On Monday I wrote about phytochemicals in relation to obesity.  Bioflavonoids are phytochemicals, or plant nutrient, that I have written about often.  Fruit and vegetables and other plant-based foods such as nuts, seeds, pulses, beans are the richest sources of flavonoids.  A favoured source of flavonoids for me is cocoa.  Cocoa and dark chocolate made from a minimum of 70% cocoa solids are a great source of flavonoids that have high antioxidant potential and have been linked to a reduced risk of all sorts of health problems such as heart disease and certain cancers.  In addition to antioxidant bioflavonoids cocoa contains a number of minerals such as magnesium. Dark chocolate also contains fibre and is much lower in sugar than milk chocolate, so most people find that they need far less to satisfy their chocolate cravings.

A recent study (1) has found that a high intake of cocoa bioflavonoids may be related to a reduced inflammatory response in the body in patients at high risk of cardiovascular disease (heart disease and stroke).  Cardiovascular disease is considered an inflammatory condition.  The authors note that “These antiinflammatory effects may contribute to the overall benefits of cocoa consumption against atherosclerosis”.

The study involved forty two individuals at high risk of cardiovascular disease.  The individuals received 40g cocoa powder with 500mL skimmed milk or only 500ml skimmed milk for 4 weeks.  The regimen was then switched.   Before and after each intervention period, inflammatory markers in the cells and in blood serum were evaluated.  The results indicate that intake of cocoa polyphenols may positively change inflammatory chemicals in individuals at high risk of cardiovascular disease (1)

Flavonoids act as antioxidants in the body, helping to prevent cell damage and protection against disease by mopping-up destructive unstable oxygen molecules known as 'free radicals'.  Polypheonols also seem to have other protective effects on the heart and blood vessels.  They seem to prevent blood clotting, abnormal heart beat and blood vessel narrowing.  As yet scientists are not exactly sure of how these plant compounds act, however they do seem to positively change the way our genes function.

A recent review of published evidence(2) also suggests that there could be a link between cocoa consumption and protection against cancer.  The high concentration of bioflavonoids - catechins and procyanidins, found in cocoa and dark chocolate products is thought to be the important factor.  As mentioned the anti-inflammatory and antioxidant properties of these bioflavonoids probably also accounts for the cancer protective properties.  Studies into cocoa and cancer prevention have been small and are preliminary.  Larger trials would be necessary for any definitive evidence.

The major flavonols to be found in cocoa are called epicatechin and catechin.  The important message is that dark chocolate (minimum 70% cocoa solids) and cocoa rich products can be enjoyed in moderation and as part of a healthy balanced diet rich in bioflavonoids from other sources, especially vegetables and fruits.  Vegetables and fruit should form the core of a healthy diet and getting a good variety will give the body many of the nutrients that are needed for optimal health.  Flavonoid supplements are now available, though the evidence for their use is still in the early stages.  If you feel your diet is lacking in vegetables and fruits you may want to consider a supplement to top-up and cover the shortfall, but remember supplements are not a replacement for a healthy diet.

(1)Mongas M et al.  2009.  Effect of cocoa powder on the modulation of inflammatory biomarkers in patients at high risk of cardiovascular disease.  Am J Clin Nutr.  90:1144-1150
(2)Maskarinec G.  2009.  Cancer protective properties of cocoa: a review of the epidemiologic evidence. Nutr Cancer. 61(5):573-9.
Written by Ani Kowal

Vegetables and fruits contain abundant amounts of phytochemicals (bioflavonoids), bioactive plant nutrients, which are thought to be vital to the body for many reasons and linked to a reduced risk of all kinds of conditions from heart disease and cancer to dementia and bone loss.  The recommendations to eat plenty of these plant-based foods are certainly valid and very important.  A high intake of phytochemical compounds has been shown to be important for optimal health and prevention of disease.

A recent study (1) has linked high intakes of phytochemicals with reduced adiposity,fat tissue, as well as reduced oxidative stress, a kind of stress that occurs in the cells of our bodies when they are under attack by molecules known as ‘free radicals’.  In the body antioxidant defences are important to prevent damage by these free radical molecules which can cause inflammation and are linked to many diseases.  Many phytochemicals act as antioxidants in the body.

The authors of this study(1) used a simple 'phytochemical index' to determine the levels of these plant chemicals consumed by 54 people aged between 18-30 years.  Participants were ordered into normal weight and overweight groups.  Dietary records and blood samples were collected. The phytochemical index was a way of comparing the number of calories consumed from plant-based foods with the overall number of daily calories. 

The adults in the two groups consumed about the same amount of calories.  However overweight-obese adults consumed fewer plant-based foods and subsequently fewer protective trace minerals and phytochemicals and more saturated fats. They also had higher levels of oxidative stress and inflammation than their normal-weight peers, these processes are related to the onset of obesity, heart disease, diabetes and joint disease.  The authors conclude that having more phytochemicals in the diet is related to a lower fat mass and lower levels of oxidative stress.  Phytochemicals may be having an effect on the metabolic processes associated with obesity but further research would be necessary to elucidate this (1). 

As mentioned earlier, phytochemicals are found in large amounts in vegetables and fruits, they are also present in nuts, beans, pulses and lentils.  These are foods that we are always being reminded to include in high levels in the diet.  In a press release (2) the author of the study stated  “We need to find a way to encourage people to pull back on fat and eat more foods rich in micronutrients and trace minerals from fruits, vegetables, whole grains and soy,".  The author goes on to recommend (2) "Fill your plate with colorful, low-calorie, varied-texture foods derived from plants first. By slowly eating phytochemical-rich foods such as salads with olive oil or fresh-cut fruits before the actual meal, you will likely reduce the overall portion size, fat content and energy intake. In this way, you're ensuring that you get the variety of protective, disease-fighting phytochemicals you need and controlling caloric intake."

Plant based foods are generally lower in calories but more filling than processed foods since they contain plentiful amounts of fibre that can help us to feel fuller for longer, these foods really should represent the cornerstone of a healthy diet.  Supplements can never replace a healthy diet, however if you feel you are frequently falling short of eating enough vegetables and fruits you may want to consider taking a bioflavonoid supplement or a food-state multivitamin and mineral supplement to cover any short-term shortfalls.

There are many simple ways to include more vegetables and fruits in the diet e.g.
*Replace processed snack bars with a piece of fruit or a handful of mixed unsalted nuts
*Vegetable sticks with some hummus make a great snack
*Grate an apple into your morning oats/porridge or added a chopped banana – avoid sweet, processed breakfast cereals
*Include plenty of salad in your lunchtime sandwich, 
*Have 2-3 portions of vegetables with your evening meal
*Eat fruit with natural yoghurt as a dessert
*Replace pre-packaged, processed foods as often as possible with fresh produce – the authors of the study state (2) "We always want to encourage people to go back to the whole sources of food, the non-processed foods if we can help it," "That would be the bottom line for anyone, regardless of age and body size, keep going back to the purer plant-based foods. Remember to eat the good quality food first."

(1)Vincent HK et al.  2009.  Relationship of the dietary phytochemical index to weight gain, oxidative stress and inflammation in overweight young adults. Journal of Human Nutrition and Dietetics.  Sep 4. [Epub ahead of print]
(2)University of Florida (2009, October 22). Phytochemicals In Plant-based Foods Could Help Battle Obesity, Disease. ScienceDaily. Retrieved October 23, 2009, from http://www.sciencedaily.com¬ /releases/2009/10/091021144251.htm

Written by Ani Kowal

Earlier this year I wrote a couple of posts concentrating on the accumulating evidence which suggests that probiotic (‘friendly’ gut bacteria) supplements may be useful to boost the immune system.  In children, studies have shown that probiotic and prebiotic (food supplement that feeds the good bacteria in the digestive system) supplements may be useful in preventing recurrent ear infections and also the common cold.

A recently published study (1) has found that prebiotic and probiotic supplements, which improve the intestinal bacterial balance, may be particularly important in preventing eczema in susceptible infants.  It has been thought for a while now that modification of the intestinal bacterial balance could be an important approach to preventing allergic disease.  This particular study aimed to look at the prevention of allergic disease in high-risk children (children with parents and/or siblings with allergic conditions).  The probiotic bacteria was given to pregnant mothers of high-risk children, ie where there was a positive family history of allergic disease, and then to the infant children for the first 12months of life.  This was a controlled trial so there were some mothers/children who were given a placebo, they did not receive a probiotic supplement. 

Parental-reported eczema during the first 3 months of life was significantly lower in the intervention group compared with placebo (1).  The authors conclude their study by reporting “This particular combination of probiotic bacteria shows a preventive effect on the incidence of eczema in high-risk children, which seems to be sustained during the first 2 years of life. In addition to previous studies, the preventive effect appears to be established within the first 3 months of life”

If there are allergies in your family and you think that your child may be at risk of developing eczema or asthma then you may consider taking a probiotic and probiotic supplement during pregnancy and also giving an infant probiotic supplement (there are many available) to your baby during the first year to two years of life.  Please talk to your doctor or health professional before beginning a supplement regimen during pregnancy or with an infant child. 

A fairly recent study (2) assessed the safety of feeding probiotic supplements to newborn infants and found that such supplements were safe and seemed to increase resistance to infections during the first 2 years of life.  The study was well designed and began with pregnant mothers who were given either a mixture of probiotics or placebo for 4 weeks before they were due to give birth.  Their babies were given the same probiotics in conjunction with a prebiotic or placebo for 6 months after birth.  925 infants were involved and followed up for 2 years.  During the 6-month supplement intervention, antibiotics were prescribed less often in the prebiotic/probiotic group than in the placebo group and throughout the 2 year follow-up period, infections occurred less frequently in the group receiving these supplements.

Eczema is an inflammatory skin condition thought to be related to other allergies, such as asthma.  Due to the inflammatory nature of the condition it is thought that long chain omega 3 fatty acids may also be particularly useful in treating the condition, I have previously written about this here, as well as in the post relating to asthma.

(1) Niers L et al.  2009.  The effects of selected probiotic strains on the development of eczema (the PandA study).  Allergy.  64(9):1349-58.
(2) Kukkonen K et al.  2008.  Long-term safety and impact on infection rates of postnatal probiotic and prebiotic (synbiotic) treatment: randomized, double-blind, placebo-controlled trial. Pediatrics. 122(1):8-12.
Written by Ani Kowal

In July this year I wrote about the link between the bacteria in the digestive system and obesity.  The human adult gut contains up to 100 trillion microbial organisms and it certainly seems sensible to ensure that these are mainly made up of ‘friendly’ good bacteria.  The type of bacteria in the digestive system seems to have an effect on the entire body and not just the health of the gut.

A recent study (1) has found that prebiotic supplementation was associated with reduced appetite sensation after a meal.  Prebiotics act as food for the good ‘friendly’ bacteria in the digestive system and previous studies (2) suggest that prebiotics in the diet may reduce our energy and food intake, increase satiety, reduce hunger and appetite and reduce total daily calorie intakes.  Prebiotics may also have positive effects on blood sugar balance in the body which can also impact appetite.  This recent research (1) was set up to see whether prebiotic supplements affected the hormones associated with satiety.  The study was very small but well designed and provided interesting results.  Prebiotic treatment was associated with a three fold reduction in hunger rates and an increase in hormones which are associated with feelings of satiety/fullness. 

In past blog posts I have mentioned many nutritional ways that can help to keep us feeling satisfied after a meal and may hence prevent over eating, or even cravings (which are often related to blood sugar imbalance).

Again, I would like to stress that obesity is a complex disease involving many factors with no miracle cure and no easy solutions - I am not about to disillusion anyone by inferring that bacterial balance is a major factor and probiotic or prebiotic supplements are the cure.  However, gut bacteria may well be having some kind of impact on the development of excess body weight in some people.  What we eat does affect the composition of the microorganisms that are present in our digestive systems and in turn these microorganisms can have an effect on the health of our body.  A review paper (2) stated that “probiotic and prebiotic supplements may be useful in order to positively change the gut bacterial balance and help prevent and treat overweight but that these manipulations should clearly not be viewed as a substitute for a healthy diet and exercise”.

Further conclusive evidence needed, however prebiotics (such as FOS) and probiotics do seem to positively change the composition of bacteria in our digestive systems and affect overall health.  Supplements are readily available but should not be seem as a quick-weight loss fix.  A healthy diet and lifestyle is of paramount importance for weight control and overweight prevention and treatment.

Another factor to mention here is fibre (since prebiotics are a form of fibre), a high fibre diet can also help with feelings of fullness and therefore prevention against over-eating.  A recent study (3) in young people (aged 11-17) at high risk of obesity found that an increase in total dietary fibre intake was associated with decreases in fat tissue.  A decrease in fibre was associated with significant increases in fat tissue, this was noted even if the decrease in fibre was small (about 3g).  The authors of the study conclude that “Small reductions in dietary fiber intake over 1–2 y can have profound effects on increasing visceral adiposity [fat mass]”. 

A diet that is high in fibre has been linked to numerous health benefits in most areas of the body from the: heart, where it seems to have positive effects on blood pressure and risk of heart disease; digestive system where it seems to be useful to sufferers of irritable bowel syndrome (IBS), constipation and diverticulitis and the immune system where there seems to be a link with reduced risk of cancer.  A high fibre diet also appears to be very useful in blood sugar control and also appetite control as it gives us the feeling of fullness and helps to control satiety.  The recommended daily intake for fibre in the UK is currently set at 18g/d, however for optimal health many experts regard at least 25g per day as necessary.  In the UK our average intake is low at only 12g/d.  Foods that are naturally high in fibre are also a really important part of a healthy diet e.g. vegetables, fruits, beans/pulses, nuts/seeds and wholegrains.

(1)Cani PD et al.  2009.  Gut microbiota fermentation of prebiotics increases satietogenic and incretin gut peptide production with consequences for appetite sensation and glucose response after a meal.  Am J Clin Nutr.  90:1236-1243
(2) DoBaise JK et al.  2008.  Gut microbiota and its possible relationship with obesity.  Mayo Clinical Processings.  83:460-469
(3) Davis JN et al.  2009.   Inverse relation between dietary fiber intake and visceral adiposity in overweight Latino youth.  Am J Clin Nutr.  90:1160-1166
Written by Ani Kowal

Folate is one of the B vitamins that I have written about with regards to preventing birth defects, allergies, heart disease, premature births and improving behaviour, mood, fertility and bone health.  On Monday I wrote about folate and age-related hearing loss.  A recently published study (1) has found that women who eat a diet rich in folate seem to have a reduced risk of developing colorectal cancer.

The B vitamin folate is found mainly in green leafy vegetables, asparagus, black-eyed beans and citrus fruits.  It plays an important role in the synthesis and replication of DNA which is why it is crucial in early pregnancy when the cells of the foetus are rapidly dividing, this is also the reason why it may play a role in cancer prevention.  The authors of this study (1) postulate that if folate is not available, or poorly available in the body it can result in ineffective DNA synthesis which may be linked to initiation and progression of colorectal cancer.  It might be that a low folate intake could be contributing to colorectal cancer by making genetic mutations more likely.

The study (1) included 596 individuals with colorectal cancer and 509 individuals who were cancer free, these are known as ‘controls’.  The participants were 30-79 years old.  When the study scientists investigated the diets of the individuals they found that there was a significant relationship between higher dietary folate intake and reduced risk of colorectal cancer in women.  Women who ate the most folate were at about two-thirds lower risk of the disease than women who consumed the smallest amount of the B vitamin.  The study does not prove that folate prevents against cancer but it certainly indicates that further studies into the relationship would be interesting.  Regularly including folate rich foods in the diet seems sensible for all women but especially those of childbearing age.

Women of childbearing age are generally encouraged to take a folic acid supplement, or a multi-nutirent supplement containing folic acid, since it is known that this can prevent spina bifida, a birth defect.  Recent evidence has found that folic acid may also be important during very early pregnancy for a whole host of other reasons too.  It certainly would also seem prudent for women to take a folate supplement or a folate-containing multivitamin daily to ensure adequate amounts.  Recently the BBC (2) reported a story urging women of childbearing age to take folic acid in a bid to prevent birth defects, something I have echoed in my blog posts.  The BBC piece focuses on the fact that many women start to take the vitamin too late.  Many women start to take folic acid once they know that they are pregnant but often this is too late since they may well be 3-6 weeks pregnant before they realise.  Folic acid is very important in the earliest stages of pregnancy and it seems sensible that women take the vitamin pre-conceptionally as a precautionary measure.  As mentioned the vitamin is also linked to reducing premature births, heart defects and allergies.  The story reports that up to 75% of spina bifida cases could be prevented by the mother taking folic acid three months before conception and during pregnancy.

(1)Kim J et al.  2009.  Folate intake and the risk of colorectal cancer in a Korean population. Eur J Clin Nutr. 2009 Sep;63(9):1057-64
(2)Experts urge wider folic acid use.  Eleanor Bradford.  BBC Scotland Health Correspondent  http://news.bbc.co.uk/1/hi/scotland/8232089.stm
Written by Ani Kowal

I have mentioned folate a lot in my blog posts but mainly in relation to women, especially pregnant women.  However, recent research presented at the at the 2009 American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) Annual Meeting & OTO EXPO, in San Diego, CA(1) has found that high folate intakes in men may be associated with a 20% decreased risk of hearing loss.

The study(1) involved 3,559 cases of men with hearing loss.  The study authors found that men over the age of 60 who have a high intake of foods and supplement high in folate had a 20% decrease in risk of developing hearing loss.  The authors believe this is the largest study to delve into the relation between dietary intake and hearing loss. They also believe their findings could allow for greater education, prevention, and screening efforts in a bid to prevent hearing loss.  Further studies would certainly be necessary as this study only shows an association and not cause and effect. 

Ten years ago a small study in women (2) found that poor folate levels were associated with age-related decline in hearing.  The study was conducted in 55 healthy women aged 60-71.  The women were tested for hearing function and categorised into two groups – those with normal hearing and those with impaired hearing.  Women with impaired hearing had a 31% lower blood level of folate than women with normal hearing.  In addition to this study a couple of years ago a research team (3) found that folic acid supplementation seemed to slow the decline of low-frequency hearing in folate-deficient, older adults.  The objective of this study was to determine whether folic acid supplementation slows age-related hearing loss.  728 men and women were involved.  Subjects received daily oral folic acid (800 micro-grams) or placebo supplementation for 3 years.  Folic acid supplementation slowed the decline in hearing of the speech frequencies associated with aging in a population (but did not affect the decline in hearing high frequencies).  The authors note that the results need to be replicated in further larger studies but that folic acid supplementation seemed to slow the decline of low-frequency hearing in folate-deficient, older adults.

Folic acid may be playing a role in the prevention of age-related hearing loss by improving blood circulation to the artery that supplies blood to the cochlea of the ear.  In addition, folic acid is also related to lowering elevated homocysteine levels.  Elevated homocysteine could be related to age-related hearing loss.  Most people are aware that high levels of homocysteine in the blood have been linked to an increased risk of heart problems.  Recently high homocysteine levels have also been linked to poor bone health, poor eye health (such as age-related macular degeneration) and other health problems.  To recap from my past blog posts: 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.

Foods particularly rich in folate include leafy vegetables such as spinach, asparagus, turnip greens, lettuces, dried or fresh beans and peas, fortified cereal products, sunflower seeds, yeast extract, liver and liver products.  Vitamin B6 is mainly found in meat, fish and eggs.  Vitamin B12 is found in liver, meats, eggs, milk and yeast extract. 

Vegetarians and vegans and those who feel they are not eating a varied, balanced diet may wish to consider taking a multiple B vitamin supplement to ensure good levels of these important B vitamins

(1)American Academy of Otolaryngology -- Head and Neck Surgery (2009, October 6). Higher Folates, Not Antioxidants, Can Reduce Hearing Loss Risk In Men. ScienceDaily. Retrieved October 6, 2009, from http://www.sciencedaily.com/releases/2009/10/091005161116.htm
(2)Houston DK et al.  1999.  Age-related hearing loss, vitamin B-12, and folate in elderly women.  American Journal of Clinical Nutrition.  69(3):564-571.
(3) Durga J et al.  2007.  Effects of folic acid supplementation on hearing in older adults: a randomized, controlled trial.  Ann Intern Med.  146(1):1-9.
Written by Ani Kowal

Back in May I reported the results of a study which found that taking folic acid before pregnancy and during early pregnancy was associated with a reduced risk of premature birth.  A recent study (1) has found that women with high antioxidant levels in their blood seem less likely to give birth prematurely.

The study(1) was a case control study.  It included over 5000 women.  All the women involved in the study had an interview, examination and blood test at week 24-26 of their pregnancy.  Some of the placentas from term and preterm births were also analysed.  There were 207 preterm births in total.  Women with high (above the average) blood plasma concentrations of carotene (both alpha and beta carotene), cryptoxanthin (a type of carotenoid), and lycopene seemed to have a reduced risk of preterm birth.  (I have written about carotenoids a number of times). 

Carotenoids such as alpha and beta carotene, lutein and zeaxanthin are a family of over 700 naturally occurring yellow, red, orange and dark green pigments found in vegetables and fruits.  Good sources include carrots, sweet potatoes, tomatoes, squash, peppers, cantaloupe melons, nectarines, papaya, mango and dark green vegetables such as spinach, kale, watercress and asparagus.  Introducing a good mix of these fruits and vegetables on a regular basis in the diet will help keep carotenoid levels in the body high.  Carotenoids act as antioxidants in the body.  Antioxidants are important to prevent damage to the body cells by naturally occurring unstable oxygen molecules, known as free radicals.  Antioxidants may help to ‘quench’ or mop-up the destructive free radical molecules and therefore protect against cell-damage.

This study found that women with higher blood levels of certain carotenoids were less likely to deliver their babies preterm.  In the study, the one-half of mothers-to-be with the highest blood levels of certain carotenoids were 30 percent to 50 percent less likely to deliver prematurely than women with lower levels. The findings do not prove cause-and-effect. There may be other things about women with high carotenoid levels that explain the association with lower preterm-birth risk but the authors conclude that further studies are certainly warranted to investigate the apparent link found in this study.

If carotenoids, or other antioxidants, do help prevent premature delivery, the reasons are not yet entirely clear.  The authors speculate that it could be related to protection from any ill effects of environmental toxins, like air pollution, or exposure to bacteria or other infectious agents.

Eating a healthy diet during pregnancy, and indeed at any time, is crucial.  Ensuring that you achieve the minimum 5 portions of vegetables and fruits daily is a good idea.  Aiming to eat plenty of these foods will mean that antioxidant levels in the body will naturally be high.  In addition, many women may choose to take a multivitamin and mineral supplement specifically designed for use during pregnancy and this may also boost levels of important antioxidants in the body, as well as providing folic acid.

(1)Kramer MS et al.  2009.  Antioxidant Vitamins, Long-Chain Fatty Acids, and Spontaneous Preterm Birth.  Epidemiology. 20(5):707-713.
Written by Ani Kowal

At the beginning of September I wrote a piece about light therapy in the treatment of seasonal affective disorder (SAD).  A common feature of SAD is low mood and depression and many individuals suffering from these kinds of symptoms would really prefer to take a natural alternative to conventional anti-depressant medications.  One option to consider is the herb, St John’s wort (Hypericum perforatum). 

Historically St John’s wort has been used as a remedy for the treatment of depression and there is now quite a bank of medical and scientific evidence(1) confirming the effectiveness of this herb for aiding various mood disturbances.  St John’s wort is a shrubby perennial plant with bright yellow flowers, named after St John the Baptist.  Ancient Greeks and Romans believed that the herb could deter evil spirits but today it is mainly used as a natural, alternative to antidepressants.  The herb has been routinely used in Germany for many years where doctors and health practitioners frequently prescribe supplements for the treatment of depression.  The available supplements are made from the dried flowers of the plant. 

Last year I wrote about a well carried out review which concluded that for people suffering from mild to moderate depression, St John’s wort can provide effective relief, similar to that of standard antidepressants but with fewer side effects.

Last month a paper was published (2) which commented on the above mentioned review paper, the author wanted to delve into assessing whether St John’s wort was also an effective treatment for major depression.  The author concluded that “Hypericum (St John’s wort) extracts are more effective than placebo in people with major depression. They are similarly effective to standard antidepressants but with fewer side effects”.  This is really interesting data as it now seems that St John’s wort can be used effectively in mild, moderate and major depression.  The author comments that evidence for the use of this herb has been steadily increasing over the years and that most studies have shown that the herb is superior to placebo in alleviating depression.  He also states that this research suggests “good evidence to assume that the risks associated with this herbal medicine are significantly less than those of synthetic antidepressants. This conclusion is also supported by data from observational and other non-randomised studies.  The implications of all this are clear. St John’s wort extracts are effective antidepressants. Provided herb–drug interactions can be avoided, they are also safer than conventional drugs. Considering the current debate about the value of synthetic antidepressants, one wonders why they are not used more widely”. 

I wonder about the same thing!   The ‘herb-drug interactions’ that the author mentions are important to note – St John’s wort interacts with certain medications so it is vital to ALWAYS CHECK WITH YOUR DOCTOR BEFORE STARTING ST JOHNS WORT SUPPLEMENTS.

The antidepressant properties of St John’s wort are thought to be ascribed to the compounds hypericin and hyperforin that are contained within the herb.  It is not entirely known how the herb works to lift the mood but it seems to act on certain ‘feel-good’ brain chemicals (known as neurotransmitters) such as dopamine, serotonin and noradrenaline.

The typical recommended dose is usually around 300mg of St John’s wort extract three times a day for supplements standardised to contain 0.3% hypericin.  One a day supplements containing 900mcg hypericin are also available – but always check the manufacturers dosage instructions an ALWAYS check with a doctor before taking the herb.  It may take 4 weeks before you see any benefit.  Side effects are uncommon, however in people with fair skin it is advisable to avoid prolonged exposure to sunlight whilst taking the herb.

St John’s Wort also seems useful for the treatment of other mood disturbances such as anxiety, apathy, insomnia, stress and SAD, if you think you could benefit from taking St Johns wort I would suggest chatting with a health professional prior to undertaking a supplementation regimen.

Obviously depression is a multifactorial condition, if you are suffering with depression or low mood you may want to seek psychological help from a counsellor or therapist, look into relaxation techniques and read about other nutritional aids.  A key nutrient that can be very effective in treating depression is the omega 3 essential fatty acid EPA (eicosapentaenoic acid) which I hope to discuss in relation to depression soon.

(1) Linde K et al.  2008.  St John’s wort for major depression.  Cochrane Database of Systematic Reviews Issue 3. Art. No.: CD000448. DOI: 10.1002/14651858.CD000448.pub3
(2)Ernst E.  2009.  Review: St John's wort superior to placebo and similar to antidepressants for major depression but with fewer side effects. Evid Based Ment Health.  12(3):78.
Written by Ani Kowal