1
|
Poulter M, Coe S, Graham CAM, Leach B, Tammam J. A systematic review of the effect of dietary and nutritional interventions on the behaviours and mental health of prisoners. Br J Nutr 2024:1-14. [PMID: 38682285 DOI: 10.1017/s0007114524000849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
Prisoners experience a higher burden of poor health, aggressive behaviours and worsening mental health than the general population. This systematic review aimed to identify research that used nutrition-based interventions in prisons, focusing on outcomes of mental health and behaviours. The systematic review was registered with Prospective Register of Systematic Reviews on 26 January 2022: CRD42022293370. Inclusion criteria comprised of current prisoners with no limit on time, location, age, sex or ethnicity. Only quantitative research in the English language was included. PubMed/Medline, Web of Science, EMBASE, PsycINFO and CINAHL were searched, retrieving 933 results, with 11 included for qualitative synthesis. Studies were checked for quality using the revised tool to assess risk of bias in randomised trials or risk of bias in non-randomised studies of interventions tool. Of the included studies, seven used nutritional supplements, three included diet changes, and one used education. Of the seven supplement-based studies, six included rule violations as an outcome, and only three demonstrated significant improvements. One study included mental health as an outcome; however, results did not reach significance. Of the three diet change studies, two investigated cognitive function as an outcome, with both reaching significance. Anxiety was included in one diet change study, which found a significant improvement through consuming oily fish. One study using diet education did not find a significant improvement in overall mental resilience. Overall, results are mixed, with the included studies presenting several limitations and heterogeneity. Future research should aim to consider increased homogeneity in research design, allowing for a higher quality of evidence to assess the role nutrition can play in improving the health of prisoners.
Collapse
Affiliation(s)
- Matthew Poulter
- Centre for Nutrition and Health, Faculty of Health & Life Sciences, Oxford Brookes University, OX3 0BP, Oxford, UK
| | - Shelly Coe
- Centre for Nutrition and Health, Faculty of Health & Life Sciences, Oxford Brookes University, OX3 0BP, Oxford, UK
| | - Catherine Anna-Marie Graham
- Centre for Nutrition and Health, Faculty of Health & Life Sciences, Oxford Brookes University, OX3 0BP, Oxford, UK
- Cereneo Foundation, Center for Interdisciplinary Research (CEFIR), 6354Vitznau, Switzerland
- Lake Lucerne Institute AG, Rubistrasse 9, 6354Vitznau, Switzerland
| | - Bethan Leach
- Practice Plus Group, Hawker House 5-6 Napier Court, Napier Rd, Reading, BerkshireRG1 8BW, UK
| | - Jonathan Tammam
- Centre for Nutrition and Health, Faculty of Health & Life Sciences, Oxford Brookes University, OX3 0BP, Oxford, UK
| |
Collapse
|
2
|
Sanne I, Bjørke-Monsen AL. Dietary behaviors and attitudes among Norwegian medical students. BMC MEDICAL EDUCATION 2023; 23:220. [PMID: 37024871 PMCID: PMC10080805 DOI: 10.1186/s12909-023-04194-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 03/24/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Dietary patterns and beliefs are influenced by socioeconomic status, cultural influences, as well as medical advice, social media and marketing. Medical doctors are expected to provide correct, updated and non-biased nutritional advice to their patients, but their own dietary behaviors and attitudes may influence nutritional counselling. METHODS We have investigated dietary habits and food attitudes among medical students by using an anonymous survey distributed to all students at the Medical Faculty, University of Bergen, Norway. The survey included a 36-item questionnaire covering information about demographics, former and current diet, use of nutritional supplements, tobacco and alcohol, in addition to food attitudes and nutritional knowledge. Descriptive statistics were calculated for each survey item. RESULTS Of the 880 students, 394 responded to the survey. Although 90% of the students were omnivores, the majority had a negative attitude towards meat, and considered fish to be healthier than meat. Significantly more women than men reported use of a special diet and excluded meat from their diet, even if they were omnivores. The most frequently used supplement was cod liver oil or omega 3 fatty acids. CONCLUSION The medical students' diet and food attitudes not only reflect current health recommendations, but also popular beliefs and marketing in Norway. Curriculum planners should make the students capable of recognizing the influence of social media, marketing and medicine-food industry interactions, to ensure relevant nutrition knowledge for future doctors.
Collapse
Affiliation(s)
- Ingebjørg Sanne
- Department of Hematology and Oncology, Stavanger University Hospital, Stavanger, Norway
| | - Anne-Lise Bjørke-Monsen
- Laboratory of Medical Biochemistry, Innlandet Hospital Trust, Lillehammer, Norway.
- Laboratory of Medical Biochemistry, Førde Central Hospital, Førde, Norway.
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, 5021, Norway.
| |
Collapse
|
3
|
Vitamin D Status and Physical Activity during Wintertime in Forensic Inpatients-A Randomized Clinical Trial. Nutrients 2021; 13:nu13103510. [PMID: 34684511 PMCID: PMC8539268 DOI: 10.3390/nu13103510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 10/01/2021] [Accepted: 10/02/2021] [Indexed: 12/22/2022] Open
Abstract
This study aimed to gain deeper knowledge about the relationship between vitamin D and physical activity in a sample of forensic inpatients. Sixty-seven male forensic inpatients participated. Participants were randomly assigned into an Intervention group (vitamin D) or a Control group (placebo). The Physical Activity–Rating (PA-R) questionnaire was used to measure physical activity from January to May. Vitamin D status was measured as 25-hydroxy vitamin D (25-OHD) pre- and post-intervention. The results revealed that vitamin D status at post-test was positively correlated with physical activity, but there was no effect of vitamin D supplementation looking at the two randomized groups. However, controlling for body mass index (BMI), the results showed an effect of BMI and a main effect of groups with a higher level of physical activity in the Intervention group. No interaction effects were found. Participants were also assigned into High and Low vitamin D groups based on the vitamin D status at post-test; i.e., the upper (75.1 nmol/L) and lower quartile (46.7 nmol/L). T-tests revealed that participants with a vitamin D status above 75 nmol/L showed significantly higher levels of physical activity than participants with a vitamin D status below 46.7 nmol/L. Thus, a vitamin D status above 75 nmol/L seems to be an optimal level.
Collapse
|
4
|
Kris-Etherton PM, Petersen KS, Hibbeln JR, Hurley D, Kolick V, Peoples S, Rodriguez N, Woodward-Lopez G. Nutrition and behavioral health disorders: depression and anxiety. Nutr Rev 2021; 79:247-260. [PMID: 32447382 PMCID: PMC8453603 DOI: 10.1093/nutrit/nuaa025] [Citation(s) in RCA: 99] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Suboptimal nutrition has been implicated in the underlying pathology of behavioral health disorders and may impede treatment and recovery. Thus, optimizing nutritional status should be a treatment for these disorders and is likely important for prevention. The purpose of this narrative review is to describe the global burden and features of depression and anxiety, and summarize recent evidence regarding the role of diet and nutrition in the prevention and management of depression and anxiety. Current evidence suggests that healthy eating patterns that meet food-based dietary recommendations and nutrient requirements may assist in the prevention and treatment of depression and anxiety. Randomized controlled trials are needed to better understand how diet and nutrition-related biological mechanisms affect behavioral health disorders, to assist with the development of effective evidence-based nutrition interventions, to reduce the impact of these disorders, and promote well-being for affected individuals.
Collapse
Affiliation(s)
- Penny M Kris-Etherton
- Department of Nutritional Sciences, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Kristina S Petersen
- Department of Nutritional Sciences, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Joseph R Hibbeln
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland, USA
| | | | - Valerie Kolick
- Substance Abuse and Mental Health Services Administration, Rockville, Maryland, USA
| | - Sevetra Peoples
- Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Nancy Rodriguez
- Department of Nutritional Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Gail Woodward-Lopez
- Nutrition Policy Institute, University of California, Agriculture and Natural Resources, Berkeley, California, USA
| |
Collapse
|
5
|
Vuholm S, Teisen MN, Mølgaard C, Lauritzen L, Damsgaard CT. Sleep and physical activity in healthy 8-9-year-old children are affected by oily fish consumption in the FiSK Junior randomized trial. Eur J Nutr 2021; 60:3095-3106. [PMID: 33515093 DOI: 10.1007/s00394-021-02490-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 01/08/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE Studies indicate that long-chain n-3 PUFA (n-3LCPUFA) affect sleep and physical activity (PA) in childhood. However, few studies used objective tools and none studies examined the effect of fish per se. We aimed to explore if fish consumption affected sleep and PA assessed by accelerometry in children, and if effects were modified by sex. METHODS In a randomized 12-week trial, 199 healthy 8-9-year-old children received ~ 300 g/week of oily fish or poultry. Sleep and PA were pre-specified explorative outcomes examined by accelerometers that the children wore on their hip for 7 days at baseline and endpoint, while parents registered sleep. Compliance was verified by erythrocyte n-3LCPUFA. RESULTS The children slept 9.4 ± 0.5 h/night but the sleep duration variability across the week was 6.0 (95%CI: 0.8, 11.1) min lower in the fish vs poultry group. Furthermore, children in the fish group exhibited increased spare time sedentary activity [9.4 (95%CI: 1.8, 16.9) min/day] at the expense of light PA [- 8.2 (95%CI: - 14.4, - 2.0) min/day]. These effects were supported by dose-dependency with n-3LCPUFA. Additionally, latency to sleep onset was reduced by 3.6 (95%CI: 1.0, 6.3) min on weekends and moderate-vigorous PA during school hours was 3.5 (95%CI: 0.1, 6.8) min longer in fish vs poultry. P values for sex interactions were all > 0.05 but the effects tended to be most pronounced on sleep in girls and PA in boys. CONCLUSION Oily fish intake altered sleep and PA patterns among healthy schoolchildren, with some slight indications of sex differences. These findings warrant further investigation. CLINICAL TRIAL REGISTRY At clinicaltrials.gov (NCT02809508) and a published protocol in Trials [Damsgaard et al. in Trials, 2016].
Collapse
Affiliation(s)
- Stine Vuholm
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 26, 1958, Frederiksberg C, Denmark
| | - Marie N Teisen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 26, 1958, Frederiksberg C, Denmark
| | - Christian Mølgaard
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 26, 1958, Frederiksberg C, Denmark
| | - Lotte Lauritzen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 26, 1958, Frederiksberg C, Denmark.
| | - Camilla T Damsgaard
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 26, 1958, Frederiksberg C, Denmark
| |
Collapse
|
6
|
Vitamin D Supplementation during Winter: Effects on Stress Resilience in a Randomized Control Trial. Nutrients 2020; 12:nu12113258. [PMID: 33114392 PMCID: PMC7692327 DOI: 10.3390/nu12113258] [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: 09/17/2020] [Revised: 10/19/2020] [Accepted: 10/22/2020] [Indexed: 01/01/2023] Open
Abstract
Vitamin D status may be important for stress resilience. This study investigated the effects of vitamin D supplements during winter on biological markers of stress resilience such as psychophysiological activity, serotonin, and cortisol in a placebo-controlled, randomized clinical trial. Eighty-six participants were randomly assigned to the Intervention (vitamin D) or Control (placebo) groups. Before and after the intervention participants were exposed to an experimental stress procedure. Psychophysiological activity was measured during three main conditions: baseline, stress, and recovery. Fasting blood samples were taken in the morning and saliva samples were collected at seven different time points across 24 h. Prior to intervention both groups had normal/sufficient vitamin D levels. Both groups showed a normal pattern of psychophysiological responses to the experimental stress procedure (i.e., increased psychophysiological responses from resting baseline to stress-condition, and decreased psychophysiological responses from stress-condition to recovery; all p < 0.009). Post-intervention, the Intervention group showed increased vitamin D levels (p < 0.001) and normal psychophysiological responses to the experimental stress procedure (p < 0.001). Importantly, the Control group demonstrated a classic nadir in vitamin D status post-intervention (spring) (p < 0.001) and did not show normal psychophysiological responses. Thus, physiologically the Control group showed a sustained stress response. No significant effects of vitamin D were found on serotonin and cortisol.
Collapse
|
7
|
Hansen AL, Ambroziak G, Thornton D, Dahl L, Grung B. The effects of diet on levels of physical activity during winter in forensic inpatients - A randomized controlled trial. Food Nutr Res 2020; 64:3610. [PMID: 32180692 PMCID: PMC7054642 DOI: 10.29219/fnr.v64.3610] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 11/29/2019] [Accepted: 01/10/2020] [Indexed: 11/26/2022] Open
Abstract
Background Fish consumption has been shown to have beneficial effects on biological and subjective measures of health and well-being. However, little is known about the effects of fish consumption at the behavioral level. Objective The primary aim of this study was to investigate the influence of diet on behavior such as physical activity during winter in forensic inpatients. The secondary aim was to investigate the relationship between vitamin D status and physical activity. Design Eighty-one male forensic inpatients participated in this study. Participants were randomized into two different diet groups: a Fish group receiving fatty fish three times per week and a Control group receiving an alternative meal (e.g. chicken, pork, and beef); while the Fish group received their fish, the Control group received an alternate meal, but with the same nutritional value as their habitual diet. The duration of the food intervention was 6 months. Results The results revealed that the Fish group had a regular pattern of physical activity throughout the intervention period. The participants in the Control group showed a more irregular pattern of physical activity in addition to a significant reduction in physical activity over time. Conclusion Behavior such as physical activity during winter seemed to be influenced by the diet.
Collapse
Affiliation(s)
- Anita L Hansen
- Department of Clinical Psychology, University of Bergen, Bergen, Norway and Department of Psychosocial Science, University of Bergen, Bergen, Norway.,Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Gina Ambroziak
- Sand Ridge Secure Treatment Center (SRSTC), Mauston, WI, USA
| | - David Thornton
- Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway.,FASTR, Madison, WI, USA
| | - Lisbeth Dahl
- Institute of Marine Research (IMR), Bergen, Norway
| | - Bjørn Grung
- Department of Chemistry, University of Bergen, Bergen, Norway
| |
Collapse
|
8
|
Hansen AL, Ambroziak G, Thornton D, Dahl L, Molde H, Grung B. Fatty Fish Intervention and Psychophysiological Responses to Mental Workload in Forensic Inpatients. J PSYCHOPHYSIOL 2020. [DOI: 10.1027/0269-8803/a000231] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. The overall aim of this randomized controlled trial was to investigate the effect of a long-term fatty fish intervention during winter time on psychophysiological responses, that is, heart rate variability (HRV), to mental workload. Forty-seven forensic inpatients were randomly assigned into a fish group (FG) or a control group (CG). HRV responses to an experimental test procedure consisting of a resting baseline, mental workload, and a resting recovery were measured pre- and post-intervention. The results revealed that the FG showed attenuated physiological responses to mental workload from pretest to posttest by a significant increase in HRV. Additionally, the FG showed a higher HRV during recovery compared to the baseline and test conditions at both pretest and posttest. The CG showed no changes in psychophysiological responses from pretest to posttest to mental workload. Importantly, the CG showed impaired recovery at posttest, indicating a sustained physiological arousal after the stressor (mental workload) ended. Thus, the results indicate that increased fatty fish intake has the potential to increase resilience to mild cognitive stress in human beings with psychiatric illnesses.
Collapse
Affiliation(s)
- Anita L. Hansen
- Department of Clinical Psychology, University of Bergen, Norway
- Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Gina Ambroziak
- Sand Ridge Secure Treatment Center (SRSTC), Mauston, WI, USA
| | - David Thornton
- Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
- Forensic Assessment, Training, & Research (FAsTR), LLC, Madison, WI, USA
| | - Lisbeth Dahl
- Food Security and Nutrition, Institute of Marine Research (IMR), Bergen, Norway
| | - Helge Molde
- Department of Clinical Psychology, University of Bergen, Norway
| | - Bjørn Grung
- Department of Chemistry, University of Bergen, Norway
| |
Collapse
|
9
|
Eid A, Khoja S, AlGhamdi S, Alsufiani H, Alzeben F, Alhejaili N, Tayeb HO, Tarazi FI. Vitamin D supplementation ameliorates severity of generalized anxiety disorder (GAD). Metab Brain Dis 2019; 34:1781-1786. [PMID: 31478182 DOI: 10.1007/s11011-019-00486-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 08/20/2019] [Indexed: 12/21/2022]
Abstract
This study investigated the effects of vitamin D supplementation on Generalized Anxiety Disorder (GAD) clinical symptoms and neurochemical biomarkers including serotonin, neopterin and kynurenine. Thirty male and female patients diagnosed with GAD and had vitamin D deficiency were recruited from the psychiatric clinic at King Abdulaziz University Hospital and divided into two groups; one group of patients (n = 15) received standard of care (SOC) plus 50,000 IU vitamin D (once/week) for 3 months, while the other group (n = 15) received SOC alone. Biochemical parameters including serum vitamin D, serotonin, neopterin and kynurenine were measured for all patients enrolled in the trial. In addition, the Generalized Anxiety Disorder 7-item (GAD-7) scale was used to measure the severity of GAD symptoms in both vitamin D treated- and untreated-patients. Significant improvements in GAD scores were observed in the vitamin D-treated group compared to the group that did not receive vitamin D. In addition, serum serotonin concentrations were significantly increased while serum neopterin were significantly decreased in vitamin D-treated vs. untreated patients. In contrast, no significant differences were found in serum kynurenine concentrations at the end of the study period between the two groups. No changes either in GAD-7 scores or in any of the biochemical measurements were observed in the group that received only SOC after 3 months. Vitamin D supplementation was effective in ameliorating the severity of GAD symptoms by increasing serotonin concentrations and decreasing the levels of the inflammatory biomarker neopterin in GAD patients.
Collapse
Affiliation(s)
- Alaa Eid
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Sawsan Khoja
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
- Vitamin D Pharmacogenomics Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Shareefa AlGhamdi
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia.
- Vitamin D Pharmacogenomics Research Group, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Hadeil Alsufiani
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
- Vitamin D Pharmacogenomics Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
- Experimental Biochemistry Unit, King Fahad Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Faten Alzeben
- Division of Psychiatry, Department of Internal Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Nasim Alhejaili
- Division of Psychiatry, Department of Internal Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Haythum O Tayeb
- Division of Neurology, Department of Internal Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Frank I Tarazi
- Department of Psychiatry and Neuroscience Program, Harvard Medical School and McLean Hospital, Boston, MA, USA
| |
Collapse
|
10
|
Abstract
Vitamin D, a fat-soluble vitamin, plays a role not only in calcium and phosphate homeostasis but also in several other functions, including cell growth and neuromuscular and immune function. The deficiency of vitamin D is highly prevalent throughout the world and has been suggested to be associated with an enhanced risk of major depressive disorder (MDD) and anxiety disorders. Therefore, vitamin D supplementation has been investigated for the prevention and treatment of these disorders. This review presents preclinical and clinical evidence of the effects of vitamin D supplementation in these disorders. Although preclinical studies provide limited evidence on the possible mechanisms underlying the beneficial effects of vitamin D for the management of these disorders, most of the clinical studies have indicated that vitamin D supplementation is associated with the reduction of symptoms of depression and anxiety, particularly when the supplementation was carried out in individuals with an MDD diagnosis (of the 13 studies in which MDD diagnosis was established, 12 had positive results with vitamin supplementation). However, some heterogeneity in the outcomes was observed and might be associated with an absence of overt psychiatric symptoms in several studies, genetic polymorphisms that alter vitamin D metabolism and bioavailability, differences in the supplementation regimen (monotherapy, adjunctive therapy, or large bolus dosing), and levels of 25-hydroxyvitamin D3 (25(OH)D) at baseline (individuals with low vitamin D status may respond better) and attained after supplementation. Additionally, factors such as sex, age, and symptom severity also need to be further explored in relation to the effects of vitamin D. Therefore, although vitamin D may hold significant potential for mental health, further preclinical and clinical studies are clearly necessary to better understand its role on mood/affect modulation.
Collapse
|
11
|
Abstract
The purpose of this study was to examine the effect of auricular acupressure on bowel symptoms, stress, mental health, and heart rate variability in women with irritable bowel syndrome (IBS). A quasi-experimental study design with a nonequivalent control group assessed a total sample of 56 women diagnosed with IBS according to Rome III criteria. There were 29 women in the experimental group who received auricular acupressure; 27 women were in the control group. Semen sinapis albae seeds were used to administer acupressure to four auricular points: endocrine, large intestine, lung, and Shenmen for 5 days/week for 4 weeks; the control group received no treatment. Bowel symptoms, stress, mental health, and heart rate variability were measured twice, once before and once after the intervention. Chi-square tests, t tests, and paired t tests were used for analysis. The experimental group had decreased loose stools, abdominal pain, diarrhea, abdominal discomfort, stress, and heart rate variability compared with the control group (p < .05). Auricular acupressure was effective for symptom improvement in patients with IBS.
Collapse
Affiliation(s)
- Gee Youn Go
- Gee Youn Go, PhD, RN, is Head Nurse, Dongkuk University Hospital, Ilsan, South Korea. Hyojung Park, PhD, RN, is Professor, College of Nursing, Ewha Womans University, Seoul, South Korea
| | | |
Collapse
|
12
|
Laborde S, Mosley E, Mertgen A. A unifying conceptual framework of factors associated to cardiac vagal control. Heliyon 2018; 4:e01002. [PMID: 30623126 PMCID: PMC6313821 DOI: 10.1016/j.heliyon.2018.e01002] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 07/20/2018] [Accepted: 11/29/2018] [Indexed: 11/30/2022] Open
Abstract
Cardiac vagal control (CVC) reflects the activity of the vagus nerve regulating cardiac functioning. CVC can be inferred via heart rate variability measurement, and it has been positively associated to a broad range of cognitive, emotional, social, and health outcomes. It could then be considered as an indicator for effective self-regulation, and given this role, one should understand the factors increasing and decreasing CVC. The aim of this paper is to review the broad range of factors influencing CVC, and to provide a unifying conceptual framework to integrate comprehensively those factors. The structure of the unifying conceptual framework is based on the theory of ecological rationality, while its functional aspects are based on the neurovisceral integration model. The structure of this framework distinguishes two broad areas of associations: person and environment, as this reflects adequately the role played by CVC regarding adaptation. The added value of this framework lies at different levels: theoretically, it allows integrating findings from a variety of scientific disciplines and refining the predictions of the neurovisceral integration model; methodologically, it helps identifying factors that increase and decrease CVC; and lastly at the applied level, it can play an important role for society regarding health policies and for the individual to empower one's flourishing.
Collapse
Affiliation(s)
- Sylvain Laborde
- German Sport University Cologne, Institute of Psychology, Department of Performance Psychology, Germany.,Normandie Université Caen, UFR STAPS, EA 4260, Germany
| | | | | |
Collapse
|
13
|
Enhancing cardiac vagal activity: Factors of interest for sport psychology. PROGRESS IN BRAIN RESEARCH 2018; 240:71-92. [PMID: 30390842 DOI: 10.1016/bs.pbr.2018.09.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Self-regulation plays a critical role in sport performance. An objective, psychophysiological marker of self-regulation is cardiac vagal activity, the activity of the vagus nerve regulating cardiac functioning. The aim of this paper is to provide an overview of factors influencing cardiac vagal activity, which can be useful for athletes. Specifically, we organize this overview in two main domains: personal factors and environmental factors. Among the personal factors, we discuss the behavioral strategies that can be used by athletes: nutrition, non-ingestive oral habits, water immersion, body temperature reduction, sleeping habits, relaxation methods, cognitive techniques, praying, music, and exercise. Among environmental factors, we discuss those linked to the social (i.e., contact with humans and animals) and physical (i.e., aromas, lights, sounds, temperature, outdoor, altitude) environment. Future research directions are given, as well as practical implications for athletes and coaches.
Collapse
|
14
|
Natacci L, M Marchioni D, C Goulart A, Nunes MA, B Moreno A, O Cardoso L, Giatti L, B Molina MDC, S Santos I, Brunoni AR, A Lotufo P, M Bensenor I. Omega 3 Consumption and Anxiety Disorders: A Cross-Sectional Analysis of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Nutrients 2018; 10:nu10060663. [PMID: 29882923 PMCID: PMC6024589 DOI: 10.3390/nu10060663] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 05/15/2018] [Accepted: 05/21/2018] [Indexed: 12/20/2022] Open
Abstract
Few studies have evaluated the association between diet and mental disorders, and it has been established that ω-3 (n-3) fatty acids may have a beneficial effect for sufferers of anxiety disorders. This study is part of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)—a population-based cohort study on diet and mental health—and searched for associations between anxiety disorders and consumption of n-3 polyunsaturated fatty acids (PUFA). The study had a cross-sectional design, with a total sample of 12,268 adults. Dietary exposure was measured by a quantitative food-frequency questionnaire, and mental diagnoses were assessed by the Clinical Interview Schedule—Revised Version and diagnosed according to the International Classification of Diseases (ICD-10). Logistic regression models were built using quintiles of n-3, ω 6 (n-6), n-6/n-3 ratio, and PUFA, using the 1st quintile as reference. Anxiety disorders were identified in 15.4% of the sample. After adjusting for sociodemographic variables, cardiovascular risk factors, diet variables, and depression, intakes in the 5th quintile were inversely associated with anxiety disorders for EPA (OR = 0.82, 95% CI = 0.69⁻0.98), DHA (OR = 0.83, 95% CI = 0.69⁻0.98), and DPA (OR = 0.82, 95% CI = 0.69⁻0.98). Participants in the fifth quintile of n-6/n-3 ratio had a positive association with anxiety disorders. Although results suggest a possible protective effect of n-3 fatty acids against anxiety, all associations lost significance after adjustment for multiple comparisons.
Collapse
Affiliation(s)
- Lara Natacci
- Postgraduate student, School of Medicine, University of São Paulo (USP), São Paulo SP 05508-000, Brazil.
| | - Dirce M Marchioni
- Department of Nutrition, School of Public health, University of São Paulo (USP), São Paulo SP 01246-904, Brazil.
| | - Alessandra C Goulart
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo (USP), São Paulo SP 05508-000, Brazil.
| | - Maria Angélica Nunes
- Postgraduate Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul (UFRS), Porto Alegre RS 90035-003, Brazil.
| | - Arlinda B Moreno
- Department of Epidemiology and Quantitative Methods in Health, National School of Public Health Sérgio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro RJ 90035-003, Brazil.
| | - Letícia O Cardoso
- Department of Epidemiology and Quantitative Methods in Health, National School of Public Health Sérgio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro RJ 90035-003, Brazil.
| | - Luana Giatti
- Postgraduate Program in Public Health; General Hospital, School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte MG 30130-100, Brazil.
| | - Maria Del Carmen B Molina
- Departament of Nutrition, Federal University of Espírito Santo (UFES), Vitória ES 29043-900, Brazil.
| | - Itamar S Santos
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo (USP), São Paulo SP 05508-000, Brazil.
| | - André R Brunoni
- Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, University of São Paulo (USP), São Paulo SP 05403-010, Brazil.
| | - Paulo A Lotufo
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo (USP), São Paulo SP 05508-000, Brazil.
| | - Isabela M Bensenor
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo (USP), São Paulo SP 05508-000, Brazil.
| |
Collapse
|
15
|
Sessa F, Anna V, Messina G, Cibelli G, Monda V, Marsala G, Ruberto M, Biondi A, Cascio O, Bertozzi G, Pisanelli D, Maglietta F, Messina A, Mollica MP, Salerno M. Heart rate variability as predictive factor for sudden cardiac death. Aging (Albany NY) 2018; 10:166-177. [PMID: 29476045 PMCID: PMC5842851 DOI: 10.18632/aging.101386] [Citation(s) in RCA: 154] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 02/09/2018] [Indexed: 02/01/2023]
Abstract
Sudden cardiac death (SCD) represents about 25% of deaths in clinical cardiology. The identification of risk factors for SCD is the philosopher's stone of cardiology and the identification of non-invasive markers of risk of SCD remains one of the most important goals for the scientific community.The aim of this review is to analyze the state of the art around the heart rate variability (HRV) as a predictor factor for SCD.HRV is probably the most analyzed index in cardiovascular risk stratification technical literature, therefore an important number of models and methods have been developed.Nowadays, low HRV has been shown to be independently predictive of increased mortality in post- myocardial infarction patients, heart failure patients, in contrast with the data of the general population.Contrariwise, the relationship between HRV and SCD has received scarce attention in low-risk cohorts. Furthermore, in general population the attributable risk is modest and the cost/benefit ratio is not always convenient.The HRV evaluation could become an important tool for health status in risks population, even though the use of HRV alone for risk stratification of SCD is limited and further studies are needed.
Collapse
Affiliation(s)
- Francesco Sessa
- University of Foggia, Department of Clinical and Experimental Medicine, Foggia, Italy
- Equal contribution
| | - Valenzano Anna
- University of Foggia, Department of Clinical and Experimental Medicine, Foggia, Italy
- Equal contribution
| | - Giovanni Messina
- University of Foggia, Department of Clinical and Experimental Medicine, Foggia, Italy
| | - Giuseppe Cibelli
- University of Foggia, Department of Clinical and Experimental Medicine, Foggia, Italy
| | - Vincenzo Monda
- Università degli Studi di Napoli Federico II, Department of Experimental Medicine, Naples, Italy
| | - Gabriella Marsala
- Struttura Complessa di Farmacia, Azienda Ospedaliero-Universitaria, Foggia, Italy
| | - Maria Ruberto
- CRD Center, Santa Maria del Pozzo, Somma Vesuviana (NA), Italy
| | - Antonio Biondi
- University of Catania, Department of Surgery, Catania, Italy
| | - Orazio Cascio
- University of Catania, Department of Anatomy, Catania, Italy
| | - Giuseppe Bertozzi
- University of Foggia, Department of Clinical and Experimental Medicine, Foggia, Italy
| | - Daniela Pisanelli
- University of Foggia, Department of Clinical and Experimental Medicine, Foggia, Italy
| | - Francesca Maglietta
- University of Foggia, Department of Clinical and Experimental Medicine, Foggia, Italy
| | - Antonietta Messina
- Università degli Studi di Napoli Federico II, Department of Experimental Medicine, Naples, Italy
| | - Maria P. Mollica
- Università degli Studi di Napoli Federico II, Department of Experimental Medicine, Naples, Italy
| | - Monica Salerno
- University of Foggia, Department of Clinical and Experimental Medicine, Foggia, Italy
| |
Collapse
|
16
|
Hidayat K, Yang J, Zhang Z, Chen GC, Qin LQ, Eggersdorfer M, Zhang W. Effect of omega-3 long-chain polyunsaturated fatty acid supplementation on heart rate: a meta-analysis of randomized controlled trials. Eur J Clin Nutr 2017; 72:805-817. [PMID: 29284786 PMCID: PMC5988646 DOI: 10.1038/s41430-017-0052-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 10/06/2017] [Accepted: 10/17/2017] [Indexed: 12/13/2022]
Abstract
Background Elevated resting heart rate (HR) has emerged as a new risk factor for all-cause and cardiovascular mortality. The effect of marine-derived omega-3 long-chain polyunsaturated fatty acid (n−3 LCPUFAs) supplementation on HR was investigated as an outcome in many clinical trials. The present study was to provide an updated meta-analysis on the HR-slowing effect of n−3 LCPUFAs, and to differentiate the chronotropic effect between eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Methods PubMed and Cochrane databases were searched for relevant articles examining the effects of n−3 PUFAs on HR through May 2017. A random-effects model was used to generate the pooled effect sizes and 95% confidence intervals (CIs). The pooled effect sizes were presented as weighted mean differences (WMDs). Results A total of 51 randomized controlled trials (RCTs) with approximately 3000 participants were included in this meta-analysis. Compared to placebo, n−3 PUFA supplementation mildly but significantly reduced HR (−2.23 bpm; 95% CI: −3.07, −1.40 bpm). Moderate evidence of heterogeneity was observed among included trials (I2 = 49.1%, P heterogeneity < 0.001). When DHA and EPA were separately administered, modest HR reduction was observed in trials that supplemented with DHA (−2.47 bpm; 95% CI: −3.47, −1.46 bpm), but not in trials with EPA. Conclusions The present meta-analysis provides strong clinical evidence demonstrating the effect of heart rate reduction by n−3 LCPUFA supplementation. When DHA or EPA administered alone, heart rate was slowed by DHA rather than by EPA.
Collapse
Affiliation(s)
- Khemayanto Hidayat
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, 215123, China
| | - Jing Yang
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, 215123, China
| | - Zheng Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, 215123, China
| | - Guo-Chong Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, 215123, China
| | - Li-Qiang Qin
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, 215123, China.
| | - Manfred Eggersdorfer
- DSM Nutritional Products, Human Nutrition and Health, 4303, Kaiseraugst, Switzerland
| | - Weiguo Zhang
- DSM Nutritional Products, Human Nutrition and Health, Beijing, 100020, China.
| |
Collapse
|
17
|
From psychological moments to mortality: A multidisciplinary synthesis on heart rate variability spanning the continuum of time. Neurosci Biobehav Rev 2017; 83:547-567. [PMID: 28888535 DOI: 10.1016/j.neubiorev.2017.09.006] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 09/04/2017] [Indexed: 02/05/2023]
Abstract
Heart rate variability (HRV) indexes functioning of the vagus nerve, arguably the most important nerve in the human body. The Neurovisceral Integration Model has provided a structural framework for understanding brain-body integration, highlighting the role of the vagus in adaptation to the environment. In the present paper, we emphasise a temporal framework in which HRV may be considered a missing, structural link between psychological moments and mortality, a proposal we label as Neurovisceral Integration Across a Continuum of Time (or NIACT). This new framework places neurovisceral integration on a dimension of time, highlighting implications for lifespan development and healthy aging, and helping to bridge the gap between clearly demarcated disciplines such as psychology and epidemiology. The NIACT provides a novel framework, which conceptualizes how everyday psychological moments both affect and are affected by the vagus in ways that have long-term effects on mortality risk. We further emphasize that a longitudinal approach to understanding change in vagal function over time may yield novel scientific insights and important public health outcomes.
Collapse
|
18
|
Depression and resting state heart rate variability in children and adolescents — A systematic review and meta-analysis. Clin Psychol Rev 2016; 46:136-50. [DOI: 10.1016/j.cpr.2016.04.013] [Citation(s) in RCA: 155] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 04/18/2016] [Accepted: 04/23/2016] [Indexed: 12/13/2022]
|
19
|
Resting state vagal tone in borderline personality disorder: A meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry 2016; 64:18-26. [PMID: 26169575 DOI: 10.1016/j.pnpbp.2015.07.002] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 07/03/2015] [Accepted: 07/06/2015] [Indexed: 01/21/2023]
Abstract
Borderline personality disorder (BPD) is the most common personality disorder in clinical settings. It is characterized by negative affectivity, emotional liability, anxiety, depression, as well as disinhibition (i.e., impulsivity and risk taking), all of which have been linked to lower resting state vagal tone, which may be indexed by vagally-mediated heart rate variability (vmHRV). Here, we aimed to quantify the current evidence on alterations in resting state vmHRV in individuals with BPD, relative to healthy controls. A rigorous search of the literature, according to the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses", revealed 5 studies suitable for meta-analysis, reporting vmHRV in individuals with BPD (n=95), relative to healthy controls (n=105). Short-term measures of resting state vmHRV were extracted and subjected to meta-analysis using both random- and fixed effect models in RevMan. BPD displayed lower resting state vmHRV relative to healthy controls in random- (Hedges' g=-0.59, 95% CI [-1.11; -0.06], k=5) and fixed-effect meta-analysis (Hedges' g=-0.56, 95% CI [-0.86; -0.27], k=5). Control for potential publication bias did not change observed findings. Lowered resting state vagal tone may be an important trait characteristic underlying BPD. As prior studies have observed lowered vmHRV in a variety of psychiatric disorders, we propose that lowered vmHRV may reflect a common psychophysiological mechanism underlying difficulties in emotion regulation and impulsivity, in particular.
Collapse
|
20
|
Beauchaine TP, Thayer JF. Heart rate variability as a transdiagnostic biomarker of psychopathology. Int J Psychophysiol 2015; 98:338-350. [PMID: 26272488 DOI: 10.1016/j.ijpsycho.2015.08.004] [Citation(s) in RCA: 495] [Impact Index Per Article: 55.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Revised: 08/01/2015] [Accepted: 08/03/2015] [Indexed: 02/06/2023]
Abstract
The Research Domain Criteria (RDoC), developed by the National Institute of Mental Health as a neuroscience-informed alternative to traditional psychiatric nosology, is an explicitly dimensional system in which classification of psychopathology is derived inductively (i.e., from basic science), across multiple levels of analysis (e.g., genetic, neural, psychophysiological, and behavioral). Although RDoC is often presented as paradigmatically revolutionary, a review of the history of psychophysiology suggests that roots of RDoC thinking extend at least as far back as the mid-20th Century. In this paper, we briefly and selectively review the historical emergence of neurobiologically-informed dimensional trait models of psychopathology, and we summarize our thinking regarding high frequency heart rate variability (HF-HRV) as a transdiagnostic biomarker of self-regulation and cognitive control. When functional interactions between HF-HRV and systems of behavioral approach and avoidance are considered, diverse patterns of behavioral maladjustment can be subsumed into a single model. This model accommodates the general bifactor structure of psychopathology, and suggests that HF-HRV can be viewed as an autonomic, transdiagnostic biomarker of mental illness.
Collapse
|
21
|
Grung B, Hansen AL, Berg M, Møen-Knudseth MP, Olson G, Thornton D, Dahl L, Thayer JF. Exploratory multivariate analysis of the effect of fatty fish consumption and medicinal use on heart rate and heart rate variability data. Front Psychol 2015; 6:135. [PMID: 25741303 PMCID: PMC4330718 DOI: 10.3389/fpsyg.2015.00135] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 01/26/2015] [Indexed: 01/27/2023] Open
Abstract
The overall aim of the present study was to explore the relationship between medicinal use and fatty fish consumption on heart rate variability (HRV) and heart rate (HR) in a group of forensic inpatients on a variety of medications. A total of 49 forensic inpatients, randomly assigned to a fish group (n = 27) or a control group (n = 22) were included in the present study. Before and by the end of the food intervention period HR and HRV were measured during an experimental test procedure. An additional aim of this paper is to show how multivariate data analysis can highlight differences and similarities between the groups, thus being a valuable addition to traditional statistical hypothesis testing. The results indicate that fish consumption may have a positive effect on both HR and HRV regardless of medication, but that the influence of medication is strong enough to mask the true effect of fish consumption. Without correcting for medication, the fish group and control group become indistinguishable (p = 0.0794, Cohen’s d = 0.60). The effect of medication is demonstrated by establishing a multivariate regression model that estimates HR and HRV in a recovery phase based on HR and HRV data recorded during psychological tests. The model performance is excellent for HR data, but yields poor results for HRV when employed on participants undergoing the more severe medical treatments. This indicates that the HRV behavior of this group is very different from that of the participants on no or lower level of medication. When focusing on the participants on a constant medication regime, a substantial improvement in HRV and HR for the fish group compared to the control group is indicated by a principal component analysis and t-tests (p = 0.00029, Cohen’s d = 2.72). In a group of psychiatric inpatients characterized by severe mental health problems consuming different kinds of medication, the fish diet improved HR and HRV, indices of both emotional regulation and physical health.
Collapse
Affiliation(s)
- Bjørn Grung
- Department of Chemistry, University of Bergen Bergen, Norway
| | - Anita L Hansen
- Department of Psychosocial Science, University of Bergen Bergen, Norway ; Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital Bergen, Norway
| | - Mari Berg
- Department of Chemistry, University of Bergen Bergen, Norway
| | | | - Gina Olson
- Sand Ridge Secure Treatment Centre Mauston, WI USA
| | | | - Lisbeth Dahl
- National Institute of Nutrition and Seafood Research Bergen, Norway
| | - Julian F Thayer
- Department of Psychology, The Ohio State University Columbus, OH, USA
| |
Collapse
|