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Śliwiński W, Gawlik-Kotelnicka O. Circulating B vitamins metabolites in depressive disorders - connections with the microbiota-gut-brain axis. Behav Brain Res 2024; 472:115145. [PMID: 38992845 DOI: 10.1016/j.bbr.2024.115145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 07/02/2024] [Accepted: 07/08/2024] [Indexed: 07/13/2024]
Abstract
PURPOSE In this review, we aim to summarize recent information about the association of B vitamins with immune-metabolic aspects of depression and their connection with the gut-brain axis. VIEWS B vitamins may alter depressive symptoms by many various mechanisms such as reducing oxidative stress, inflammation, gut permeability, controlling epigenetics, modifying the microbiome, and stimulating it to produce many beneficial substances such as short-chain fatty acids or neurotransmitters: norepinephrine, dopamine, serotonin, gamma-aminobutyric acid, and acetylcholine. CONCLUSIONS Specifically, vitamins B1 (thiamine), B6 (pyridoxine), B9 (folate), and B12 (cyanocobalamin), B2 (riboflavin) have been observed to affect depression. Given probiotic's capability to produce vitamins from the B group, and modify intestinal function, inflammation, or metabolic dysfunction, their supplementation might be a possible treatment method for the immunometabolic form of depression. Thus, the intake of certain probiotic bacterial strains simultaneously with controlling the required daily intake of B vitamins may positively affect the course of depression. Circulating B vitamins metabolite levels, especially B9, B12, and B6 may also be biomarkers of depression. Further investigation is needed to find stronger evidence on this topic.
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Affiliation(s)
- Wiktor Śliwiński
- Faculty of Medicine, Medical University of Lodz, Lodz 92-216, Poland.
| | - Oliwia Gawlik-Kotelnicka
- Department of Affective and Psychotic Disorders, Medical University of Lodz, Lodz 92-216, Poland.
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Lyons OC, Kerr MA, Flynn MAT, Hoey L, Hughes CF, Caffrey A, Laird E, Moore K, Porter KM, Cunningham C, McCarroll K, Molloy AM, Tracey F, O'Kane M, Strain JJ, Ward M, McNulty H. Identification of nutrition factors in the metabolic syndrome and its progression over time in older adults: analysis of the TUDA cohort. Diabetol Metab Syndr 2024; 16:125. [PMID: 38849940 PMCID: PMC11162058 DOI: 10.1186/s13098-024-01367-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 05/29/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Nutrition is recognized as playing an important role in the metabolic syndrome (MetS), but the dietary components involved are unclear. We aimed to investigate nutrition factors in relation to MetS and its progression in older adults over a follow-up period of 5.4 years. METHODS Community-dwelling adults (≥ 60y) from the Trinity-Ulster-Department-of-Agriculture study, sampled at baseline (2008-12) and follow-up (2014-18; n 953), were classified as 'with MetS' by having three or more of: waist circumference (≥ 102 cm, males; ≥ 88 cm, females); HDL-cholesterol (< 1.0 mmol/L, males; < 1.3 mmol/L, females); triglycerides (≥ 1.7 mmol/L); blood pressure (systolic ≥ 130 and/or diastolic ≥ 85 mmHg); and hemoglobin A1c (≥ 39 mmol/mol). RESULTS MetS was identified in 67% of participants, increasing to 74% at follow-up. Predictors at baseline for the development of metabolic syndrome (MetS) at follow-up were higher waist circumference (odds ratio [95%CI]; 1.06 [1.01-1.11]), but not BMI, and increased triglyceride concentrations (2.01 [1.29-3.16]). In dietary analysis (at follow-up), higher protein (g/kg bodyweight/day) and monounsaturated fatty acid (g/day) intakes were each associated with lower risk of MetS (0.06 [0.02-0.20] and 0.88 [0.78-1.00], respectively), whilst higher protein was also associated with lower abdominal obesity (0.10 [0.02-0.51]) and hypertension (0.22 [0.00-0.80]). Furthermore, participants with, compared to without, MetS consumed less high-quality protein foods (P = 0.006) and more low-quality protein foods (P < 0.001), as defined by the protein digestibility-corrected amino acid score. CONCLUSIONS Dietary interventions targeting protein quantity and quality may have specific benefits in preventing or delaying the progression of MetS in at-risk older people, but this requires investigation in the form of randomized trials.
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Affiliation(s)
- Oonagh C Lyons
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Cromore Road, Coleraine, BT52 1SA, Northern Ireland, UK
- Food Safety Authority of Ireland, Dublin, Ireland
| | - Maeve A Kerr
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Cromore Road, Coleraine, BT52 1SA, Northern Ireland, UK.
| | - Mary A T Flynn
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Cromore Road, Coleraine, BT52 1SA, Northern Ireland, UK
- Food Safety Authority of Ireland, Dublin, Ireland
| | - Leane Hoey
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Cromore Road, Coleraine, BT52 1SA, Northern Ireland, UK
| | - Catherine F Hughes
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Cromore Road, Coleraine, BT52 1SA, Northern Ireland, UK
| | - Aoife Caffrey
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Cromore Road, Coleraine, BT52 1SA, Northern Ireland, UK
| | - Eamon Laird
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Katie Moore
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Cromore Road, Coleraine, BT52 1SA, Northern Ireland, UK
| | - Kirsty M Porter
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Cromore Road, Coleraine, BT52 1SA, Northern Ireland, UK
| | - Conal Cunningham
- Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Ireland
| | - Kevin McCarroll
- Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Ireland
| | - Anne M Molloy
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Fergal Tracey
- Causeway Hospital, Northern Health and Social Care Trust, Coleraine, Northern Ireland, UK
| | - Maurice O'Kane
- Clinical Chemistry Laboratory, Western Health and Social Care Trust, Altnagelvin Hospital, Londonderry, Northern Ireland, UK
| | - J J Strain
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Cromore Road, Coleraine, BT52 1SA, Northern Ireland, UK
| | - Mary Ward
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Cromore Road, Coleraine, BT52 1SA, Northern Ireland, UK
| | - Helene McNulty
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Cromore Road, Coleraine, BT52 1SA, Northern Ireland, UK
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Dyer AH, McNulty H, Caffrey A, Gordon S, Laird E, Hoey L, Hughes CF, Ward M, Strain JJ, O'Kane M, Tracey F, Molloy AM, Cunningham C, McCarroll K. Low-Grade systemic inflammation is associated with domain-specific cognitive performance and cognitive decline in older adults: Data from the TUDA study. Neurobiol Aging 2024; 134:94-105. [PMID: 38043161 DOI: 10.1016/j.neurobiolaging.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 11/12/2023] [Accepted: 11/21/2023] [Indexed: 12/05/2023]
Abstract
Studies examining the relationships between chronic inflammation, cognitive function and cognitive decline in older adults have yielded conflicting results. In a large cohort of older adults free from established dementia (n = 3270; 73.1 ± 7.9 years; 68.4% female), we evaluated the cross-sectional and longitudinal relationships between serum cytokines (IL-6, IL-10, TNF-α) and both global and domain-specific cognitive performance (Repeatable Battery for Assessment of Neuropsychological Status [RBANS]). Higher IL-6 (OR: 1.33; 1.06, 1.66, p = 0.01), TNF-α (OR: 1.35; 1.09, 1.67, p = 0.01) and IL-6:IL-10 Ratio (OR: 1.43; 1.17, 1.74, p = 0.001) were cross-sectionally associated with impaired global RBANS performance. For specific cognitive domains, greatest effect sizes were observed between higher TNF-α levels and poorer visual-spatial and attention performance. In a subset of participants (n = 725; 69.8 ± 5.5 years; 67.0% female) with repeat assessment performed at a median of 5.4 years, only higher baseline IL-6:IL-10 ratio was associated with impaired incident overall, immediate memory and visual-spatial performance. Associations were stronger in females, but not modified by age or APOE genotype.
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Affiliation(s)
- Adam H Dyer
- Department of Age-Related Healthcare, Tallaght University Hospital, United Kingdom; Department of Medical Gerontology, School of Medicine, Trinity College Dublin, United Kingdom.
| | - Helene McNulty
- The Nutrition Innovation Centre for Food and Health, School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Aoife Caffrey
- The Nutrition Innovation Centre for Food and Health, School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Shane Gordon
- The Nutrition Innovation Centre for Food and Health, School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Eamon Laird
- Department of Physical Education and Sport Science, University of Limerick, United Kingdom
| | - Leane Hoey
- The Nutrition Innovation Centre for Food and Health, School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Catherine F Hughes
- The Nutrition Innovation Centre for Food and Health, School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Mary Ward
- The Nutrition Innovation Centre for Food and Health, School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - J J Strain
- The Nutrition Innovation Centre for Food and Health, School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Maurice O'Kane
- Clinical Chemistry Laboratory, Altnagelvin Hospital, Western Health and Social Care Trust, Londonderry, Northern Ireland, United Kingdom
| | - Fergal Tracey
- Causeway Hospital, Northern Health and Social Care Trust, Coleraine, Northern Ireland, United Kingdom
| | | | - Conal Cunningham
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, United Kingdom; Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
| | - Kevin McCarroll
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, United Kingdom; Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
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Li J, Wang L, Wang Z, Zhao F, Sun Y, Lu Y, Yang L. Association between suicide attempts and anemia in late-life depression inpatients. BMC Geriatr 2024; 24:43. [PMID: 38200429 PMCID: PMC10782764 DOI: 10.1186/s12877-023-04649-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 12/29/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Anemia is strongly associated with late-life depression (LLD), however, few studies have investigated the relationship between anemia and suicide attempts in LLD patients. It is still challenging to predict suicide risk in patients with depression. Therefore, there is growing interest in potential biomarkers of depressive disorders and suicidal behavior, which may play a significant role in the early diagnosis and treatment of depression. This study aimed to compare serum ferritin, folate, vitamin B12, and erythrocyte parameter levels in patients with LLD with those in healthy older adults, and the relationship between serum ferritin, folate, vitamin B12, and suicide attempts in patients. METHODS Serum ferritin, folate, vitamin B12, and erythrocyte parameter levels were measured in 66 hospitalized LLD patients (30 without suicide attempt, 36 with suicide attempt) and 47 healthy individuals. All participants were surveyed for basic conditions and suicide attempts, and depression was assessed in LLD patients. RESULTS Serum ferritin, folate, vitamin B12, red blood cell count, hemoglobin, hematocrit, mean platelet volume and plateletcrit levels were significantly lower in LLD patients compared with healthy older adults (P < 0.05). Further analysis of the relationship between serum ferritin, folate, and vitamin B12 levels and LLD patients' suicide attempts and showed a significant negative association between serum folate and vitamin B12 and suicide attempts (P < 0.05). CONCLUSIONS Serum ferritin, folate, vitamin B12, red blood cell count, hemoglobin, hematocrit, mean platelet volume and plateletcrit levels were significantly lower in LLD patients than in healthy older adults. In addition, reduced serum folate and vitamin B12 levels in patients may have some effect on suicide attempts. More mechanistic studies are needed to further explain this association.
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Affiliation(s)
- Jie Li
- The Second Affiliated Hospital, School of Nursing, Xinxiang Medical University, 453000, Xinxiang, Henan, China
| | - Lan Wang
- The Second Affiliated Hospital, School of Nursing, Xinxiang Medical University, 453000, Xinxiang, Henan, China
| | - Ziyi Wang
- The Second Affiliated Hospital, School of Nursing, Xinxiang Medical University, 453000, Xinxiang, Henan, China
| | - Fengxue Zhao
- The Second Affiliated Hospital, School of Nursing, Xinxiang Medical University, 453000, Xinxiang, Henan, China
| | - Yadi Sun
- The Second Affiliated Hospital, School of Nursing, Xinxiang Medical University, 453000, Xinxiang, Henan, China
| | - Ying Lu
- Nursing Department of Henan Provincial People's Hospital, 450003, Zhengzhou, Henan, China
| | - Lei Yang
- The Second Affiliated Hospital, School of Nursing, Xinxiang Medical University, 453000, Xinxiang, Henan, China.
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Sanchez M, Courtois-Amiot P, Capdepon A, Neveux N, Gautry J, Dorigny B, Brossault L, Bouillanne O, Aussel C, Raynaud-Simon A, Cynober L. Four-week administration of an energy and protein dense oral nutritional supplement improves micronutrient concentrations but does not completely correct deficiencies in institutionalized malnourished older adults. Front Nutr 2023; 10:1249936. [PMID: 37829732 PMCID: PMC10565821 DOI: 10.3389/fnut.2023.1249936] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 08/25/2023] [Indexed: 10/14/2023] Open
Abstract
Introduction Poor food intake is common among elderly living in nursing homes, leading to micronutrient deficiency (MD). There are no recommendations for the management of MD in malnourished older adults. Methods We conducted a single arm, open-label, multicenter interventional study in institutionalized malnourished older adults to describe the effect of a 4-week daily energy and protein dense oral nutritional supplementation (ONS, 600 kcal, 30 g protein per unit) containing 50% of the recommended daily micronutrient intake on micronutrient status. Plasma concentrations of vitamins (A, B9, B12, C, E), magnesium (Mg), selenium (Se) and zinc (Zn), and erythrocyte vitamin B9 were measured at baseline and after 4 weeks. Results Forty-six participants completed the study (age 87.4 ± 6.6). At baseline, the most frequent MD were Se (48%), Zn (35%), Mg (24%) and vitamin C (24%). Plasma concentrations of vitamins B9, B12, C and E, Mg, Se and Zn significantly increased and the proportion of subjects with at least one MD decreased (p = 0.006). However, after 4 weeks, 40% of subjects still had at least one MD. Discussion ONS consumption improved micronutrient status but did not correct MD in all participants. Our data suggest that the prescription of vitamin, mineral and trace element supplementation should be considered in institutionalized malnourished older adults in addition to high energy and high protein ONS.
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Affiliation(s)
- Manuel Sanchez
- Department of Geriatrics, APHP Bichat Hospital, Paris, France
- Faculty of Medicine, Paris Cité University, Paris, France
| | | | - Audrey Capdepon
- Nestlé Health Science, Issy-les-Moulineaux, France
- Research Unit in Pharmacology URP4466, Faculty of Pharmacy, Paris Cité University, Paris, France
| | - Nathalie Neveux
- Research Unit in Pharmacology URP4466, Faculty of Pharmacy, Paris Cité University, Paris, France
- Clinical Chemistry Laboratory, APHP Cochin Hospital, Paris, France
| | | | | | | | - Olivier Bouillanne
- Research Unit in Pharmacology URP4466, Faculty of Pharmacy, Paris Cité University, Paris, France
- Department of Geriatrics, APHP Emile Roux Hospital, Limeil-Brévannes, France
| | - Christian Aussel
- Research Unit in Pharmacology URP4466, Faculty of Pharmacy, Paris Cité University, Paris, France
- Clinical Chemistry Laboratory, APHP Saint-Antoine Hospital, Paris, France
| | - Agathe Raynaud-Simon
- Department of Geriatrics, APHP Bichat Hospital, Paris, France
- Faculty of Medicine, Paris Cité University, Paris, France
- Research Unit in Pharmacology URP4466, Faculty of Pharmacy, Paris Cité University, Paris, France
| | - Luc Cynober
- Research Unit in Pharmacology URP4466, Faculty of Pharmacy, Paris Cité University, Paris, France
- Clinical Chemistry Laboratory, APHP Cochin Hospital, Paris, France
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Luo X, Zhou Y, Yuan S, Chen X, Zhang B. The changes in metabolomics profile induced by intermittent theta burst stimulation in major depressive disorder: an exploratory study. BMC Psychiatry 2023; 23:550. [PMID: 37516823 PMCID: PMC10387200 DOI: 10.1186/s12888-023-05044-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 07/22/2023] [Indexed: 07/31/2023] Open
Abstract
BACKGROUND Recently, there has been an ongoing interest in the mechanism of intermittent theta burst stimulation (iTBS) in major depressive disorder. Studying the metabolite changes induced by iTBS may help to understand the mechanism. METHODS Eleven participants with major depressive disorder received 10 days iTBS treatment. Magnetic resonance imaging (MRI) was used to target the region of the left dorsolateral prefrontal cortex (DLPFC) in each participant. We analyzed the effects of iTBS on metabolites using high-throughput profiling and assessed its impact on depressive symptoms. These analyses were considered exploratory, and no correction for multiple comparisons was applied. RESULTS Among the 318 measured metabolites, a significant increase in cystine, asymmetric dimethylarginine (ADMA), 1-methylhistidine, indoleacetic acid (IAA), diethanolamine (DEA), dopa, riboflavin-5'-monophosphate (FMN), and a significant decrease in alphalinolenic acid (ALA), gamma-linolenic acid (GLA), serotonin, linoleic acid (LA) (p < 0.05) were detected in the patients after iTBS treatment. In Pearson correlation analysis, the plasma levels of LA, FMN and ADMA at baseline were significantly related to the reduction rate of the 17-item Hamilton Depression Rating Scale and the Patient Health Questionnaire-9 scores (p < 0.05). CONCLUSIONS Our study highlights that LA, FMN, ADMA and their relationship with oxidative stress, may be key factors in the antidepressant efficacy of iTBS.
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Affiliation(s)
- Xin Luo
- Psychiatric & Psychological Neuroimage Laboratory (PsyNI Lab), The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yuwen Zhou
- Institute of Mental Health, Tianjin Anding Hospital, Tianjin Medical University, Tianjin, China
| | - Shiqi Yuan
- Psychiatric & Psychological Neuroimage Laboratory (PsyNI Lab), The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiaoyu Chen
- Psychiatric & Psychological Neuroimage Laboratory (PsyNI Lab), The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Bin Zhang
- Institute of Mental Health, Tianjin Anding Hospital, Tianjin Medical University, Tianjin, China.
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Caffrey A, Lamers Y, Murphy MM, Letourneau N, Irwin RE, Pentieva K, Ward M, Tan A, Rojas‐Gómez A, Santos‐Calderón LA, Canals‐Sans J, Leung BMY, Bell R, Giesbrecht GF, Dewey D, Field CJ, Kobor M, Walsh CP, McNulty H. Epigenetic effects of folate and related B vitamins on brain health throughout life: Scientific substantiation and translation of the evidence for health improvement strategies. NUTR BULL 2023; 48:267-277. [PMID: 36807740 PMCID: PMC10946506 DOI: 10.1111/nbu.12611] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/15/2023] [Accepted: 01/23/2023] [Indexed: 02/23/2023]
Abstract
Suboptimal status of folate and/or interrelated B vitamins (B12 , B6 and riboflavin) can perturb one-carbon metabolism and adversely affect brain development in early life and brain function in later life. Human studies show that maternal folate status during pregnancy is associated with cognitive development in the child, whilst optimal B vitamin status may help to prevent cognitive dysfunction in later life. The biological mechanisms explaining these relationships are not clear but may involve folate-related DNA methylation of epigenetically controlled genes related to brain development and function. A better understanding of the mechanisms linking these B vitamins and the epigenome with brain health at critical stages of the lifecycle is necessary to support evidence-based health improvement strategies. The EpiBrain project, a transnational collaboration involving partners in the United Kingdom, Canada and Spain, is investigating the nutrition-epigenome-brain relationship, particularly focussing on folate-related epigenetic effects in relation to brain health outcomes. We are conducting new epigenetics analysis on bio-banked samples from existing well-characterised cohorts and randomised trials conducted in pregnancy and later life. Dietary, nutrient biomarker and epigenetic data will be linked with brain outcomes in children and older adults. In addition, we will investigate the nutrition-epigenome-brain relationship in B vitamin intervention trial participants using magnetoencephalography, a state-of-the-art neuroimaging modality to assess neuronal functioning. The project outcomes will provide an improved understanding of the role of folate and related B vitamins in brain health, and the epigenetic mechanisms involved. The results are expected to provide scientific substantiation to support nutritional strategies for better brain health across the lifecycle.
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Affiliation(s)
- A. Caffrey
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical SciencesUlster UniversityColeraineUK
| | - Y. Lamers
- British Columbia Children's Hospital Research Institute, Food Nutrition and Health Program, Faculty of Land and Food SystemsThe University of British ColumbiaVancouverBritish ColumbiaCanada
| | - M. M. Murphy
- Unit of Preventive Medicine & Public Health, Department of Basic Medical Sciences, Faculty of Medicine & Health SciencesUniversitat Rovira i Virgili, IISPVReusSpain
- CIBEROBN, ISCIIIMadridSpain
| | - N. Letourneau
- Faculty of Nursing and Cumming School of MedicineUniversity of CalgaryCalgaryAlbertaCanada
| | - R. E. Irwin
- Genomic Medicine Group, School of Biomedical SciencesUlster UniversityColeraineUK
| | - K. Pentieva
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical SciencesUlster UniversityColeraineUK
| | - M. Ward
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical SciencesUlster UniversityColeraineUK
| | - A. Tan
- British Columbia Children's Hospital Research Institute, Food Nutrition and Health Program, Faculty of Land and Food SystemsThe University of British ColumbiaVancouverBritish ColumbiaCanada
| | - A. Rojas‐Gómez
- Unit of Preventive Medicine & Public Health, Department of Basic Medical Sciences, Faculty of Medicine & Health SciencesUniversitat Rovira i Virgili, IISPVReusSpain
| | - L. A. Santos‐Calderón
- Unit of Preventive Medicine & Public Health, Department of Basic Medical Sciences, Faculty of Medicine & Health SciencesUniversitat Rovira i Virgili, IISPVReusSpain
| | - J. Canals‐Sans
- Department of Psychology, Faculty of Educational Sciences and PsychologyUniversitat Rovira i VirgiliTarragonaSpain
| | - B. M. Y. Leung
- Faulty of Health SciencesUniversity of LethbridgeLethbridgeAlbertaCanada
| | - R. Bell
- Faculty of Agricultural, Life and Environment ScienceUniversity of AlbertaEdmontonAlbertaCanada
| | - G. F. Giesbrecht
- Faculty of Nursing and Cumming School of MedicineUniversity of CalgaryCalgaryAlbertaCanada
| | - D. Dewey
- Faculty of Nursing and Cumming School of MedicineUniversity of CalgaryCalgaryAlbertaCanada
| | - C. J. Field
- Faculty of Agricultural, Life and Environment ScienceUniversity of AlbertaEdmontonAlbertaCanada
| | - M. Kobor
- British Columbia Children's Hospital Research Institute, Food Nutrition and Health Program, Faculty of Land and Food SystemsThe University of British ColumbiaVancouverBritish ColumbiaCanada
| | - C. P. Walsh
- Genomic Medicine Group, School of Biomedical SciencesUlster UniversityColeraineUK
| | - H. McNulty
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical SciencesUlster UniversityColeraineUK
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8
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Liu X, Liu X, Wang Y, Zeng B, Zhu B, Dai F. Association between depression and oxidative balance score: National Health and Nutrition Examination Survey (NHANES) 2005-2018. J Affect Disord 2023:S0165-0327(23)00712-7. [PMID: 37244542 DOI: 10.1016/j.jad.2023.05.071] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 05/07/2023] [Accepted: 05/21/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND Few studies have investigated the relationship between systemic oxidative stress status and depression. The oxidative balance score (OBS) was used to assess systemic oxidative stress status, with higher OBS scores implying exposure to more antioxidants. This study aimed to explore whether OBS is associated with depression. METHODS 18,761 subjects from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018 were selected. Depression was diagnosed by the Patient Health Questionnaire (PHQ-9, score ≥ 10). OBS was scored by 20 dietary and lifestyle factors. Weighted logistic regression and restricted cubic splines (RCS) were used to assess the association between OBS and depression. RESULTS The prevalence of depression was 8.42 %. There was a significant negative nonlinear relationship between OBS, dietary OBS, lifestyle OBS and depression (p for nonlinear < 0.05). Compared to the lowest quartile of OBS, the adjusted ORs for the highest quartile of OBS, dietary OBS, and lifestyle OBS and depression were 0.290 (95 % CI: 0.193-0.434), 0.500(95 % CI: 0.380-0.658), 0.403(95 % CI: 0.299-0.545) respectively, and all P for trend < 0.001. In stratified analyses, three OBS were negatively associated with the odds of depression across sex groups (all P for trend < 0.05), and the OR was smaller in the female group than in the male group. LIMITATIONS Cross-sectional data and absence of drug considerations. CONCLUSIONS OBS was strongly negatively associated with depression, especially in females. The findings underline the significance of adhering to an antioxidant diet and lifestyle, which helps prevent depression and appears to be of greater benefit to women.
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Affiliation(s)
- Xuna Liu
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - Xuyan Liu
- Department of Medicine, Northwest Minzu University, Lanzhou 730030, China
| | - Yiwen Wang
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - Beibei Zeng
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - Boxu Zhu
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - Fei Dai
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China.
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Bakir B, Çalapkorur S. Relationship between nutritional status and anxiety and depression in hospitalized diabetic patients in Turkey. Int J Psychiatry Med 2023:912174231164289. [PMID: 36914586 DOI: 10.1177/00912174231164289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
BACKGROUND Anxiety and depression often coexist in patients with chronic diseases. We evaluated the nutritional status of diabetic patients and its relationship with anxiety and depression. METHODS Demographic, diabetic information (disease duration, treatment, hospitalization) information and anthropometric measurements (weight, height, waist, and hip circumference) were recorded. The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depression. 24-h food records were obtained to determine daily energy and nutrient intake. RESULTS In this study of 222 patients, the rates of anxiety, depression and anxious depression were 23.8%, 21.6%, 12.2%, respectively. Those who skipped medication/insulin doses and did not exercise regularly had significantly higher anxiety and depression scores. Anxiety and depression scores were positively correlated with disease duration, waist circumference, waist/hip, and waist/height. Being married, engaging in regular exercise, and increased vitamin B6 consumption were inversely related to anxiety and depression. According to food records, patients with anxiety and depression have a higher proportion of energy from dietary carbohydrates. Anxiety and depression scores were negatively related to dietary energy, protein, fat, some vitamin (retinol, group B, C, and D), and mineral (K, Mg, P, Fe, Zn, Cu) intake. CONCLUSIONS Maintaining healthy body weight, compliance with medication/insulin treatment, and regular exercise may help in the prevention of anxiety and depression in hospitalized diabetic patients. Alternatively, anxiety and depression may adversely affect body weight, compliance with treatment, and engaging in regular exercise. Prospective studies are needed to determine the direction of causality.
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Affiliation(s)
- Buse Bakir
- Department of Nutrition and Dietetics, Faculty of Health Sciences, İzmir Kâtip Çelebi University, İzmir, Turkey
| | - Sema Çalapkorur
- Department of Nutrition and Dietetics, Faculty of Health Sciences, 52958Erciyes University, Kayseri, Turkey
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10
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Chrzastek Z, Guligowska A, Sobczuk P, Kostka T. Dietary factors, risk of developing depression, and severity of its symptoms in older adults-A narrative review of current knowledge. Nutrition 2023; 106:111892. [PMID: 36436336 DOI: 10.1016/j.nut.2022.111892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 10/10/2022] [Accepted: 10/19/2022] [Indexed: 11/27/2022]
Abstract
Depression is one of the most common diseases in the older population. Difficulties in recognizing its etiology and recurrence make depression a major challenge for health care professionals. The risk of developing depression is influenced by many factors, including lifestyle and diet. Research studies have shown a relationship between the consumption of specific macro- and microelements and depression. However, so far, no nutritional recommendations on how to reduce the risk of the disease and its relapses in older adults have been developed. This review outlines research results of conducted studies and focuses on both basic and potentially promising elements of diet, such as proteins, carbohydrates, fats, dietary fiber, vitamins (D, E, C, and B), and microelements such as magnesium, zinc, selenium, or iron.
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Affiliation(s)
- Zuzanna Chrzastek
- Department of Geriatrics, Healthy Ageing Research Centre, Medical University of Lodz, Lodz, Poland.
| | - Agnieszka Guligowska
- Department of Geriatrics, Healthy Ageing Research Centre, Medical University of Lodz, Lodz, Poland
| | - Piotr Sobczuk
- Department of Emergency Medicine and Disaster Medicine, Medical University of Lodz, Lodz, Poland
| | - Tomasz Kostka
- Department of Geriatrics, Healthy Ageing Research Centre, Medical University of Lodz, Lodz, Poland
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11
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Luo Y, Yang P, Wan Z, Kang Y, Dong X, Li Y, Wang Y, Xie J, Duan Y. Dietary diversity, physical activity and depressive symptoms among middle-aged women: A cross-sectional study of 48,637 women in China. J Affect Disord 2023; 321:147-152. [PMID: 36330900 DOI: 10.1016/j.jad.2022.10.038] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 10/12/2022] [Accepted: 10/20/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Depression is the leading cause of mental health-related disease burden. This study aimed to investigate the relationship among dietary diversity, physical activity and depressive symptoms in middle-aged women. METHOD Based on the WHO guidelines on physical activity, subjects who meet moderate-intensity aerobic physical exercise of 150-300 min per week were qualified or otherwise unqualified. The dietary diversity scores (DDS) were developed according to the balanced diet pagoda and assessed the consumption of nine food groups. The total scores ranged from 0 to 9 and could divide into three levels: insufficient [DDS-1] (score of 1-5), moderate [DDS-2] (score of 6-7), and sufficient [DDS-3] (score of 8-9). RESULTS An age at menarche ≥12 years old (OR = 0.94; 95 % CI: 0.89-1.00; p < 0.05), a higher dietary diversity score [DDS-3] (OR = 0.59; 95 % CI: 0.55-0.63; p < 0.001), drinking coffee (OR = 0.88; 95 % CI: 0.84-0.92; p < 0.001), and qualified physical activity (OR = 0.69; 95 % CI: 0.66-0.72; p < 0.001) were protective factors for depressive symptoms, while an age at first birth ≤20 years old (OR = 1.23; 95 % CI: 1.12-1.36; p < 0.001) or ≥30 years old (OR = 1.18; 95 % CI: 1.11-1.26; p < 0.001), eating late-night snacks (OR = 1.44; 95 % CI: 1.36-1.52; p < 0.001), drinking sugar-sweetened beverages (OR = 1.15; 95 % CI: 1.06-1.24; p < 0.001), and overeating (OR = 2.30; 95 % CI: 2.069-2.56; p < 0.001) were risk factors. CONCLUSION This study suggested that dietary diversity and physical activity are associated with depressive symptoms in middle-aged women. To improve dietary diversity, attention should be given to dietary patterns and dietary habits, instead of simply increasing the amount of food.
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Affiliation(s)
- Yating Luo
- Health Management Center, The Third Xiangya Hospital of Central South University, Changsha, China; Xiangya School of Nursing, Central South University, Changsha, China
| | - Pingting Yang
- Health Management Center, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Ziyu Wan
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Yue Kang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Xiaoqian Dong
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Ying Li
- Health Management Center, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Yaqin Wang
- Health Management Center, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Jianfei Xie
- Department of Nursing, The Third Xiangya Hospital of Central South University, Changsha, China.
| | - Yinglong Duan
- Department of Nursing, The Third Xiangya Hospital of Central South University, Changsha, China.
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12
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Clements M, Heffernan M, Ward M, Hoey L, Doherty LC, Hack Mendes R, Clarke MM, Hughes CF, Love I, Murphy S, McDermott E, Grehan J, McCann A, McAnena LB, Strain JJ, Brennan L, McNulty H. A 2-Year Randomized Controlled Trial With Low-Dose B-Vitamin Supplementation Shows Benefits on Bone Mineral Density in Adults With Lower B12 Status. J Bone Miner Res 2022; 37:2443-2455. [PMID: 36128889 PMCID: PMC10092614 DOI: 10.1002/jbmr.4709] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 09/04/2022] [Accepted: 09/17/2022] [Indexed: 01/19/2023]
Abstract
Folate, vitamins B12, B6, and riboflavin are required for one-carbon metabolism and may affect bone health, but no previous randomized trial has investigated all four nutrients in this context. We investigated the effect of low-dose B-vitamins for 2 years on bone mineral density (BMD) in a dual-centered, 2-year randomized controlled trial (RCT) in adults aged ≥50 years. Eligible participants not consuming B-vitamin supplements or fortified foods >4 times weekly were randomized to receive daily either combined folic acid (200 μg), vitamin B12 (10 μg), vitamin B6 (10 mg), and riboflavin (5 mg), or "active" placebo, whereby both the intervention and placebo groups received vitamin D (10 μg). BMD was assessed before and after intervention using dual-energy X-ray absorptiometry (DXA) scanning of the total hip, femoral neck, and lumbar spine (L1 to L4). Of 205 eligible participants randomized, 167 completed the trial in full. B-vitamin intervention resulted in increases in serum folate (p < 0.001), serum B12 (p < 0.001), and plasma pyridoxal-5-phosphate (p < 0.001) and decreases in functional biomarkers of B-vitamin status, erythrocyte glutathione reductase activation coefficient (p < 0.001), serum methylmalonic acid (MMA; p < 0.001), and serum total homocysteine (p < 0.001). B-vitamin intervention had no overall effect on BMD, which declined in both treatment groups by approximately 1% (ranging from -0.7% to -1.4%). However, in participants with lower baseline B12 status (serum B12 <246 pmol/L or MMA ≥0.22 μmol/L), B-vitamin intervention reduced the 2-year BMD decline versus placebo: adjusted mean (95% confidence interval [CI]) change of -0.003 (-0.008, 0.002) versus -0.015 (-0.021, -0.010) g/cm2 at the total hip and -0.004 (-0.010, 0.001) versus -0.013 (-0.018, -0.007) g/cm2 at the femoral neck. In conclusion, the findings indicate that although low-dose B-vitamin intervention for 2 years had no overall effect on BMD, improving B-vitamin status appears to have specific benefits for bone health in adults with lower B12 status. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Michelle Clements
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Maria Heffernan
- UCD School of Agriculture and Food Science, Institute of Food and Health, Conway Institute, University College Dublin, Dublin, Ireland
| | - Mary Ward
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Leane Hoey
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Leanne C Doherty
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Roberta Hack Mendes
- UCD School of Agriculture and Food Science, Institute of Food and Health, Conway Institute, University College Dublin, Dublin, Ireland
| | - Michelle M Clarke
- UCD School of Agriculture and Food Science, Institute of Food and Health, Conway Institute, University College Dublin, Dublin, Ireland
| | - Catherine F Hughes
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Ingrid Love
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Shauna Murphy
- Section of Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Dublin, Ireland
| | - Eilish McDermott
- Section of Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Dublin, Ireland
| | - Jennifer Grehan
- Section of Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Dublin, Ireland
| | | | - Liadhan B McAnena
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - J J Strain
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Lorraine Brennan
- UCD School of Agriculture and Food Science, Institute of Food and Health, Conway Institute, University College Dublin, Dublin, Ireland
| | - Helene McNulty
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
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13
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Jarrett H, McNulty H, Hughes CF, Pentieva K, Strain JJ, McCann A, McAnena L, Cunningham C, Molloy AM, Flynn A, Hopkins SM, Horigan G, O'Connor C, Walton J, McNulty BA, Gibney MJ, Lamers Y, Ward M. Vitamin B-6 and riboflavin, their metabolic interaction, and relationship with MTHFR genotype in adults aged 18-102 years. Am J Clin Nutr 2022; 116:1767-1778. [PMID: 36264281 PMCID: PMC9761749 DOI: 10.1093/ajcn/nqac240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 07/15/2022] [Accepted: 08/27/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The generation of the active form of vitamin B-6, pyridoxal 5'-phosphate (PLP), in tissues is dependent upon riboflavin as flavin mononucleotide, but whether this interaction is important for maintaining vitamin B-6 status is unclear. OBJECTIVE To investigate vitamin B-6 and riboflavin status, their metabolic interaction, and relationship with methylenetetrahydrofolate reductase (MTHFR) genotype in adulthood. METHODS Data from 5612 adults aged 18-102 y were drawn from the Irish National Adult Nutrition Survey (NANS; population-based sample) and the Trinity-Ulster Department of Agriculture (TUDA) and Genovit cohorts (volunteer samples). Plasma PLP and erythrocyte glutathione reductase activation coefficient (EGRac), as a functional indicator of riboflavin, were determined. RESULTS Older (≥65 y) compared with younger (<65 y) adults had significantly lower PLP concentrations (P < 0.001). A stepwise decrease in plasma PLP was observed across riboflavin categories, from optimal (EGRac ≤1.26), to suboptimal (EGRac: 1.27-1.39), to deficient (EGRac ≥1.40) status, an effect most pronounced in older adults (mean ± SEM: 76.4 ± 0.9 vs 65.0 ± 1.1 vs 55.4 ± 1.2 nmol/L; P < 0.001). In individuals with the variant MTHFR 677TT genotype combined with riboflavin deficiency, compared with non-TT (CC/CT) genotype participants with sufficient riboflavin, we observed PLP concentrations of 52.1 ± 2.9 compared with 76.8 ±0.7 nmol/L (P < 0.001). In participants with available dietary data (i.e., NANS cohort, n = 936), PLP was associated with vitamin B-6 intake (nonstandardized regression coefficient β: 2.49; 95% CI 1.75, 3.24; P < 0.001), supplement use (β: 81.72; 95% CI: 66.01, 97.43; P < 0.001), fortified food (β: 12.49; 95% CI: 2.08, 22.91; P = 0.019), and EGRac (β: -65.81; 95% CI: -99.08, -32.54; P < 0.001), along with BMI (β: -1.81; 95% CI: -3.31, -0.30; P = 0.019). CONCLUSIONS These results are consistent with the known metabolic dependency of PLP on flavin mononucleotide (FMN) and suggest that riboflavin may be the limiting nutrient for maintaining vitamin B-6 status, particularly in individuals with the MTHFR 677TT genotype. Randomized trials are necessary to investigate the PLP response to riboflavin intervention within the dietary range. The TUDA study and the NANS are registered at www.ClinicalTrials.gov as NCT02664584 (27 January 2016) and NCT03374748 (15 December 2017), respectively.Clinical Trial Registry details: Trinity-Ulster-Department of Agriculture (TUDA) study, ClinicalTrials.gov no. NCT02664584 (January 27th 2016); National Adult Nutrition Survey (NANS), ClinicalTrials.gov no. NCT03374748 (December 15th 2017).
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Affiliation(s)
- Harry Jarrett
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, United Kingdom
| | | | - Catherine F Hughes
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, United Kingdom
| | - Kristina Pentieva
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, United Kingdom
| | - J J Strain
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, United Kingdom
| | - Adrian McCann
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, United Kingdom
| | - Liadhan McAnena
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, United Kingdom
| | | | - Anne M Molloy
- School of Medicine and School of Biochemistry and Immunology, Trinity College, Dublin, Ireland
| | - Albert Flynn
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Sinead M Hopkins
- Institute of Food and Health, University College Dublin, Dublin, Ireland
| | - Geraldine Horigan
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, United Kingdom
| | - Ciara O'Connor
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, United Kingdom
| | - Janette Walton
- Department of Biological Sciences, Munster Technological University, Cork, Ireland
| | - Breige A McNulty
- Institute of Food and Health, University College Dublin, Dublin, Ireland
| | - Michael J Gibney
- Institute of Food and Health, University College Dublin, Dublin, Ireland
| | - Yvonne Lamers
- Food Nutrition and Health Program, Faculty of Land and Food Systems, University of British Columbia, Vancouver, Canada
| | - Mary Ward
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, United Kingdom
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14
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Zhang B, Dong W, Ma Z, Duan S, Han R, Lv Z, Liu X, Mao Y. Hyperbaric oxygen improves depression-like behaviors in chronic stress model mice by remodeling gut microbiota and regulating host metabolism. CNS Neurosci Ther 2022; 29:239-255. [PMID: 36261870 PMCID: PMC9804075 DOI: 10.1111/cns.13999] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 09/09/2022] [Accepted: 09/30/2022] [Indexed: 02/06/2023] Open
Abstract
AIMS There is growing evidence that the gut microbiota plays a significant part in the pathophysiology of chronic stress. The dysbiosis of the gut microbiota closely relates to dysregulation of microbiota-host cometabolism. Composition changes in the gut microbiota related to perturbations in metabolic profiles are vital risk factors for disease development. Hyperbaric oxygen therapy is commonly applied as an alternative or primary therapy for various diseases. Therefore, a metabolic and gut bacteria perspective is essential to uncover possible mechanisms of chronic stress and the therapeutic effect of hyperbaric oxygenation. We determined that there were significantly disturbed metabolites and disordered gut microbiota between control and chronic stress group. The study aims to offer further information on the interactions between host metabolism, gut microbiota, and chronic stress. METHODS At present, chronic unpredictable mild stress is considered the most widespread method of modeling chronic stress in animals, so we used a chronic unpredictable mild stress mouse model to characterize changes in the metabolome and microbiome of depressed mice by combining 16S rRNA gene sequencing and UHPLC-MS/MS-based metabolomics. Pearson's correlation-based clustering analysis was performed with above metabolomics and fecal microbiome data to determine gut microbiota-associated metabolites. RESULTS We found that 18 metabolites showed a significant correlation with campylobacterota. Campylobacterota associated metabolites were significantly enriched mainly in the d-glutamate and d-glutamine metabolism. Hyperoxia treatment may improve depression-like behaviors in chronic stress model mice through regulating the disrupted metabolites. CONCLUSIONS Hyperbaric oxygen improves depression-like behaviors in chronic stress model mice by remodeling Campylobacterota associated metabolites.
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Affiliation(s)
- Bohan Zhang
- Department of Anesthesiology and Surgical Intensive Care Unit, Xinhua HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| | - Wenwen Dong
- Department of Anesthesiology and Surgical Intensive Care Unit, Xinhua HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| | - Zhixin Ma
- Translational Medical InstituteShanghai UniversityShanghaiChina
| | - Shuxian Duan
- Department of Anesthesiology and Surgical Intensive Care Unit, Xinhua HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| | - Ruina Han
- Translational Medical InstituteShanghai UniversityShanghaiChina
| | - Zhou Lv
- Department of Anesthesiology and Surgical Intensive Care Unit, Xinhua HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| | - Xinru Liu
- Translational Medical InstituteShanghai UniversityShanghaiChina
| | - Yanfei Mao
- Department of Anesthesiology and Surgical Intensive Care Unit, Xinhua HospitalShanghai Jiaotong University School of MedicineShanghaiChina
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15
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Sparling TM, Deeney M, Cheng B, Han X, Lier C, Lin Z, Offner C, Santoso MV, Pfeiffer E, Emerson JA, Amadi FM, Mitu K, Corvalan C, Verdeli H, Araya R, Kadiyala S. Systematic evidence and gap map of research linking food security and nutrition to mental health. Nat Commun 2022; 13:4608. [PMID: 35941261 PMCID: PMC9359994 DOI: 10.1038/s41467-022-32116-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 07/18/2022] [Indexed: 11/24/2022] Open
Abstract
Connections between food security and nutrition (FSN) and mental health have been analytically investigated, but conclusions are difficult to draw given the breadth of literature. Furthermore, there is little guidance for continued research. We searched three databases for analytical studies linking FSN to mental health. Out of 30,896 records, we characterized and mapped 1945 studies onto an interactive Evidence and Gap Map (EGM). In these studies, anthropometry (especially BMI) and diets were most linked to mental health (predominantly depression). There were fewer studies on infant and young child feeding, birth outcomes, and nutrient biomarkers related to anxiety, stress, and mental well-being. Two-thirds of studies hypothesized FSN measures as the exposure influencing mental health outcomes. Most studies were observational, followed by systematic reviews as the next largest category of study. One-third of studies were carried out in low- and middle-income countries. This map visualizes the extent and nature of analytical studies relating FSN to mental health and may be useful in guiding future research. There is a broad range of research available on the relationship between food security and mental health. Here the authors carry out a systematic mapping of evidence on food security and nutrition related to mental health and identifies trends in themes, setting, and study design over the 20 year period studied.
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Affiliation(s)
- Thalia M Sparling
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Megan Deeney
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Bryan Cheng
- Global Mental Health Lab, Teachers College, Columbia University, New York, NY, USA
| | - Xuerui Han
- Global Mental Health Lab, Teachers College, Columbia University, New York, NY, USA
| | - Chiara Lier
- Global Mental Health Lab, Teachers College, Columbia University, New York, NY, USA
| | - Zhuozhi Lin
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Maryland, MD, USA
| | - Claudia Offner
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | | | | | | | | | - Khadija Mitu
- Department of Anthropology, University of Chittagong, Chittagong, Bangladesh
| | - Camila Corvalan
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Helen Verdeli
- Global Mental Health Lab, Teachers College, Columbia University, New York, NY, USA
| | - Ricardo Araya
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Suneetha Kadiyala
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
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16
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Dyer AH, Laird E, Hoey L, Hughes CF, McNulty H, Ward M, Strain JJ, O’Kane M, Tracey F, Molloy AM, Cunningham C, Sexton DJ, McCarroll K. Reduced kidney function is associated with poorer domain-specific cognitive performance in community-dwelling older adults. Int J Geriatr Psychiatry 2022; 37:10.1002/gps.5771. [PMID: 35719039 PMCID: PMC9327725 DOI: 10.1002/gps.5771] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 06/01/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Whilst chronic kidney disease has been associated with cognitive impairment, the association between reduced estimated Glomerular Filtration Rate (eGFR) and domain-specific cognitive performance is less clear and may represent an important target for the promotion of optimal brain health in older adults. METHODS Participants aged >60 years from the Trinity-Ulster-Department of Agriculture study underwent detailed cognitive assessment using the Mini-Mental State Examination (Mini-Mental State Examination (MMSE)), Frontal Assessment Battery (FAB) and Repeatable Battery for Assessment of Neuropsychological Status (RBANS). Poisson and linear regression models assessed the relationship between eGFR strata and cognitive performance. RESULTS In 4887 older adults (73.9 ± 8.3 years; 67.7% female), declining eGFR strata was associated with greater likelihood of error on the MMSE/FAB and poorer overall performance on the RBANS. Following robust covariate adjustment, findings were greatest for GFR <45 ml/ml/1.73 m2 (Incidence Rate Ratio: 1.17; 95% CI 1.08, 1.27; p < 0.001 for MMSE; IRR: 1.13; 95% CI 1.04, 1.13; p < 0.001 for FAB; β: -3.66; 95% CI -5.64, -1.86; p < 0.001 for RBANS). Additionally, eGFR <45 ml/ml/1.73 m2 was associated with poorer performance on all five RBANS domains, with greatest effect sizes for immediate memory, delayed memory and attention. Associations were strongest in those aged 60-70, with no associations observed in those >80 years. CONCLUSIONS Reduced kidney function was associated with poorer global and domain-specific neuropsychological performance. Associations were strongest with eGFR <45 ml/min/1.73 m2 and in those aged 60-70 years, suggesting that this population may potentially benefit from potential multi-domain interventions aimed at promoting optimal brain health in older adults.
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Affiliation(s)
- Adam H. Dyer
- Mercer's Institute for Successful AgeingSt James's HospitalDublinIreland,Wellcome‐HRB Clinical Research FacilitySt James's HospitalDublinIreland,Department of Medical GerontologySchool of MedicineTrinity College DublinDublinIreland
| | - Eamon Laird
- Department of Medical GerontologySchool of MedicineTrinity College DublinDublinIreland
| | - Leane Hoey
- The Nutrition Innovation Centre for Food and Health (NICHE)School of Biomedical SciencesUlster UniversityColeraineNorthern IrelandUK
| | - Catherine F. Hughes
- The Nutrition Innovation Centre for Food and Health (NICHE)School of Biomedical SciencesUlster UniversityColeraineNorthern IrelandUK
| | - Helene McNulty
- The Nutrition Innovation Centre for Food and Health (NICHE)School of Biomedical SciencesUlster UniversityColeraineNorthern IrelandUK
| | - Mary Ward
- The Nutrition Innovation Centre for Food and Health (NICHE)School of Biomedical SciencesUlster UniversityColeraineNorthern IrelandUK
| | - J. J. Strain
- The Nutrition Innovation Centre for Food and Health (NICHE)School of Biomedical SciencesUlster UniversityColeraineNorthern IrelandUK
| | - Maurice O’Kane
- Clinical Chemistry LaboratoryAltnagelvin HospitalWestern Health and Social Care TrustLondonderryNorthern IrelandUK
| | - Fergal Tracey
- Causeway HospitalNorthern Health and Social Care TrustColeraineNorthern IrelandUK
| | | | - Conal Cunningham
- Mercer's Institute for Successful AgeingSt James's HospitalDublinIreland,Wellcome‐HRB Clinical Research FacilitySt James's HospitalDublinIreland
| | - Donal J. Sexton
- Department of Medical GerontologySchool of MedicineTrinity College DublinDublinIreland,School of MedicineTrinity College DublinDublinIreland,Trinity Health Kidney CentreSchool of MedicineTrinity College DublinDublinIreland
| | - Kevin McCarroll
- Mercer's Institute for Successful AgeingSt James's HospitalDublinIreland,Department of Medical GerontologySchool of MedicineTrinity College DublinDublinIreland
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Nutrition policy: developing scientific recommendations for food-based dietary guidelines for older adults living independently in Ireland. Proc Nutr Soc 2022; 81:49-61. [DOI: 10.1017/s0029665122001008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Older adults (≥65 years) are the fastest growing population group. Thus, ensuring nutritional well-being of the ‘over-65s’ to optimise health is critically important. Older adults represent a diverse population – some are fit and healthy, others are frail and many live with chronic conditions. Up to 78% of older Irish adults living independently are overweight or obese. The present paper describes how these issues were accommodated into the development of food-based dietary guidelines for older adults living independently in Ireland. Food-based dietary guidelines previously established for the general adult population served as the basis for developing more specific recommendations appropriate for older adults. Published international reports were used to update nutrient intake goals for older adults, and available Irish data on dietary intakes and nutritional status biomarkers were explored from a population-based study (the National Adult Nutrition Survey; NANS) and two longitudinal cohorts: the Trinity-Ulster and Department of Agriculture (TUDA) and the Irish Longitudinal Study on Ageing (TILDA) studies. Nutrients of public health concern were identified for further examination. While most nutrient intake goals were similar to those for the general adult population, other aspects were identified where nutritional concerns of ageing require more specific food-based dietary guidelines. These include, a more protein-dense diet using high-quality protein foods to preserve muscle mass; weight maintenance in overweight or obese older adults with no health issues and, where weight-loss is required, that lean tissue is preserved; the promotion of fortified foods, particularly as a bioavailable source of B vitamins and the need for vitamin D supplementation.
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Maratha S, Sharma V, Walia V. Possible involvement of NO-sGC-cGMP signaling in the antidepressant like effect of pyridoxine in mice. Metab Brain Dis 2022; 37:173-183. [PMID: 34739660 DOI: 10.1007/s11011-021-00858-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/23/2021] [Indexed: 11/28/2022]
Abstract
The present study was designed to determine the antidepressant like effect of pyridoxine in mice. Pyridoxine (12.5, 25 and 50 mg/kg, i.p.) was administered to the mice and depression related behavioral and neurochemical alterations were determined. It was observed that pyridoxine (50 mg/kg, i.p.) treatment decreased the immobility period in tail suspension test (TST) and forced swim test (FST) significantly as compared to control. Pyridoxine (50 mg/kg, i.p.) treatment increased the level of serotonin (5-HT) and decreased the level of nitrite in the brain of mice significantly as compared to control. Pyridoxine thus confer antidepressant like effect by increasing the level of 5-HT and by decreasing the level of nitrite in the brain of mice. Further the influence of nitric oxide (NO)/ soluble guanylate cyclase (sGC)/ cyclic guanosine monophosphate (cGMP) in antidepressant-like effect of pyridoxine was studied. It was observed that the pretreatment of NO donor (i.e. L-Arginine) and cGMP modulator (i.e. sildenafil) counteracted while the pretreatment of NO/sGC inhibitor (i.e. methylene blue) potentiated the effect of pyridoxine in TST and FST. Pretreatment of NO donor did not influence, pretreatment of NO/sGC inhibitor decreased while the pretreatment of cGMP modulator increased the level of brain nitrite in pyridoxine treated mice. Further the pretreatment of NO donor and cGMP modulator decreased while the pretreatment of NO/sGC inhibitor increased the level of brain serotonin in pyridoxine treated mice. Pyridoxine thus exerted antidepressant like effect and NO-sGC-cGMP signaling modulated the antidepressant like effect of pyridoxine in mice.
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Affiliation(s)
- Sushma Maratha
- SGT College of Pharmacy, SGT University, Gurugram, India
| | - Vijay Sharma
- SGT College of Pharmacy, SGT University, Gurugram, India
| | - Vaibhav Walia
- SGT College of Pharmacy, SGT University, Gurugram, India.
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Lanuza F, Petermann-Rocha F, Celis-Morales C, Concha-Cisternas Y, Nazar G, Troncoso-Pantoja C, Lassere-Laso N, Martínez-Sanguinetti MA, Parra-Soto S, Zamora-Ros R, Andrés-Lacueva C, Meroño T. A healthy eating score is inversely associated with depression in older adults: results from the Chilean National Health Survey 2016-2017. Public Health Nutr 2021; 25:1-12. [PMID: 34895386 PMCID: PMC9991839 DOI: 10.1017/s1368980021004869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 12/01/2021] [Accepted: 12/09/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To investigate the relationship of a healthy eating score with depression in Chilean older adults. DESIGN Cross-sectional study. SETTING Older adults from the Chilean National Health Survey 2016-2017. Associations were analysed using complex samples multivariable logistic regressions adjusted for age, sex, socio-demographic, lifestyles (physical activity, smoking, alcohol consumption and sleep duration), BMI and clinical conditions (hypertension, diabetes, hypercholesterolaemia and cardiovascular diseases). PARTICIPANTS The number of participants was 2031 (≥ 60 years). The Composite International Diagnostic Interview-Short Form was applied to establish the diagnosis of major depressive episode. Six healthy eating habits were considered to produce the healthy eating score (range: 0-12): consumption of seafood, whole grain, dairy, fruits, vegetables and legumes. Participants were categorised according to their final scores as healthy (≥ 9), average (5-8) and unhealthy (≤ 4). RESULTS Participants with a healthy score had a higher educational level, physical activity and regular sleep hours than participants with an average and unhealthiest healthy eating score. Participants classified in the healthiest healthy eating score had an inverse association with depression (OR: 0·28, (95 % CI 0·10, 0·74)). Food items that contributed the most to this association were legumes (15·2 %) and seafood (12·7 %). CONCLUSION Older adults classified in the healthiest healthy eating score, characterised by a high consumption of legumes and seafood, showed a lower risk for depression in a representative sample of Chilean population.
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Affiliation(s)
- Fabian Lanuza
- Biomarkers and Nutrimetabolomics Laboratory, Department of Nutrition, Food Sciences and Gastronomy, Food Technology Reference Net (XIA), Nutrition and Food Safety Research Institute (INSA), Faculty of Pharmacy and Food Sciences, University of Barcelona, Avinguda Joan XXIII, 27-31, Barcelona, 08028, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Spain
- Centro de Epidemiología Cardiovascular y Nutricional (EPICYN), Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
| | - Fanny Petermann-Rocha
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
- Facultad de Medicina, Universidad Diego Portales, Santiago, Chile
| | - Carlos Celis-Morales
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
- Center for Exercise Physiology Research (CIFE), University Mayor, Santiago, Chile
- Laboratorio de Rendimiento Humano, Grupo de Estudio en Educación, Actividad Física y Salud (GEEAFyS), Universidad Católica del Maule, Talca, Chile
| | - Yeny Concha-Cisternas
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Chile
- Pedagogía en Educación Física, Facultad de Educación, Universidad Autónoma de Chile, Chile
| | - Gabriela Nazar
- Departamento de Psicología, Universidad de Concepción, Concepción, Chile
- Centro de Vida Saludable, Universidad de Concepción, Concepción, Chile
| | - Claudia Troncoso-Pantoja
- Centro de Investigación en Educación y Desarrollo (CIEDE-UCSC), Departamento de Salud Pública, Facultad de Medicina, Universidad Católica de la Santísima Concepción, Concepción, Chile
| | - Nicole Lassere-Laso
- Escuela de Nutrición y Dietética, Facultad de Salud, Universidad Santo Tomás, Chile
| | | | | | - Raul Zamora-Ros
- Biomarkers and Nutrimetabolomics Laboratory, Department of Nutrition, Food Sciences and Gastronomy, Food Technology Reference Net (XIA), Nutrition and Food Safety Research Institute (INSA), Faculty of Pharmacy and Food Sciences, University of Barcelona, Avinguda Joan XXIII, 27-31, Barcelona, 08028, Spain
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Cristina Andrés-Lacueva
- Biomarkers and Nutrimetabolomics Laboratory, Department of Nutrition, Food Sciences and Gastronomy, Food Technology Reference Net (XIA), Nutrition and Food Safety Research Institute (INSA), Faculty of Pharmacy and Food Sciences, University of Barcelona, Avinguda Joan XXIII, 27-31, Barcelona, 08028, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Spain
| | - Tomás Meroño
- Biomarkers and Nutrimetabolomics Laboratory, Department of Nutrition, Food Sciences and Gastronomy, Food Technology Reference Net (XIA), Nutrition and Food Safety Research Institute (INSA), Faculty of Pharmacy and Food Sciences, University of Barcelona, Avinguda Joan XXIII, 27-31, Barcelona, 08028, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Spain
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20
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Heffernan M, Doherty LC, Hack Mendes R, Clarke M, Hodge S, Clements M, McAnena L, Rivelsrud M, Ward M, Strain JJ, McNulty H, Brennan L. Effectiveness of a fortified drink in improving B vitamin biomarkers in older adults: a controlled intervention trial. Nutr Metab (Lond) 2021; 18:104. [PMID: 34876175 PMCID: PMC8650259 DOI: 10.1186/s12986-021-00630-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 11/25/2021] [Indexed: 11/10/2022] Open
Abstract
Background Older adults are reported to have sub-optimal B vitamin status; targeted food-based solutions may help to address this. The objectives of the OptiAge food intervention study were to develop and investigate the effectiveness of a B vitamin-fortified drink in improving B vitamin biomarkers in older Irish adults with a primary outcome of change in the B vitamin biomarker status. Methods A double-blinded randomised controlled trial was performed in parallel at University College Dublin and Ulster University. Participants aged > 50 years were recruited following screening for exclusion criteria (i.e. taking medications known to interfere with B vitamin metabolism, supplements containing B vitamins, consuming > 4 portions of B vitamin-fortified foods per week or diagnosed with gastrointestinal, liver or pulmonary disease). Recruited participants meeting the inclusion criteria were randomised (by sex and study centre) to receive daily for 16 weeks either B vitamin-fortified or placebo drinks as developed by Smartfish, Norway. Each B vitamin-fortified drink (200 ml) contained 200 µg folic acid, 10 µg vitamin B12, 10 mg vitamin B6 and 5 mg riboflavin, while the placebo was an identical, isocaloric formulation without added B vitamins. Fasting blood samples were collected pre- and post-intervention which were used to measure the primary outcome of change in B vitamin biomarker levels. Results A total of 95 participants were randomised, of which 81 commenced the trial. Of these, 70 completed (37 in the active and 33 in the placebo groups). Intention to treat (ITT) analysis of the B vitamins demonstrated a significant improvement in all B vitamin biomarkers in the active compared to placebo groups: p < 0.01 for each of serum folate, serum vitamin B12 and plasma pyridoxal 5′-phosphate (vitamin B6) and the functional riboflavin biomarker, erythrocyte glutathione reductase activation coefficient (EGRac). Correspondingly, a significant lowering of serum homocysteine from 11.9 (10.3–15.1) µmol/L to 10.6 (9.4–13.0) µmol/L was observed in response to the active treatment (P < 0.001). Similar results were seen in a per-protocol analysis. Conclusions The results demonstrate that a B vitamin-fortified drink was effective in optimising B vitamin status, making this a useful intervention option to improve B vitamin status in older adults. Trial registration ISRCTN, ISRCTN61709781—Retrospectively registered, https://www.isrctn.com/ISRCTN61709781 Supplementary Information The online version contains supplementary material available at 10.1186/s12986-021-00630-8.
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Affiliation(s)
- Maria Heffernan
- UCD School of Agriculture and Food Science, Institute of Food and Health, Conway Institute, University College Dublin, Belfield, Dublin 4, Ireland
| | - Leanne C Doherty
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Roberta Hack Mendes
- UCD School of Agriculture and Food Science, Institute of Food and Health, Conway Institute, University College Dublin, Belfield, Dublin 4, Ireland
| | - Michelle Clarke
- UCD School of Agriculture and Food Science, Institute of Food and Health, Conway Institute, University College Dublin, Belfield, Dublin 4, Ireland
| | - Stephanie Hodge
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Michelle Clements
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Liadhan McAnena
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | | | - Mary Ward
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - J J Strain
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Helene McNulty
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Lorraine Brennan
- UCD School of Agriculture and Food Science, Institute of Food and Health, Conway Institute, University College Dublin, Belfield, Dublin 4, Ireland.
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Sparling TM, Cheng B, Deeney M, Santoso MV, Pfeiffer E, Emerson JA, Amadi FM, Mitu K, Corvalan C, Verdeli H, Araya R, Kadiyala S. Global Mental Health and Nutrition: Moving Toward a Convergent Research Agenda. Front Public Health 2021; 9:722290. [PMID: 34722437 PMCID: PMC8548935 DOI: 10.3389/fpubh.2021.722290] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 09/09/2021] [Indexed: 01/05/2023] Open
Abstract
Both malnutrition and poor mental health are leading sources of global mortality, disease, and disability. The fields of global food security and nutrition (FSN) and mental health have historically been seen as separate fields of research. Each have undergone substantial transformation, especially from clinical, primary care orientations to wider, sociopolitical approaches to achieve Sustainable Development Goals. In recent years, the trajectories of research on mental health and FSN are further evolving into an intersection of evidence. FSN impacts mental health through various pathways such as food insecurity and nutrients important for neurotransmission. Mental health drives FSN outcomes, for example through loss of motivation and caregiving capacities. They are also linked through a complex and interrelated set of determinants. However, the heterogeneity of the evidence base limits inferences about these important dynamics. Furthermore, interdisciplinary projects and programmes are gaining ground in methodology and impact, but further guidance in integration is much needed. An evidence-driven conceptual framework should inform hypothesis testing and programme implementation. The intersection of mental health and FSN can be an opportunity to invest holistically in advancing thinking in both fields.
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Affiliation(s)
- Thalia M Sparling
- Innovative Methods and Metrics for Agriculture, Nutrition and Health Actions (IMMANA), London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Bryan Cheng
- Global Mental Health Lab, Teachers College, Columbia University, New York, NY, United States
| | - Megan Deeney
- Innovative Methods and Metrics for Agriculture, Nutrition and Health Actions (IMMANA), London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Marianne V Santoso
- Department of Anthropology, Northwestern University, Evanston, IL, United States
| | - Erin Pfeiffer
- Independent Consultant, Winston-Salem, NC, United States
| | | | | | - Khadija Mitu
- Department of Anthropology, University of Chittagong, Chittagong, Bangladesh
| | - Camila Corvalan
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Helen Verdeli
- Global Mental Health Lab, Teachers College, Columbia University, New York, NY, United States
| | - Ricardo Araya
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Suneetha Kadiyala
- Innovative Methods and Metrics for Agriculture, Nutrition and Health Actions (IMMANA), London School of Hygiene and Tropical Medicine, London, United Kingdom
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22
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Dyer AH, Briggs R, Laird E, Hoey L, Hughes CF, McNulty H, Ward M, Strain JJ, Molloy AM, Cunningham C, McCarroll K. Glycated haemoglobin (HbA 1c ), diabetes and neuropsychological performance in community-dwelling older adults. Diabet Med 2021; 38:e14668. [PMID: 34343367 DOI: 10.1111/dme.14668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/17/2021] [Accepted: 08/02/2021] [Indexed: 12/01/2022]
Abstract
AIMS Given that diabetes is associated with cognitive impairment and dementia in later life, we aimed to investigate the relationship between glycated haemoglobin (HbA1c ), diabetes and domain-specific neuropsychological performance in older adults. METHODS Cross-sectional cohort study using data from the Trinity-Ulster-Department of Agriculture (TUDA) study. Participants underwent detailed cognitive and neuropsychological assessment using the Mini-Mental State Examination (MMSE), Frontal Assessment Battery (FAB) and Repeatable Assessment for Neuropsychological Status (RBANS). Linear regression was used to assess associations between HbA1c , diabetes status and neuropsychological performance, with adjustment for important clinical covariates. RESULTS Of 4938 older adults (74.1 ± 8.3 years; 66.9% female), 16.3% (n = 803) had diabetes (HbA1c ≥ 6.5%; 48 mmol/mol), with prediabetes (HbA1c ≥ 5.7%-6.4%; 39-47 mmol/mol) present in 28.3% (n = 1395). Increasing HbA1c concentration was associated with poorer overall performance on the FAB [β: -0.01 (-0.02, -0.00); p = 0.04 per % increase] and RBANS [β = -0.66 (-1.19, -0.13); p = 0.02 per % increase]. Increasing HbA1c was also associated with poorer performance on immediate memory, visuo-spatial, language and attention RBANS domains. Diabetes was associated poorer performance on neuropsychological tests of immediate memory, language, visual-spatial and attention. CONCLUSIONS Both increasing HbA1c and the presence of diabetes were associated with poorer cognitive and domain-specific performance in older adults. HbA1c , and not just diabetes status per se, may represent an important target in the promotion of optimal brain health in older adults.
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Affiliation(s)
- Adam H Dyer
- Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Ireland
- Wellcome-HRB Clinical Research Facility, St James's Hospital, Dublin, Ireland
| | - Robert Briggs
- Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
| | - Eamon Laird
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Ireland
| | - Leane Hoey
- The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Catherine F Hughes
- The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Helene McNulty
- The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Mary Ward
- The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - J J Strain
- The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Anne M Molloy
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Conal Cunningham
- Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Ireland
| | - Kevin McCarroll
- Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Ireland
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Dyer AH, Laird E, Hoey L, Hughes CF, McNulty H, Ward M, Strain JJ, Molloy AM, Cunningham C, McCarroll K. Long-term anticholinergic, benzodiazepine and Z-drug use in community-dwelling older adults: What is the impact on cognitive and neuropsychological performance? Int J Geriatr Psychiatry 2021; 36:1767-1777. [PMID: 34227695 DOI: 10.1002/gps.5598] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 06/22/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND Long-term use of anticholinergics, benzodiazepines and related drugs (or "Z-drugs") have been associated with cognitive impairment and dementia. However, the relationship of these medications with cognitive function and domain-specific neuropsychological performance in older adults without dementia, is unclear. METHODS 5135 older adults (74.0 ± 8.3 years; 67.4% female) without a diagnosis of dementia were recruited in Ireland to the Trinity-Ulster-Department of Agriculture (TUDA) study. Detailed cognitive and neuropsychological assessment was conducted using the Mini-Mental State Examination (MMSE), Frontal Assessment Battery (FAB) and Repeatable Battery for Assessment of Neuropsychological Status (RBANS). RESULTS A total of 44% (2259 of 5153) used either a potential or definite anticholinergic medication. Overall, 9.7% (n = 500) used a definite anticholinergic medication. Regular benzodiazepine use was reported by 7% (n = 363), whilst 7.5% (n = 387) used a "Z-drug". Use of definite, but not potential anticholinergic medication was associated with poorer performance on all three assessments (β: -0.09; 95% CI: -0.14, -0.03, p = 0.002 for MMSE; β: -0.04; 95% CI: -0.06, -0.02; p < 0.001 for FAB; β: -4.15; 95% CI: -5.64, -2.66; p < 0.001 for RBANS) in addition to all domains of the RBANS. Regular benzodiazepine use was also associated with poorer neuropsychological test performance, especially in Immediate Memory (β: -4.98; 95% CI: -6.81, -3.15; p < 0.001) and Attention (β: -6.81; 95% CI: -8.60, -5.03; p < 0.001) RBANS domains. CONCLUSIONS Regular use of definite anticholinergic medications and benzodiazepines, but not potential anticholinergics or "Z-drugs", was associated with poorer overall and domain-specific neuropsychological performance in older adults.
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Affiliation(s)
- Adam H Dyer
- Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
| | - Eamon Laird
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Leane Hoey
- The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, NI, UK
| | - Catherine F Hughes
- The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, NI, UK
| | - Helene McNulty
- The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, NI, UK
| | - Mary Ward
- The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, NI, UK
| | - J J Strain
- The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, NI, UK
| | - Anne M Molloy
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Conal Cunningham
- Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
| | - Kevin McCarroll
- Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
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24
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Porter KM, Hoey L, Hughes CF, Ward M, Clements M, Strain J, Cunningham C, Casey MC, Tracey F, O'Kane M, Pentieva K, McAnena L, McCarroll K, Laird E, Molloy AM, McNulty H. Associations of atrophic gastritis and proton-pump inhibitor drug use with vitamin B-12 status, and the impact of fortified foods, in older adults. Am J Clin Nutr 2021; 114:1286-1294. [PMID: 34134144 PMCID: PMC8488868 DOI: 10.1093/ajcn/nqab193] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 05/18/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Atrophic gastritis (AG) and use of proton pump inhibitors (PPIs) result in gastric acid suppression that can impair the absorption of vitamin B-12 from foods. The crystalline vitamin B-12 form, found in fortified foods, does not require gastric acid for its absorption and could thus be beneficial for older adults with hypochlorhydria, but evidence is lacking. OBJECTIVES To investigate associations of AG and PPI use with vitamin B-12 status, and the potential protective role of fortified foods, in older adults. METHODS Eligible participants (n = 3299) not using vitamin B-12 supplements were drawn from the Trinity-Ulster and Department of Agriculture cohort, a study of noninstitutionalized adults aged ≥60 y and recruited in 2008-2012. Vitamin B-12 status was measured using 4 biomarkers, and vitamin B-12 deficiency was defined as a combined indicator value < -0.5. A pepsinogen I:II ratio <3 was considered indicative of AG. RESULTS AG was identified in 15% of participants and associated with significantly lower serum total vitamin B-12 (P < 0.001) and plasma holotranscobalamin (holoTC; P < 0.001), and higher prevalence of vitamin B-12 deficiency (38%), compared with PPI users (21%) and controls (without AG and nonusers of PPIs; 15%; P < 0.001). PPI drugs were used (≥6 mo) by 37% of participants and were associated with lower holoTC concentrations, but only in participants taking higher doses (≥30 mg/d). Regular, compared with nonregular, consumption of fortified foods (i.e., ≥5 and 0-4 portions/wk, respectively) was associated with higher vitamin B-12 biomarkers in all participants, but inadequate to restore normal vitamin B-12 status in those with AG. CONCLUSIONS Older adults who have AG and/or use higher doses of PPIs are more likely to have indicators of vitamin B-12 deficiency. Fortified foods, if consumed regularly, were associated with enhanced vitamin B-12 status, but higher levels of added vitamin B-12 than currently provided could be warranted to optimize status in people with AG.
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Affiliation(s)
- Kirsty M Porter
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Leane Hoey
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Catherine F Hughes
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Mary Ward
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Michelle Clements
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Jj Strain
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Conal Cunningham
- Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Ireland
| | - Miriam C Casey
- Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Ireland
| | - Fergal Tracey
- Causeway Hospital, Northern Health and Social Care Trust, Coleraine, Northern Ireland, United Kingdom
| | - Maurice O'Kane
- Clinical Chemistry Laboratory, Western Health and Social Care Trust, Altnagelvin Hospital, Londonderry, Northern Ireland, United Kingdom
| | - Kristina Pentieva
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Liadhan McAnena
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Kevin McCarroll
- Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Ireland
| | - Eamon Laird
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Anne M Molloy
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Helene McNulty
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom
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25
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Wu Y, Zhang L, Li S, Zhang D. Associations of dietary vitamin B1, vitamin B2, vitamin B6, and vitamin B12 with the risk of depression: a systematic review and meta-analysis. Nutr Rev 2021; 80:351-366. [PMID: 33912967 DOI: 10.1093/nutrit/nuab014] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 01/12/2021] [Accepted: 02/24/2021] [Indexed: 01/24/2023] Open
Abstract
CONTEXT The results from epidemiologic studies on the intake of dietary vitamin B1, B2, B6, and B12 and association with risk of developing depression have been inconsistent. OBJECTIVE The purpose of this systematic review and meta-analysis was to summarize the existing evidence and synthesize the results. DATA SOURCES The databases of Web of Science and PubMed were searched for relevant articles published in English until September 2020. STUDY SELECTION Observational studies that evaluated the associations between depression and dietary vitamin B1, B2, B6, and B12 were included in this study. DATA EXTRACTION The job of data extraction was undertaken by 2 authors, and the pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated using a fixed-effects model. RESULTS Thirteen articles related to 18 studies were eligible for inclusion in this systematic review and meta-analysis. The pooled RR (95% CI) of depression for the highest vs the lowest category of dietary vitamin B1, B2, B6, and B12 was 0.69 (0.55-0.87), 0.77 (0.67-0.89), 0.81 (0.71-0.93), and 0.86 (0.75-0.99), respectively. The pooled RR (95% CI) of depression for the highest vs the lowest category of dietary vitamin B2 was 0.80 (0.64-0.99) in females and 0.83 (0.67-1.02) in males, for dietary vitamin B6 was 0.71 (0.59-0.86) in females and 0.92 (0.76-1.12) in males, and for dietary vitamin B12 was 0.79 (0.65-0.97) in females and 0.94 (0.77-1.15) in males. CONCLUSION This study suggested that the intake of dietary vitamin B1, B2, B6, and B12 may be inversely associated with the risk of depression; the inverse associations observed between depression and intake of dietary vitamin B2, B6, and B12 were significant in females, but not in males. Further studies are needed to confirm these results.
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Affiliation(s)
- Yanjun Wu
- Y. Wu, L. Zhang, S. Li, and D. Zhang are with the Department of Epidemiology and Health Statistics, the College of Public Health of Qingdao University, Qingdao, People's Republic of China
| | - Liming Zhang
- Y. Wu, L. Zhang, S. Li, and D. Zhang are with the Department of Epidemiology and Health Statistics, the College of Public Health of Qingdao University, Qingdao, People's Republic of China
| | - Suyun Li
- Y. Wu, L. Zhang, S. Li, and D. Zhang are with the Department of Epidemiology and Health Statistics, the College of Public Health of Qingdao University, Qingdao, People's Republic of China
| | - Dongfeng Zhang
- Y. Wu, L. Zhang, S. Li, and D. Zhang are with the Department of Epidemiology and Health Statistics, the College of Public Health of Qingdao University, Qingdao, People's Republic of China
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26
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Aly J, Engmann O. The Way to a Human's Brain Goes Through Their Stomach: Dietary Factors in Major Depressive Disorder. Front Neurosci 2020; 14:582853. [PMID: 33364919 PMCID: PMC7750481 DOI: 10.3389/fnins.2020.582853] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 11/09/2020] [Indexed: 12/12/2022] Open
Abstract
Globally, more than 250 million people are affected by depression (major depressive disorder; MDD), a serious and debilitating mental disorder. Currently available treatment options can have substantial side effects and take weeks to be fully effective. Therefore, it is important to find safe alternatives, which act more rapidly and in a larger number of patients. While much research on MDD focuses on chronic stress as a main risk factor, we here make a point of exploring dietary factors as a somewhat overlooked, yet highly promising approach towards novel antidepressant pathways. Deficiencies in various groups of nutrients often occur in patients with mental disorders. These include vitamins, especially members of the B-complex (B6, B9, B12). Moreover, an imbalance of fatty acids, such as omega-3 and omega-6, or an insufficient supply with minerals, including magnesium and zinc, are related to MDD. While some of them are relevant for the synthesis of monoamines, others play a crucial role in inflammation, neuroprotection and the synthesis of growth factors. Evidence suggests that when deficiencies return to normal, changes in mood and behavior can be, at least in some cases, achieved. Furthermore, supplementation with dietary factors (so called "nutraceuticals") may improve MDD symptoms even in the absence of a deficiency. Non-vital dietary factors may affect MDD symptoms as well. For instance, the most commonly consumed psychostimulant caffeine may improve behavioral and molecular markers of MDD. The molecular structure of most dietary factors is well known. Hence, dietary factors may provide important molecular tools to study and potentially help treat MDD symptoms. Within this review, we will discuss the role of dietary factors in MDD risk and symptomology, and critically discuss how they might serve as auxiliary treatments or preventative options for MDD.
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Affiliation(s)
- Janine Aly
- Faculty of Medicine, Friedrich Schiller Universität, Jena, Germany
| | - Olivia Engmann
- Institute for Human Genetics, Jena University Hospital, Jena, Germany
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27
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Sangle P, Sandhu O, Aftab Z, Anthony AT, Khan S. Vitamin B12 Supplementation: Preventing Onset and Improving Prognosis of Depression. Cureus 2020; 12:e11169. [PMID: 33251075 PMCID: PMC7688056 DOI: 10.7759/cureus.11169] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 10/26/2020] [Indexed: 01/27/2023] Open
Abstract
Depression is a common mental health condition occurring across all ages, genders, and populations and is almost always multifaceted. It can manifest as a form of metabolic disorder, endocrine disorder, cardiovascular diseases, inflammatory disorders, deficiencies, or neurodegenerative disorders. Although there have been various treatment options available for the treatment of depression, it is still a sizable global health concern requiring more attention. This review article was produced by researching data and studies to prove a relationship between Vitamin B12 and depression. Numerous studies were reviewed, and based on these studies, it was concluded that supplementation of Vitamin B12 early enough can delay the onset of depression and improve the effect of anti-depressants when used in conjunction with Vitamin B12. Although other vitamins like Vitamin B6 and folate are known to have an impact on depression, we have primarily focused on Vitamin B12 in an attempt to offer the providers a foundation to address this concern with their patients prone to depression or have had a major depressive episode in their life.
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Affiliation(s)
- Prerna Sangle
- Family Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Osama Sandhu
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Zarmeena Aftab
- Family Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Adarsh Thomas Anthony
- Family Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Safeera Khan
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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28
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Jungert A, McNulty H, Hoey L, Ward M, Strain JJ, Hughes CF, McAnena L, Neuhäuser-Berthold M, Pentieva K. Riboflavin Is an Important Determinant of Vitamin B-6 Status in Healthy Adults. J Nutr 2020; 150:2699-2706. [PMID: 32805038 DOI: 10.1093/jn/nxaa225] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/26/2020] [Accepted: 07/08/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Riboflavin is required to generate the active form of vitamin B-6 (pyridoxal 5'-phosphate; PLP) in tissues, but the relevance of this metabolic interaction for nutritional status of vitamin B-6 is unclear because riboflavin biomarkers are rarely measured in human studies. OBJECTIVES The purpose of this study was to identify the determinants of biomarkers of vitamin B-6 and riboflavin status and to examine the relationship between these nutrients in healthy adults. METHODS Multiple linear regression was performed on observational data in 407 healthy adults aged 18-92 y who did not use B-vitamin supplements. Vitamin B-6 status was assessed by plasma PLP concentrations and erythrocyte glutathione reductase activation coefficient (EGRac) was used as a functional indicator of riboflavin status. RESULTS Dietary intakes of vitamin B-6 and riboflavin were below the average requirements in 10% and 29% of participants, respectively. Suboptimal status of vitamin B-6 (PLP ≤30.0 nmol/L) was more prevalent in adults aged ≥60 y than in younger participants (i.e., 14% compared with 5%), whereas a high proportion (i.e., overall 37%) of both age groups had deficient riboflavin status (EGRac ≥1.40). In multiple regression analysis, EGRac (P = 0.019) was a significant determinant of plasma PLP, along with dietary vitamin B-6 intake (P = 0.003), age (P < 0.001), BMI (kg/m2) (P = 0.031), and methylenetetrahydrofolate reductase gene (MTHFR) genotype (P < 0.001). Significant determinants of EGRac were dietary riboflavin intake (P < 0.001), age (P < 0.001) and MTHFR genotype (P = 0.020). Plasma PLP showed a stepwise decrease across riboflavin status categories from optimal (EGRac ≤1.26) to low (EGRac 1.27-1.39) to deficient status (P = 0.001), independent of dietary vitamin B-6 intake. CONCLUSIONS The findings are consistent with the known metabolic dependency of vitamin B-6 on riboflavin status and indicate that riboflavin may be the limiting nutrient, particularly in older people, for maintaining adequate vitamin B-6 status.
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Affiliation(s)
- Alexandra Jungert
- Interdisciplinary Research Center for Biosystems, Land Use and Nutrition (IFZ), Biometry and Population Genetics, Justus Liebig University, Giessen, Germany
| | - Helene McNulty
- Nutrition Innovation Centre for food and Health (NICHE), Ulster University, Coleraine, United Kingdom
| | - Leane Hoey
- Nutrition Innovation Centre for food and Health (NICHE), Ulster University, Coleraine, United Kingdom
| | - Mary Ward
- Nutrition Innovation Centre for food and Health (NICHE), Ulster University, Coleraine, United Kingdom
| | - J J Strain
- Nutrition Innovation Centre for food and Health (NICHE), Ulster University, Coleraine, United Kingdom
| | - Catherine F Hughes
- Nutrition Innovation Centre for food and Health (NICHE), Ulster University, Coleraine, United Kingdom
| | - Liadhan McAnena
- Nutrition Innovation Centre for food and Health (NICHE), Ulster University, Coleraine, United Kingdom
| | | | - Kristina Pentieva
- Nutrition Innovation Centre for food and Health (NICHE), Ulster University, Coleraine, United Kingdom
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29
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Sun J, Wang W, Zhang D. Associations of different types of dairy intakes with depressive symptoms in adults. J Affect Disord 2020; 274:326-333. [PMID: 32469823 DOI: 10.1016/j.jad.2020.05.095] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 04/06/2020] [Accepted: 05/15/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Current evidence on the associations between different types of milk products and depressive symptoms is few and controversial, and there has been no study focusing on different types of milk (whole-fat, low-fat, and skim). This study aimed to appraise their associations. METHODS This cross-sectional study included adults (N=21,924) from the National Health and Nutrition Examination Survey 2007-2016. Patient Health Questionnaire was used to evaluate depressive symptoms. Logistic regression model was implemented to assess the association of dairy consumption with depressive symptoms. RESULTS After multivariate adjustment, compared to non-consumers, the odds ratios (95% confidence intervals) of depressive symptoms for intake < 175.38 g/d and 175.38 to < 321.56 g/d of skim milk were 0.48 (0.27-0.85) and 0.46 (0.29-0.75), and 0.70 (0.55-0.88) for intake < 81.00 g/d of milk desserts, while 1.61 (1.05-2.46), 1.70 (1.15-2.50) and 1.55 (1.11-2.16) for intake < 129.63 g/d, 129.63 to < 289.75 g/d and ≥ 289.75 g/d of whole milk, respectively. These associations remained significant in stratified analyses by gender and age. Additionally, yogurt was negatively associated with depressive symptoms in both females and the age group (≥ 60 years). Low-fat milk was inversely associated with depressive symptoms for both males and the age group (≥ 60 years). Moderate creams intake was negatively associated with depressive symptoms in males. LIMITATIONS It was difficult to infer causality for a cross-sectional study. CONCLUSIONS Intakes of skim milk and moderate milk desserts were negatively associated with depressive symptoms, while whole milk was positively associated with depressive symptoms among adults.
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Affiliation(s)
- Jing Sun
- Department of Epidemiology and Health Statistics, the School of Public Health of Qingdao University, Qingdao, Shandong Province, People's Republic of China
| | - Weijing Wang
- Department of Epidemiology and Health Statistics, the School of Public Health of Qingdao University, Qingdao, Shandong Province, People's Republic of China
| | - Dongfeng Zhang
- Department of Epidemiology and Health Statistics, the School of Public Health of Qingdao University, Qingdao, Shandong Province, People's Republic of China.
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30
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Dorrington N, Fallaize R, Hobbs DA, Weech M, Lovegrove JA. A Review of Nutritional Requirements of Adults Aged ≥65 Years in the UK. J Nutr 2020; 150:2245-2256. [PMID: 32510125 DOI: 10.1093/jn/nxaa153] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 02/24/2020] [Accepted: 05/05/2020] [Indexed: 01/16/2023] Open
Abstract
Appropriate dietary choices in later life may reduce the risk of chronic diseases and rate of functional decline, however, there is little well-evidenced age-specific nutritional guidance in the UK for older adults, making it challenging to provide nutritional advice. Therefore, the aim of this critical review was to propose evidence-based nutritional recommendations for older adults (aged ≥65 y). Nutrients with important physiological functions in older adults were selected for inclusion in the recommendations. For these nutrients: 1) recommendations from the UK Scientific Advisory Committee for Nutrition (SACN) reports were reviewed and guidance retained if recent and age-specific, and 2) a literature search conducted where SACN guidance was not sufficient to set or confirm recommendations for older adults, searching Web of Science up to March 2020. Data extracted from a total of 190 selected publications provided evidence to support age-specific UK recommendations for protein (1.2 g·kg-1·d-1), calcium (1000 mg·d-1), folate (400 μg·d-1), vitamin B-12 (2.4 μg·d-1), and fluid (1.6 L·d-1 women, 2.0 L·d-1 men) for those ≥65 y. UK recommendations for carbohydrates, free sugars, dietary fiber, dietary fat and fatty acids, sodium, and alcohol for the general population are likely appropriate for older adults. Insufficient evidence was identified to confirm or change recommendations for all other selected nutrients. In general, significant gaps in current nutritional research among older adults existed, which should be addressed to support delivery of tailored nutritional guidance to this age group to promote healthy aging.
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Affiliation(s)
- Nicole Dorrington
- Hugh Sinclair Unit of Human Nutrition and Institute of Cardiovascular and Metabolic Research, University of Reading, Reading, United Kingdom
| | - Rosalind Fallaize
- Hugh Sinclair Unit of Human Nutrition and Institute of Cardiovascular and Metabolic Research, University of Reading, Reading, United Kingdom.,School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Ditte A Hobbs
- Hugh Sinclair Unit of Human Nutrition and Institute of Cardiovascular and Metabolic Research, University of Reading, Reading, United Kingdom
| | - Michelle Weech
- Hugh Sinclair Unit of Human Nutrition and Institute of Cardiovascular and Metabolic Research, University of Reading, Reading, United Kingdom
| | - Julie A Lovegrove
- Hugh Sinclair Unit of Human Nutrition and Institute of Cardiovascular and Metabolic Research, University of Reading, Reading, United Kingdom
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31
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Amenyah SD, Ward M, Strain JJ, McNulty H, Hughes CF, Dollin C, Walsh CP, Lees-Murdock DJ. Nutritional Epigenomics and Age-Related Disease. Curr Dev Nutr 2020; 4:nzaa097. [PMID: 32666030 PMCID: PMC7335360 DOI: 10.1093/cdn/nzaa097] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/27/2020] [Accepted: 05/21/2020] [Indexed: 12/24/2022] Open
Abstract
Recent advances in epigenetic research have enabled the development of epigenetic clocks, which have greatly enhanced our ability to investigate molecular processes that contribute to aging and age-related disease. These biomarkers offer the potential to measure the effect of environmental exposures linked to dynamic changes in DNA methylation, including nutrients, as factors in age-related disease. They also offer a compelling insight into how imbalances in the supply of nutrients, particularly B-vitamins, or polymorphisms in regulatory enzymes involved in 1-carbon metabolism, the key pathway that supplies methyl groups for epigenetic reactions, may influence epigenetic age and interindividual disease susceptibility. Evidence from recent studies is critically reviewed, focusing on the significant contribution of the epigenetic clock to nutritional epigenomics and its impact on health outcomes and age-related disease. Further longitudinal studies and randomized nutritional interventions are required to advance the field.
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Affiliation(s)
- Sophia D Amenyah
- Genomic Medicine Research Group , School of Biomedical Sciences, Ulster University, Northern Ireland, United Kingdom. BT52 1SA
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom. BT52 1SA
| | - Mary Ward
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom. BT52 1SA
| | - J J Strain
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom. BT52 1SA
| | - Helene McNulty
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom. BT52 1SA
| | - Catherine F Hughes
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom. BT52 1SA
| | - Caitlin Dollin
- Genomic Medicine Research Group , School of Biomedical Sciences, Ulster University, Northern Ireland, United Kingdom. BT52 1SA
| | - Colum P Walsh
- Genomic Medicine Research Group , School of Biomedical Sciences, Ulster University, Northern Ireland, United Kingdom. BT52 1SA
| | - Diane J Lees-Murdock
- Genomic Medicine Research Group , School of Biomedical Sciences, Ulster University, Northern Ireland, United Kingdom. BT52 1SA
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32
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Angelino D, Caffrey A, Moore K, Laird E, Moore AJ, Gill CIR, Mena P, Westley K, Pucci B, Boyd K, Mullen B, McCarroll K, Ward M, Strain JJ, Cunningham C, Molloy AM, McNulty H, Del Rio D. Phenyl‐γ‐valerolactones and healthy ageing: Linking dietary factors, nutrient biomarkers, metabolic status and inflammation with cognition in older adults (the VALID project). NUTR BULL 2020. [DOI: 10.1111/nbu.12444] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- D. Angelino
- Human Nutrition Unit Department of Veterinary Science University of Parma Parma Italy
- Faculty of Bioscience and Technology for Food, Agriculture, and Environment University of Teramo Teramo Italy
| | - A. Caffrey
- Nutrition Innovation Centre for Food and Health (NICHE) School of Biomedical Sciences Ulster University Coleraine UK
| | - K. Moore
- Nutrition Innovation Centre for Food and Health (NICHE) School of Biomedical Sciences Ulster University Coleraine UK
| | - E. Laird
- Department of Clinical Medicine School of Medicine Trinity College DublinTrinity Centre for Health Sciences Dublin 8 Ireland
| | - A. J. Moore
- School of Geography and Environmental Sciences Ulster University Coleraine UK
| | - C. I. R. Gill
- Nutrition Innovation Centre for Food and Health (NICHE) School of Biomedical Sciences Ulster University Coleraine UK
| | - P. Mena
- Human Nutrition Unit Department of Food and Drug University of Parma Parma Italy
| | - K. Westley
- School of Geography and Environmental Sciences Ulster University Coleraine UK
| | - B. Pucci
- School of Geography and Environmental Sciences Ulster University Coleraine UK
| | - K. Boyd
- Department of Clinical Medicine School of Medicine Trinity College DublinTrinity Centre for Health Sciences Dublin 8 Ireland
| | - B. Mullen
- Department of Clinical Medicine School of Medicine Trinity College DublinTrinity Centre for Health Sciences Dublin 8 Ireland
| | - K. McCarroll
- Department of Clinical Medicine School of Medicine Trinity College DublinTrinity Centre for Health Sciences Dublin 8 Ireland
| | - M. Ward
- Nutrition Innovation Centre for Food and Health (NICHE) School of Biomedical Sciences Ulster University Coleraine UK
| | - J. J. Strain
- Nutrition Innovation Centre for Food and Health (NICHE) School of Biomedical Sciences Ulster University Coleraine UK
| | - C. Cunningham
- Department of Clinical Medicine School of Medicine Trinity College DublinTrinity Centre for Health Sciences Dublin 8 Ireland
| | - A. M. Molloy
- Department of Clinical Medicine School of Medicine Trinity College DublinTrinity Centre for Health Sciences Dublin 8 Ireland
| | - H. McNulty
- Nutrition Innovation Centre for Food and Health (NICHE) School of Biomedical Sciences Ulster University Coleraine UK
| | - D. Del Rio
- Human Nutrition Unit Department of Veterinary Science University of Parma Parma Italy
- School of Advanced Studies on Food and Nutrition University of Parma Parma Italy
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33
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Sun J, Li Z, Li Y, Zhang D. Intakes of Specific Categories of Vegetables and Fruits Are Inversely Associated With Depressive Symptoms Among Adults. J Epidemiol 2020; 31:210-219. [PMID: 32281554 PMCID: PMC7878715 DOI: 10.2188/jea.je20200003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Epidemiological evidence on the relationships between intakes of different categories of vegetables and fruits and depressive symptoms is very limited and inconsistent, especially with no evidence from the general population. This study aimed to estimate their relationships among a large general population. METHODS The cross-sectional design was based on the National Health and Nutrition Examination Survey (2007-2014) and included 16,925 adults. Dietary information was attained from two nonconsecutive 24-hr dietary recalls. Patient Health Questionnaire was applied for measuring depressive symptoms. The associations between vegetables and fruits intakes and depressive symptoms were appraised utilizing logistic regression and restricted cubic spline. RESULTS Compared with the lowest category of intake, the most-adjusted odds ratios of depressive symptoms for the highest intake category of tomatoes and tomato mixtures were 0.81 (95% confidence interval [CI], 0.66-0.99), and 0.64 (95% CI, 0.48-0.85) for dark-green vegetables, 0.67 (95% CI, 0.53-0.84) for other vegetables, 0.48 (95% CI, 0.29-0.79) for berries, 0.67 (95% CI, 0.55-0.82) for total vegetables, and 0.70 (95% CI, 0.57-0.86) for total fruits, and for the medium categories of bananas and dried fruits were 0.62 (95% CI, 0.41-0.95) and 0.39 (95% CI, 0.19-0.81), respectively. After sensitivity analysis further excluding subjects with co-morbid health conditions, these findings remained significant, except for bananas. An L-shaped relationship was observed between depressive symptoms and intake of total vegetables, while the association was linear with total fruits intake. CONCLUSIONS Intakes of tomatoes and tomato mixtures, dark-green vegetables, other vegetables, berries, dried fruits, total vegetables, and total fruits were inversely related to depressive symptoms among adults.
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Affiliation(s)
- Jing Sun
- Department of Epidemiology and Health Statistics, the School of Public Health of Qingdao University
| | - Zhaoying Li
- Department of Epidemiology and Health Statistics, the School of Public Health of Qingdao University
| | - Yan Li
- Department of Epidemiology and Health Statistics, the School of Public Health of Qingdao University
| | - Dongfeng Zhang
- Department of Epidemiology and Health Statistics, the School of Public Health of Qingdao University
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34
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Ryan KM, Allers KA, Harkin A, McLoughlin DM. Blood plasma B vitamins in depression and the therapeutic response to electroconvulsive therapy. Brain Behav Immun Health 2020; 4:100063. [PMID: 34589848 PMCID: PMC8474603 DOI: 10.1016/j.bbih.2020.100063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 03/22/2020] [Accepted: 03/22/2020] [Indexed: 02/07/2023] Open
Abstract
A growing body of research has indicated a role for B vitamins in depression, with some previous studies suggesting that B vitamin status in patients with depression can impact on antidepressant response. Here we aimed to investigate B vitamin plasma concentrations in medicated patients with depression (n = 94) compared to age- and sex-matched healthy controls (n = 57), and in patients with depression after electroconvulsive therapy (ECT) in a real-world clinical setting. Our results show that nicotinamide (vitamin B3), N1-methylnicotinamide (vitamin B3 metabolite), and pyridoxal 5'-phosphate (PLP; vitamin B6) concentrations were significantly reduced in patients with depression compared to controls. The Cohen's d effect sizes for nicotinamide, N1-methylnicotinamide, and PLP were moderate-large (-0.47, -0.51, and -0.59, respectively), and likely to be of clinical relevance. Functional biomarkers of vitamin B6 status (PAr index, 3-hydroxykynurenine: hydroxyanthranilic acid ratio, 3-hydroxykynurenine: xanthurenic acid ratio, and HKr) were elevated in depressed patients compared to controls, suggestive of reduced vitamin B6 function. Over 30% of the patient cohort were found to have low to deficient PLP concentrations, and exploratory analyses revealed that these patients had higher IL-6 and CRP concentrations compared to patients with PLP levels within the normal range. Treatment with ECT did not alter B vitamin concentrations, and B vitamin concentrations were not associated with depression severity or the therapeutic response to ECT. Overall, reduced plasma PLP, nicotinamide, and N1-methylnicotinamide concentrations could have wide ranging effects on pathways and systems implicated in depression. Further studies are required to understand the reasons why patients with depression present with low plasma B vitamin concentrations.
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Affiliation(s)
- Karen M Ryan
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin 2, Ireland.,Department of Psychiatry, Trinity College Dublin, St. Patrick's University Hospital, James Street, Dublin 8, Ireland
| | - Kelly A Allers
- Central Nervous System Disease Research, Boehringer Ingelheim Pharma GmbH + Co. KG, Birkendorferstrabe 65, Biberach a.d. Riss, Germany
| | - Andrew Harkin
- Neuropsychopharmacology Research Group, School of Pharmacy and Pharmaceutical Sciences & Trinity College Institute of Neuroscience, Trinity College, Dublin 2, Ireland
| | - Declan M McLoughlin
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin 2, Ireland.,Department of Psychiatry, Trinity College Dublin, St. Patrick's University Hospital, James Street, Dublin 8, Ireland
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35
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Pyridoxine supplementation for levetiracetam-related neuropsychiatric adverse events: A systematic review. Epilepsy Behav 2020; 103:106861. [PMID: 31917143 DOI: 10.1016/j.yebeh.2019.106861] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 12/14/2019] [Accepted: 12/14/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Among people with epilepsy, levetiracetam (LEV) can cause neuropsychiatric adverse events (NPAEs) that impact negatively on quality of life. It has been suggested that pyridoxine can ameliorate LEV-related NPAEs. We conducted a systematic review of studies on the use of pyridoxine supplementation to relieve NPAEs associated with LEV therapy. METHODS The review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Medline, EMBASE, Scholar, Cochrane-CENTRAL (2000-2019), and EThOS platform were searched for studies on the use of pyridoxine in patients with LEV-related NPAEs. Proportions of patients reported to benefit from pyridoxine supplementation were tabulated, and a random-effect model meta-analysis was conducted. RESULTS Eleven retrospective studies/case reports and one randomized prospective study, mostly including pediatric populations, were identified. Retrospective studies, which were rated as low quality due to failure to control for bias, reported an overall improvement of NPAEs after pyridoxine supplementation in 72.5% (108/149) of patients. The proportion of patients showing improvement in a pooled analysis of the four largest retrospective studies (n = 134) was 72.1% (95% confidence interval (CI) 47.1-88.3), although there was high heterogeneity across studies (I2 = 82%, pheterogeneity < 0.01). In the only prospective trial, patients randomized to pyridoxine supplementation were more likely to show relief from NPAEs than patients not receiving supplementation (p < 0.01), but outcomes might have been affected by assessment bias. CONCLUSION This systematic review suggests that pyridoxine might be of benefit in relieving LEV-related NPAEs. However, the quality of the evidence is poor, and better-designed prospective studies that include quantitative as well as qualitative data are needed to define the role of pyridoxine in the management of LEV-related NPAEs.
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