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Zhang Y, Liu X, Liu M, Li M, Chen P, Yan G, Ma Q, Li Y, You D. Multidimensional influencing factors of postpartum depression based on the perspective of the entire reproductive cycle: evidence from western province of China. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02686-2. [PMID: 38789557 DOI: 10.1007/s00127-024-02686-2] [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: 10/13/2023] [Accepted: 05/03/2024] [Indexed: 05/26/2024]
Abstract
OBJECTIVE China has a serious burden of Postpartum depression (PPD). In order to improve the current situation of high burden of PPD, this study explores the factors affecting PPD from the multidimensional perspectives with physiology, family support and social support covering the full-time chain of pre-pregnancy-pregnancy-postpartum. METHODS A follow-up survey was conducted in the Qujing First People's Hospital of Yunnan Province from 2020 to 2022, and a total of 4838 pregnant women who underwent antenatal checkups in the hospital were enrolled as study subjects. Mothers were assessed for PPD using the Edinburgh Postnatal Depression Scale (EPDS), and logistic regression was used to analyse the level of mothers' postnatal depression and identify vulnerability characteristics. RESULTS The prevalence of mothers' PPD was 46.05%, with a higher prevalence among those who had poor pre-pregnancy health, had sleep problems during pregnancy, and only had a single female fetus. In the family support dimension, only family care (OR = 0.52, 95% CI 0.42-0.64) and only other people care(OR = 0.78, 95% CI 0.64-0.96) were the protective factors of PPD. The experience risk of PPD was higher among mothers who did not work or use internet. CONCLUSION The PPD level in Yunnan Province was significantly higher than the global and Chinese average levels. Factors affecting mothers' PPD exist in all time stages throughout pregnancy, and the influence of family support and social support on PPD shouldn't be ignored. There is an urgent need to extend the time chain of PPD, move its prevention and treatment forward and broaden the dimensions of its intervention.
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Affiliation(s)
- Yiyun Zhang
- School of Ethnology and Sociology, Yunnan University, Kunming, 650091, Yunnan, China
| | - Xinwei Liu
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, 150086, Heilongjiang, China
| | - Mengmei Liu
- School of Public Health, Kunming Medical University, Kunming, 650500, Yunnan, China
| | - Min Li
- School of Public Health, Kunming Medical University, Kunming, 650500, Yunnan, China
| | - Ping Chen
- School of Public Health, Kunming Medical University, Kunming, 650500, Yunnan, China
| | - Guanghong Yan
- School of Public Health, Kunming Medical University, Kunming, 650500, Yunnan, China
| | - Qingyan Ma
- School of Public Health, Kunming Medical University, Kunming, 650500, Yunnan, China
| | - Ye Li
- School of Public Health, Hangzhou Normal University, Hangzhou, 311121, Zhejiang, China.
| | - Dingyun You
- Yunnan Provincial Key Laboratory of Public Health and Biosafety & School of Public Health, Kunming Medical University, Kunming, 650500, Yunnan, China.
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Di Benedetto MG, Landi P, Mencacci C, Cattaneo A. Depression in Women: Potential Biological and Sociocultural Factors Driving the Sex Effect. Neuropsychobiology 2024; 83:2-16. [PMID: 38272005 PMCID: PMC10871691 DOI: 10.1159/000531588] [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: 05/16/2022] [Accepted: 05/24/2023] [Indexed: 01/27/2024]
Abstract
Important sex-related differences have been observed in the onset, prevalence, and clinical phenotype of depression, based on several epidemiological studies. Social, behavioural, and educational factors have a great role in underlying this bias; however, also several biological factors are extensively involved. Indeed, sexually dimorphic biological systems might represent the underlying ground for these disparities, including cerebral structures and neural correlates, reproductive hormones, stress response pathways, the immune system and inflammatory reaction, metabolism, and fat distribution. Furthermore, in this perspective, it is also important to consider and focus the attention on specific ages and life stages of individuals: indeed, women experience during their life specific periods of reproductive transitional phases, which are not found in men, that represent windows of particular psychological vulnerability. In addition to these, other biologically related risk factors, including the occurrence of sleep disturbances and the exposure to childhood trauma, which are found to differentially affect men and women, are also putative underlying mechanisms of the clinical bias of depression. Overall, by taking into account major differences which characterize men and women it might be possible to improve the diagnostic process, as well as treat more efficiently depressed individuals, based on a more personalized medicine and research.
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Affiliation(s)
- Maria Grazia Di Benedetto
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy,
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy,
| | - Paola Landi
- Department of Neuroscience, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Claudio Mencacci
- Department of Neuroscience, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Annamaria Cattaneo
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
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Cáceres A, Cruz SM, de León C, Méndez R. Yield and Chemical Characteristics of Salvia hispanica L. (Chia) Oil from Native Seeds from Four Provenances of Guatemala. Comb Chem High Throughput Screen 2024; 27:555-561. [PMID: 37183473 DOI: 10.2174/1386207326666230512124457] [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: 03/18/2023] [Revised: 04/13/2023] [Accepted: 04/13/2023] [Indexed: 05/16/2023]
Abstract
INTRODUCTION Chia (Salvia hispanica L.) is a plant from the Lamiaceae family that has been used as ancestral food, medicine, and oil, with culinary, artistic, and religious purposes by most of the Mesoamerican civilizations. Native from Mesoamerica, introduced into South America, Australia, and Europe, it is presently consumed as a nutritional and functional food. OBJECTIVE This research aims to characterize ancient native cultivars from four provenances in Guatemala to recommend their direct consumption by the population as well as to establish its trade. METHODS Seed samples were collected in four places where they have been cultivated for several generations. The oil was obtained by expression and analyzed chemically by gas chromatography following standard qualitative and quantitative methods. RESULTS Variations in oil yield and some of the characteristic parameters of the phytochemical analysis were obtained. In general, the profile was similar to most of the reported data in the literature, with the saturated fatty acids (8.54-9.25%) relatively lower than the references (7.95-11.45%) but a higher concentration of unsaturated fatty oils, particularly of omega-3 (64.68-68.62%). CONCLUSION The oil from native cultivars contains high quantities of omega-3, which might help pregnant women during gestation and to control other conditions such as metabolic syndrome, particularly in low- and middle-income populations where these seeds are consumed regularly. The suggestion is made to encourage the cultivation and use of these ancestral seeds with the possibility of commercialization abroad with an appellation of origin label.
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Affiliation(s)
- Armando Cáceres
- Laboratorio de Investigación de Productos Naturales (Lipronat), Facultad de Ciencias Químicas y Farmacia, Universidad de San Carlos, Cdad. de Guatemala, 01002, Guatemala
- Laboratorio de Productos Naturales Farmaya, Guatemala
| | - Sully M Cruz
- Laboratorio de Investigación de Productos Naturales (Lipronat), Facultad de Ciencias Químicas y Farmacia, Universidad de San Carlos, Cdad. de Guatemala, 01002, Guatemala
| | - Claudia de León
- Instituto de Investigaciones Químicas, Biológicas, Biomédicas y Biofísicas, Universidad Mariano Gálvez, Cdad. de Guatemala, Guatemala
| | - Rebeca Méndez
- Instituto de Investigaciones Químicas, Biológicas, Biomédicas y Biofísicas, Universidad Mariano Gálvez, Cdad. de Guatemala, Guatemala
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Masot O, Ochoa Herrera JJ, Paraíso Pueyo E, Roca J, Miranda J, Lavedán A. The impact of docosahexaenoic acid on maternal mental health: scoping review. NUTR HOSP 2023; 40:848-857. [PMID: 37334807 DOI: 10.20960/nh.04523] [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] [Indexed: 06/21/2023] Open
Abstract
Introduction Docosahexaenoic acid (DHA) is a polyunsaturated essential fatty acid from the omega-3 series that appears to be key to perinatal mental health. For this, the aim of this review is to evaluate the effect of DHA on maternal mental health during pregnancy and lactation with respect to depression and anxiety. The present scoping review was carried out following the methodology of Arksey and O'Malley (2005). The selection of studies was carried out in accordance with PRISMA by means of systematic searches in the PubMed, Scopus, PsycINFO and Medline databases. The results classified according to the effectiveness of DHA. In most (n = 9) of the 14 studies finally included, DHA plasma levels with or without other polyunsaturated omega-3 fatty acids were significantly lower in pregnant women with depressive and anxiety symptoms. However, no study reported a beneficial effect of DHA on mental health during the postpartum period. The majority used detection method was the Edinburgh Postpartum Depression Scale (n = 11). The prevalence of depressive symptoms ranged between 5.9 % and 50 %. As a conclusion, although more research is needed in this area, these exploratory results suggest that DHA could play an important role in preventing the pathogenesis of depression and anxiety during gestation.
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Affiliation(s)
- Olga Masot
- Department of Nursing and Physiotherapy. Universidad de Lleida. Health Care Research Group (GRECS). Instituto de Investigación Biomédica de Lleida Fundación Dr. Pifarré. IRBLleida
| | - Julio José Ochoa Herrera
- Instituto de Nutrición y Tecnología de los Alimentos José Mataix Verdú (INYTA). Department of Physiology. Universidad de Granada
| | - Elena Paraíso Pueyo
- Department of Nursing and Physiotherapy. Universidad de Lleida. Health Care Research Group (GRECS). Instituto de Investigación Biomédica de Lleida Fundación Dr. Pifarré. IRBLleida
| | - Judith Roca
- Department of Nursing and Physiotherapy. Universidad de Lleida. Health Care Research Group (GRECS). Instituto de Investigación Biomédica de Lleida Fundación Dr. Pifarré. IRBLleida
| | - Jéssica Miranda
- Department of Nursing and Physiotherapy. Universidad de Lleida. Health Care Research Group (GRECS). Instituto de Investigación Biomédica de Lleida Fundación Dr. Pifarré. IRBLleida
| | - Ana Lavedán
- Department of Nursing and Physiotherapy. Universidad de Lleida. Health Care Research Group (GRECS). Instituto de Investigación Biomédica de Lleida Fundación Dr. Pifarré. IRBLleida
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Antao HS, Sacadura-Leite E, Bandarra NM, Figueira ML. Omega-3 index as risk factor in psychiatric diseases: a narrative review. Front Psychiatry 2023; 14:1200403. [PMID: 37575565 PMCID: PMC10416246 DOI: 10.3389/fpsyt.2023.1200403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 07/12/2023] [Indexed: 08/15/2023] Open
Abstract
Numerous studies have described associations between the omega-3 index (defined as the RBC percentage of EPA and DHA) and mental conditions, but no risk stratification or target value has gathered consensus so far. This narrative review aims to summarize the published data on the association between omega-3 index and mental illness and to contribute to the concept of an omega-3 index in the field of mental health. The bibliographic searches have been carried out in PubMed, Scopus and Web of Science databases to find relevant English language original research studies related to that association. The study search and selection process were registered in a PRISMA flow. Thirty-six studies were included in this review examining the links between omega-3 index and postpartum depression (3), major depression (15), major depression and bipolar disorder (1), bipolar disorder (4), schizophrenia and major depression (1), schizophrenia and other psychosis (5) and dementia (7). Thirty of these studies found either significant differences in omega-3 index between patients and controls or inverse relationships between omega-3 index and disease severity. The published evidence is compelling enough to suggest omega-3 index as a risk factor for some psychiatric diseases, specifically, major depression, postpartum depression, psychosis, and dementia. In occidental populations, we propose a risk threshold of (a) 4-5% in major depression and dementia, (b) 5% in postpartum depression, and (c) 4% for psychosis transition.
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Affiliation(s)
| | - Ema Sacadura-Leite
- Faculty of Medicine, University of Lisbon, Lisbon, Portugal
- CISP – Centro de Investigação em Saúde Pública, ENSP, Lisbon, Portugal
- Centro Hospitalar Universitário de Lisboa Norte (CHULN), Lisbon, Portugal
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Jiang Y, Chen Y, Wei L, Zhang H, Zhang J, Zhou X, Zhu S, Du Y, Su R, Fang C, Ding W, Feng L. DHA supplementation and pregnancy complications. J Transl Med 2023; 21:394. [PMID: 37330569 PMCID: PMC10276458 DOI: 10.1186/s12967-023-04239-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 05/31/2023] [Indexed: 06/19/2023] Open
Abstract
Docosahexaenoic acid (DHA) supplementation is recommended for women during pregnancy because of its neurological, visual, and cognitive effects. Previous studies have suggested that DHA supplementation during pregnancy may prevent and treat certain pregnancy complications. However, there are contradictions in the current related studies, and the specific mechanism by which DHA acts remains unclear. This review summarizes the research on the relationship between DHA intake during pregnancy and preeclampsia, gestational diabetes mellitus, preterm birth, intrauterine growth restriction, and postpartum depression. Furthermore, we explore the impact of DHA intake during pregnancy on the prediction, prevention, and treatment of pregnancy complications as well as its impact on offspring neurodevelopment. Our results suggest that there is limited and controversial evidence for the protective effect of DHA intake on pregnancy complications, with the exception of preterm birth and gestational diabetes mellitus. However, additional DHA supplementation may improve long-term neurodevelopmental outcomes in the offspring of women with pregnancy complications.
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Affiliation(s)
- Yi Jiang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Yuting Chen
- Department of Obstetrics and Gynecology Ultrasound, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Lijie Wei
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Huiting Zhang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Jingyi Zhang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Xuan Zhou
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Shenglan Zhu
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Yuanyuan Du
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Rui Su
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Chenyun Fang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Wencheng Ding
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, 430030, Hubei, China.
| | - Ling Feng
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, 430030, Hubei, China.
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Osuna E, Symington EA, Malan L, Ricci C, Zandberg L, Smuts CM, Baumgartner J. Higher n-3 polyunsaturated fatty acid status during early pregnancy is associated with lower risk for depression at 12 months postpartum: The NuPED study. Prostaglandins Leukot Essent Fatty Acids 2023; 190:102528. [PMID: 36716632 DOI: 10.1016/j.plefa.2022.102528] [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: 07/06/2022] [Revised: 11/30/2022] [Accepted: 12/23/2022] [Indexed: 01/15/2023]
Abstract
Perinatal depression can negatively affect the health of the mother and her offspring. N-3 polyunsaturated fatty acids (PUFA) may play a role in the aetiology of depression. Therefore, we investigated the association of n-3 PUFA status during early pregnancy with perinatal depression among women living in urban Johannesburg, South Africa. For this prospective analysis, we analysed red blood cell (RBC) total phospholipid fatty acid (FA) composition (% of total FA) of 242 pregnant women at <18 weeks' gestation. We used the Edinburgh Postnatal Depression Scale (EPDS) to identify women at risk for depression (EPDS score ≥9) at <18, 22 and 36 weeks' gestation, and at 6 and 12 months postpartum. RBC EPA status was negatively (β=-0.22, p<0.05), and the AA/EPA ratio positively (β=0.24, p<0.05) associated with EPDS scores at 12 months postpartum. Higher RBC DHA and n-3 index were further associated with lower odds (OR=0.56 [95% CI: 0.32-0.91]; OR=0.63 [95% CI: 0.39-0.94]), while higher n-6/n-3 PUFA and AA/EPA ratios early in pregnancy were associated with higher odds for depression at 12 months postpartum ((OR=2.34 [95% CI: 1.12-4.97]; OR=1.02 [95% CI: 1.00-1.05]). Our results suggest that women with a higher RBC n-3 PUFA status during early pregnancy may be at lower risk for depression at 12 months postpartum.
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Affiliation(s)
- Ester Osuna
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Switzerland
| | - Elizabeth A Symington
- Department of Life and Consumer Sciences, University of South Africa, Johannesburg, South Africa
| | - Linda Malan
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
| | - Cristian Ricci
- Africa Unit for Transdisciplinary Health Research (AUTHER), North-West University, Potchefstroom, South Africa
| | - Lizelle Zandberg
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
| | - Cornelius M Smuts
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
| | - Jeannine Baumgartner
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Switzerland; Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa; Department of Nutritional Sciences, King's College London, London, United Kingdom.
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Harris WS, Tintle NL, Sathyanarayanan SP, Westra J. Association between blood N-3 fatty acid levels and the risk of coronavirus disease 2019 in the UK Biobank. Am J Clin Nutr 2023; 117:357-363. [PMID: 36863828 PMCID: PMC9972865 DOI: 10.1016/j.ajcnut.2022.11.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/10/2022] [Accepted: 11/15/2022] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND The role of nutritional status and the risk of contracting and/or experiencing adverse outcomes from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are unclear. Preliminary studies suggest that higher n-3 PUFA intakes are protective. OBJECTIVES This study aimed to compare the risk of 3 coronavirus disease 2019 (COVID-19) outcomes (testing positive for SARS-CoV-2, hospitalization, and death) as a function of the baseline plasma DHA levels. METHODS The DHA levels (% of total fatty acids [FAs]) were measured by nuclear magnetic resonance. The 3 outcomes and relevant covariates were available for 110,584 subjects (hospitalization and death) and for 26,595 ever-tested subjects (positive for SARS-CoV-2) in the UK Biobank prospective cohort study. Outcome data between 1 January, 2020, and 23 March, 2021, were included. The Omega-3 Index (O3I) (RBC EPA + DHA%) values across DHA% quintiles were estimated. The multivariable Cox proportional hazards models were constructed, and linear (per 1 SD) relations with the risk of each outcome were computed as HRs. RESULTS In the fully adjusted models, comparing the fifth to the first DHA% quintiles, the HRs (95% confidence intervals) for testing positive, being hospitalized, and dying with COVID-19 were 0.79 (0.71, 0.89, P < 0.001), 0.74 (0.58, 0.94, P < 0.05), and 1.04 (0.69-1.57, not significant), respectively. On a per 1-SD increase in DHA% basis, the HRs for testing positive, hospitalization, and death, were 0.92 (0.89, 0.96, P < 0.001), 0.89 (0.83, 0.97, P < 0.01), and 0.95 (0.83, 1.09), respectively. The estimated O3I values across DHA quintiles ranged from 3.5% (quintile 1) to 8% (quintile 5). CONCLUSIONS These findings suggest that nutritional strategies to increase the circulating n-3 PUFA levels, such as increased consumption of oily fish and/or use of n-3 FA supplements, may reduce the risk of adverse COVID-19 outcomes.
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Affiliation(s)
- William S Harris
- Fatty Acid Research Institute, Sioux Falls, SD, USA; Department of Internal Medicine, Sanford School of Medicine, University of South Dakota, Sioux Falls, SD, USA.
| | - Nathan L Tintle
- Fatty Acid Research Institute, Sioux Falls, SD, USA; Department of Population Health Nursing Science, College of Nursing, University of Illinois-Chicago, Chicago, IL, USA
| | | | - Jason Westra
- Fatty Acid Research Institute, Sioux Falls, SD, USA
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Li S, Yang Z, Yao M, Shen Y, Zhu H, Jiang Y, Ji Y, Yin J. Exploration for biomarkers of postpartum depression based on metabolomics: A systematic review. J Affect Disord 2022; 317:298-306. [PMID: 36031003 DOI: 10.1016/j.jad.2022.08.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 08/16/2022] [Accepted: 08/19/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND Postpartum depression (PPD) is the most frequent psychiatric complication during the postnatal period and its mechanisms are not fully understood. Metabolomics, can quantitatively measure metabolites in a high-throughput method, and thus uncover the underlying pathophysiology of disease. OBJECTIVES In this study, we reviewed metabolomics studies conducted on PPD, aiming to understand the changes of metabolites in PPD patients and analyze the potential application of metabolomics in PPD prediction and diagnosis. METHODS Relevant articles were searched in PubMed, Google scholar, and Web of Science databases from January 2011 to July 2022. The metabolites involved were systematically examined and compared. MetaboAnalyst online software was applied to analyze metabolic pathways. RESULTS A total of 14 papers were included in this study. There were several highly reported metabolites, such as kynurenine, kynurenic acid, and eicosapentaenoic acid. Dysregulation of metabolic pathways involved amino acids metabolism, fatty acids metabolism, and steroids metabolism. LIMITATIONS The included studies are relatively inadequate, and further work is needed. CONCLUSIONS This study summarized significant metabolic alterations that provided clues for the prediction, diagnosis, and pathogenesis of PPD.
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Affiliation(s)
- Shiming Li
- The affiliated Wuxi Mental Health Center with Nanjing Medical University, Wuxi Tongren Rehabilitation Hospital, Wuxi, Jiangsu 214151, China
| | - Zhuoqiao Yang
- Department Of Epidemiology and Health Statistics, Medical College of Soochow University, Suzhou, China
| | - Mengxin Yao
- Department Of Epidemiology and Health Statistics, Medical College of Soochow University, Suzhou, China
| | - Ying Shen
- Rehabilitation Medicine Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Haohao Zhu
- The affiliated Wuxi Mental Health Center with Nanjing Medical University, Wuxi Tongren Rehabilitation Hospital, Wuxi, Jiangsu 214151, China
| | - Ying Jiang
- The affiliated Wuxi Mental Health Center with Nanjing Medical University, Wuxi Tongren Rehabilitation Hospital, Wuxi, Jiangsu 214151, China
| | - Yingying Ji
- The affiliated Wuxi Mental Health Center with Nanjing Medical University, Wuxi Tongren Rehabilitation Hospital, Wuxi, Jiangsu 214151, China.
| | - Jieyun Yin
- Department Of Epidemiology and Health Statistics, Medical College of Soochow University, Suzhou, China.
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Spahr A, Divnic‐Resnik T. Impact of health and lifestyle food supplements on periodontal tissues and health. Periodontol 2000 2022; 90:146-175. [PMID: 35916868 PMCID: PMC9804634 DOI: 10.1111/prd.12455] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
According to the new classification, periodontitis is defined as a chronic multifactorial inflammatory disease associated with dysbiotic biofilms and characterized by progressive destruction of the tooth-supporting apparatus. This definition, based on the current scientific evidence, clearly indicates and emphasizes, beside the microbial component dental biofilm, the importance of the inflammatory reaction in the progressive destruction of periodontal tissues. The idea to modulate this inflammatory reaction in order to decrease or even cease the progressive destruction was, therefore, a logical consequence. Attempts to achieve this goal involve various kinds of anti-inflammatory drugs or medications. However, there is also an increasing effort in using food supplements or so-called natural food ingredients to modulate patients' immune responses and maybe even improve the healing of periodontal tissues. The aim of this chapter of Periodontology 2000 is to review the evidence of various food supplements and ingredients regarding their possible effects on periodontal inflammation and wound healing. This review may help researchers and clinicians to evaluate the current evidence and to stimulate further research in this area.
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Affiliation(s)
- Axel Spahr
- Discipline of Periodontics, School of Dentistry, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Tihana Divnic‐Resnik
- Discipline of Periodontics, School of Dentistry, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
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Schuchardt JP, Cerrato M, Ceseri M, DeFina LF, Delgado GE, Gellert S, Hahn A, Howard BV, Kadota A, Kleber ME, Latini R, Maerz W, Manson JE, Mora S, Park Y, Sala-Vila A, von Schacky C, Sekikawa A, Tintle N, Tucker KL, Vasan RS, Harris WS. Red blood cell fatty acid patterns from 7 countries: Focus on the Omega-3 index. Prostaglandins Leukot Essent Fatty Acids 2022; 179:102418. [PMID: 35366625 PMCID: PMC10440636 DOI: 10.1016/j.plefa.2022.102418] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/23/2022] [Accepted: 03/23/2022] [Indexed: 11/29/2022]
Abstract
Red blood cell (RBC) fatty acid (FA) patterns are becoming recognized as long-term biomarkers of tissue FA composition, but different analytical methods have complicated inter-study and international comparisons. Here we report RBC FA data, with a focus on the Omega-3 Index (EPA + DHA in% of total FAs in RBC), from samples of seven countries (USA, Canada, Italy, Spain, Germany, South Korea, and Japan) including 167,347 individuals (93% of all samples were from the US). FA data were generated by a uniform methodology from a variety of interventional and observational studies and from clinical laboratories. The cohorts differed in size, demographics, health status, and year of collection. Only the Canadian cohort was a formal, representative population-based survey. The mean Omega-3 Index of each country was categorized as desirable (>8%), moderate (>6% to 8%), low (>4% to 6%), or very low (≤4%). Only cohorts from Alaska (treated separately from the US), South Korea and Japan showed a desirable Omega-3 Index. The Spanish cohort had a moderate Omega-3 Index, while cohorts from the US, Canada, Italy, and Germany were all classified as low. This study is limited by the use of cohorts of convenience and small sample sizes in some countries. Countries undertaking national health status studies should utilize a uniform method to measure Omega-3 FA levels.
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Affiliation(s)
- Jan Philipp Schuchardt
- Institute of Food Science and Human Nutrition, Leibniz University Hannover, Am Kleinen Felde 30, Hannover 30167, Germany; The Fatty Acid Research Institute, Sioux Falls, SD, USA.
| | - Marianna Cerrato
- Department of Cardiovascular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Martina Ceseri
- Department of Cardiovascular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | | | - Graciela E Delgado
- Vth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sandra Gellert
- Institute of Food Science and Human Nutrition, Leibniz University Hannover, Am Kleinen Felde 30, Hannover 30167, Germany
| | - Andreas Hahn
- Institute of Food Science and Human Nutrition, Leibniz University Hannover, Am Kleinen Felde 30, Hannover 30167, Germany
| | | | - Aya Kadota
- NCD Epidemiology Research Center, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Marcus E Kleber
- Vth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; SYNLAB MVZ Humangenetik Mannheim, Mannheim, Germany
| | - Roberto Latini
- Department of Cardiovascular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Winfried Maerz
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria; Medical Clinic V, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; SYNLAB Academy, Mannheim, Germany
| | - JoAnn E Manson
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Samia Mora
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Yongsoon Park
- The Fatty Acid Research Institute, Sioux Falls, SD, USA; Department of Food and Nutrition, Hanyang University, Seoul, South Korea
| | - Aleix Sala-Vila
- The Fatty Acid Research Institute, Sioux Falls, SD, USA; Cardiovascular risk and nutrition group, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain
| | | | - Akira Sekikawa
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Nathan Tintle
- The Fatty Acid Research Institute, Sioux Falls, SD, USA; Department of Population Health Nursing Science, College of Nursing, University of Illinois - Chicago, Chicago, IL, USA
| | - Katherine L Tucker
- Department of Biomedical Nutritional Sciences and Center for Population Health, University of Massachusetts Lowell, Lowell, MA, USA
| | - Ramachandran S Vasan
- Department of Medicine, Preventive Medicine & Epidemiology, School of Medicine, Boston University, Boston, MA, USA
| | - William S Harris
- The Fatty Acid Research Institute, Sioux Falls, SD, USA; Department of Internal Medicine, Sanford School of Medicine, University of South Dakota, Sioux Falls, SD, USA
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12
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Letourneau N, Aghajafari F, Bell RC, Deane AJ, Dewey D, Field C, Giesbrecht G, Kaplan B, Leung B, Ntanda H. The Alberta Pregnancy Outcomes and Nutrition (APrON) longitudinal study: cohort profile and key findings from the first three years. BMJ Open 2022; 12:e047503. [PMID: 35131812 PMCID: PMC8823238 DOI: 10.1136/bmjopen-2020-047503] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
PURPOSE The objectives of the ongoing Canadian longitudinal cohort called the Alberta Pregnancy Outcomes and Nutrition (APrON) study are to: (1) determine the relationship between maternal nutrient intake and status before, during, after pregnancy, and (a) maternal mental health, (b) pregnancy and birth outcomes, and (c) infant/child neurodevelopment and behavior; (2) identify maternal mental health and nutrient predictors of child behaviour; and (3) establish a DNA biobank to explore genomic predictors of children's neurodevelopment and behavior. The purpose of this paper is to describe the participants, measures, and key findings on maternal and paternal mental health, maternal nutrition, and child outcomes to when children are 3 years of age. PARTICIPANTS Participants included mothers and their children (n=2189) and mothers' partners (usually fathers; n=1325) from whom data were collected during the period from pregnancy to when children were 3 years of age, in Alberta, Canada. More than 88% of families have been retained to take part in completed data collection at 8 years of age. FINDINGS TO DATE Data comprise: questionnaires completed by pregnant women/mothers and their partners on mothers', fathers' and children's health; dietary interviews; clinical assessments; linkage to hospital obstetrical records; and biological samples such as DNA. Key findings on mental health, nutrition and child outcomes are presented. APrON women who consumed more selenium and omega-3 were less likely to develop symptoms of perinatal depression. Higher prenatal consumption of choline rich foods such as eggs and milk were recommended as was vitamin D supplementation for both mothers and children to meet guidelines. Couples in which both mothers and fathers were affected by perinatal depression reported lower incomes and higher maternal prenatal depressive symptoms and lower support from fathers postnatally and their children presented with the most behavioural problems. Maternal experiences of early adversity predicted increased likelihood of perinatal depression and anxiety and children's behavioural problems. FUTURE PLANS The APrON cohort offers a unique opportunity to advance understanding of the developmental origins of health and disease. There is a planned follow-up to collect data at 12 years of age.
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Affiliation(s)
- Nicole Letourneau
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
- Cumming School of Medicine (Departments of Paediatrics, Psychiatry & Community Health Sciences), University of Calgary, Calgary, Alberta, Canada
| | - Fariba Aghajafari
- Cumming School of Medicine (Family Medicine & Community Health Sciences), University of Calgary, Calgary, Alberta, Canada
| | - Rhonda C Bell
- Faculty of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Andrea J Deane
- Cumming School of Medicine (Pediatrics), University of Calgary, Calgary, Alberta, Canada
| | - Deborah Dewey
- Cumming School of Medicine (Pediatrics), University of Calgary, Calgary, Alberta, Canada
| | - Catherine Field
- Faculty of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Gerald Giesbrecht
- Cumming School of Medicine (Pediatrics & Community Health Sciences), University of Calgary, Calgary, Alberta, Canada
| | - Bonnie Kaplan
- Cumming School of Medicine (Pediatrics & Community Health Sciences), University of Calgary, Calgary, Alberta, Canada
| | - Brenda Leung
- Health Science - Public Health Program, University of Lethbridge, Lethbridge, Alberta, Canada
| | - Henry Ntanda
- Cumming School of Medicine (Pediatrics), University of Calgary, Calgary, Alberta, Canada
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13
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Murff HJ, Greevy RA, Sanghani RS, Hartmann KE, Hartert TV, Graves CR, Lee SS, Tindle HA. Investigating N-3 Fatty Acids to prevent Neonatal Tobacco-related outcomeS (INFANTS): study protocol for a double-blind, randomized, placebo-controlled parallel clinical trial of n-3 polyunsaturated fatty acids in pregnant smokers. Trials 2021; 22:922. [PMID: 34906201 PMCID: PMC8669400 DOI: 10.1186/s13063-021-05865-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 11/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Tobacco use during pregnancy is the most important modifiable risk factor associated with adverse pregnancy outcomes, increasing the risk of preterm birth, intrauterine growth restriction and sudden infant death syndrome. Fewer than half of pregnant smokers can quit on their own. Identifying safe and effective therapies to prevent tobacco-related adverse pregnancy outcomes and/or increase smoking cessation in pregnant women would have a substantial public health impact. Cigarette smoking is associated with a relative deficiency in circulating n-3 long-chain polyunsaturated fatty acid (n-3 LCPUFA) levels. A recent analysis found that smokers taking n-3 LCPUFAs during pregnancy had a reduction in preterm labor risk when compared to non-smokers. Studies have shown that supplemental n-3 LCPUFAs may also reduce nicotine cravings and daily cigarette use. Thus, smokers may benefit from supplemental n-3 LCPUFAs by lowering the risk of preterm labor and/or increased smoking cessation. To address important remaining knowledge gaps, we propose the Investigating N-3 Fatty Acids to prevent Neonatal Tobacco related outcomeS (INFANTS). METHODS The INFANTS study is a multicenter, randomized, double-blind, placebo-controlled study that will randomize 400 pregnant smokers to either supplemental n-3 LCPUFAs or placebo. Participants will be enrolled between 12 and 24 weeks' gestation and followed until 6 weeks after delivery. We will recruit from clinical centers throughout Middle Tennessee. We will assess smoking behavior after 12 weeks of supplementation using self-report and validated biomarkers of tobacco exposure. We will measure response to supplementation using biological markers of n-3 LCPUFA status. Our primary endpoint will be preterm labor as reflected by gestational age at delivery. Our secondary endpoint will be change from baseline in cigarettes per day at 12 weeks. DISCUSSION This study tests the hypothesis that smoking-induced n-3 LCPUFA deficiencies contribute to tobacco-related adverse pregnancy outcomes and that supplementation of n-3 LCPUFAs in pregnant smokers may prevent these complications. If our study demonstrates that supplemental n-3 LCPUFAs are effective at reducing the risk of tobacco-related adverse neonatal outcomes and/or reducing tobacco use during pregnancy, our results could have an immediate and major impact on pregnancy care and neonatal outcomes. TRIAL REGISTRATION ClinicalTrials.gov NCT04417595. Registered on April 21, 2020.
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Affiliation(s)
- Harvey J Murff
- Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, 2525 West End Avenue, Suite 450, Nashville, TN, 37232, USA.
- Geriatric Research, Education and Clinical Center, Tennessee Valley Healthcare System, Nashville, TN, USA.
| | - Robert A Greevy
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, USA
| | - Reesha S Sanghani
- Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, USA
| | - Katherine E Hartmann
- Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, USA
| | - Tina V Hartert
- Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, USA
| | | | - Scott S Lee
- Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, 2525 West End Avenue, Suite 450, Nashville, TN, 37232, USA
| | - Hilary A Tindle
- Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, 2525 West End Avenue, Suite 450, Nashville, TN, 37232, USA
- Geriatric Research, Education and Clinical Center, Tennessee Valley Healthcare System, Nashville, TN, USA
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14
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Xavier S, Soch A, Younesi S, Malik S, Spencer SJ, Sominsky L. Maternal diet before and during pregnancy modulates microglial activation and neurogenesis in the postpartum rat brain. Brain Behav Immun 2021; 98:185-197. [PMID: 34418500 DOI: 10.1016/j.bbi.2021.08.223] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 08/11/2021] [Accepted: 08/14/2021] [Indexed: 01/12/2023] Open
Abstract
The implications of poor maternal diet on offspring metabolic and neuroimmune development are well established. Increasing evidence now suggests that maternal obesity and poor diet can also increase the risk of postpartum mood disorders, but the mechanisms are unknown. Here we investigated the effects of a poor, high-fat-high-sugar diet (HFSD) on peripheral and central inflammation, neurogenesis and postpartum anxiety-like behaviours. We hypothesised that long-term consumption of a HFSD pre- and post-conception would increase the levels of circulating cytokines and induce microglial activation, particularly in the arcuate nucleus of the hypothalamus (ARC), as the primary brain region involved in the integration of satiety signalling; and this would lead to increased anxiety, stress responsivity and disrupted neurogenesis. We further hypothesised that these effects would be ameliorated by consumption of a healthier diet during pregnancy - specifically a diet high in omega-3 polyunsaturated fatty acids (PUFAs). As expected, the HFSD significantly increased pre-conception body weight, elevated circulating cytokines and activated microglia in the ARC, as well as in the basolateral amygdala. The HFSD also significantly increased the numbers of immature (doublecortin (DCX)-positive) neurons in the subgranular/granular region of the hippocampus, a neurogenic response that was, surprisingly, mimicked by consumption of a diet high in omega-3 PUFAs. Despite these effects of peri-pregnancy dietary imbalance, we detected no differences in anxiety-like behaviours or hypothalamic-pituitary-adrenal (HPA) axis reactivity between the groups. A shift to a healthier diet post-conception reversed the peripheral inflammation and alleviated the microglial activation. These novel data indicate the importance of a balanced peri-pregnancy diet and highlight the need for future research into key triggers that alter the neuroimmune balance in the maternal brain.
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Affiliation(s)
- Soniya Xavier
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
| | - Alita Soch
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
| | - Simin Younesi
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
| | - Sajida Malik
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
| | - Sarah J Spencer
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia; ARC Centre of Excellence for Nanoscale Biophotonics, RMIT University, Melbourne, VIC, Australia
| | - Luba Sominsky
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia; Barwon Health Laboratory, Barwon Health University Hospital, Geelong, VIC, Australia; Institute for Physical and Mental Health and Clinical Transformation, School of Medicine, Deakin University, Geelong, VIC, Australia.
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15
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Importance of EPA and DHA Blood Levels in Brain Structure and Function. Nutrients 2021; 13:nu13041074. [PMID: 33806218 PMCID: PMC8066148 DOI: 10.3390/nu13041074] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/24/2021] [Accepted: 03/24/2021] [Indexed: 12/14/2022] Open
Abstract
Brain structure and function depend on a constant and sufficient supply with eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) by blood. Blood levels of EPA and DHA reflect dietary intake and other variables and are preferably assessed as percentage in erythrocytes with a well-documented and standardized analytical method (HS-Omega-3 Index®). Every human being has an Omega-3 Index between 2 and 20%, with an optimum of 8–11%. Compared to an optimal Omega-3 Index, a lower Omega-3 Index was associated with increased risk for total mortality and ischemic stroke, reduced brain volume, impaired cognition, accelerated progression to dementia, psychiatric diseases, compromises of complex brain functions, and other brain issues in epidemiologic studies. Most intervention trials, and their meta-analyses considered EPA and DHA as drugs with good bioavailability, a design tending to produce meaningful results in populations characterized by low baseline blood levels (e.g., in major depression), but otherwise responsible for many neutral results and substantial confusion. When trial results were evaluated using blood levels of EPA and DHA measured, effects were larger than comparing EPA and DHA to placebo groups, and paralleled epidemiologic findings. This indicates future trial design, and suggests a targeted use EPA and DHA, based on the Omega-3 Index.
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16
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Yu Y, Liang HF, Chen J, Li ZB, Han YS, Chen JX, Li JC. Postpartum Depression: Current Status and Possible Identification Using Biomarkers. Front Psychiatry 2021; 12:620371. [PMID: 34211407 PMCID: PMC8240635 DOI: 10.3389/fpsyt.2021.620371] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 05/19/2021] [Indexed: 12/25/2022] Open
Abstract
Postpartum depression (PPD) is a serious health issue that can affect about 15% of the female population within after giving birth. It often conveys significant negative consequences to the offsprings. The symptoms and risk factors are somewhat similar to those found in non-postpartum depression. The main difference resides in the fact that PPD is triggered by postpartum specific factors, including especially biological changes in the hormone levels. Patients are usually diagnosed using a questionnaire onsite or in a clinic. Treatment of PPD often involves psychotherapy and antidepressant medications. In recent years, there have been more researches on the identification of biological markers for PPD. In this review, we will focus on the current research status of PPD, with an emphasis on the recent progress made on the identification of PPD biomarkers.
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Affiliation(s)
- Yi Yu
- Central Laboratory, Yangjiang People's Hospital, Yangjiang, China.,Center for Analyses and Measurements, College of Chemical Engineering, Zhejiang University of Technology, Hangzhou, China
| | - Hong-Feng Liang
- Central Laboratory, Yangjiang People's Hospital, Yangjiang, China
| | - Jing Chen
- Central Laboratory, Yangjiang People's Hospital, Yangjiang, China.,Institute of Cell Biology, Zhejiang University, Hangzhou, China
| | - Zhi-Bin Li
- Central Laboratory, Yangjiang People's Hospital, Yangjiang, China.,Institute of Cell Biology, Zhejiang University, Hangzhou, China
| | - Yu-Shuai Han
- Central Laboratory, Yangjiang People's Hospital, Yangjiang, China.,Institute of Cell Biology, Zhejiang University, Hangzhou, China
| | - Jia-Xi Chen
- Central Laboratory, Yangjiang People's Hospital, Yangjiang, China.,Institute of Cell Biology, Zhejiang University, Hangzhou, China
| | - Ji-Cheng Li
- Central Laboratory, Yangjiang People's Hospital, Yangjiang, China.,Institute of Cell Biology, Zhejiang University, Hangzhou, China
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17
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van der Wurff ISM, von Schacky C, Bergeland T, Leontjevas R, Zeegers MP, Kirschner PA, de Groot RHM. Effect of one year krill oil supplementation on depressive symptoms and self-esteem of Dutch adolescents: A randomized controlled trial. Prostaglandins Leukot Essent Fatty Acids 2020; 163:102208. [PMID: 33232912 DOI: 10.1016/j.plefa.2020.102208] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 10/29/2020] [Accepted: 11/07/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Observational studies have shown a relationship between omega-3 long-chain polyunsaturated fatty acids (n-3 LCPUFA) and depression in adolescents. However, n-3 LCPUFA supplementation studies investigating the potential improvement in depressive feelings in adolescents from the general population are missing. METHODS A one-year double-blind, randomized, placebo controlled krill oil supplementation trial was conducted in two cohorts. Cohort I started with 400 mg eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) or placebo, after three months this increased to 800 mg EPA and DHA per day, whilst cohort II started with this higher dose. Omega-3 Index (O3I) was monitored via finger-prick blood measurements. At baseline, six and 12 months participants completed the Centre for Epidemiologic Studies Depression Scale (CES-D) and the Rosenberg Self Esteem questionnaire (RSE). Adjusted mixed models were run with treatment allocation/O3I as predictor of CES-D and RSE scores. RESULTS Both intention-to-treat and assessing the change in O3I analyses did not show significant effects on CES-D or RSE scores. CONCLUSION There is no evidence for less depressive feelings, or higher self-esteem after one year of krill oil supplementation. However, due to a lack of adherence and drop-out issues, these results should be interpreted with caution.
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Affiliation(s)
- I S M van der Wurff
- Faculty of Educational Sciences, Open University of the Netherlands, the Netherlands, Heerlen 6419 AT, the Netherlands.
| | - C von Schacky
- Omegametrix, Martinsried 82 152, Germany; Preventive Cardiology, Medical Clinic and Poli-Clinic I, Ludwig Maximilians-University Munich, 80336 Munich, Germany
| | - T Bergeland
- Aker BioMarine Antarctic AS, Lysaker NO-1327, Norway (former)
| | - R Leontjevas
- Faculty of Psychology, Open University of the Netherlands, 6419 AT Heerlen, The Netherlands
| | - M P Zeegers
- Nutrition and Translational Research in Metabolism (School NUTRIM), Maastricht University, 6200 MD Maastricht, The Netherlands; Care and Public Health Research Institute (School CAPHRI), Maastricht University, 6200 MD Maastricht, The Netherlands
| | - P A Kirschner
- Faculty of Educational Sciences, Open University of the Netherlands, the Netherlands, Heerlen 6419 AT, the Netherlands; Expertise Centre for Effective Learning, Thomas More University of Applied Sciences, Mechelen, Belgium; University of Oulu, Oulu, Finland
| | - R H M de Groot
- Faculty of Educational Sciences, Open University of the Netherlands, the Netherlands, Heerlen 6419 AT, the Netherlands; Nutrition and Translational Research in Metabolism (School NUTRIM), Maastricht University, 6200 MD Maastricht, The Netherlands
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18
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Abstract
Pregnancy is a time where expectant mothers often focus on their diet to improve their own health and to preserve the future health of their children. There is much conflicting information in the public domain about the safety and/or efficacy of nutritional supplements during pregnancy. Despite this, the market for supplements is growing. This review discusses the roles of critical nutrients in pregnancy and the available evidence on the use of supplements to reduce risks and improve maternal and fetal outcomes. Recommendations are made for pregnant women, taking into account safety data and tolerable upper intakes set for pregnant women. It is important for dieticians, nutritionists, physicians, and other healthcare providers to be able to offer accurate and evidence-based advice on supplement use in pregnancy. Routine supplementation may not be necessary for all, but individuals at risk are identified.
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19
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Araujo P, Kjellevold M, Nerhus I, Dahl L, Aakre I, Moe V, Smith L, Markhus MW. Fatty Acid Reference Intervals in Red Blood Cells among Pregnant Women in Norway-Cross Sectional Data from the 'Little in Norway' Cohort. Nutrients 2020; 12:nu12102950. [PMID: 32993043 PMCID: PMC7601079 DOI: 10.3390/nu12102950] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/23/2020] [Accepted: 09/24/2020] [Indexed: 12/15/2022] Open
Abstract
There is a growing interest in determining fatty acid reference intervals from pregnancy cohort, especially considering the lack of reference values for pregnant women in the literature and the generalized misconception of equating reference intervals for nonpregnant women as equivalent to pregnant women. Seafood and supplements are important dietary sources for the omega-3 long-chain polyunsaturated fatty acids (ω-3 LCPUFA), such as eicosapentaenoic acid (EPA, 20:5ω-3), docosapentaenoic acid (DPA, 22:55ω-3), and docosahexaenoic acid (DHA, 22:6ω-3). Sufficient intake of EPA and DHA is vital during pregnancy for the development of the fetus, as well as for maintaining adequate levels for the mother. This study describes the fatty acid status and suggests reference values and cut-offs for fatty acids in red blood cells (RBC) from pregnant women (n = 247). An electronic food frequency questionnaire (e-FFQ) mapped the dietary habits of the participants, and gas chromatography was used to determine the fatty acid levels in RBC. The association between e-FFQ variables and fatty acid concentrations was established using a principal component analysis (PCA). Twenty-nine-point-one percent (29.1%) of the participants reported eating seafood as dinner according to the Norwegian recommendations, and they added in their diet as well a high percentage (76.9%) intake of ω-3 supplements. The concentration levels of fatty acids in RBC were in agreement with those reported in similar populations from different countries. The reference interval 2.5/97.5 percentiles for EPA, DPA, DHA were 0.23/2.12, 0.56/2.80, 3.76/10.12 in relative concentration units (%), and 5.99/51.25, 11.08/61.97, 64.25/218.08 in absolute concentration units (µg/g), respectively. The number of participants and their selection from all over Norway vouch for the representativeness of the study and the validity of the proposed reference values, and therefore, the study may be a useful tool when studying associations between fatty acid status and health outcome in future studies. To the best of our knowledge, this is the first PCA study reporting a direct association between ω-3 LCPUFA and intake of seafood and ω-3 supplements in a pregnancy cohort.
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Affiliation(s)
- Pedro Araujo
- Institute of Marine Research, 1870 Nordnes, N-5817 Bergen, Norway; (I.N.); (L.D.); (I.A.); (M.W.M.)
- Correspondence: (P.A.); (M.K.); Tel.: +47-47645029 (P.A.); +47-40854582 (M.K.)
| | - Marian Kjellevold
- Institute of Marine Research, 1870 Nordnes, N-5817 Bergen, Norway; (I.N.); (L.D.); (I.A.); (M.W.M.)
- Correspondence: (P.A.); (M.K.); Tel.: +47-47645029 (P.A.); +47-40854582 (M.K.)
| | - Ive Nerhus
- Institute of Marine Research, 1870 Nordnes, N-5817 Bergen, Norway; (I.N.); (L.D.); (I.A.); (M.W.M.)
| | - Lisbeth Dahl
- Institute of Marine Research, 1870 Nordnes, N-5817 Bergen, Norway; (I.N.); (L.D.); (I.A.); (M.W.M.)
| | - Inger Aakre
- Institute of Marine Research, 1870 Nordnes, N-5817 Bergen, Norway; (I.N.); (L.D.); (I.A.); (M.W.M.)
| | - Vibeke Moe
- Department of Psychology, Faculty of Social Sciences, University of Oslo, 0317 Oslo, Norway; (V.M.); (L.S.)
| | - Lars Smith
- Department of Psychology, Faculty of Social Sciences, University of Oslo, 0317 Oslo, Norway; (V.M.); (L.S.)
| | - Maria Wik Markhus
- Institute of Marine Research, 1870 Nordnes, N-5817 Bergen, Norway; (I.N.); (L.D.); (I.A.); (M.W.M.)
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20
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Levels of n-3 and n-6 Fatty Acids in Maternal Erythrocytes during Pregnancy and in Human Milk and Its Association with Perinatal Mental Health. Nutrients 2020; 12:nu12092773. [PMID: 32932815 PMCID: PMC7551231 DOI: 10.3390/nu12092773] [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: 07/21/2020] [Revised: 09/03/2020] [Accepted: 09/09/2020] [Indexed: 12/27/2022] Open
Abstract
Omega-3 long-chain polyunsaturated fatty acid (n-3 FA) status may be associated with mood disorders. Here, we evaluated the potential association between antenatal depression/anxiety and n-3/n-6 FA in (a) maternal erythrocytes and (b) human milk. In addition, we explored associations between n-3/n-6 FA in erythrocytes and in human milk and postpartum depression, while controlling for antenatal depression. Twenty-seven pregnant women diagnosed with a current major depressive disorder (MDD; n = 9), anxiety disorder (AD; n = 10) or a mixed anxiety-depression disorder (MADD; n = 8), and 40 healthy controls were included. n-3/n-6 FA were determined in maternal erythrocytes in gestational week 32 and in human milk in postpartum week 1. In the first week postpartum, the Edinburgh-Postnatal-Depression-Questionnaire was used to assess postpartum depression. Results show that women with M(A)DD had significantly lower erythrocyte levels of total n-3 FA, EPA, DHA and DGLA, and significantly higher n-6 DPA, and n-6:n-3, AA:EPA and n-6 DPA:DHA ratios compared to healthy controls. No significant associations between antenatal depression or anxiety and n-3/n-6 FA in human milk were found. After controlling for antenatal mental health, n-3/n-6 FA in maternal erythrocytes or in human milk were not significantly associated with postpartum depression. In conclusion, antenatal depression, alone or with an anxiety disorder, was associated with lower n-3 FA levels and higher n-6:n-3 FA ratios in maternal erythrocytes during gestation. This study provides some insights into the associations between n-3/n-6 FA levels during pregnancy and lactation and perinatal mental health.
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Colucci P, De Castro V, Peloso A, Splendori M, Trezza V, Campolongo P. Perinatal exposure to omega-3 fatty acid imbalance leads to early behavioral alterations in rat pups. Behav Brain Res 2020; 392:112723. [DOI: 10.1016/j.bbr.2020.112723] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 05/16/2020] [Accepted: 05/19/2020] [Indexed: 01/05/2023]
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Omega-3 Fatty Acids in Pregnancy-The Case for a Target Omega-3 Index. Nutrients 2020; 12:nu12040898. [PMID: 32224878 PMCID: PMC7230742 DOI: 10.3390/nu12040898] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 03/17/2020] [Accepted: 03/24/2020] [Indexed: 12/18/2022] Open
Abstract
Scientific societies recommend increasing intake of docosahexaenoic acid (DHA) by 200 mg/day during pregnancy. However, individually, clinical events correlate quite strongly with levels of eicosapentaenoic acid (EPA) and DHA in blood, but these levels poorly correlate with amounts ingested. EPA and DHA in erythrocytes (Omega-3 Index) have a low biologic variability. If analyzed with a standardized analytical procedure (HS-Omega-3 Index®), analytical variability is low. Thus, the largest database of any fatty acid analytical method was provided. Pregnant women in Germany had a mean Omega-3 Index below the target range suggested for cardiovascular disease of 8–11%, with large interindividual variation, and quite independent of supplementation with EPA and DHA. In Germany, premature birth is a major health issue. Premature birth and other health issues of pregnant women and their offspring correlate with levels of EPA and DHA in blood and can be reduced by increasing intake of EPA and DHA, according to individual trials and pertinent meta-analyses. Very high intake or levels of EPA and DHA may also produce health issues, like bleeding, prolonged gestation, or even premature birth. While direct evidence remains to be generated, evidence from various scientific approaches supports that the target range for the Omega-3 Index of 8–11% might also pertain to pregnancy and lactation.
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An analysis of omega-3 fatty acid status in a population of pregnant women with obesity, at higher risk of preterm birth. Eur J Clin Nutr 2020; 74:1478-1482. [PMID: 32203238 DOI: 10.1038/s41430-020-0613-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 03/09/2020] [Accepted: 03/11/2020] [Indexed: 11/08/2022]
Abstract
An updated Cochrane Review showed that maternal supplementation with omega-3 fatty acids reduced preterm birth, offering a potential strategy for prevention. We hypothesised that pregnant women with obesity, at higher risk of preterm birth, would have low omega-3 fatty acid levels and may benefit from supplementation. Our study measured the omega-3 fatty acid levels of 142 participants from the Healthy Mums and Babies study, Counties Manukau, Auckland, New Zealand. Counties Manukau is a multi-ethnic community with high rates of socio-economic deprivation, obesity, and preterm birth. Red blood cell omega-3 fatty acid levels were measured from samples collected between 120 and 176 weeks' gestation. Contrary to our hypothesis, participants in our study had similar or higher levels of omega-3 fatty acids to those reported in pregnant populations in Australia, Norway, China, and Germany. Our findings emphasise the importance of testing omega-3 fatty acid status before supplementing groups at risk of preterm birth.
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Impact of erythrocyte long-chain omega-3 polyunsaturated fatty acid levels in early pregnancy on birth outcomes: findings from a Belgian cohort study. J Perinatol 2020; 40:488-496. [PMID: 31913325 DOI: 10.1038/s41372-019-0573-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 11/15/2019] [Accepted: 12/18/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To examine the association between maternal erythrocyte long-chain omega-3 PUFA (n-3 LCPUFA), measured in early pregnancy, and pregnancy and birth outcomes. STUDY DESIGN One hundred and eight healthy women with a singleton pregnancy were included. Erythrocyte fatty acids were analyzed using gas chromatography. Gestational length, birth anthropometric measures, and pregnancy-associated complications were collected from hospital medical records. RESULTS We observed significant positive associations between maternal docosahexaenoic acid (DHA) levels (p = 0.024) and omega-3 index values (p = 0.021) and gestational length in adjusted linear regression models. Each point in maternal DHA level was associated with 2.19 days longer gestational duration (β = 2.19; 95% CI 0.29-4.09). No consistent associations were found between n-3 PUFA levels and composite pregnancy outcome. CONCLUSION These findings suggest that the gestational length is positively affected by maternal n-3 LCPUFA status as soon as the early stages of pregnancy.
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Moe V, Fredriksen E, Kjellevold M, Dahl L, Markhus MW, Stormark KM, von Soest T, Olafsen KS, Vannebo UT, Smith L. Little in Norway: a prospective longitudinal community-based cohort from pregnancy to child age 18 months. BMJ Open 2019; 9:e031050. [PMID: 31892648 PMCID: PMC6955541 DOI: 10.1136/bmjopen-2019-031050] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PURPOSE The Little in Norway (LiN) project is a cross-disciplinary prospective longitudinal study starting in pregnancy. It was set up to investigate maternal and paternal mental health functioning in the transition to parenthood, detect pathways to healthy and aberrant child development and generate new knowledge about mechanisms underlying differential child mental health susceptibility. PARTICIPANTS The LiN cohort is a community-based sample comprising 1036 families (1036 mothers, 884 partners, 1017 children). All pregnant women and their partners receiving routine prenatal care at well-baby clinics at nine geographically selected sites across Norway were invited to participate. Enrolment took place from September 2011 to October 2012. This cohort profile comprises 10 data collection waves spanning from enrolment in pregnancy until child age 18 months. FINDINGS TO DATE Four types of information have been collected: multi-informant questionnaire reports, direct observation of interaction, test data and biological samples. The most significant findings so far relate to three domains of results. First, when examining risk factors for parental mental health problems, results showed that the parents' own adverse childhood experiences and attachment style were related to anxiety, depression and stress in the perinatal period. The perception of difficult child temperament was also found to contribute to parenting stress in the first year after birth. Second, we studied how parental mental health risk factors were related to later child development and social emotional functioning, for example, linking maternal symptoms to social-emotional outcomes and paternal symptoms to language outcomes. Third, we investigated the relation between maternal nutrition during pregnancy and aspects of early child development. Results showed that mild to moderate maternal iodine deficiency in pregnancy was associated with poorer language skills up to 18 months, but not with reduced cognitive or fine and gross motor skills. FUTURE PLANS A data collection point at 36 months is completed and currently being analysed. A new data collection wave is planned when the children are 8 years of age. TRIAL REGISTRATION NUMBER ISRCTN66710572.
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Affiliation(s)
- Vibeke Moe
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
- Regional Centre for Child and Adolescent Mental Health, East and South, Norway, Oslo, Norway
| | - Eivor Fredriksen
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
- Regional Centre for Child and Adolescent Mental Health, East and South, Norway, Oslo, Norway
| | | | | | | | - Kjell Morten Stormark
- Centre for Child and Adolescent Mental Health Uni Health, Uni Research, Bergen, Norway
| | - Tilmann von Soest
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | - Kåre Sten Olafsen
- Regional Centre for Child and Adolescent Mental Health, East and South, Norway, Oslo, Norway
| | - Unni Tranaas Vannebo
- Regional Centre for Child and Adolescent Mental Health, East and South, Norway, Oslo, Norway
| | - Lars Smith
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
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Asch RH, Schurdak JD, McNamara RK. Perinatal dietary omega-3 fatty acid deficiency reduces maternal nurturing behavior in rats: dissociation from elevated pro-inflammatory signaling. Nutr Neurosci 2019; 24:735-746. [PMID: 31599208 DOI: 10.1080/1028415x.2019.1674507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objectives: Maternal-pup nurturing behavior has previously been shown to impact offspring neurodevelopment independent of diet. Here we investigated the effects of perinatal maternal n-3 fatty acid deficiency on maternal-pup nurturing behavior and potential associations with pro-inflammatory signaling.Methods: Eight-week-old virgin female Long-Evans hooded rats were randomized to a control diet containing alpha-linolenic acid (ALA, 18:3n-3) (CON, n = 10) or an ALA-free diet (Deficient, DEF, n = 11) 30 d prior to mating. On postnatal day 2 (P2) litters were culled to eight per dam. On P3, P6, and P9 dams and their litters were video recorded and maternal nurturing behaviors, including licking/grooming of pups and arched-back nursing, were scored by a blinded rater. Following weaning on P21, dam postmortem central (prefrontal cortex, PFC) and peripheral (red blood cell, RBC) fatty acid composition and central (PFC IL-1β, IL-2, IL-6, TNFα, cPLA2, COX-2 mRNA) and peripheral (plasma IL-1β, IL-2, IL-6, TNFα, CRP) pro-inflammatory biostatus assessed.Results: DEF dams exhibited significantly lower RBC (p ≤ 0.0001) and PFC (p ≤ 0.0001) docosahexaenoic acid (DHA) levels compared with CON dams. Irrespective of diet dams exhibited significantly lower RBC, but not PFC, DHA levels compared with non-parous rats. DEF dams exhibited less licking/grooming (p = 0.008), arched-back nursing (p ≤ 0.0001) and blanket nursing (p = 0.003), and exhibited more passive nursing (p = 0.003) but not time off pups (p = 0.1), compared with CON dams. PFC and plasma inflammatory measures did not differ significantly between groups.Discussion: Perinatal dietary n-3 fatty acid deficiency reduces maternal nurturing behavior and this effect is not associated with enduring elevations in pro-inflammatory signaling.
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Affiliation(s)
- Ruth H Asch
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jennifer D Schurdak
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Robert K McNamara
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Imbalance between Omega-6 and Omega-3 Polyunsaturated Fatty Acids in Early Pregnancy Is Predictive of Postpartum Depression in a Belgian Cohort. Nutrients 2019; 11:nu11040876. [PMID: 31003520 PMCID: PMC6521039 DOI: 10.3390/nu11040876] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 04/10/2019] [Accepted: 04/15/2019] [Indexed: 12/21/2022] Open
Abstract
While studies revealed that the omega-3 polyunsaturated fatty acids (n-3 PUFA) and their mediators would be able to regulate several biological processes involved into the development of postpartum depression (PPD), evidence from observational studies remains mixed. The aim of the present study was to investigate the association between maternal erythrocyte n-3 PUFA, measured in early pregnancy, and the risk of PPD. A Belgian cohort of 72 healthy women was screened. Erythrocyte fatty acids were analysed using gas chromatography. PPD was assessed using the Bromley Postnatal Depression Scale by phone interview one year after delivery. We observed a significant negative association between docosahexaenoic acid (DHA) levels and the risk of postpartum depression in the adjusted model (p = 0.034). Higher n-6/n-3 and arachidonic acid (AA)/eicosapentaenoic acid (EPA) ratios were significantly associated with an increased odds of PPD (p = 0.013 and p = 0.043, respectively). Women with an omega-3 index <5% had a 5-fold increased risk of depressive episode than did those with an omega-3 index ≥5% (OR 5.22 (95% CI 1.24–21.88)). A low n-3 PUFA status, alone and combined with high n-6 PUFA status, in early pregnancy was associated with a greater risk of PPD. Management of maternal n-3 PUFA deficiency can be a simple, safe and cost-effective strategy for the prevention of this major public health issue.
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Un faible statut en acides gras oméga-3 à longue chaine en début de grossesse est associé à un risque plus élevé de dépression post-partum. NUTR CLIN METAB 2019. [DOI: 10.1016/j.nupar.2019.01.270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Yalagala PCR, Sugasini D, Dasarathi S, Pahan K, Subbaiah PV. Dietary lysophosphatidylcholine-EPA enriches both EPA and DHA in the brain: potential treatment for depression. J Lipid Res 2019; 60:566-578. [PMID: 30530735 PMCID: PMC6399499 DOI: 10.1194/jlr.m090464] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 12/07/2018] [Indexed: 12/21/2022] Open
Abstract
EPA and DHA protect against multiple metabolic and neurologic disorders. Although DHA appears more effective for neuroinflammatory conditions, EPA is more beneficial for depression. However, the brain contains negligible amounts of EPA, and dietary supplements fail to increase it appreciably. We tested the hypothesis that this failure is due to absorption of EPA as triacylglycerol, whereas the transporter at the blood-brain barrier requires EPA as lysophosphatidylcholine (LPC). We compared tissue uptake in normal mice gavaged with equal amounts (3.3 μmol/day) of either LPC-EPA or free EPA (surrogate for current supplements) for 15 days and also measured target gene expression. Compared with the no-EPA control, LPC-EPA increased brain EPA >100-fold (from 0.03 to 4 μmol/g); free EPA had little effect. Furthermore, LPC-EPA, but not free EPA, increased brain DHA 2-fold. Free EPA increased EPA in adipose tissue, and both supplements increased EPA and DHA in the liver and heart. Only LPC-EPA increased EPA and DHA in the retina, and expression of brain-derived neurotrophic factor, cyclic AMP response element binding protein, and 5-hydroxy tryptamine (serotonin) receptor 1A in the brain. These novel results show that brain EPA can be increased through diet. Because LPC-EPA increased both EPA and DHA in the brain, it may help in the treatment of depression as well as neuroinflammatory diseases, such as Alzheimer's disease.
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Importance of n-3 PUFA consumption during pregnancy: perception discrepancies between pregnant women and gynaecologists-obstetricians in Belgium. Public Health Nutr 2019; 22:1259-1268. [PMID: 30782241 DOI: 10.1017/s1368980019000089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE n-3 PUFA during pregnancy have been subject to intense research interest, but also much controversy, creating a situation of confusion among patients and health-care providers. The present study was carried out to explore knowledge, attitude and practices regarding n-3 PUFA in two independent populations of pregnant women and gynaecologists-obstetricians in Belgium and to assess the relationship between the pregnant women's attributes and their n-3 PUFA status measured by the omega-3 index. DESIGN Cross-sectional study. Knowledge, attitude and practices were collected by self-administered questionnaires while laboratory data were available for each pregnant woman. SETTING During the first antenatal hospital appointment (for the pregnant women) and by email (for the gynaecologists-obstetricians).ParticipantsWomen in early pregnancy (n 122) and gynaecologists-obstetricians (n 67). RESULTS Marked discrepancies in perception were evidenced between the pregnant women and health-care providers. While 82 % of the women attached high importance to n-3 PUFA during pregnancy, only a third of the gynaecologists-obstetricians did. About 35 % of the women declared paying particular attention to their consumption of n-3 PUFA. After adjusting for sociodemographic characteristics, these positive dietary practices were significantly associated with higher omega-3 index (P=0·04). Overall, 43·3 % of professionals did not provide any information about n-3 PUFA to their pregnant patients and 46·3 % did not take any preventive actions. CONCLUSIONS Evidence-based guidelines, refreshment training and communication tools are needed to improve awareness and clinical practices among caregivers regarding n-3 PUFA to benefit both mothers and their children.
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Jackson KH, Harris WS. A Prenatal DHA Test to Help Identify Women at Increased Risk for Early Preterm Birth: A Proposal. Nutrients 2018; 10:E1933. [PMID: 30563193 PMCID: PMC6316227 DOI: 10.3390/nu10121933] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 11/26/2018] [Accepted: 11/30/2018] [Indexed: 12/11/2022] Open
Abstract
Fish intake and docosahexaenoic acid (DHA), a nutrient found in fish, have been favorably linked to several pregnancy outcomes. The risk of early preterm birth (ePT, <34 weeks gestation) is associated with low fish intake and DHA blood levels and can be reduced by supplemental DHA. Here, we summarize the evidence linking blood DHA levels with risk for ePT birth, and based on the available studies, propose that women who are pregnant or trying to become pregnant aim for a red blood cell (RBC) DHA value of at least 5% (of total RBC fatty acids). In the US, ~70% of women of childbearing age are likely below this cut-point, and dietary intake data suggest that this group, including pregnant women, consumes ~60 mg/day DHA and that >90% of this group do not take an omega-3 supplement. Since the recommendations for women to consume fish and to take a 200 mg DHA supplement during pregnancy are not being heeded generally, there is a need to motivate practitioners and pregnant women to attend to these recommendations. Having an objective prenatal blood DHA test could provide such motivation. More research is needed to test the clinical utility of this proposed target prenatal DHA level.
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Affiliation(s)
| | - William S Harris
- OmegaQuant, LLC, 5009 W. 12th St., Suite 8, Sioux Falls, SD 57106, USA.
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Riazanova OV, Alexandrovich YS, Ioscovich AM. The relationship between labor pain management, cortisol level and risk of postpartum depression development: a prospective nonrandomized observational monocentric trial. Rom J Anaesth Intensive Care 2018; 25:123-130. [PMID: 30393769 DOI: 10.21454/rjaic.7518.252.rzn] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Postpartum depression (PPD) is the main psychological status disorder and women suffering from postpartum depression often need long-term psychological and socio-economic rehabilitation. The study is dedicated to the evaluation of the role of labor pain management using epidural analgesia in natural delivery on stress level in labor and frequency of postnatal depression. Materials and methods 210 women were investigated and divided into two groups. In the first group for labor pain management in natural delivery, patient-controlled epidural analgesia was used (bolus - 10.0 - 0.08% ropivacaine hydrochloride, lockout - 30 min, limit - 120 ml/6 h) with a background of continuous-flow infusion of local anesthetic 0.08% ropivacaine hydrocluoride solution. Patients in the second group had no pain relief in delivery. The stress level was evaluated using blood plasma cortisol level in the early stages of labor, 6 hours and 3 days after delivery. The assessment of depression development was carried out step-by-step: Before the delivery, 6 hours after, 3 days and 6 weeks after the delivery. Results The baby blues frequency 6 hours after the delivery in the group where the pain relief was conducted was 29.91%, with cortisol level below and equal to 2310.91 nmol/l. In the group with no pain relief 6 hours after delivery, baby blues was found in 15.53% of puerperas (p < 0.05) and the cortisol level was 2673.82 nmol/l (p < 0.05). Six weeks after the birth, postpartum depression was diagnosed in 4.67% of women who received epidural analgesia during delivery, in comparison to 6.79% with no pain relief during delivery. However, the difference was not statistically significant (p < 0.05). Conclusions The use of epidural analgesia leads to a significant reduction of pain syndrome and stress response during natural delivery, increases the risk of baby blues in the early postnatal period, but slightly influences the frequency of postpartum depression.
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Affiliation(s)
- Oksana V Riazanova
- Department of Anesthesiology and Intensive Care, Saint-Petersburg State Pediatric Medical University, St. Petersburg, Russia
| | - Yurii S Alexandrovich
- Department of Anesthesiology and Intensive Care, Saint-Petersburg State Pediatric Medical University, St. Petersburg, Russia
| | - Alexander M Ioscovich
- Department of Anesthesiology, Perioperative Medicine and Pain Treatment, Shaare Zedek Medical Center, Hebrew University, Jerusalem, Israel
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Hsu MC, Tung CY, Chen HE. Omega-3 polyunsaturated fatty acid supplementation in prevention and treatment of maternal depression: Putative mechanism and recommendation. J Affect Disord 2018; 238:47-61. [PMID: 29860183 DOI: 10.1016/j.jad.2018.05.018] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 04/03/2018] [Accepted: 05/15/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Women are vulnerable to depression during their childbearing years, and giving birth to a child precipitates postpartum depression (PPD) in some women. This review focuses on comparing the effectiveness of omega-3 polyunsaturated fatty acid supplementation on depression during pregnancy or PPD after childbirth. METHODS MEDLINE, PubMed, PsycINFO, and the Cochrane Collaboration Registry of Controlled Trials etc. through July 2017 were searched. Studies of dietary intake and plasma and/or milk levels of omega-3 fatty acids and trials of benefits and effects of omega-3 fatty acids supplements on pregnant or postpartum women with depression were specifically selected. RESULTS Omega-3 fatty acid deficiency, due to inadequate intake, fast depletion during pregnancy and lactation, is one of the risk factors of PPD. Associations between neuroinflammation (elevated pro-inflammatory cytokines) and aberrant neurotransmission (low serotonergic transmission activity) and risk of PPD have also been reported by numerous studies. Supplementation with eicosapentaenoic acid (EPA)-rich oil can effectively reduce depression during pregnancy and PPD after childbirth. Long term treatment with docosahexaenoic acid (DHA)-rich oil can be effective in reducing the risk of PPD in healthy women, but not in lactating women. Supplementation of DHA-rich oil to women begun at pregnancy and continued after childbirth exerts no beneficial effect on depression. CONCLUSIONS Dietary supplementation with omega-3 fatty acids rich in EPA during pregnancy or postpartum reduces some symptoms associated with depression. DHA supplementation to healthy pregnant women can also reduce the risk of PPD.
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Affiliation(s)
- Mei-Chi Hsu
- Department of Nursing, I-Shou University, No. 8, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung City 82445, Taiwan, ROC.
| | - Chia-Yi Tung
- Nursing Department, E-Da Hospital, No.1, Yida Road, Jiaosu Village Yanchao District, Kaohsiung City 82445, Taiwan, ROC
| | - Hsing-E Chen
- Nursing Department, E-Da Hospital, No.1, Yida Road, Jiaosu Village Yanchao District, Kaohsiung City 82445, Taiwan, ROC
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Larrieu T, Layé S. Food for Mood: Relevance of Nutritional Omega-3 Fatty Acids for Depression and Anxiety. Front Physiol 2018; 9:1047. [PMID: 30127751 PMCID: PMC6087749 DOI: 10.3389/fphys.2018.01047] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 07/13/2018] [Indexed: 12/28/2022] Open
Abstract
The central nervous system (CNS) has the highest concentration of lipids in the organism after adipose tissue. Among these lipids, the brain is particularly enriched with polyunsaturated fatty acids (PUFAs) represented by the omega-6 (ω6) and omega-3 (ω3) series. These PUFAs include arachidonic acid (AA) and docosahexaenoic acid (DHA), respectively. PUFAs have received substantial attention as being relevant to many brain diseases, including anxiety and depression. This review addresses an important question in the area of nutritional neuroscience regarding the importance of ω3 PUFAs in the prevention and/or treatment of neuropsychiatric diseases, mainly depression and anxiety. In particular, it focuses on clinical and experimental data linking dietary intake of ω3 PUFAs and depression or anxiety. In particular, we will discuss recent experimental data highlighting how ω3 PUFAs can modulate neurobiological processes involved in the pathophysiology of anxiety and depression. Potential mechanisms involved in the neuroprotective and corrective activity of ω3 PUFAs in the brain are discussed, in particular the sensing activity of free fatty acid receptors and the activity of the PUFAs-derived endocannabinoid system and the hypothalamic-pituitary-adrenal axis.
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Affiliation(s)
- Thomas Larrieu
- UMR 1286, NutriNeuro: Laboratoire Nutrition et Neurobiologie Intégrée, Institut National de la Recherche Agronomique, Université de Bordeaux, Bordeaux, France
| | - Sophie Layé
- UMR 1286, NutriNeuro: Laboratoire Nutrition et Neurobiologie Intégrée, Institut National de la Recherche Agronomique, Université de Bordeaux, Bordeaux, France
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Braarud HC, Markhus MW, Skotheim S, Stormark KM, Frøyland L, Graff IE, Kjellevold M. Maternal DHA Status during Pregnancy Has a Positive Impact on Infant Problem Solving: A Norwegian Prospective Observation Study. Nutrients 2018; 10:nu10050529. [PMID: 29695097 PMCID: PMC5986409 DOI: 10.3390/nu10050529] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 04/16/2018] [Accepted: 04/17/2018] [Indexed: 12/18/2022] Open
Abstract
Docosahexaenoic acid (DHA, 22:6, n-3) is a long-chain polyunsaturated fatty acid necessary for normal brain growth and cognitive development. Seafood and dietary supplements are the primary dietary sources of DHA. This study addresses the associations between DHA status in pregnant women and healthy, term-born infant problem-solving skills assessed using the Ages and Stages Questionnaire. The fatty acid status of maternal red blood cells (RBCs) was assessed in the 28th week of gestation and at three months postpartum. The infants’ fatty acid status (RBC) was assessed at three, six, and twelve months, and problem-solving skills were assessed at six and twelve months. Maternal DHA status in pregnancy was found to be positively associated with infants’ problem-solving skills at 12 months. This association remained significant even after controlling for the level of maternal education, a surrogate for socio-economic status. The infants’ DHA status at three months was associated with the infants’ problem solving at 12 months. The results accentuate the importance for pregnant and lactating women to have a satisfactory DHA status from dietary intake of seafood or other sources rich in DHA.
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Affiliation(s)
- Hanne Cecilie Braarud
- Regional Centre for Child and Youth Mental Health, Uni Research Health, Uni Research, P.O. Box 7810, 5020 Bergen, Norway.
- The Office for Children, Youth and Family Affairs, Region West, P.O. Box 2233, 3103 Tønsberg, Norway.
| | - Maria Wik Markhus
- Institute of Marine Research, P.O. Box 1870 Nordnes, 5817 Bergen, Norway.
| | - Siv Skotheim
- Regional Centre for Child and Youth Mental Health, Uni Research Health, Uni Research, P.O. Box 7810, 5020 Bergen, Norway.
- The Office for Children, Youth and Family Affairs, Region South, P.O. Box 2233, 3103 Tønsberg, Norway.
| | - Kjell Morten Stormark
- Regional Centre for Child and Youth Mental Health, Uni Research Health, Uni Research, P.O. Box 7810, 5020 Bergen, Norway.
- Department of Health Promotion and Development, University of Bergen, P.O. Box 7800, 5020 Bergen, Norway.
| | - Livar Frøyland
- Institute of Marine Research, P.O. Box 1870 Nordnes, 5817 Bergen, Norway.
| | - Ingvild Eide Graff
- Institute of Marine Research, P.O. Box 1870 Nordnes, 5817 Bergen, Norway.
- Uni Research Health, Uni Research, P.O. Box 7810, 5020 Bergen, Norway.
| | - Marian Kjellevold
- Institute of Marine Research, P.O. Box 1870 Nordnes, 5817 Bergen, Norway.
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Hoge A, Bernardy F, Donneau AF, Dardenne N, Degée S, Timmermans M, Nisolle M, Guillaume M, Castronovo V. Low omega-3 index values and monounsaturated fatty acid levels in early pregnancy: an analysis of maternal erythrocytes fatty acids. Lipids Health Dis 2018; 17:63. [PMID: 29606136 PMCID: PMC5879610 DOI: 10.1186/s12944-018-0716-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 03/21/2018] [Indexed: 12/31/2022] Open
Abstract
Background It is unanimously recognized that the maternal nutritional status at the pregnancy onset influence both short-term and long-term health of the mother and offspring. Among several nutrients, LCPUFA, particularly from the omega-3 family, are of utmost importance. This study was carried out to determine fatty acids profile of maternal erythrocyte membranes in early pregnancy and to identify potential determinants impacting on this status. Methods A cohort of 122 healthy women with a singleton pregnancy was included. Fatty acids were analyzed using gas chromatography. Because of the lack of cutoff values, reference ranges were used to determine fatty acids categories. Results Of concern, our data revealed low monounsaturated and long-chain omega-3 fatty acid status in most participants. More than 75% of Belgian pregnant women exhibited Pal, AO and EPA levels as well as IOM3 values below the laboratory reference ranges. Higher DHA concentrations and IOM3 values were found among foreign-nationality participants, non-smokers and physically active women. With regard to dietary factors, omega-3 supplements and diet seem to be complementary since DHA from supplements (but not from diet) and EPA from diet (but not from supplements) were found to be associated with higher concentrations of DHA and EPA, respectively. Conclusions Our study presents evidence demonstrating that the fatty acid status of most early pregnant women is far from being optimal based on the admitted general reference values. Clinicians should be advice to carefully evaluate and improve this status to guarantee the best possible outcome for both the mother and the baby. Electronic supplementary material The online version of this article (10.1186/s12944-018-0716-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Axelle Hoge
- Department of Public Health, University of Liège, Avenue Hippocrate 13 - B23, 4000, Liège, Belgium.
| | - Florence Bernardy
- Department of Public Health, University of Liège, Avenue Hippocrate 13 - B23, 4000, Liège, Belgium
| | - Anne-Françoise Donneau
- Department of Public Health, University of Liège, Avenue Hippocrate 13 - B23, 4000, Liège, Belgium
| | - Nadia Dardenne
- Department of Public Health, University of Liège, Avenue Hippocrate 13 - B23, 4000, Liège, Belgium
| | - Sylvie Degée
- Department of Obstetrics and Gynecology, CHR Citadelle Hospital, University of Liège, Liège, Belgium
| | - Marie Timmermans
- Department of Obstetrics and Gynecology, CHR Citadelle Hospital, University of Liège, Liège, Belgium
| | - Michelle Nisolle
- Department of Obstetrics and Gynecology, CHR Citadelle Hospital, University of Liège, Liège, Belgium
| | - Michèle Guillaume
- Department of Public Health, University of Liège, Avenue Hippocrate 13 - B23, 4000, Liège, Belgium
| | - Vincenzo Castronovo
- Metastasis Research Laboratory, GIGA-CANCER, University of Liège, Liège, Belgium
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van der Wurff ISM, von Schacky C, Bergeland T, Leontjevas R, Zeegers MP, Kirschner PA, de Groot RHM. Exploring the association between whole blood Omega-3 Index, DHA, EPA, DHA, AA and n-6 DPA, and depression and self-esteem in adolescents of lower general secondary education. Eur J Nutr 2018; 58:1429-1439. [PMID: 29549496 PMCID: PMC6561989 DOI: 10.1007/s00394-018-1667-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 03/14/2018] [Indexed: 12/20/2022]
Abstract
Purpose Depression is common in adolescents and long-chain polyunsaturated fatty acids (LCPUFA) are suggested to be associated with depression. However, research in adolescents is limited. Furthermore, self-esteem has never been studied in relation to LCPUFA. The objective here was to determine associations of depression and self-esteem with eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), Omega-3 Index (O3I), n-6 docosapentaenoic acid (n-6 DPA, also called Osbond acid, ObA), n-3 docosapentaenoic acid (DPA), and arachidonic acid (AA) concentrations in blood of adolescents attending lower general secondary education (LGSE). Methods Baseline cross-sectional data from a krill oil supplementation trial in adolescents attending LGSE with an O3I ≤ 5% were analysed using regression models built with the BayesFactor package in R. Fatty acids and O3I were determined in blood. Participants filled out the Centre for Epidemiologic Studies Depression (CES-D) scale and the Rosenberg Self-Esteem scale (RSE). Results Scores indicative of depression (CES-D ≥ 16) were found in 29.4% of the respondents. Of all fatty acids, we found extreme evidence [Bayes factor (BF) > 100] for a weak negative association between ObA and depression score [− 0.16; 95% credible interval (CI) − 0.28 to − 0.04; BF10 = 245], and substantial evidence for a weak positive association between ObA and self-esteem score (0.09; 95% CI, − 0.03 to 0.20; BF10 = 4). When all fatty acids were put in one model as predictors of CES-D or RSE, all of the 95% CI contained 0, i.e., no significant association. Conclusion No evidence was found for associations of DHA, EPA and O3I with depression or self-esteem scores in LGSE adolescents with O3I ≤ 5%. The associations of higher ObA status with lower depression and higher self-esteem scores warrant more research.
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Affiliation(s)
- I S M van der Wurff
- Welten Institute, Research Centre for Learning, Teaching, and Technology, Open University of the Netherlands, Valkenburgerweg 177, P.O. Box 2960, 6419 AT, Heerlen, The Netherlands.
| | - C von Schacky
- Omegametrix, 82 152, Martinsried, Germany.,Preventive Cardiology, Medical Clinic and Poli-Clinic I, Ludwig Maximilians-University Munich, Munich, Germany
| | - T Bergeland
- Aker BioMarine Antarctic AS, 1327, Lysaker, Norway
| | - R Leontjevas
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, 6419 AT, Heerlen, The Netherlands
| | - M P Zeegers
- Nutrition and Translational Research in Metabolism (School NUTRIM), Maastricht University, 6200 MD, Maastricht, The Netherlands.,Care and Public Health Research Institute (School CAPHRI), Maastricht University, 6200 MD, Maastricht, The Netherlands
| | - P A Kirschner
- Welten Institute, Research Centre for Learning, Teaching, and Technology, Open University of the Netherlands, Valkenburgerweg 177, P.O. Box 2960, 6419 AT, Heerlen, The Netherlands.,University of Oulu, Oulu, Finland
| | - R H M de Groot
- Welten Institute, Research Centre for Learning, Teaching, and Technology, Open University of the Netherlands, Valkenburgerweg 177, P.O. Box 2960, 6419 AT, Heerlen, The Netherlands.,Nutrition and Translational Research in Metabolism (School NUTRIM), Maastricht University, 6200 MD, Maastricht, The Netherlands
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Hahn-Holbrook J, Cornwell-Hinrichs T, Anaya I. Economic and Health Predictors of National Postpartum Depression Prevalence: A Systematic Review, Meta-analysis, and Meta-Regression of 291 Studies from 56 Countries. Front Psychiatry 2018; 8:248. [PMID: 29449816 PMCID: PMC5799244 DOI: 10.3389/fpsyt.2017.00248] [Citation(s) in RCA: 300] [Impact Index Per Article: 50.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 11/07/2017] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Postpartum depression (PPD) poses a major global public health challenge. PPD is the most common complication associated with childbirth and exerts harmful effects on children. Although hundreds of PPD studies have been published, we lack accurate global or national PPD prevalence estimates and have no clear account of why PPD appears to vary so dramatically between nations. Accordingly, we conducted a meta-analysis to estimate the global and national prevalence of PPD and a meta-regression to identify economic, health, social, or policy factors associated with national PPD prevalence. METHODS We conducted a systematic review of all papers reporting PPD prevalence using the Edinburgh Postnatal Depression Scale. PPD prevalence and methods were extracted from each study. Random effects meta-analysis was used to estimate global and national PPD prevalence. To test for country level predictors, we drew on data from UNICEF, WHO, and the World Bank. Random effects meta-regression was used to test national predictors of PPD prevalence. FINDINGS 291 studies of 296284 women from 56 countries were identified. The global pooled prevalence of PPD was 17.7% (95% confidence interval: 16.6-18.8%), with significant heterogeneity across nations (Q = 16,823, p = 0.000, I2 = 98%), ranging from 3% (2-5%) in Singapore to 38% (35-41%) in Chile. Nations with significantly higher rates of income inequality (R2 = 41%), maternal mortality (R2 = 19%), infant mortality (R2 = 16%), or women of childbearing age working ≥40 h a week (R2 = 31%) have higher rates of PPD. Together, these factors explain 73% of the national variation in PPD prevalence. INTERPRETATION The global prevalence of PPD is greater than previously thought and varies dramatically by nation. Disparities in wealth inequality and maternal-child-health factors explain much of the national variation in PPD prevalence.
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Affiliation(s)
- Jennifer Hahn-Holbrook
- Department of Psychology, University of California, Merced, Merced, CA, United States
- Center for Excellence in Biopsychosocial Approaches to Health, Chapman University, Orange, CA, United States
| | | | - Itzel Anaya
- Department of Psychology, Palo Alto University, Palo Alto, CA, United States
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Chang JPC, Lin CY, Lin PY, Shih YH, Chiu TH, Ho M, Yang HT, Huang SY, Gałecki P, Su KP. Polyunsaturated fatty acids and inflammatory markers in major depressive episodes during pregnancy. Prog Neuropsychopharmacol Biol Psychiatry 2018; 80:273-278. [PMID: 28536068 DOI: 10.1016/j.pnpbp.2017.05.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 04/25/2017] [Accepted: 05/09/2017] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Prenatal depression (PND) is a common psychiatric disorder in pregnant women and leads to psychosocial dysfunction, high suicidal rate, and adverse childcare. Patients with PND have omega-3 polyunsaturated fatty acid (omega-3 or n-3 PUFAs) deficits, which might link to chronic low-grade inflammatory process and the pathophysiological mechanisms of depression. In this case-control study, we examined the levels of PUFAs and inflammatory cytokines in PND. METHOD Blood samples were obtained and analyzed from 16 healthy controls and 17 depressed cases (PND group) diagnosed with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Independent sample t-test and correlation analysis were performed with Statistical Package for the Social Sciences (SPSS) logistics correlation analysis. RESULTS PND group had significantly lower levels of total n-3 (p=0.026), docosahexaenoic acid (DHA) (p=0.020) and eicosapentaenoic (EPA) (p=0.019) but a higher omega-6 (n-6)/n-3 PUFAs ratio (p=0.007) and tumor necrosis factor alpha (TNF-α) (p=0.016) level. Moreover, the duration of current PND episodes were also significantly correlated with DHA, EPA, n-3 PUFAs, n-6/n-3 ratio and TNF-α. In terms of PUFAs and cytokine levels, only DHA was inversely correlated with TNF-α. CONCLUSION PND is significantly associated with lower DHA, EPA, and total n-3 PUFAs levels and an increased n-6/n-3 PUFAs ratio, while the duration of PND is associated with lower levels of n-3 PUFAs, including DHA and EPA. The correlation of PUFAs levels with depression and TNF-α level grant further investigation into the inflammatory process underlying PND, mediated by PUFAs.
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Affiliation(s)
- Jane Pei-Chen Chang
- Department of Psychiatry, Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung, Taiwan; Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King's College London, UK; College of Medicine, Brain Disease Research Center (BDRC), China Medical University, Taichung, Taiwan
| | - Chih-Ying Lin
- Department of Psychiatry, Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung, Taiwan; College of Medicine, Brain Disease Research Center (BDRC), China Medical University, Taichung, Taiwan
| | - Pan-Yen Lin
- Department of Psychiatry, Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung, Taiwan; College of Medicine, Brain Disease Research Center (BDRC), China Medical University, Taichung, Taiwan
| | - Yin-Hua Shih
- Department of Psychiatry, Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung, Taiwan
| | - Tsan-Hung Chiu
- Department of Obstetrics, China Medical University Hospital, Taichung, Taiwan; College of Medicine, Brain Disease Research Center (BDRC), China Medical University, Taichung, Taiwan
| | - Ming Ho
- Department of Obstetrics, China Medical University Hospital, Taichung, Taiwan
| | - Hui-Ting Yang
- College of Biopharmaceutical and Food Sciences, China Medical University, Taichung, Taiwan
| | - Shih-Yi Huang
- College of Public Health and Nutrition, Taipei Medical University, Taiwan
| | | | - Kuan-Pin Su
- Department of Psychiatry, Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung, Taiwan; Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King's College London, UK; College of Medicine, Brain Disease Research Center (BDRC), China Medical University, Taichung, Taiwan.
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Abstract
Pregnancy and lactation deplete nutrients essential to the neurotransmission system. This may be one reason for the increased risk of depression during the perinatal period. The objective of the present review was to systematically review the literature and summarise evidence on whether blood nutrient levels influence the risk of perinatal depression. PubMed, EMBASE and CINAHL databases were searched for studies of any design. A total of twenty-four articles of different designs were included, representing 14 262 subjects. We extracted data on study population, depression prevalence, nutrients examined, deficiency prevalence, timing of assessment, reporting, analysis strategy and adjustment factors. In all, fourteen studies found associations of perinatal depression with lower levels of folate, vitamin D, Fe, Se, Zn, and fats and fatty acids, while two studies found associations between perinatal depression and higher nutrient levels, and eight studies found no evidence of an association. Only ten studies had low risk of bias. Given the methodological limitations and heterogeneity of study approaches and results, the evidence for a causal link between nutritional biomarkers and perinatal depression is still inconclusive. High-quality studies in deficient populations are needed.
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Antidepressant-Like Effect of Lipid Extract of Channa striatus in Postpartum Model of Depression in Rats. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 2017:1469209. [PMID: 29317891 PMCID: PMC5727658 DOI: 10.1155/2017/1469209] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 10/15/2017] [Indexed: 12/16/2022]
Abstract
Postpartum depression affects 15% of women. Channa striatus, a freshwater fish, is consumed in local Malay population as a rejuvenating diet during postpartum period. This study evaluated the antidepressant-like effect of lipid extract of C. striatus fillet and its mechanism of action in female Sprague-Dawley rats in postpartum model of depression. The rats were ovariectomized and treated with high dose of progesterone and estradiol benzoate for 23 days to have hormone-simulated pregnancy. The day 24 and afterwards were considered as the postpartum period. During the postpartum period, lipid extract was administered at 125, 250, and 500 mg/kg through intraperitoneal route for 15 days. Fluoxetine (10 mg/kg) was used as the positive control. On postpartum day 15, the animals were tested in forced swimming test (FST) and open field test (OFT) followed by biochemical analysis. Withdrawal of hormone administration during the postpartum period induced depressive-like behavior in FST. Administration of lipid extract reversed that depressive-like behavior at 125, 250, and 500 mg/kg in FST. In OFT, it decreased the exploratory activity. The mechanism of the antidepressant-like effect may be mediated through the decrease in plasma corticosterone, increase in plasma oxytocin, and decrease in nuclear factor-kappa B in prefrontal cortex of rats.
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Polyunsaturated Fatty Acids in Perinatal Depression: A Systematic Review and Meta-analysis. Biol Psychiatry 2017; 82:560-569. [PMID: 28410627 DOI: 10.1016/j.biopsych.2017.02.1182] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 02/24/2017] [Accepted: 02/27/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND Omega-3 (or n-3) polyunsaturated fatty acids (PUFAs) are promising antidepressant treatments for perinatal depression (PND) because of supporting evidence from clinical trials, the advantage in safety, and their anti-inflammatory and neuroplastic effects. Although several observational studies have shown n-3 PUFA deficits in women with PND, the results of individual PUFAs from different studies were inconsistent. METHODS This systematic review and meta-analysis aims to compare the levels of PUFA indices, including eicosapentaenoic acid, docosahexaenoic acid, arachidonic acid, total n-3, total n-6, and the n-6/n-3 ratio between women with PND and healthy control subjects. The meta-analysis included 12 eligible studies available as of December 2016. The effect sizes were synthesized by using a random effects model. In addition, we performed subgroup analysis for the PUFA levels in patients with prenatal and postnatal depression, both of which were compared with healthy control subjects. RESULTS There were significantly lower levels of total n-3 PUFAs and docosahexaenoic acid and significantly increased n-6/n-3 ratios in PND patients. In the subgroup analyses, there were significantly lower levels of n-3 PUFAs, eicosapentaenoic acid, and docosahexaenoic acid in women with prenatal depression. The n-6/n-3 ratio was significantly increased in both prenatal and postnatal depression subgroups. CONCLUSIONS Our meta-analysis consolidates the important role of n-3 PUFAs in PND. Nutritional medicine is an important strategy to improve the effectiveness of treatment for depression, and our findings provide the strong rationale to conduct clinical trials to test the therapeutic and prophylactic effects of n-3 PUFAs in PND.
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Cook RL, O'Dwyer NJ, Donges CE, Parker HM, Cheng HL, Steinbeck KS, Cox EP, Franklin JL, Garg ML, Rooney KB, O'Connor HT. Relationship between Obesity and Cognitive Function in Young Women: The Food, Mood and Mind Study. J Obes 2017; 2017:5923862. [PMID: 29291133 PMCID: PMC5651104 DOI: 10.1155/2017/5923862] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 06/11/2017] [Accepted: 08/09/2017] [Indexed: 11/17/2022] Open
Abstract
Limited research addresses links between obesity and cognitive function in young adults. Objective. To investigate the relationship between obesity and cognitive function in young women. Methods. This cross-sectional study recruited healthy, young (18-35 y) women of normal (NW: BMI = 18.5-24.9 kg·m-2) or obese (OB: BMI ≥ 30.0 kg·m-2) weight. Participants completed a validated, computer-based cognitive testing battery evaluating impulsivity, attention, information processing, memory, and executive function. Questionnaires on depression and physical activity and a fasting blood sample for C-reactive protein and the Omega-3 Index were also collected. Cognition data are presented as z-scores (mean ± SD), and group comparisons were assessed via ANOVA. Potential confounding from questionnaire and blood variables were evaluated using ANCOVA. Results. 299 women (NW: n = 157; OB: n = 142) aged 25.8 ± 5.1 y were enrolled. Cognition scores were within normal range (±1 z-score), but OB had lower attention (NW: 0.31 ± 1.38; OB: -0.25 ± 1.39; ES: 0.41, CI: 0.17-0.64; p < 0.001) and higher impulsivity (NW: 0.36 ± 1.14; OB: -0.07 ± 1.07; ES: 0.39, CI: 0.15-0.62; p=0.033). Confounder adjustment had minimal impact on results. Conclusion. The OB group had normal but significantly lower performance on attention and were more impulsive compared to NW participants. This may indicate early cognitive decline, but longitudinal research confirming these findings is warranted.
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Affiliation(s)
- Rebecca L. Cook
- Discipline of Exercise and Sport Science, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia
| | - Nicholas J. O'Dwyer
- Discipline of Exercise and Sport Science, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia
- School of Human Movement Sciences, Charles Sturt University, Bathurst, NSW, Australia
| | - Cheyne E. Donges
- School of Human Movement Sciences, Charles Sturt University, Bathurst, NSW, Australia
| | - Helen M. Parker
- Discipline of Exercise and Sport Science, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia
- Charles Perkins Centre, University of Sydney, Camperdown, NSW, Australia
| | - Hoi Lun Cheng
- Charles Perkins Centre, University of Sydney, Camperdown, NSW, Australia
- Discipline of Paediatrics and Child Health, The Children's Hospital at Westmead, University of Sydney, NSW, Australia
| | - Katharine S. Steinbeck
- Discipline of Paediatrics and Child Health, The Children's Hospital at Westmead, University of Sydney, NSW, Australia
| | - Eka P. Cox
- Discipline of Exercise and Sport Science, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia
| | - Janet L. Franklin
- Metabolism and Obesity Services, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Manohar L. Garg
- Nutraceuticals Research Program, School of Biomedical Sciences & Pharmacy, University of Newcastle, Callaghan, NSW, Australia
| | - Kieron B. Rooney
- Discipline of Exercise and Sport Science, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia
- Charles Perkins Centre, University of Sydney, Camperdown, NSW, Australia
| | - Helen T. O'Connor
- Discipline of Exercise and Sport Science, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia
- Charles Perkins Centre, University of Sydney, Camperdown, NSW, Australia
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Metherel AH, Kitson AP, Domenichiello AF, Lacombe RJS, Hopperton KE, Trépanier MO, Alashmali SM, Lin L, Bazinet RP. Maternal liver docosahexaenoic acid (DHA) stores are increased via higher serum unesterified DHA uptake in pregnant long Evans rats. J Nutr Biochem 2017. [PMID: 28628798 DOI: 10.1016/j.jnutbio.2017.05.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Maternal docosahexaenoic acid (DHA, 22:6n-3) supplies the developing fetus during pregnancy; however, the mechanisms are unclear. We utilized pregnant rats to determine rates of DHA accretion, tissue unesterified DHA uptake and whole-body DHA synthesis-secretion. Female rats maintained on a DHA-free, 2% α-linolenic acid diet were either:1) sacrificed at 56 days for baseline measures, 2) mated and sacrificed at 14-18 days of pregnancy or 3) or sacrificed at 14-18 days as age-matched virgin controls. Maternal brain, adipose, liver and whole body fatty acid concentrations was determined for balance analysis, and kinetic modeling was used to determine brain and liver plasma unesterified DHA uptake and whole-body DHA synthesis-secretion rates. Total liver DHA was significantly higher in pregnant (95±5 μmol) versus non-pregnant (49±5) rats with no differences in whole-body DHA synthesis-secretion rates. However, liver uptake of plasma unesterified DHA was 3.8-fold higher in pregnant animals compared to non-pregnant controls, and periuterine adipose DHA was lower in pregnant (0.89±0.09 μmol/g) versus non-pregnant (1.26±0.06) rats. In conclusion, higher liver DHA accretion during pregnancy appears to be driven by higher unesterified DHA uptake, potentially via DHA mobilization from periuterine adipose for delivery to the fetus during the brain growth spurt.
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Affiliation(s)
- Adam H Metherel
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, 150 College St., Toronto, Ontario, Canada, M5S 3E2.
| | - Alex P Kitson
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, 150 College St., Toronto, Ontario, Canada, M5S 3E2
| | - Anthony F Domenichiello
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, 150 College St., Toronto, Ontario, Canada, M5S 3E2
| | - R J Scott Lacombe
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, 150 College St., Toronto, Ontario, Canada, M5S 3E2
| | - Kathryn E Hopperton
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, 150 College St., Toronto, Ontario, Canada, M5S 3E2
| | - Marc-Olivier Trépanier
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, 150 College St., Toronto, Ontario, Canada, M5S 3E2
| | - Shoug M Alashmali
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, 150 College St., Toronto, Ontario, Canada, M5S 3E2
| | - Lin Lin
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, 150 College St., Toronto, Ontario, Canada, M5S 3E2
| | - Richard P Bazinet
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, 150 College St., Toronto, Ontario, Canada, M5S 3E2
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Henjum S, Lie Ø, Ulak M, Thorne-Lyman AL, Chandyo RK, Shrestha PS, W Fawzi W, Strand TA, Kjellevold M. Erythrocyte fatty acid composition of Nepal breast-fed infants. Eur J Nutr 2017; 57:1003-1013. [PMID: 28238109 DOI: 10.1007/s00394-017-1384-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 01/24/2017] [Indexed: 12/19/2022]
Abstract
PURPOSE Essential fatty acids play a critical role in the growth and development of infants, but little is known about the fatty acid status of populations in low-income countries. The objective was to describe the fatty acid composition of red blood cells (RBC) in breastfeed Nepali infants and a subsample of their mothers and to identify the main sources of fatty acids in the mother's diet, as well as the fatty acid composition of breast milk. METHODS RBC fatty acid composition was analyzed in a random sample of 303 infants and 72 mother, along with 68 breastmilk samples. Fatty acid profiles of the most important dietary fat sources were analyzed. Information on mother's diet and intake of fat was collected by three 24-h dietary recalls. RESULTS In infant RBC's, docosahexaenoic acid (DHA) was the main n-3 fatty acid, and arachidonic acid (AA) was the major n-6 fatty acid. Total n-6 PUFA was three times higher than total n-3 PUFA. Height-for-age (HAZ) was positively associated with DHA status and AA status in multivariable models. The concentration of all fatty acids was higher in children, compared to mothers, except Total n-6 PUFA and Linoleic acid (LA) where no differences were found. The mother's energy intake from fat was 13% and cooking oil (sesame, mustard, soybean or sunflower oil) contributed 52% of the fat intake. CONCLUSIONS RBC-DHA levels in both infants and mother was unexpected high taking into account few dietary DHA sources and the low DHA concentrations in breastmilk.
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Affiliation(s)
- Sigrun Henjum
- Oslo and Akershus University College of Applied Sciences, St. Olavs plass, P.O. Box 4, 0130, Oslo, Norway.
| | - Øyvind Lie
- National Institute of Nutrition and Seafood Research (NIFES), P.O. Box 2029, 5817, Bergen, Norway
| | - Manjeswori Ulak
- Department of Child Health, Institute of Medicine, Tribhuvan University, Maharajgunj, P.O. Box 1524, 44600, Kathmandu, Nepal
| | - Andrew L Thorne-Lyman
- Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
- Departments of Nutrition, Epidemiology, and Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, USA
| | - Ram K Chandyo
- Department of Community Medicine, Kathmandu Medical College, 21266, Kathmandu, Nepal
| | - Prakash S Shrestha
- Department of Child Health, Institute of Medicine, Tribhuvan University, Maharajgunj, P.O. Box 1524, 44600, Kathmandu, Nepal
| | - Wafaie W Fawzi
- Departments of Nutrition, Epidemiology, and Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, USA
| | - Tor A Strand
- Department of Research, Innlandet Hospital Trust and Centre for International Health, University of Bergen, 2629, Lillehammer, Norway
| | - Marian Kjellevold
- National Institute of Nutrition and Seafood Research (NIFES), P.O. Box 2029, 5817, Bergen, Norway
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Kobayashi M, Ogawa K, Morisaki N, Tani Y, Horikawa R, Fujiwara T. Dietary n-3 Polyunsaturated Fatty Acids in Late Pregnancy and Postpartum Depressive Symptom among Japanese Women. Front Psychiatry 2017; 8:241. [PMID: 29218019 PMCID: PMC5703735 DOI: 10.3389/fpsyt.2017.00241] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 11/06/2017] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The use of n-3 polyunsaturated fatty acids (n-3PUFA) in preventive or therapeutic modalities for postpartum depression, especially long-chain types such as eicosapentaenoic acid (EPA) and a docosahexaenoic acid (DHA), is of considerable interest. High n-3PUFA consumption has been reported among pregnant Japanese women. Therefore, analysis of this group could provide important insights into the relationship between postpartum depression and dietary n-3PUFA consumption. To further examine the relationship between the risk of postpartum depression and n-3PUFA consumption, we conducted a prospective hospital-based birth cohort study in Japan. DESIGN AND METHODS Our prospective birth cohort study was performed at the National Center for Child Health and Development (NCCHD) in suburban Tokyo, Japan. Dietary n-3PUFA intake during late pregnancy was assessed by a semi-quantitative food questionnaire and participants were categorized by quintile distributions of n-3PUFA intake. A Japanese translation of the Edinburgh Postnatal Depression Scale was used to screen women for postpartum depression at 1 month after delivery (967 women) and at 6 months after delivery (710 women). We performed logistic regression analysis to examine the relationship between the risk of postpartum depression and n-3PUFA consumption after adjusting for confounding factors. RESULTS Significant associations between EPA, DHA, and n-3PUFA intakes in late pregnancy and postpartum depression at both 1 and 6 months after delivery were not observed. CONCLUSION This prospective study indicated that EPA, DHA, and n-3PUFA intake during late pregnancy was not associated with the risk of postpartum depression.
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Affiliation(s)
- Minatsu Kobayashi
- Department of Food Science, Faculty of Home Economics, Otsuma Women's University, Tokyo, Japan
| | - Kohei Ogawa
- Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Naho Morisaki
- Department of Social Medicine, National Research Institute for Child Health and Development, National Center for Child Health and Development, Tokyo, Japan
| | - Yukako Tani
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan
| | - Reiko Horikawa
- Division of Endocrinology and Metabolism, National Center for Child Health and Development, Tokyo, Japan
| | - Takeo Fujiwara
- Department of Social Medicine, National Research Institute for Child Health and Development, National Center for Child Health and Development, Tokyo, Japan.,Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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Grosso G, Micek A, Marventano S, Castellano S, Mistretta A, Pajak A, Galvano F. Dietary n-3 PUFA, fish consumption and depression: A systematic review and meta-analysis of observational studies. J Affect Disord 2016; 205:269-281. [PMID: 27544316 DOI: 10.1016/j.jad.2016.08.011] [Citation(s) in RCA: 144] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 08/08/2016] [Accepted: 08/14/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Fish consumption and n-3 polyunsaturated fatty acids (PUFA) have been hypothesized to exert preventive effects toward depressive disorders, but findings are contrasting. We aimed to systematically review and perform meta-analysis of results from observational studies exploring the association between fish, n-3 PUFA dietary intake, and depression. METHODS A search on the main bibliographic source of the observational studies up to August 2015 was performed. Random-effects models of the highest versus the lowest (reference) category of exposure and dose-response meta-analysis were performed. RESULTS A total of 31 studies including 255,076 individuals and over 20,000 cases of depression, were examined. Analysis of 21 datasets investigating relation between fish consumption and depression resulted in significant reduced risk (RR=0.78, 95% CI: 0.69, 0.89), with a linear dose-response despite with moderate heterogeneity. Pooled risk estimates of depression for extreme categories of both total n-3 PUFA and fish-derived n-3 PUFA [eicosapentaenoic acid (EPA)+docosahexaenoic acid (DHA)] resulted in decreased risk for the highest compared with the lowest intake (RR=0.78, 95% CI: 0.67, 0.92 and RR=0.82, 95% CI: 0.73, 0.92, respectively) and dose-response analysis revealed a J-shaped association with a peak decreased risk for 1.8g/d intake of n-3 PUFA (RR=0.30, 95% CI: 0.09, 0.98). LIMITATION Design of the studies included and confounding due to lack adjustment for certain variables may exist. CONCLUSIONS The present analysis supports the hypothesis that dietary n-3 PUFA intake are associated with lower risk of depression.
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Affiliation(s)
- Giuseppe Grosso
- Integrated Cancer Registry of Catania-Messina-Siracusa-Enna, Azienda Ospedaliero-Universitaria Policlinico-Vittorio Emanuele, Catania, Italy
| | - Agnieszka Micek
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland
| | - Stefano Marventano
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, Catania, Italy.
| | - Sabrina Castellano
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Antonio Mistretta
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, Catania, Italy
| | - Andrzej Pajak
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland
| | - Fabio Galvano
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
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48
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Hamazaki K, Harauma A, Tanabe S, Namai M, Moriguchi T, Inadera H. Association of serum n-3 polyunsaturated fatty acids with psychological distress in the second and third trimesters of pregnancy: Adjunct Study of Japan Environment and Children's Study. Prostaglandins Leukot Essent Fatty Acids 2016; 114:21-27. [PMID: 27926460 DOI: 10.1016/j.plefa.2016.09.005] [Citation(s) in RCA: 2] [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: 08/31/2016] [Revised: 09/29/2016] [Accepted: 09/30/2016] [Indexed: 01/16/2023]
Abstract
The results of several epidemiological studies and clinical trials investigating the effects of n-3 polyunsaturated fatty acids (PUFAs) on antenatal and postnatal depression remain controversial. In a previous case-control study of early pregnancy in Japan, we found an inverse association between eicosapentaenoic acid and risk of psychological distress after adjusting for possible confounders. Here, in a 1:2 matched case-control study, we further investigated the possible relationship between serum n-3 PUFAs and risk of psychological distress in the second and third trimesters of pregnancy. The psychological distress group (n=71) consisted of subjects with a score of ≥13 on the Kessler Psychological Distress Scale. The control group (n=142) was matched for age, educational level, and family income. Fatty acid composition of total lipid was determined from serum samples by gas chromatography. Associations between fatty acid levels and incidence of psychological distress were evaluated by logistic regression. Sixty-six percent of blood samples were collected in the second trimester and the remainder in the third. There were no significant differences in any of the n-3 PUFAs between the two groups. After adjustment for possible confounders, none of the n-3 PUFAs showed an association with risk of psychological distress. Peripheral n-3 PUFA levels might not influence the risk of psychological distress in later pregnancy. Further research is warranted to clarify this finding.
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Affiliation(s)
- Kei Hamazaki
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan.
| | - Akiko Harauma
- Laboratory for Functional Analysis of Marine Materials, School of Life and Environmental Science, Azabu University, Kanagawa, Japan
| | - Satoru Tanabe
- Laboratory of Food and Nutritional Science, Department of Food and Life Science, School of Life and Environmental Science, Azabu University, Kanagawa, Japan
| | - Miho Namai
- Laboratory of Food and Nutritional Science, Department of Food and Life Science, School of Life and Environmental Science, Azabu University, Kanagawa, Japan
| | - Toru Moriguchi
- Laboratory for Functional Analysis of Marine Materials, School of Life and Environmental Science, Azabu University, Kanagawa, Japan; Laboratory of Food and Nutritional Science, Department of Food and Life Science, School of Life and Environmental Science, Azabu University, Kanagawa, Japan
| | - Hidekuni Inadera
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan
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49
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Li J, Yin H, Bibus DM, Byelashov OA. The role of Omega-3 docosapentaenoic acid in pregnancy and early development. EUR J LIPID SCI TECH 2016. [DOI: 10.1002/ejlt.201600076] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Juan Li
- Omega Protein Corporation; Houston; TX USA
| | | | - Douglas M. Bibus
- University of Minnesota; Minneapolis; MN USA
- Lipid Technologies; LLC.; Austin MN USA
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50
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Fenton JI, Gurzell EA, Davidson EA, Harris WS. Red blood cell PUFAs reflect the phospholipid PUFA composition of major organs. Prostaglandins Leukot Essent Fatty Acids 2016; 112:12-23. [PMID: 27637336 DOI: 10.1016/j.plefa.2016.06.004] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Revised: 06/26/2016] [Accepted: 06/28/2016] [Indexed: 02/02/2023]
Abstract
Numerous clinical trials examining the use of omega-3 long chain polyunsaturated fatty acids (n-3 LCPUFAs) on various health outcomes have been conducted, and fish oil remains one of the most widely used nutritional supplements. More recently, studies have begun to utilize the omega-3 index, defined as the sum of EPA+DHA in red blood cells (RBCs), as both a biomarker of n-3 LCPUFA exposure and a potential risk factor for coronary heart disease (CHD). Considerably less research evaluates whether RBC phospholipid fatty acids reflect the phospholipid fatty acid composition of other tissues across increasing intakes of n-3 LCPUFAs. We fed mice diets containing increasing amounts of EPA+DHA, equivalent to current recommendations by the American Heart Association on a percent of energy basis, and analyzed the phospholipid fatty acid composition of various tissues in relation to RBCs. We observed that RBCs, heart, muscle, spleen, lung, and adipose tissues all respond to dietary supplementation with EPA+DHA with increasing n-3 LCPUFA and decreasing n-6 LCPUFA levels. Furthermore, the n-3 LCPUFA profiles of all measured tissues had strong (r>0.7) and significant (p<0.001) correlations to RBCs. Interestingly, we also observed changes in saturated fatty acid (SFA) and monounsaturated fatty acid (MUFA) levels across various tissues in response to increased EPA+DHA intakes despite there being no change in dietary SFA and MUFA. Specifically, there were increases in RBC SFA and spleen MUFA and decreases in heart MUFA. These demonstrate that the RBC, including the omega-3 index, may serve as a marker for the relative levels of n-3 and n-6 LCPUFAs in phospholipids of certain tissues.
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Affiliation(s)
- Jenifer I Fenton
- Department of Food Science and Human Nutrition, Michigan State University, United States; College of Osteopathic Medicine, East Lansing, MI, United States.
| | - Eric A Gurzell
- Department of Food Science and Human Nutrition, Michigan State University, United States
| | - Emily A Davidson
- Department of Food Science and Human Nutrition, Michigan State University, United States
| | - William S Harris
- Sanford School of Medicine, The University of South Dakota, and OmegaQuant, LLC, Sioux Falls, SD, United States
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