popular choice with those looking for a drug-free approach to dealing with SAD or the ‘winter blues’. An equally important consideration is how diet affects mood and symptoms in those with SAD – and in particular the importance of the macronutrients carbohydrate, protein and fat in the management of this condition.

Hormones and SAD

SAD is characterised by symptoms such as low mood, carbohydrate cravings, weight gain and fatigue (1, 2). These symptoms are linked to hormones that control our mood and energy levels.

Our body’s natural anti-depressant hormone, serotonin, is stimulated by light. The more light we have during the daytime, the more serotonin we produce. In the darker months of autumn and winter, serotonin levels can drop, resulting in feelings such as low mood, lack of energy and food cravings.

Likewise, darkness stimulates the hormone melatonin, which lowers body temperature and causes tiredness and feelings of fatigue.

How can diet help?

Those with SAD are thought to crave sugary and starchy foods because these types of carbohydrate temporarily boost levels of the body’s natural anti-depressant serotonin. These types of foods also boost energy levels and raise body temperature, countering the effects of melatonin.

Whole grains such as brown rice and oats and proteins such as nuts help to keep blood sugar levels stable. (5)

Eating this type of diet can only be a temporary ‘fix’ however. In fact, a carbohydrate-rich diet based around sugary and starchy foods, leads to unstable blood sugar levels. This in turn can create a variety of symptoms that we might link to the ‘winter blues’ – moodiness, fatigue, foggy thinking and food cravings.

The solution is to eat a diet based around ‘low glycemic index’ carbohydrates that help to keep blood sugar levels stable. Whole grains such as brown rice and oats, as well as fresh fruits and vegetables are the wisest choices of carbohydrate.

Including a source of lean protein (such as chicken, turkey, eggs, beans or lentils) with each main meal is also a good idea. This helps the body in two ways. Firstly, including protein with each meal helps to control blood sugar levels, fighting off energy dips and cravings. Secondly, protein provides a source of the amino acid tryptophan, which the body can convert to serotonin. Including foods high in tryptophan – such as chicken, tuna, tofu, eggs, nuts, seeds and milk – in your daily diet can help to support your body in making serotonin.

Finally, healthy fats have been extensively studied in relation to depression and mood. Omega-3 fats also have a role in the production and utilisation of serotonin. Inflammatory chemicals in the body can cause serotonin deficiency in the brain. Omega-3 oils can reduce levels of these inflammatory chemicals, therefore helping to boost the brain’s serotonin levels.

The importance of omega-3 in dealing with SAD might explain the low incidence of SAD in Icelanders who have a diet high in oily fish (3). Ensuring a good level of omega-3 in your diet is essential. Including oily fish such as sardines, mackerel, herring or salmon in your diet can help to boost levels of omega-3, as can eating flaxseed oil, walnuts and omega-3 eggs.

Formal research in this area is limited, with many studies simply looking at the impact of a single meal on symptoms of SAD. This is an inadequate assessment of the role of diet. One study that looked at the longer term impact of diet on SAD showed promising results (4). I have certainly found in clinical practice that patients need to be consistent in their dietary choices in order to see an improvement in symptoms over time.

A well-managed diet, along with light therapy (such as a sunrise alarm clock or SAD light box), appears to be a safe approach to managing SAD. Of course carbohydrates, protein and fats are not the only nutrients of importance to those with the winter blues. Part 3 will examine the evidence behind other nutrients and dietary supplements in the support of SAD.

Written by Nadia Mason

References

1. Sher L. Genetic studies of seasonal affective disorder and seasonality. Comprehensive Psychiatry, 2001, Vol. 42, No. 2, pp. 105-110.

2. Magnusson A, Boivin D. Seasonal affective disorder: an overview. Chronobiology Int. 2003. 20(2):189-207.

3. Cott J, Hibbeln JR. Lack of seasonal mood change in Icelanders. American Journal of Psychiatry. 2001.

4. Wells, A, et al. (1998) Alterations in mood after changing to a low-fat diet. British Journal of Nutrition 79(1):23-30.

5. Image courtesy of Marcuso.

Researchers find that eating trans-fats may increase the risk of depression

AniKowal — Mon, 14 Mar 2011 05:00:40 +0000

Studies have found that long chain omega 3 fatty acids, from oily fish such as salmon, trout, mackerel and sardines, may be useful in the prevention and treatment of depression and low mood. Now research has found (1) that eating trans-fats may increase the risk of suffering depression, and that olive oil may protect against depression.

Trans fatty acids are created through manufacture when liquid vegetable oils are hardened, to a solid or semi-solid state, via a process known as hydrogenation. (Hydrogenation is when naturally occurring cis-unsaturated double bonds are converted into trans unsaturated double bonds). The process of hydrogenation also destroys the essential short chain omega 3 fatty acid alpha-linolenic acid from oils (for more information about the health benefits of omega 3 fats please read through my numerous posts on the subject). Trans fatty acids have been linked to various adverse health effects.

The study ran from 1999-2010 and involved 12,059 Spanish university graduates with an average age of 37.5 years. All of the participants were initially free of depression. At the beginning of the study a detailed and extensive food frequency questionnaire was used to estimate the intake of fatty acids. During the six year follow-up period any cases of depression, as diagnosed by a physician, were reported. In this time over 650 new cases of depression were identified. Results found that trans fatty acids were associated with an increased risk of depression – the more trans fats consumed the higher the risk of depression. On the other hand the more monounsaturated fat e.g. olive oil consumed the lower the risk, this was also true for polyunsaturated fats e.g. fish oil. The authors of the study conclude: “A detrimental relationship was found between TFA [trans fatty acid] intake and depression risk, whereas weak inverse associations were found for MUFA [monosunsaturated fatty acid], PUFA [polyunsaturated fatty acids] and olive oil. These findings suggest that cardiovascular disease and depression may share some common nutritional determinants related to subtypes of fat intake”.

Specifically the results found that participants with an elevated consumption of trans-fats (2)“presented up to a 48% increase in the risk of depression when they were compared to participants who did not consume these fats,”. Associate professor Almudena Sánchez-Villegas one of the study authors also said (2)“the more trans-fats that were consumed, the greater the harmful effect they produced in the volunteers,”

It is estimated that around 150 million persons worldwide suffer from depression. In a press release Almudena Sánchez Villegas boldly hypothesises that this may be due (2) “to radical changes in the sources of fats consumed in Western diets, where we have substituted certain types of beneficial fats — polyunsaturated and monounsaturated in nuts, vegetable oils and fish — for the saturated and trans-fats found in meats, butter and other products such as mass-produced pastries and fast food.”

It is important to note that this published research (1) took place in a population with a low average intake of trans-fats, given that it made up only 0.4% of the total energy ingested by the volunteers. “Despite this, we observed an increase in the risk of suffering depression of nearly 50%. On this basis,” concluded another study author (2) “we derive the importance of taking this effect into account in countries like the U.S., where the percentage of energy derived from these foots is around 2.5%.”

Please read my previous post for more information about the hypothesized dangers of eating a diet containing trans fats. Evidence is increasing to support a relationship between improved nutrition and better mental health. Please read my previous blog posts on depression and mood.

(1)Sánchez-Villegas A et al. 2011. Dietary Fat Intake and the Risk of Depression: The SUN Project. PLoS ONE, 2011; 6 (1): e16268 DOI: 10.1371/journal.pone.0016268

(2)Press Release. Public Library of Science (2011, January 26). Eating poorly can make you blue: Trans-fats increase risk of depression, while olive oil helps avoid risk. ScienceDaily. Retrieved January 27, 2011, from http://www.sciencedaily.com /releases/2011/01/110126171451.htm

Written by Ani Kowal

Nutrient supplements might impact brain function

AniKowal — Mon, 08 Nov 2010 05:00:02 +0000

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

New study suggests omega 3 fats may be helpful for those suffering with major depression

AniKowal — Mon, 05 Jul 2010 05:00:36 +0000

Nutrition and the links to depression and mood are topics I have written about numerous times and I am highly interested in. In particular I have been paying attention to the extensive work on long chain omega 3 fatty acids for the treatment of depression. The long chain omega 3 fat, EPA (eicosapentaenoic acid) which is found naturally in oily fish such as mackerel, trout, sardines and salmon seems particularly important in mood disorders.

Until now most studies have concentrated omega 3 fats for the treatment of mild and moderate depression. However a newly published study (1) has found that omega 3 supplements are effective in individuals with major depression who do not have anxiety disorders. The study (1) was published online in the internationally renowned ‘Journal of Clinical Psychiatry’ and concluded that “there was a clear benefit of omega-3 supplementation among patients with MDE [major depressive episode] without comorbid anxiety disorders”.

The study (1) was the largest ever study to assess the use of long chain omega 3 fatty acids in treating major depression. The double-blind, placebo-controlled, randomised trial involved over 400 male and female individuals with major unipolar depression. For 8 weeks half the participants took three capsules daily of a specific high EPA omega 3 supplement and the other half took three placebo capsules containing sunflower oil flavoured with a small quantity of fish oil. The initial results found that, although there was a trend toward omega 3 being helpful for treating major depression the results were not significant. However, further analysis found that omega 3 supplements significantly improved depressive symptoms in individuals diagnosed with depression unaccompanied by an anxiety disorder (such as generalized anxiety, phobias, post-traumatic stress disorder and panic disorder). In these patients the results showed that efficacy of omega 3 fats was comparable to conventional antidepressant treatment. An exciting and highly important finding.

In a press release (2) the lead study author, Dr Lespérance noted “Despite significant progress in neuroscience over the past two decades, depression is difficult to treat,”. Depression, is now the world’s fourth leading cause of morbidity and death is expected to move up to the number two position by 2020. The press release also mentions that there are a large number of patients who stop taking their medications in the first few months of treatment and those who refuse such treatment due to fear of stigmatization or side effects. A large number of patients suffering from major depression use alternative treatments offered outside the healthcare system, Dr Lespérance comments that “Many of these treatments have not been adequately evaluated. That is why it was important to assess the efficacy of Omega-3, one of the most popular alternative approaches,”

The study (1) adds to previous evidence that omega 3 fats, especially EPA, might be useful in depressive disorders. Many doctors and scientists have not been convinced by the current evidence and I hope that this broader study has made some impact. It would be really encouraging if medical doctors started to use omega 3 fats as treatments for suitable patients suffering with depression. As mentioned in a past post some psychiatrists, such as Professor Basant Puri, do use EPA supplements with their patients and have experienced fantastic results. The press release (2) rightly states that “Additional research directly comparing Omega-3 with conventional antidepressants could more clearly confirm their usefulness for patients suffering from depression”

Many people in the UK do not regularly, at least twice weekly, eat oily fish and may, therefore, have low intakes of omega 3 fats in their diets. These fats are essential for health and cannot be made by the body. As you can see from my past posts on omega 3 fats they are linked to a number of conditions from heart disease, to mood related issues and immune problems. Having a good intake of these essential fats is vital for health. 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. If you are feeling depressed, or have been diagnosed as suffering from depression please check with a medical doctor prior to taking any form of supplementation. If you are receiving medication of any kind it is also important to check with your medical doctor prior to taking supplements.

(1) Lespérance F et al. 2010. The Efficacy of Omega-3 Supplementation for Major Depression: A Randomized Controlled Trial. Journal of Clinical Psychiatry, 2010;E-Pub prior to print, June 15, DOI 10.4088/JCP.10m05966blu.

(2)Press release Centre hospitalier de l’Université de Montréal (2010, June 21). Treating depression with Omega-3: Encouraging results from largest clinical study. ScienceDaily. Retrieved June 22, 2010, from http://www.sciencedaily.com /releases/2010/06/100621111238.htm

Written by Ani Kowal

Healthy diet, healthy mind

admin — Wed, 03 Mar 2010 18:43:35 +0000

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.

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

Can chamomile impact anxiety?

admin — Wed, 17 Feb 2010 17:23:46 +0000

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

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

admin — Mon, 15 Feb 2010 14:38:26 +0000

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 may help to improve mood

admin — Mon, 30 Nov 2009 16:24:45 +0000

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

Study finds that overall healthy diet may protect against depression in middle age

admin — Wed, 11 Nov 2009 18:40:06 +0000

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

Long chain omega 3 fatty acids may be helpful in treating depression

admin — Mon, 09 Nov 2009 18:36:57 +0000

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