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Berger MM, Shenkin A. Micronutrient deficiency and supplements in schoolchildren and teenagers. Curr Opin Clin Nutr Metab Care 2024; 27:266-274. [PMID: 38462972 DOI: 10.1097/mco.0000000000001027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
PURPOSE OF REVIEW The essential micronutrients are corner stones in the functional and physical development. Early deficiency has life-long consequences. While awareness about iron deficiency is relatively high, it remains lower for other micronutrients. This review aims at reporting on recent data and attracting attention to the high prevalence of micronutrient deficiencies in school-age and adolescent individuals. RECENT FINDINGS Iron deficiency anaemia remains highly prevalent worldwide and the most frequent deficiency but can be corrected with simple tools ranging from food fortification, nutritional intervention, and to supplements. The link between micronutrient (MN) deficiency and neurobehavioral disorders is increasingly established and is worrying even in Western countries. Paediatric individuals are prone to imbalanced diets and picky eating behaviour, and their diets may then become incomplete: the highest risk for deficiency is observed for iron, zinc and vitamin D. SUMMARY There is not much new information, but rather confirmation of the importance of health policies. Well conducted randomized controlled trials confirm that deficiencies can be corrected efficiently including with food fortification, and result in clinical benefits. Individual complementation should be considered in children and adolescents with proven deficiency.
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Affiliation(s)
- Mette M Berger
- Faculty of Biology & Medicine, Lausanne University, Lausanne, Switzerland
| | - Alan Shenkin
- Institute of Aging and Chronic Disease, University of Liverpool, Liverpool, UK
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2
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Yaceczko S, Baltz J. Evaluation of nutrition components within prehabilitation programs in gastrointestinal cancers: Is prehab worth the hype? Nutr Clin Pract 2024; 39:117-128. [PMID: 37772471 DOI: 10.1002/ncp.11079] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 08/01/2023] [Accepted: 08/27/2023] [Indexed: 09/30/2023] Open
Abstract
Nutrition impact symptoms and unintended weight loss are prevalent in patients with gastrointestinal cancers, especially during the perioperative period or while prescribed anticancer treatments. Because patients may experience loss of lean body mass and malnutrition, aggressive nutrition intervention prior to surgery should be considered. Cancer prehabilitation is a process spanning the care continuum from diagnosis to the time of surgery encompassing nutrition support, psychological and physical assessment, and targeted interventions. Thirteen studies published between 2013 and 2023 were included in this review and evaluated prehabilitation programs' impact on postoperative outcomes in patients with gastrointestinal cancers. Literature continues to emerge supporting the integration of nutrition into a prehabilitation program because of its potential to contribute to improved clinical outcomes, quality of life, and cost-effectiveness, but considerable variation exists with respect to the specific recommendations provided by current prehabilitation programs.
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Affiliation(s)
- Shelby Yaceczko
- UCLA David Geffen School of Medicine, Los Angeles, California, USA
| | - Jami Baltz
- Stanford Health Care, Comprehensive Cancer Center, Stanford, California, USA
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Podpeskar A, Crazzolara R, Kropshofer G, Hetzer B, Rabensteiner E, Meister B, Obexer P, Salvador C. Recommendations for Nutritional Supplementation in Pediatric Oncology: A Compilation of the Facts. Nutrients 2023; 15:3239. [PMID: 37513658 PMCID: PMC10386187 DOI: 10.3390/nu15143239] [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: 06/29/2023] [Revised: 07/18/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND As one of the few modifiable risk factors, the importance of dietary patterns for both disease prevention and treatment outcome in pediatric oncology has gained increasing popularity. Malnutrition is associated with lower survival rates, tolerance to treatment, and quality of life. Yet, especially in children with malignancies, nutritional deterioration is common, and pediatric cancer patients often present with inadequate intake of micro- and macronutrients alike. Despite the reported widespread use of dietary supplements, few empirical data provide a basis for clinical recommendations, and evidence for their efficacy is inconsistent. Current literature lacks a systematic approach as to how and which supplements should be recommended for specific patients, types of cancer, or during specific treatments. The aim of this review is to highlight the role of the most frequently used nutrients in pediatric malignant diseases and to give a practical guide based on current scientific evidence. METHODS A comprehensive literature search was conducted on PubMed through April 2023 to select meta-analyses, systematic reviews, observational studies, and individual randomized controlled trials (RCTs) of macro- and micronutrient supplementation in pediatric oncology. The search strategy included the following medical subject headings (MeSH) and keywords: "childhood cancer", "pediatric oncology", "nutritional status", "dietary supplements", "vitamins", "micronutrients", "calcium", "magnesium", "vitamin D", "zinc" "glutamine", "selen", and "omega-3 fatty acids". The reference lists of all relevant articles were screened to include potentially pertinent studies. RESULTS The present review provides a comprehensive and updated overview of the latest evidence about the role of nutrition and diet in pediatric oncology, also focusing on different nutritional interventions available for the management of the disease. We summarize evidence about the importance of adequate nutrition in childhood cancer and the role of several micronutrients and critically interpret the findings. Possible effects and benefits of supplementation during chemotherapy are discussed, as are strategies for primary and secondary prevention. CONCLUSIONS We here describe the obvious benefits of dietary supplementation for childhood cancer. Further large-scale clinical trials are required to verify the impacts of deficiencies and the possible benefits of supplementation and optimal dosages. (337 words).
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Affiliation(s)
- Alexandra Podpeskar
- Department of Pediatrics I, Division of Hematology and Oncology, Medical University of Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria
| | - Roman Crazzolara
- Department of Pediatrics I, Division of Hematology and Oncology, Medical University of Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria
| | - Gabriele Kropshofer
- Department of Pediatrics I, Division of Hematology and Oncology, Medical University of Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria
| | - Benjamin Hetzer
- Department of Pediatrics I, Division of Hematology and Oncology, Medical University of Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria
| | - Evelyn Rabensteiner
- Department of Pediatrics I, Division of Hematology and Oncology, Medical University of Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria
| | - Bernhard Meister
- Department of Pediatrics I, Division of Hematology and Oncology, Medical University of Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria
| | - Petra Obexer
- Department of Pediatrics II, Institute of Experimental Neonatology, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Christina Salvador
- Department of Pediatrics I, Division of Hematology and Oncology, Medical University of Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria
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Vitale M, Crossland S, Shinwell J, Stretesky PB, Defeyter MA, Brownlee IA. The Nutritional Quality of Food Provision at UK Government-Funded Holiday Clubs: A Cross-Sectional Analysis of Energy and Nutrient Content. Nutrients 2023; 15:1937. [PMID: 37111156 PMCID: PMC10144653 DOI: 10.3390/nu15081937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 04/06/2023] [Indexed: 04/29/2023] Open
Abstract
A large proportion of children are at risk of food insecurity during school holidays in the UK. The government-funded Holiday Activities and Food (HAF) programme provides free holiday clubs offering at least one healthy meal/day to eligible children and adolescents. This study aims at evaluating the nutritional quality of food provision at HAF holiday clubs, particularly hot/cold and vegetarian/non-vegetarian meals. Menu variants (n = 2759) from 49 HAF holiday clubs were assessed for adherence to School Food Standards (SFS) and their notional compositional quality, which was scored utilising a novel nutrient-based meal quality index. The median adherence to SFS across all available menus was 70% (IQR 59-79%). Overall, hot variants scored statistically higher menu quality scores than cold variants for both 5-11y (92.3 (80.7-102.7) vs. 80.4 (69.3-90.6)) and 11-18y (73.5 (62.5-85.8) vs. 58.9 (50.0-70.7)) criteria. Cold and hot menu variants tended to score differentially for quality sub-components. These findings highlight areas for potential future improvement in HAF holiday club provision with a tendency for food provision to appear less ideal for attendees for those aged 11-18. Ensuring that children from low-income households have access to a healthy diet is crucial to reduce UK health inequalities.
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Affiliation(s)
- Martina Vitale
- Department of Applied Sciences, Northumbria University, Newcastle upon Tyne NE1 8ST, UK; (M.V.); (S.C.)
| | - Shannon Crossland
- Department of Applied Sciences, Northumbria University, Newcastle upon Tyne NE1 8ST, UK; (M.V.); (S.C.)
| | - Jackie Shinwell
- Healthy Living Lab, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne NE1 8ST, UK; (J.S.); (M.A.D.)
| | - Paul B. Stretesky
- Department of Social Sciences, Northumbria University, Newcastle upon Tyne NE7 7YT, UK;
| | - Margaret Anne Defeyter
- Healthy Living Lab, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne NE1 8ST, UK; (J.S.); (M.A.D.)
| | - Iain Andrew Brownlee
- Department of Applied Sciences, Northumbria University, Newcastle upon Tyne NE1 8ST, UK; (M.V.); (S.C.)
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Bhatara VS, Bernstein B, Fazili S. Complementary and Integrative Treatments of Aggressiveness/Emotion Dysregulation: Associated with Disruptive Disorders and Disruptive Mood Dysregulation Disorder. Child Adolesc Psychiatr Clin N Am 2023; 32:297-315. [PMID: 37147041 DOI: 10.1016/j.chc.2022.08.010] [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: 05/07/2023]
Abstract
Youth with emotional dysregulation (ED) and irritability/aggression, common in disruptive disorders (frequently comorbid with attention-deficit/hyperactivity disorder), are underserved by conventional treatments. Anger dysregulation is usually the core feature of ED. Complementary and integrative Medicine (CIM) treatments for youth with disruptive disorders and ED are reviewed. Broad-spectrum micronutrient supplementation has a medium effect and is supported by two double-blind randomized controlled trials using similar formulations. Other CIM treatments supported by controlled data but needing further research, include omega-3 fatty acid supplementation, music therapy, martial arts, restricting exposure to media violence, decreasing sleep deprivation, and increased exposure to green-blue spaces.
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Affiliation(s)
- Vinod S Bhatara
- Department of Psychiatry, University of South Dakota, Sanford School of Medicine, Sioux Falls, SD, USA; Department of Pediatrics, University of South Dakota, Sanford School of Medicine, Sioux Falls, SD, USA.
| | - Bettina Bernstein
- Philadelphia College of Osteopathic Medicine, 4170 City Ave, Philadelphia, PA 19131, USA; Department of Child and Adolescent Psychiatry, The Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA
| | - Sheeba Fazili
- University of South Dakota Sanford School of Medicine, 4400 West 69th street, suite 1500, Sioux Falls, SD 57104, USA
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Wilcox MD, Chater PI, Stanforth KJ, Williams R, Brownlee IA, Pearson JP. A Pilot Pre and Post 4 Week Intervention Evaluating the Effect of a Proprietary, Powdered, Plant Based Food on Micronutrient Status, Dietary Intake, and Markers of Health in a Healthy Adult Population. Front Nutr 2022; 9:945622. [PMID: 35903454 PMCID: PMC9315961 DOI: 10.3389/fnut.2022.945622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 06/22/2022] [Indexed: 11/25/2022] Open
Abstract
Background A "balanced, adequate, and varied diet" is recommended as the basis of nutritionally sound diet by the World Health Organisation and national public health agencies. Huel is a proprietary, on-the-go, powdered, plant based food, providing all 26 essential vitamins and minerals, protein, essential fats, carbohydrate, fibre, and phytonutrients. Objectives Assessing the effect of solely consuming Huel on micronutrient status, dietary intake and markers of health was achieved through a 4-week intervention of solely Huel powder. Methods Habitual energy intake was assessed through a one-week lead in period with healthy adult participants (aged 18 or over) logging their food intake, after which only Huel was consumed for 4 weeks. Blood samples and body composition was assessed before and after the lead in week as well the end of the intervention. Thirty participants were recruited with 20 (11 females, median age 31, range 22-44) completing the study, 19 sets of blood samples were collected. 22 blood markers were analysed along with weight, BMI, waist circumference, visceral adipose tissue (VAT), and body composition. All blood micronutrients, except for Thyroid Stimulating Hormone and choline were sent to Royal Victoria Infirmary NHS, Newcastle Laboratory (Newcastle upon Tyne, United Kingdom) for analysis. Results Fourteen of the parameters significantly changed over the course of the study with circulating haemoglobin, iron, vitamins B12 and D as well as selenium significantly increasing (p < 0.05). HbA1c, total and non-HDL cholesterol, vitamins A and E, potassium, BMI, VAT, and waist circumference all significantly decreased (p < 0.05) post intervention. Conclusion Although energy intake decreased during the intervention period, the adherence to recommended micronutrient intake, as quantified by the dietary Total Adherence Score, significantly increased which tallies with the preservation or improvement of micronutrient status. This study potentially demonstrates that consuming only Huel for 4 weeks does not negatively affect micronutrient status.
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Affiliation(s)
- Matthew D. Wilcox
- Biosciences Institute, Medical School, Newcastle University, Newcastle upon Tyne, United Kingdom,Aelius Biotech Ltd., The Biosphere, Newcastle upon Tyne, United Kingdom,*Correspondence: Matthew D. Wilcox,
| | - Peter I. Chater
- Biosciences Institute, Medical School, Newcastle University, Newcastle upon Tyne, United Kingdom,Aelius Biotech Ltd., The Biosphere, Newcastle upon Tyne, United Kingdom
| | - Kyle J. Stanforth
- Biosciences Institute, Medical School, Newcastle University, Newcastle upon Tyne, United Kingdom,Aelius Biotech Ltd., The Biosphere, Newcastle upon Tyne, United Kingdom
| | | | - Iain A. Brownlee
- Department of Applied Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Jeffrey P. Pearson
- Biosciences Institute, Medical School, Newcastle University, Newcastle upon Tyne, United Kingdom,Aelius Biotech Ltd., The Biosphere, Newcastle upon Tyne, United Kingdom
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Aksoy N, Ozturk N. Rational Use of vitamins during pregnancy and The pregnancy multivitamin products' available in Turkey. Nutr Health 2022; 29:205-213. [PMID: 35651306 DOI: 10.1177/02601060221104313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Despite the imperative role of sufficient vitamin intake during pregnancy, not all women are capable of following a balanced diet during these times. As an attempt to resolve the issue of micronutrient deficiencies, many women resort to the use of multivitamins; ones often made for pregnant women. Aim: The review aims to compare the Daily Recommended Dietary Allowance of each vitamin, micronutrient, and macronutrient with the doses available in a sample of products found in the Turkish markets, whether imported or manufactured in Turkey. Methods: The Daily Recommended Dietary Allowance doses were collected from the CDC, WHO, and IOM databases. The doses present in each product were gathered using the database offered by the Turkish pharmacist association "Tebrp" as well as RxMediaPharma. Elevit® and decavit® were selected as they've been approved by the Turkish Ministry of Health, while the other products were randomly chosen using a computer program. Results: Several formulations available in Turkey display higher or lower daily contents of vitamins and minerals than is normally ideal for pregnant women as specified by the Recommended Dietary Allowance (RDA). Formulations that exceed the recommended RDA while remaining underneath the tolerable Upper Intake Level (UL) range for specific vitamins includes Pregnacare®, Decavit®, and Elevit®. Conclusion: All of these variances in multivitamin content must be considered by physicians and clinical pharmacists when selecting the appropriate multivitamin for pregnant women, taking into account all of the hazards and benefits that vitamin supplements may bring to fetus health and development.
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Affiliation(s)
- Nilay Aksoy
- Department of Clinical Pharmacy, 187458Altınbaş University, Istanbul, Turkey
| | - Nur Ozturk
- Department of Clinical Pharmacy, 187458Altınbaş University, Istanbul, Turkey
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Kakebeen AD, Niswander L. Micronutrient imbalance and common phenotypes in neural tube defects. Genesis 2021; 59:e23455. [PMID: 34665506 PMCID: PMC8599664 DOI: 10.1002/dvg.23455] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/31/2021] [Accepted: 09/03/2021] [Indexed: 12/24/2022]
Abstract
Neural tube defects (NTDs) are among the most common birth defects, with a prevalence of close to 19 per 10,000 births worldwide. The etiology of NTDs is complex involving the interplay of genetic and environmental factors. Since nutrient deficiency is a risk factor and dietary changes are the major preventative measure to reduce the risk of NTDs, a more detailed understanding of how common micronutrient imbalances contribute to NTDs is crucial. While folic acid has been the most discussed environmental factor due to the success that population-wide fortification has had on prevention of NTDs, folic acid supplementation does not prevent all NTDs. The imbalance of several other micronutrients has been implicated as risks for NTDs by epidemiological studies and in vivo studies in animal models. In this review, we highlight recent literature deciphering the multifactorial mechanisms underlying NTDs with an emphasis on mouse and human data. Specifically, we focus on advances in our understanding of how too much or too little retinoic acid, zinc, and iron alter gene expression and cellular processes contributing to the pathobiology of NTDs. Synthesis of the discussed literature reveals common cellular phenotypes found in embryos with NTDs resulting from several micronutrient imbalances. The goal is to combine knowledge of these common cellular phenotypes with mechanisms underlying micronutrient imbalances to provide insights into possible new targets for preventative measures against NTDs.
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Affiliation(s)
- Anneke Dixie Kakebeen
- Department of Molecular, Cellular, and Developmental Biology, University of Colorado Boulder, Boulder, Colorado, USA
| | - Lee Niswander
- Department of Molecular, Cellular, and Developmental Biology, University of Colorado Boulder, Boulder, Colorado, USA
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Dass M, Nyako J, Tortoe C, Fanou-Fogny N, Nago E, Hounhouigan J, Berger J, Wieringa F, Greffeuille V. Comparison of Micronutrient Intervention Strategies in Ghana and Benin to Cover Micronutrient Needs: Simulation of Bene-Fits and Risks in Women of Reproductive Age. Nutrients 2021; 13:2286. [PMID: 34371796 PMCID: PMC8308306 DOI: 10.3390/nu13072286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 06/25/2021] [Accepted: 06/28/2021] [Indexed: 11/16/2022] Open
Abstract
Overlapping micronutrient interventions might increase the risk of excessive micronutrient intake, with potentially adverse health effects. To evaluate how strategies currently implemented in Benin and Ghana contribute to micronutrient intake in women of reproductive age (WRA), and to assess the risk for excess intakes, scenarios of basic rural and urban diets were built, and different on-going interventions were added. We estimated micronutrient intakes for all different scenarios. Four types of intervention were included in the scenarios: fortification, biofortification, supplementation and use of locally available nutrient-rich foods. Basic diets contributed poorly to daily micronutrient intake in WRA. Fortification of oil and salt were essential to reach daily requirements for vitamin A and iodine, while fortified flour contributed less. Biofortified products could make an important contribution to the coverage of vitamin A needs, while they were not sufficient to cover the needs of WRA. Iron and folic acid supplementation was a major contributor in the intake of iron and folate, but only in pregnant and lactating women. Risk of excess were found for three micronutrients (vitamin A, folic acid and niacin) in specific contexts, with excess only coming from voluntary fortified food, supplementation and the simultaneous overlap of several interventions. Better regulation and control of fortification and targeting of supplementation could avoid excess intakes.
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Affiliation(s)
- Mamta Dass
- Institut de Recherche pour le Développement (IRD), BP 64501-911, av. d’Agropolis, 34394 Montpellier, France; (M.D.); (J.B.); (F.W.)
- QualiSud, Univ Montpellier, Avignon Université, CIRAD, Institut Agro, IRD, Université de La Réunion, 34394 Montpellier, France
| | - Jolene Nyako
- Nutrition Unit, Food Research Institute, Council for Scientific and Industrial Research (CSIR), Accra P.O. Box M20, Ghana; (J.N.); (C.T.)
| | - Charles Tortoe
- Nutrition Unit, Food Research Institute, Council for Scientific and Industrial Research (CSIR), Accra P.O. Box M20, Ghana; (J.N.); (C.T.)
| | - Nadia Fanou-Fogny
- Faculté des Sciences Agronomiques (FSA), Université d’Abomey-Calavi (UAC), Jéricho 03 BP 2819, Benin; (N.F.-F.); (E.N.); (J.H.)
| | - Eunice Nago
- Faculté des Sciences Agronomiques (FSA), Université d’Abomey-Calavi (UAC), Jéricho 03 BP 2819, Benin; (N.F.-F.); (E.N.); (J.H.)
| | - Joseph Hounhouigan
- Faculté des Sciences Agronomiques (FSA), Université d’Abomey-Calavi (UAC), Jéricho 03 BP 2819, Benin; (N.F.-F.); (E.N.); (J.H.)
| | - Jacques Berger
- Institut de Recherche pour le Développement (IRD), BP 64501-911, av. d’Agropolis, 34394 Montpellier, France; (M.D.); (J.B.); (F.W.)
- QualiSud, Univ Montpellier, Avignon Université, CIRAD, Institut Agro, IRD, Université de La Réunion, 34394 Montpellier, France
| | - Frank Wieringa
- Institut de Recherche pour le Développement (IRD), BP 64501-911, av. d’Agropolis, 34394 Montpellier, France; (M.D.); (J.B.); (F.W.)
- QualiSud, Univ Montpellier, Avignon Université, CIRAD, Institut Agro, IRD, Université de La Réunion, 34394 Montpellier, France
| | - Valerie Greffeuille
- Institut de Recherche pour le Développement (IRD), BP 64501-911, av. d’Agropolis, 34394 Montpellier, France; (M.D.); (J.B.); (F.W.)
- QualiSud, Univ Montpellier, Avignon Université, CIRAD, Institut Agro, IRD, Université de La Réunion, 34394 Montpellier, France
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Johnstone JM, Hughes A, Goldenberg JZ, Romijn AR, Rucklidge JJ. Multinutrients for the Treatment of Psychiatric Symptoms in Clinical Samples: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients 2020; 12:E3394. [PMID: 33158241 PMCID: PMC7694278 DOI: 10.3390/nu12113394] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 10/28/2020] [Indexed: 12/16/2022] Open
Abstract
This systematic review and meta-analysis focused on randomized controlled trials (RCT) of multinutrients consisting of at least four vitamins and/or minerals as interventions for participants with psychiatric symptoms. A systematic search identified 16 RCTs that fit the inclusion criteria (n = 1719 participants) in six psychiatric categories: depression, post-disaster stress, antisocial behavior, behavioral deficits in dementia, attention-deficit/hyperactivity disorder, and autism. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) was used to rate the evidence base. Significant clinical benefit was assessed using minimal clinically important differences (MIDs). Due to heterogeneity in participants, multinutrient formulas, outcome measures, and absence of complete data, only the Attention-Deficit/Hyperactivity Disorder (ADHD) category was eligible for meta-analyses. In ADHD populations, statistically and clinically significant improvements were found in global functioning, Mean Difference (MD) -3.3, p = 0.001, MID -3.26; Standardized Mean Difference (SMD) -0.49 p = 0.001 MD -0.5), clinician ratings of global improvement (MD -0.58, p = 0.001, MID -0.5) and ADHD improvement (MD -0.54, p = 0.002, MID -0.5), and clinician (but not observer) measures of ADHD inattentive symptoms (MD -1.53, p = 0.05, MID -0.5). Narrative synthesis also revealed a pattern of benefit for global measures of improvement, for example: in autism, and in participants with behavioral deficits in dementia. Post-natural disaster anxiety and the number of violent incidents in prison populations also improved. Broad-spectrum formulas (vitamins + minerals) demonstrated more robust effects than formulas with fewer ingredients. This review highlights the need for robust methodology-RCTs that report full data, including means and standard deviations for all outcomes-in order to further elucidate the effects of multinutrients for psychiatric symptoms.
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Affiliation(s)
- Jeanette M. Johnstone
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR 97201, USA;
- Child and Adolescent Psychiatry, Oregon Health & Science University, Portland, OR 97239, USA
| | - Andrew Hughes
- Adult Psychiatry, Oregon Health & Science University, Portland, OR 97239, USA;
| | - Joshua Z. Goldenberg
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR 97201, USA;
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Sydney 2007, Australia
| | - Amy R. Romijn
- Department of Psychology, Swansea University, Swansea SA2 8PP, UK;
| | - Julia J. Rucklidge
- School of Psychology, Speech and Hearing, University of Canterbury, 8140 Christchurch, New Zealand
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An Observational Preliminary Study on the Safety of Long-Term Consumption of Micronutrients for the Treatment of Psychiatric Symptoms. J Altern Complement Med 2019; 25:613-622. [DOI: 10.1089/acm.2018.0352] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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