Effect of folic acid supplementation on mood and serotonin response in healthy males

A Systematic Review and Meta-Analysis of B Vitamin Supplementation on Depressive Symptoms, Anxiety, and Stress: Effects on Healthy and 'At-Risk' Individuals

A systematic review and meta-analysis was undertaken to examine and quantify the effects of B vitamin supplementation on mood in both healthy and 'at-risk' populations. A systematic search identified all available randomised controlled trials (RCTs) of daily supplementation with ≥3 B group vitamins with an intervention period of at least four weeks. Random effects models for a standardized mean difference were used to test for overall effect. Heterogeneity was tested using the I² statistic. Eighteen articles (16 trials, 2015 participants) were included, of which 12 were eligible for meta-analysis. Eleven of the 18 articles reported a positive effect for B vitamins over a placebo for overall mood or a facet of mood. Of the eight studies in 'at-risk' cohorts, five found a significant benefit to mood. Regarding individual facets of mood, B vitamin supplementation benefited stress (n = 958, SMD = 0.23, 95% CI = 0.02, 0.45, p = 0.03). A benefit to depressive symptoms did not reach significance (n = 568, SMD = 0.15, 95% CI = -0.01, 0.32, p = 0.07), and there was no effect on anxiety (n = 562, SMD = 0.03, 95% CI = -0.13, 0.20, p = 0.71). The review provides evidence for the benefit of B vitamin supplementation in healthy and at-risk populations for stress, but not for depressive symptoms or anxiety. B vitamin supplementation may particularly benefit populations who are at risk due to (1) poor nutrient status or (2) poor mood status.

Subjective well-being in older adults: folate and vitamin B12 independently predict positive affect

Vitamin B12, folate and homocysteine have long been implicated in mental illness, and growing evidence suggests that they may play a role in positive mental health. Elucidation of these relationships is confounded due to the dependence of homocysteine on available levels of vitamin B12 and folate. Cross-sectional and longitudinal relationships between vitamin B12, folate, homocysteine and subjective well-being were assessed in a sample of 391 older, community-living adults without clinically diagnosed depression. Levels of vitamin B12, but not folate, influenced homocysteine levels 18 months later. Vitamin B12, folate and their interaction significantly predicted levels of positive affect (PA) 18 months later, but had no impact on the levels of negative affect or life satisfaction. Cross-sectional relationships between homocysteine and PA were completely attenuated in the longitudinal analyses, suggesting that the cross-sectional relationship is driven by the dependence of homocysteine on vitamin B12 and folate. This is the first study to offer some evidence of a causal link between levels of folate and vitamin B12 on PA in a large, non-clinical population.

Homocysteine and serotonin: association with postpartum depression

Postpartum depression (PPD) is a disorder of multifactorial origin with significant consequences on both maternal and child health. One of the biological factors implicated is perturbed methionine-homocysteine metabolism. Since this metabolic pathway plays a significant role in myelination of nerve fibers, the growth and development of the child would also be adversely affected. We carried out this study in 103 women (58 with PPD and 45 without PPD) who delivered their child in our institute from December 2010 to November 2011. The study group was evaluated for PPD using Edinburgh postnatal depression scale with a cut-off score of 10. Assessment of fetal well being was done by APGAR score assessed immediately after birth. Serum folic acid, vitamin B12, homocysteine and serotonin was done by ELISA. We found significantly elevated levels of homocysteine in women with PPD as compared to those without PPD, both at 24-48h as well as six weeks after delivery, although no associations were found with folate and vitamin B12 levels. Also, there was a significant negative correlation between serum homocysteine and serotonin levels in the postpartum depression group with a significant negative correlation between homocysteine and serotonin. Our study showed a significantly lower APGAR score in the infants born to mothers with PPD. Our study also shows that homocysteinemia is associated with PPD whether at the first week or sixth week, while low serum serotonin may play a role in depression during the first week, but may not have a role in depression status at the sixth week. Also, PPD in the mother is related to a low APGAR score in infants born to these mothers emphasizing the significance of both mental as well as nutritional status of the mother.

Obesity, whole blood serotonin and sex differences in healthy volunteers

BACKGROUND

Obesity is a growing problem throughout Europe, where the rate has more than doubled over the past 20 years. Reduced circulating serotonin may contribute to the development of obesity. This study aimed to explore associations between whole blood (WB) serotonin concentrations and anthropometric measures.

METHODS

Healthy adult volunteers (N = 68) gave whole blood samples for measurement of WB serotonin, and underwent BMI waist circumference (WC) and waist-to-hip ratio (WHR) assessment as well as DEXA (dual energy X-ray absorptiometry) scans for anthropometric parameters. Student's t-tests determined differences in WB serotonin and anthropometric measures between sexes. Partial Pearson's correlations were carried out on anthropometric measures and WB serotonin.

RESULTS

For the whole sample, WB serotonin was significantly negatively correlated with BMI, WC, WHR as well as android, gynoid and total % body fat. Analysis by sex showed significant negative correlations between WB serotonin and android, gynoid as well as total fat in males, but not in females.

CONCLUSION

This dichotomy between the sexes implies that there may be sex differences in the way that serotonin interplays with the development of obesity and body fat distribution.

No clear potentiation of antidepressant medication effects by folic acid+vitamin B12 in a large community sample

BACKGROUND

Observational studies link low folate levels to depressive symptoms and to poor antidepressant medication response. Evidence supports a role for folate in potentiating the effect of antidepressant medications.

AIM

This prospective study examines the effects of folic acid+vitamin B12 supplementation and antidepressant medication in a community-based study of older adults with depressive symptoms.

METHOD

A randomised controlled trial investigated the effectiveness of a medicinal and two behavioural preventive interventions over a two year period. The medicinal intervention compared dietary supplementation of 400 mcg/d folic acid+100 mcg/d vitamin B12 to placebo. Self reported use of antidepressant medication over two years was recorded. Participants were screened for psychological distress using the Kessler Distress 10-Scale (K-10; >15 eligible) and the main outcome measure was change in depressive symptoms on the Patient Health Questionnaire-9 (PHQ-9) at six weeks, six, 12 and 24 months. Nine hundred adults aged 60-74 years were included in the analysis, of whom 209 (23.2%) reported antidepressant use during the follow-up period.

RESULTS

A mixed model repeated measures analysis of variance for reduction in depressive symptoms found no significant three-way interaction between supplement group and antidepressant use over time on the PHQ-9 [F4, 825.1=0.32, p=0.87]. A small interaction between supplement group and antidepressant use over time was found for K-10 scores (F4, 799.5=2.50, p=0.0414).

CONCLUSIONS

There was little evidence for the potentiation of antidepressant medication by folic acid+B12 supplementation on depressive symptomatology. Further research should examine whether effects might be found at higher folic acid dosages or among clinical populations.

Folate status and mood: is there a relationship?

Objective

To explore the relationship between subjective mood, folate status and homocysteine in healthy individuals.

Design

Subjective mood assessments were completed twice daily over the course of one week using the Positive and Negative Affect Scale (PANAS). The PANAS is a validated scale which considers mood state on two distinct continua, one reflecting positive mood and the other negative mood, each requiring response to 10 adjectives on a Likert scale. A blood sample was taken on one occasion at the start of the week during which subjective mood was assessed and analysed for red-blood-cell (RBC) folate, serum folate and plasma homocysteine concentrations.

Subjects

Male volunteers aged 19–47 years (n= 58) were recruited from local industries.

Results

High concentrations of RBC folate were associated with less variability (lower standard deviation) in negative mood (P= 0.023). Subjective mood, however, was not related to serum folate or homocysteine.

Conclusions

This study appears to be the first to uncover an association between long-term folate status and subjective mood (employing the PANAS) in healthy males. More research is needed to further explore the relationship between nutritional status and mood.

The relationship between whole-blood serotonin and subjective mood in apparently healthy postmenopausal women

The aim of this research has been to determine the degree to which biochemical indices of mood reflect subjective mood. Potential relationships between whole-blood (WB) serotonin (5-hydroxytryptamine, 5-HT) levels as determined by the positive and negative affect schedule (PANAS) have been explored in apparently healthy postmenopausal women (n=39). Partial correlations indicated that WB 5-HT was positively associated with positive affect (p=0.03). No association was apparent for negative affect. These findings indicate that WB 5-HT and positive affect are related in postmenopausal women.